Domain Measurements Research Articles

Perpetration and Victimization in Offline and Cyber Contexts: A Variable- and Person-Oriented Examination of Associations and Differences Regarding Domain-Specific Self-Esteem and School Adjustment.

Self-esteem has been identified as a predictor of bullying perpetration and victimization, which, in turn, may lead to school adjustment problems. However, findings regarding the direction and strength of these associations have been inconclusive. This study aimed to resolve this by differentiating between offline and cyber contexts and various self-esteem domains. An online sample of 459 adolescents retrospectively completed measures of self-esteem domains and offline/cyber perpetration and victimization, and a subsample of 194 adolescents also completed measures of loneliness and school adjustment. A mediation analysis of bullying-related variables on the effect of self-esteem domains on school adjustment indicated that offline victimization was the only significant mediator. Positive indirect effects were found for social and emotional self-esteem, and negative indirect effects were found for school performance-related self-esteem. Furthermore, person-oriented analyses examined differences in bullying-related roles regarding self-esteem domains, loneliness, and school adjustment. Victim groups showed lower self-esteem in many domains, but cyber victims showed higher body-related self-esteem. Bullies showed lower school performance-related but higher social self-esteem. Both bullies and victims showed lower school adjustment and more loneliness. Implications for theory and practice are discussed, as the findings are relevant for teachers and could be used to develop and deploy more effective anti-bullying programs.

Effect of Pharmacological and Neurostimulation Interventions for Cognitive Domains in Patients with Bipolar Disorder: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials.

IntroductionThe priority of interventions to alleviate cognitive deficits in patients with bipolar disorder (BD) is inconclusive. We systematically evaluate the efficacy of pharmacological or neurostimulation interventions for cognitive function in BD through a network meta-analysis.MethodsThe PubMed, PsycINFO, Embase, and Cochrane Library databases were searched from database inception to September 30, 2021. Following PRISMA guidelines, all eligible studies were randomized controlled trials of adult bipolar patients that provided detailed cognitive outcomes. Studies were excluded if participants limited to comorbid substance use disorder or the intervention was a psychotherapy. Network meta-analysis comparing different interventions was conducted for 8 cognitive domains. Partially ordered set with Hasse diagram was used to resolve conflicting rankings between outcomes. The study was preregistered on PROSPERO database (CRD42020152044).ResultsTotal 21 RCTs including 42 tests for assessing intervention effects on cognition were retrieved. Adjunctive erythropoietin (SMD = 0.61, 95% CI = 0.00–1.23), Withania somnifera (SMD = 0.58, 95% CI = 0.03–1.13), and galantamine (SMD = 1.22, 95% CI = 0.10–2.35) was more beneficial for attention, working memory, and verbal learning in euthymic BD patients than treatment as usual, respectively. Hasse diagram suggested ranking of choice when multiple domains were combined.ConclusionConsiderable variability in measurements of cognitive domains in BD was observed, and no intervention resulted in superior benefits across all domains. We suggested interventions priority can be tailored according to individual patients’ cognitive deficits. As current findings from relatively small and heterogeneous dataset, future trials with consensus should be applied for building further evidence.

Carbamazepine for Irritability and Aggression after Traumatic Brain Injury: A Randomized, Placebo-Controlled Study

<h3>Research Objectives</h3> To test the hypothesis that carbamazepine (CBZ) reduces irritability/aggression among individuals > 6 months post-traumatic brain injury (TBI). <h3>Design</h3> Parallel-group, randomized, double-blind, placebo-controlled, forced-titration trial of CBZ versus placebo. <h3>Setting</h3> Outpatient. <h3>Participants</h3> 70 individuals with chronic TBI and irritability (CBZ n=35 versus placebo n=35). <h3>Interventions</h3> CBZ (titrated up to 400 mg twice daily) or placebo equivalent two times daily. <h3>Main Outcome Measures</h3> A composite measure of Neuropsychiatric Inventory Irritability and Aggression Domains (NPI-I/A). Global impression of change recorded from participant, observer, and study clinician. <h3>Results</h3> The CBZ group did not differ significantly from the placebo group (p=0.60 and 0.59 for NPI-I/A observer and participant ratings respectively). High placebo effects were observed with Minimal Clinically Important Difference in observer NPI-I/A 57% in CBZ group and 77% in placebo group (p=0.09). Findings were similar for participant ratings. 18 of 35 had therapeutic CBZ level > 4. Therapeutic sample analysis revealed similar high placebo response and non-significant differences except clinician ratings favoring CBZ. Non-serious adverse events occurred more frequently in the CBZ group with greater nervous system effects. <h3>Conclusions</h3> up to 400 mg two times daily was not superior to placebo at reducing irritability/aggression according observers and participants. Large placebo effects may have masked the detection of differences. Clinician rating metrics suggest benefit, and thus, CBZ should remain a treatment option for the experienced brain injury clinician; data are provided that may aid treatment decisions. <h3>Author(s) Disclosures</h3> Dr. Hammond serves on the Avanir Scientific Advisory Committee.

