Background
Visual complaints among people with multiple sclerosis (pwMS) are common, but often difficult to recognize. The Screening Visual Complaints questionnaire (SVCq) has been developed to ...screen for visual complaints in people with a neurodegenerative disease, including multiple sclerosis (MS). A previous study performed a factor analysis in a normal population which revealed an acceptable one-factor model, a three-factor model and a five-factor model within the SVCq. To increase the usability of the SVCq in people with MS, the purpose of the current study was to investigate the fit of the three models in a cohort of pwMS.
Results
The confirmatory factor analysis on the SVCq in 493 people with MS showed good fit for all the models. The three-factor model (
diminished visual perception
,
altered visual perception
and
ocular discomfort
) outperformed the one-factor model. The five-factor model outperformed both models, which showed that dividing the first factor (
diminished visual perception)
into three more factors (
function-related
,
luminance-related
and
task-related
) has merit.
Conclusions
All models may be useful in clinical care for pwMS. The one-factor model may give a quick overview of the presence and severity of visual complaints in general. The individual factors, of either the three- or the five factor models, may contribute to a better recognition of the nature of visual complaints in pwMS and may guide further steps in rehabilitation for pwMS with visual complaints.
The Screening Visual Complaints questionnaire (SVCq) is a short questionnaire to screen for visual complaints in people with Parkinson's disease (PD). The current study aims to investigate the factor ...structure of the SVCq to increase the usability of this measure in clinical practice and facilitate the interpretation of visual complaints in people with PD. We performed a confirmatory factor analysis using the 19 items of the SVCq of 581 people with PD, investigating the fit of three models previously found in a community sample: a one-factor model including all items, and models where items are distributed across either three or five factors. The clinical value of derived subscales was explored by comparing scores with age-matched controls (N = 583), and by investigating relationships to demographic and disease related characteristics. All three models showed a good fit in people with PD, with the five-factor model outperforming the three-factor and one-factor model. Five factors were distinguished: 'Diminished visual perception-Function related' (5 items), 'Diminished visual perception-Luminance related' (3 items), 'Diminished visual perception-Task related' (3 items), 'Altered visual perception' (6 items), and 'Ocular discomfort' (2 items). On each subscale, people with PD reported more complaints than controls, even when there was no ophthalmological condition present. Furthermore, subscales were sensitive to relevant clinical characteristics, like age, disease duration, severity, and medication use. The five-factor model showed a good fit in people with PD and has clinical relevance. Each subscale provides a solid basis for individualized visual care.
Finland's natural physical environment and climate support a wide variety of informal outdoor sports, thereby motivating the population to do physical exercise in scenic environments. The vast ...majority of Finns enjoys outdoor recreational activities, and could thus be encouraged to post accounts of their year-round activities on social media. Our aim was to find out in what kind of areas and spaces, spatially, users are tweeting about sporting activities.
We use geotagged Twitter tweets filtering for 16 sporting activity keywords in both English and Finnish. The case study was conducted in the Helsinki Metropolitan Area, Finland, with an emphasis on cross-country skiing as a sports activity when there is snow. In a secondary analysis we concentrated on the sports people were practicing in these locations when there was no snow. The location spaces are split in to three land cover types: green, blue, and street spaces.
We found that approximately half of the 150 skiing-related tweets were geotagged in green spaces, and half in street spaces. This finding related to street space was attributable to a spatial scale error: when we checked the results manually we noticed that they referenced the sporting location in the green space. Hence, then over 90% of the 745 non-ski-related tweets were geotagged in a street space.
We conclude that Twitter is a beneficial tool for detecting spaces used for informal physical activity. A shortcoming in current Finnish national sporting policies is that spaces for informal physical activity are not explicitly mentioned- we use the term informal with reference both to the space and to the sporting activity, whereby public spaces are used for physical activity. This new knowledge of sporting locations will help city planners and sports planners to improve informal sports facilities, which in turn will promote healthy exercise in cities.