The association of Lewy bodies with limbic-predominant age-related TDP-43 encephalopathy neuropathologic changes and their role in cognition and Alzheimer\u2019s dementia in older persons

Lewy bodies (LBs) and limbic-predominant age-related TDP-43 encephalopathy neuropathologic change (LATE-NC) are common in older persons and associated with cognitive impairment. However, little is known about the relationship between LBs and LATE-NC and their combined roles in cognitive impairment and Alzheimer’s dementia in community-dwelling participants. The study included 1670 community-based participants (mean age-at-death, 89.5 years (SD = 6.65); 69% females) who underwent annual assessments of cognition to create summary measures of global cognition and cognitive domains and evaluation for Alzheimer’s dementia. Systematic neuropathologic evaluations were performed to assess LBs, LATE-NC, and Alzheimer’s disease (AD) pathology. We excluded cases with pathologically confirmed frontotemporal lobar degeneration in this study. Logistic and linear regression analyses were used, adjusted for demographics and AD pathology. LBs were present in 428 (25.6%) decedents (29 nigra-predominant, 165 limbic-type, and 234 neocortical-type) while 865 (51.7%) decedents exhibited LATE-NC (307 stage 1, 167 stage 2, and 391 stage 3). LBs combined with LATE-NC were common (15% of all participants) and in those with Alzheimer’s dementia (25%). Neocortical-type, but not nigral-predominant or limbic-type LBs increased the odds of stage 2/3 LATE-NC (odds ratio = 1.70; 95% confidence interval = 1.26–2.30). The association between neocortical-type LBs and stage 2/3 LATE-NC was stronger in those under 90 years of age and in women. In analyses of cognition and Alzheimer’s dementia, LATE-NC and neocortical-type LBs, separately, were related to lower global cognition, five specific cognitive domains, and an increased odds of Alzheimer’s dementia, above and beyond the AD pathology. Limbic-type LBs were related to lower global cognition, and the domains of episodic, working, and semantic memory, and increased odds of Alzheimer’s dementia. Furthermore, there was no interaction between limbic/neocortical-type LBs and LATE-NC on cognitive function, cognitive domains, or Alzheimer’s dementia. These findings suggest that neocortical-type LBs are associated with LATE-NC, specifically in the younger old and in women. Limbic/neocortical-type LBs and LATE-NC have separate and additive effects on cognitive function and odds of Alzheimer’s dementia.

Effect of parental education and household poverty on recovery after traumatic brain injury in school-aged children

ABSTRACT Objective While prior studies have found parental socioeconomic status (SES) affects the outcomes of pediatric traumatic brain injury (TBI), the longitudinal trajectory of this effect is not well understood. Methods This prospective cohort study included children 8–18 years of age admitted to six sites with a complicated mild (n = 123) or moderate-severe TBI (n = 47). We used caregiver education and household poverty level as predictors, and multiple quality of life and health behavior domains as outcomes. Differences at 6, 12, and 24 months from baseline ratings of pre-injury functioning were compared by SES. We examined the association between measures of SES and domains of functioning over the 24 months post-injury in children with a complicated mild or moderate- severe TBI, and determined how this association varied over time. Results Parental education was associated with recovery among children with complicated mild TBI; outcomes at 6, 12, and 24 months were substantially poorer than at baseline for children with the least educated parents. After moderate-severe TBI, children in households with lower incomes had poorer outcomes compared to baseline across time. Implications Parental education and household income were associated with recovery trajectories for children with TBI of varying severity.

Kappa and AC1/2 statistics: beyond the paradox

Dear Editor, We thank Loef and colleagues for their interest in our article about the revised Cochrane risk of bias tool for randomized trials (RoB 2) inter-rater reliability and usability [[1]Minozzi S. Cinquini M. Gianola S. Gonzalez-Lorenzo M. Banzi R. The revised Cochrane risk of bias tool for randomized trials (RoB 2) showed low interrater reliability and challenges in its application.J Clin Epidemiol. 2020; 126: 37-44Abstract Full Text Full Text PDF PubMed Scopus (37) Google Scholar]. Their analysis and comments mainly focused on the choice of the more appropriate measure of inter-rater agreement. We acknowledge the paradoxes that may occur with the Kappa statistics, and referred to it as possible limitation of our results: “The expected agreement can exceed the observed agreement and then generate kappa values lower than 0. This is why in some cases Fleiss’ kappa may return low values even when agreement is actually high (Fleiss’ kappa paradox). Our results might be further affected by this paradox.”[[1]Minozzi S. Cinquini M. Gianola S. Gonzalez-Lorenzo M. Banzi R. The revised Cochrane risk of bias tool for randomized trials (RoB 2) showed low interrater reliability and challenges in its application.J Clin Epidemiol. 2020; 126: 37-44Abstract Full Text Full Text PDF PubMed Scopus (37) Google Scholar]. We agree that Gwet's AC1/2 statistics may overcome this paradoxes and be a valuable option. The two approaches differ in how the expected agreement by chance (“pe”) is calculated and this can produce an overestimation of the agreement with Gwet's AC1/2 statistics. As expected, the reanalysis of the data using this statistic led to a higher agreement, which would have been classified as moderate. We believe the main reason for this difference can be due to the sample size of our analysis (70 measurements). The two approaches are likely to estimate similar agreement values when a higher number of measurements are made, while results may be highly variable if samples are small [[2]Ohyama Tetsuji Statistical inference of Gwet's AC1 coefficient for multiple raters and binary outcomes.Commun in Statis - Theory and Meths. 2021; 50: 3564-3572https://doi.org/10.1080/03610926.2019.1708397Crossref Scopus (3) Google Scholar,[3]Wongpakaran N. Wongpakaran T. Wedding D. L Gwet K.L. A comparison of Cohen’s Kappa and Gwet’s AC1 when calculating inter-rater reliability coefficients: a study conducted with personality disorder samples.BMC Med Res Methodol. 2013; 13: 61https://doi.org/10.1186/1471-2288-13-61Crossref PubMed Scopus (417) Google Scholar]. We compared the number of studies where all the raters gave the same judgement and the interrater agreement values (Table 1) and found a good consistency. For instance, the raters gave the same overall judgement in 12 of 70 (17%) of the studies and this is consistent with the slight interrater agreement (IRR = 0.16) measured with Fleiss’ Kappa [[1]Minozzi S. Cinquini M. Gianola S. Gonzalez-Lorenzo M. Banzi R. The revised Cochrane risk of bias tool for randomized trials (RoB 2) showed low interrater reliability and challenges in its application.J Clin Epidemiol. 2020; 126: 37-44Abstract Full Text Full Text PDF PubMed Scopus (37) Google Scholar]. This seems to apply also to single domains.Table 1Interrater agreement measures for single domains and overall judgment compared with number studies where all the raters gave the same ROB judgementROB 2 domain% same ROB judgementIRR (95% CI)1470.45 (0.37 to 0.53)220Assignment 0.04 (-0.06 to 0.14)Adhering 0.21 (0.11 to 0.31)3580.22 (0.14 to 0.30)4500.27 (0.19 to 0.35)5310.30 (0.22 to 0.38)Overall170.16 (0.08 to 0.24) Open table in a new tab Simulation studies focused on the comparison between Gwet's AC1/2 statistics and Cohen's kappa for binary data. To our knowledge, robust comparison between Gwet's AC1/2 and Fleiss’ Kappa are lacking, making difficult any strong conclusion about the best approach. Both approaches rely on several assumptions about the experience of raters. The violation of these assumptions could contribute to produce paradoxical results. In practice, it is almost inevitable that the raters will vary in terms of their experience and expertise, and this was the case in our study. We believed Fliess Kappa was appropriate to our analysis given that our raters had different competences, expertise and training. Indeed, one of Kappa statistic's assumption is that raters’ judgment is independent. Regarding the second issue, we chose the Landis and Koch classification in a conservative way considering the point estimate only. However, cIMP may be a good alternative approach we will consider it in future analysis.

Interventional treatments for prolapsing haemorrhoids: network meta-analysis.

BackgroundMultiple treatments for early–moderate grade symptomatic haemorrhoids currently exist, each associated with their respective efficacy, complications, and risks. The aim of this study was to compare the relative clinical outcomes and effectiveness of interventional treatments for grade II–III haemorrhoids.MethodsA systematic review was conducted according to PRISMA criteria for all the RCTs published between 1980 and 2020; manuscripts were identified using the MEDLINE, Embase, and CENTRAL databases. Inclusion criteria were RCTs comparing procedural interventions for grade II–III haemorrhoids. Primary outcomes of interest were: symptom recurrence at a minimum follow-up of 6 weeks, postprocedural pain measured on a visual analogue scale (VAS) on day 1, and postprocedural complications (bleeding, urinary retention, and bowel incontinence). After bias assessment and heterogeneity analysis, a Bayesian network meta-analysis was performed.ResultsSeventy-nine RCTs were identified, including 9232 patients. Fourteen different treatments were analysed in the network meta-analysis. Overall, there were 59 RCTs (73 per cent) judged as being at high risk of bias, and the greatest risk was in the domain measurement of outcome. Variable amounts of heterogeneity were detected in direct treatment comparisons, in particular for symptom recurrence and postprocedural pain. Recurrence of haemorrhoidal symptoms was reported by 54 studies, involving 7026 patients and 14 treatments. Closed haemorrhoidectomy had the lowest recurrence risk, followed by open haemorrhoidectomy, suture ligation with mucopexy, stapled haemorrhoidopexy, and Doppler-guided haemorrhoid artery ligation (DG-HAL) with mucopexy. Pain was reported in 34 studies involving 3812 patients and 11 treatments. Direct current electrotherapy, DG-HAL with mucopexy, and infrared coagulation yielded the lowest pain scores. Postprocedural bleeding was recorded in 46 studies involving 5696 patients and 14 treatments. Open haemorrhoidectomy had the greatest risk of postprocedural bleeding, followed by stapled haemorrhoidopexy and closed haemorrhoidectomy. Urinary retention was reported in 30 studies comparing 10 treatments involving 3116 participants. Open haemorrhoidectomy and stapled haemorrhoidopexy had significantly higher odds of urinary retention than rubber band ligation and DG-HAL with mucopexy. Nine studies reported bowel incontinence comparing five treatments involving 1269 participants. Open haemorrhoidectomy and stapled haemorrhoidopexy had the highest probability of bowel incontinence.ConclusionOpen and closed haemorrhoidectomy, and stapled haemorrhoidopexy were associated with worse pain, and more postprocedural bleeding, urinary retention, and bowel incontinence, but had the lowest rates of symptom recurrence. The risks and benefits of each treatment should be discussed with patients before a decision is made.

Adaptive Transfer Learning Based on a Two-Stream Densely Connected Residual Shrinkage Network for Transformer Fault Diagnosis over Vibration Signals

Vibration signal analysis is an efficient online transformer fault diagnosis method for improving the stability and safety of power systems. Operation in harsh interference environments and the lack of fault samples are the most challenging aspects of transformer fault diagnosis. High-precision performance is difficult to achieve when using conventional fault diagnosis methods. Thus, this study proposes a transformer fault diagnosis method based on the adaptive transfer learning of a two-stream densely connected residual shrinkage network over vibration signals. First, novel time-frequency analysis methods (i.e., Synchrosqueezed Wavelet Transform and Synchrosqueezed Generalized S-transform) are proposed to convert vibration signals into different images, effectively expanding the samples and extracting effective features of signals. Second, a Two-stream Densely Connected Residual Shrinkage (TSDen2NetRS) network is presented to achieve a high accuracy fault diagnosis under different working conditions. Furthermore, the Residual Shrinkage layer (RS layer) is applied as a nonlinear transformation layer to the deep learning framework to remove unimportant features and enhance anti-interference performance. Lastly, an adaptive transfer learning algorithm that can automatically select the source data set by using the domain measurement method is proposed. This algorithm accelerates the training of the deep learning network and improves accuracy when the number of samples is small. Vibration experiments of transformers are conducted under different operating conditions, and their results show the effectiveness and robustness of the proposed method.

Submillimeter-Wave Permittivity Measurements of Bound Water in Collagen Hydrogels via Frequency Domain Spectroscopy

This article presents measurements of the permittivity of gelatin hydrogels between 220 and 330 GHz. Hydrated gelatin was treated as a binary mixture of free water and a compound consisting of water bound to collagen. Submillimeter-wave reflectometry was used to estimate the hydrated gelatin permittivity, hydrated gelatin density, and free-water volume fraction in phantoms composed of 62, 67, 72, and 77% water by weight. A hydrated dry/wet density ratio of 0.335 was validated with optical-coherence tomography. A constant nonfreezing bound-water mass of 0.6 g/g was observed and confirmed with differential-scanning calorimetry. Good agreement between results from different modalities supports the dielectric spectroscopy methods and data analysis. Depending on the hydrodynamics at the sample/air interface, measurements indicate a bound-water compound permittivity of 3.77-j2.52 to 3.95-j2.49-contrasting the pure-water average permittivity of 5.16-j5.63. The loss related to bound water was much higher than anticipated and characterization will help reduce uncertainty in measurements of gelatin hydrogel-based tissue phantoms; particularly corneal phantoms where adjacent free water creates complex hydration gradients. This is the first known, submillimeter-wave, frequency domain measurement of complex permittivity of the bound-water component in solid, proteinaceous matter.

A-99 Influence of TBI on Rate of Cognitive Decline in Clinically Normal Older Adults

Abstract Objective History of traumatic brain injury (TBI) is a potential risk factor for cognitive decline and neurodegenerative disease later in life, but findings have been inconsistent. We evaluate if past history of TBI affects rate of cognitive decline in clinically normal older adults. Method Participants were 190 cognitively normal (CDR &amp;lt; 0.5) older adults (age at baseline: M = 71.6, SD = 7.0) with positive history of TBI (TBI+; n = 83) or no history of TBI (TBI-; n = 107). A comprehensive neuropsychological battery of attention, memory, language, and executive functioning measures as well as functional questionnaires were administered longitudinally (number of visits: M = 3.4, SD = 1.3). Linear mixed effects models assessed the interaction between longitudinal health outcomes and TBI history. Results TBI+ showed a faster rate of decline in executive functioning (Stroop interference: p = 0.04), and a faster increase in functional impairment (Physical Activity Scale for the Elderly (PASE) total: p &amp;lt; 0.001; Unified Parkinson’s Disease Rating Scale (UPDRS) total: p = 0.002). Baseline performance on these tests did not distinguish TBI+ from TBI- (Stroop interference, p = 0.4; PASE, p = 0.5; and UPDRS, p = 0.1). TBI+ was not significantly different from TBI- on measures in other cognitive domains. Conclusions History of TBI was associated with faster rate of executive functioning decline and more rapid increase in objective and subjective functional impairment in cognitively normal older adults. Findings suggest that sustaining a TBI earlier in life could accelerate cognitive and functional changes even among clinically normal older adults.

A-15 Validity of the NIH Toolbox Cognitive Battery in a Healthy Oldest-Old 85+ Sample

Abstract Objective The NIH Toolbox (NIHTB) Cognitive assessment battery has not been validated in the oldest-old population (85 years and older). Factor analysis of the NIHTB cognitive measures with “gold-standard” measures of the same cognition domains has revealed convergent and discriminant validity of these measures in a young adult population. Here we investigate if there is convergent and discriminant validity among the NIHTB and validated measures in the oldest old. Methods An exploratory factor analysis using the principal-axis factor extraction with Varimax rotation was conducted to determine the factor structure of the NIH Toolbox Cognitive Battery and other validated measures of cognition in the healthy oldest-old population. The sample, collected as part of the McKnight Brain Aging Registry, included 170 independent, healthy, community-dwelling adults aged 85+. Results Results indicated four factors with eigenvalues exceeding one with 58.6% variance explained. These four factors were interpreted as Memory, Working Memory, Speed/Attention, and Language. NIHTB Dimensional Change Card Sort test was removed due to low correlations with other measures. Conclusion Most tests from the NIH Toolbox converged with other tests of the same domain and were discriminable from tests of different domains, especially for memory, working memory, and language. The first factor, Speed/Attention, included attention and processing speed measures, but also canonical executive functioning measures such as Trails B. This overlap indicates that executive functioning tasks that rely on motor speed task demands (like the NIHTB DCCS) may mask preserved aspects of executive function in the oldest old. Further work is needed to confirm this interpretation.

Toward better characterization of restricted and repetitive behaviors in individuals with germline heterozygous PTEN mutations.

This study aimed to further our understanding of restricted and repetitive behaviors (RRB) among individuals with germline pathogenic mutations in PTEN by providing multimethod characterization and comparison of key RRB subdomains across individuals with PTEN mutations with autism spectrum disorder (ASD) (PTEN-ASD), with PTEN mutations without ASD (PTEN-No ASD) and with ASD and macrocephaly but without PTEN mutations (Macro-ASD). Of 86 total research participants, 38 had PTEN-ASD (Mage = 8.93 years, SDage = 4.75), 25 Macro-ASD (Mage = 11.99 years; SDage = 5.15), and 23 PTEN-No ASD (Mage = 8.94 years; SDage = 4.85). The Repetitive Behavior Scale-Revised (RBS-R) and the Autism Diagnostic Interview-Revised (ADI-R) were used as measures of distinct RRB domains. There were significant group differences in the RBS-R repetitive motor behaviors (RMB; F= 4.52, p= 0.014, ω2 = 0.08), insistence on sameness (IS; F= 4.11, p= 0.02, ω2 = 0.05), and circumscribed interests (CI; F= 7.80, p= 0.001, ω2 = 0.14) scales. Post hoc comparisons showed that the PTEN-No ASD group had significantly lower RMB, IS, and CI scores compared to both PTEN-ASD and Macro-ASD groups. Importantly, PTEN-No ASD group still showed elevated RRB levels. Furthermore, there was a portion of individuals in PTEN-No ASD group whose Full-Scale Intelligence Quotient (FSIQ) was >70 that did not show floor level scores in the RMB domain. After adjusting for age and FSIQ scores, group differences were no longer statistically significant. RMB, IS, and CI domains showed distinct association patterns with sex, age, and FSIQ. This investigation provides the largest and most comprehensive characterization of distinct RRB domains in individuals with PTEN mutations to date. Despite the limitations, our findings have important assessment and treatment implications.

Characterizing gaze and postural stability deficits in people with multiple sclerosis

BackgroundPeople with Multiple Sclerosis (PwMS) experience a wide range of symptoms that can alter function and limit activity and community participation. Symptoms including sensory changes, weakness, fatigue and others have been well documented. However, symptoms related to changes in vestibular related function, including gaze and postural stability have not been fully explored. While some recent studies have begun to provide insight into these deficits in PwMS and have explored the use of rehabilitation paradigms for their management, much remains unknown about the full extent of these deficits. Therefore, this study aimed to characterize the presence of gaze and postural stability deficits in measures across the World Health Organization International Classification of Functioning, Disability, and Health (WHO ICF) and to examine how deficits in domains of body structure and function and activity contribute to participation level limitations. MethodsBaseline data from 41 PwMS (mean(SD) age = 53.9(11.2), 78% female) enrolled as part of a randomized clinical trial were used in this analysis. Measures of gaze and postural stability from the ICF domains of body structure and function (Vestibular ocular reflex [VOR] gain and postural sway area), activity (computerized dynamic visual acuity [cDVA] and MiniBEST test), and participation (Dizziness handicap inventory [DHI] and Activities Balance Confidence [ABC] scale) along with demographic data were used to characterize the sample. To explore relationships between ICF domains for gaze and postural stability, univariate correlations were performed between measures from each domain using Pearson's correlations. Separate multivariate regression models examined how measures from the body structure and function and activity domains contributed to the variance in the participation level outcomes. Variance explained by the models was quantified using R-squared statistic and contribution of the independent variables were quantified using the beta coefficient (p < 0.05). ResultsCorrelation analysis demonstrated significant relationships in the postural stability measures across domains. Specifically, between postural sway area on a firm surface and MiniBEST test score (r = -.48;p < 0.01) and MiniBEST test score and ABC score (r = 0.5;p < 0.01). Significant correlations were also found between the gaze stability measures of horizontal and vertical VOR gain (r = .68;p < 0.001), horizontal VOR gain and dynamic visual acuity (r = .38;p = 0.02), and vertical VOR gain and dynamic visual acuity (r = .54;p < 0.001). Regression models assessing postural stability, found that only the MiniBEST score significantly contributed to the variance in ABC score (p = 0.01) and the full model explained 34% of the variance in ABC score. Regression modeling of gaze stability outcomes did not produce any variable that significantly contributed to the variance in DHI score and the full model explained 18% of the variance in DHI score. ConclusionsPwMS in this sample demonstrated deficits in gaze and postural stability across the domains of the WHO ICF compared to past samples of PwMS and healthy cohorts. Correlation between measures in the different domains were present, but no strong relationship between measures of body structure and function, activity and participation level outcomes were observed. This lack of relationship across the domains is likely contributed to the relatively small sample size, the high level of variability observed in the outcomes, and the diverse presentation often seen in PwMS.

O-AD006. Heart rate variability as a tool for predicting epileptic seizures

Introduction . Epilepsy is a neurological disorder that affects the patient’s quality of life and health care budget. Autonomic involvement, particularly respiratory and cardiac involvement is extremely dangerous. A particularly life-threatening complication is SUDEP. HRV represents ANS activity. We aim to compare the HRV in preictal, interictal and postictal period in patient with various types of epilepsy. Methods . Patients admitted for presurgical evaluation for epilepsy surgery and patients with epilepsy admitted for prolonged EEG monitoring (>8 hours) having various types of seizures were selected. Amongst these 49 patients, 142 seizures with various semiologies were recorded and were sent for processing. ECG signal was extracted from EEG data. Signal processing and HRV extraction was performed using EDF browser based on MATLAB. Time domain measurements like mean HR, RRI, RMSSD, SDNN and pNN50 were analyzed at different times – 20 min before the seizure, 1 minute before the seizure, during the seizure and 20 min after the seizure for each individual event. Results . Mean age was 27.14 ± 12.15 years with a minimum age of 5 years and maximum age of 58 years. Out of a total of 142 events recorded, 23 events were focal seizures with preserved consciousness, 73 events were focal seizures with impaired consciousness, 45 events were generalized seizures and 1 was a psychogenic seizure. There was significant rise in the mean HR and a drop in RRI, RMSSD, SDNN and pNN50 in the immediate preictal and interictal period. A comparison of various time intervals compared with respect to type of event showed that generalized event had a more autonomic dysregulation compared to focal seizures. Conclusion . HRV analysis is a valid method for quantifying central influences on autonomic nervous system and its cardiac control, and can give important information when used as an adjunct during clinical seizures.

Considerations and priorities for incorporating the patient perspective on remission in rheumatoid arthritis: An OMERACT 2020 special interest group report

ObjectiveTo determine how best to incorporate the patient perspective into rheumatoid arthritis remission criteria. MethodsAt OMERACT 2020, several studies, including a longitudinal multi-centre study testing the validity of adding patient-valued domains to the ACR/EULAR criteria, were presented and discussed by the virtual Special Interest Group. ResultsOverall consensus was that there is insufficient evidence to change the remission criteria at this point. Future work should focus on measurement of the new domain of independence, clarifying the value of the patient global assessment, and optimizing the input of domains that patients value in the criteria. ConclusionIncorporating the patient perspective into remission criteria should be further explored.

A photo-electrochemical aptasensor for the determination of severe acute respiratory syndrome coronavirus 2 receptor-binding domain by using graphitic carbon nitride-cadmium sulfide quantum dots nanocomposite

Herein, a photoelectrochemical aptasensor for the quantitive measurement of the severe acute respiratory syndrome coronavirus-2 receptor-binding domain (Sars-Cov-2 RBD) has been reported for the first time. For this purpose, first, graphitic carbon nitride and (gC3N4) and cadmium sulfide (CdS) quantum dots were fabricated and characterized. After that, gC3N4 and CdS were mixed well. The fabricated nanomaterials were characterized by scanning transmission electron microscopy. Then, the CdS QDs-gC3N4 nanocomposite was added to the solution containing chitosan as an amine-rich polymer to generate a Chitosan/CdS-gC3N4 nanocomposite. Subsequently, the surface of the ITO electrode was modified with Chitosan/CdS-gC3N4. After that, the amine-terminal aptamer probes were immobilized on the surface of the Chitosan/CdS QDs-gC3N4/ITO electrode by using glutaraldehyde as an amine-amine crosslinker. The electrochemical performances of the electrodes were studied using cyclic voltammetry (CV), electrochemical Impedance Spectroscopy (EIS), and photo-electrochemistry (PEC). The surface coverage of the immobilized aptamer probe was founded to be 26.2 pmol.cm−2. The obtained results demonstrated that the proposed photo-electrochemical aptasensor can be used for the measurement of Sars-Cov-2 RBD within 0.5−32.0 nM. The limit of detection (LOD) was obtained to be 0.12 nM (at 3σ/slope). The affinity of the Aptamer/Chitosan/CdS QDs-gC3N4/ITO was also founded to be 3.4 nM by using Langmuir-typical adsorption systems. The proposed photo-electrochemical aptasensor was applied for the measurement of the spiked Sars-Cov-2 RBD in human saliva samples at two concentrations. The effect of the interfering biomaterials such as human immunoglobulin G human immunoglobulin A, human immunoglobulin M, and human serum albumin was also studied.

PHYSICAL ACTIVITY AS A PART OF CHILDREN’S QUALITY OF LIFE MODEL

Research on children’s quality of life is largely attributed to adults’ needs or perceptions of children’s quality of life. Child well-being was initially assessed in terms of objective reality: mortality rates, malnutrition, immunisation, disease, with little reliability in measuring their subjective well-being. Subjective quality of life refers to perceptions, aspirations, assessment of one’s own living conditions. A holistic model of children’s quality of life involves measuring the economic, social, physical, psychological and cognitive dimensions using instruments that reveal the subjective view of their quality of life. The aim of this paper is to examine the multidimensional nature of children’s quality of life and to identify the place of physical activity in the quality of life (QoL) model. Physical activity is associated with higher quality of life. Research on children’s quality of life through interventions that use physical activity primarily reflects an intervention-based model for disease prevention or mitigation. A QoL model using physical activity interventions may also have some limitations, unless it assumes the measurement of other domains that may influence it. Children’s quality of life is a relatively new topic in the literature. Although many models of children’s quality of life are proposed, a unified model has not been agreed upon by experts. Measuring it requires the use of instruments for each dimension of which it is composed. Physical activity as a method of intervention on children’s quality of life is associated with children’s physical as well as psychological well-being.

Chronic Red Blood Cell Exchange Transfusion Therapy Does Not Impact Hospital Utilization or Ascq-Me Pain Domains in Adults Living with Sickle Cell Disease

Introduction: Chronic red blood cell exchange transfusion (CET) therapy is currently used to prevent neurologic and other complications of sickle cell disease (SCD) in children and adults. Despite past pediatric studies showing that CET decreases stroke risk and hospital admissions, few studies have evaluated whether CET decreases hospital utilization or pain in adults with SCD. Data support health care utilization is a poor marker of pain frequency so other ways of assessing the impact of therapy on pain outcomes is necessary and important. We noted that despite receiving CET, our adult patients experienced daily pain requiring home opioid use and intermittent hospitalization for pain crisis. Thus, we conducted a study to examine the effects of CET on the pain experience. Our primary hypothesis was that adults on CET will have similar levels of pain as defined by Adult Sickle Cell Quality of Life Measurement Information System (ASCQ-Me) pain domains as compared to adults not on CET. Our secondary hypothesis was that adults on CET will have similar levels of hospital utilization, opioid use, QOL measures of domains noted to be affected by SCD or inflammatory markers shown to be correlated with pain and SCD pain crisis.Methods: We conducted a pilot cross-sectional study of adults with SCD treated with or without CET. Subjects were enrolled at scheduled clinic visits and subjects not at their heathy baseline or who receive regular simple transfusion were excluded. Our primary outcome was pain as defined by ASCQ-Me pain domains which include pain crisis frequency, pain crisis severity, and 7-day pain interference which allow the tool to measure both crisis pain and chronic pain. Our secondary outcomes were hospital utilization, opioid use, QoL measures included in ASCQ-ME: sleep, stiffness, social impact and emotional impact, Patient Reported Outcome Measurement Information System domains for nausea and anxiety and inflammation measured by WBC and platelet counts, C reactive protein (CRP) and cytokine levels. Hospital utilization (total annual admissions and emergency room visits) was assessed by medical record review over a one-year period (1/1/2016 to 12/31/2016). Weekly opioid use was estimated by review of dispensed prescriptions using the Connecticut Prescription Monitoring Program converted into average weekly oral morphine equivalents. Tumor necrosis factor alpha (TNFα), interleukin 1α and 1β (IL-1α, IL-1β) and interleukin 4 (IL-4) were measured using a luminex multiplex assay. Blood was obtained prior to starting CET. The R statistical software program was used to perform t-tests and Wilcoxon rank-sum tests where normality was not met to compare subjects on CET to those not on CET. Significance was set at p<0.05.Results: We enrolled 27 subjects (n=16 in no CET group and n=11 in CET group); indications for CET included primary (n=1) or secondary (n=10) stroke prophylaxis. There was no difference between groups in mean age (33.3 SD 10.1 vs 29.4 SD 12.4 years, p=0.4) or gender (% female: 45% vs. 63%, p=0.3). No patients on CET and 68.7% of those not on CET were prescribed hydroxyurea. Median time patients were receiving chronic transfusions was 5 (IQR 2-14.5) years, and median pre-transfusion %S was 40.3 (IQR 32.2-44.9) %. Subjects on CET had similar median admissions and ED visits compared to those not on CET (1 (IQR 0-1.5) vs 2 (IQR 0-5) admissions p=0.09, 0 (IQR 0-0.5) vs 0.5 (IQR 0-2) ED visits p=0.07). Subjects in both groups were dispensed similar median weekly doses of opioids (CET: 27.4 (IQR 3.0-200.5) vs No CET: 42.7 (IQR 13.0-171.6) mg oral morphine equivalents p=0.7). Subjects on CET had similar ASCQ-ME scores to subjects not on CET for pain episode frequency, severity, and 7-day pain impact (Table 1). Those on CET had superior scores for sleep, nausea, and anxiety (Table 1). Subjects on CET had higher baseline platelet and WBC counts and there was no difference in CRP or cytokines measured between groups (Table 1).Conclusions: Collectively, our pilot data suggest despite patients receiving CET pain could still develop. Thus, additional therapies in combination with CET may be needed to optimize pain and quality of life in adults living with SCD. We may have failed to show a difference in hospital utilization due to our subjects being placed on CET for neurologic events, not frequent crisis. A larger prospective cohort study should be done to confirm our preliminary findings. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Cognitive functioning in progressive myoclonus epilepsy type 1 (Unverricht-Lundborg Disease, EPM1)

ObjectiveThe aim of this neuropsychological study of a large cohort of patients with progressive myoclonus epilepsy type 1 (Unverricht-Lundborg disease, EPM1) was to characterize the cognitive function of EPM1 patients and to explore the association between the disability caused by the disease and cognitive performance. MethodSixty-eight genetically verified EPM1 patients homozygous for the expansion mutation in the CSTB gene (37 males and 31 females aged 35 ± 11) participated in a neuropsychological assessment of intellectual ability, verbal memory, and executive and psychomotor function. The clinical evaluation comprised administering (and video-recording) the unified myoclonus rating scale (UMRS) to assess the severity of each patient’s myoclonus. Forty-six healthy volunteers (19 males and 27 females aged 32 ± 11) served as the control group for the neuropsychological tests. ResultsThe cognitive performance of the EPM1 patient group was impaired. Verbal Intelligence Quotient (VIQ) was below the average range (VIQ < 85) in 49% of the patients; further, Performance Intelligence Quotient (PIQ) was below average in 75% of the patients. The patients performed worse than the controls in both immediate and delayed story recall (p = 0.001); however, in the word list learning task, the patients performed only slightly worse than the controls. The one-hour delayed recall of the learned words was similar in both groups, and the percentage of retained words and story contents did not differ between the patients and controls. The patients were impaired in all of the executive function tests as well as in the psychomotor speed tests (p < 0.001 for all). Also, the patients’ simple psychomotor speed in the tapping task was significantly slowed in comparison to controls (p < 0.001). ConclusionThe patients had impaired performance in the majority of the cognitive measures; they showed the highest level of impairment in all the executive function tests and in the psychomotor speed tests. The measures of these cognitive domains are timed—therefore, it is clear that severe myoclonus limits patients’ performance. In contrast, verbal memory, especially delayed recall, was the least affected cognitive domain.

Laser-spot step-heating thermography to measure the thermal diffusivity of solids

In this work we show that laser-spot step-heating thermography allows measuring the thermal diffusivity of solids accurately. It consists in illuminating the sample surface with a continuous-wave focused laser spot and recording the time evolution of the surface temperature with an infrared camera. The inherent noise associated to time domain measurements is reduced by applying a very simple image processing procedure. The methodology has been tested on reference samples. Unlike laser spot lock-in (or pulsed) thermography, a step-heating thermography device can be easily put together combining a low-end laser and an entry level IR camera.