Recent genome-wide association studies have identified single nucleotide polymorphisms (SNPs) associated with non-syndromic cleft lip with or without cleft palate (NSCL/P), and other previous studies ...showed distinctly differing facial distance measurements when comparing unaffected relatives of NSCL/P patients with normal controls. Here, we test the hypothesis that genetic loci involved in NSCL/P also influence normal variation in facial morphology. We tested 11 SNPs from 10 genomic regions previously showing replicated evidence of association with NSCL/P for association with normal variation of nose width and bizygomatic distance in two cohorts from Germany (N=529) and the Netherlands (N=2497). The two most significant associations found were between nose width and SNP rs1258763 near the GREM1 gene in the German cohort (P=6 × 10(-4)), and between bizygomatic distance and SNP rs987525 at 8q24.21 near the CCDC26 gene (P=0.017) in the Dutch sample. A genetic prediction model explained 2% of phenotype variation in nose width in the German and 0.5% of bizygomatic distance variation in the Dutch cohort. Although preliminary, our data provide a first link between genetic loci involved in a pathological facial trait such as NSCL/P and variation of normal facial morphology. Moreover, we present a first approach for understanding the genetic basis of human facial appearance, a highly intriguing trait with implications on clinical practice, clinical genetics, forensic intelligence, social interactions and personal identity.
Purpose:
Hyperthermia treatment of head and neck tumors requires accurate treatment planning, based on 3D patient models that are derived from segmented 3D images. These segmentations are currently ...obtained by manual outlining of the relevant tissue regions, which is a tedious and time-consuming procedure (∼8 h) limiting the clinical applicability of hyperthermia treatment. In this context, the authors present and evaluate an automatic segmentation algorithm for CT images of the head and neck.
Methods:
The proposed method combines anatomical information, based on atlas registration, with local intensity information in a graph cut framework. The method is evaluated with respect to ground truth manual delineation and compared with multiatlas-based segmentation on a dataset of 18 labeled CT images using the Dice similarity coefficient (DSC), the mean surface distance (MSD), and the Hausdorff surface distance (HSD) as evaluation measures. On a subset of 13 labeled images, the influence of different labelers on the method's accuracy is quantified and compared with the interobserver variability.
Results:
For the DSC, the proposed method performs significantly better for the segmentation of all the tissues, except brain stem and spinal cord. The MSD shows a significant improvement for optical nerve, eye vitreous humor, lens, and thyroid. For the HSD, the proposed method performs significantly better for eye vitreous humor and brainstem. The proposed method has a significantly better score for DSC, MSD, and HSD than the multiatlas-based method for the eye vitreous humor. For the majority of the tissues (8/11) the segmentation accuracy of the proposed method is approaching the interobserver agreement. The authors' method showed better robustness to variations in atlas labeling compared with multiatlas segmentation. Moreover, the method improved the segmentation reproducibility compared with human observer's segmentations.
Conclusions:
In conclusion, the proposed framework provides in an accurate automatic segmentation of head and neck tissues in CT images for the generation of 3D patient models, which improves reproducibility, and substantially reduces labor involved in therapy planning.
A fully automated brain tissue segmentation method is optimized and extended with white matter lesion segmentation. Cerebrospinal fluid (CSF), gray matter (GM) and white matter (WM) are segmented by ...an atlas-based
k-nearest neighbor classifier on multi-modal magnetic resonance imaging data. This classifier is trained by registering brain atlases to the subject. The resulting GM segmentation is used to automatically find a white matter lesion (WML) threshold in a fluid-attenuated inversion recovery scan. False positive lesions are removed by ensuring that the lesions are within the white matter. The method was visually validated on a set of 209 subjects. No segmentation errors were found in 98% of the brain tissue segmentations and 97% of the WML segmentations. A quantitative evaluation using manual segmentations was performed on a subset of 6 subjects for CSF, GM and WM segmentation and an additional 14 for the WML segmentations. The results indicated that the automatic segmentation accuracy is close to the interobserver variability of manual segmentations.
Aging is associated with reductions in hippocampal volume that are accelerated by Alzheimer's disease and vascular risk factors. Our genome-wide association study (GWAS) of dementia-free persons (n = ...9,232) identified 46 SNPs at four loci with P values of <4.0 × 10(-7). In two additional samples (n = 2,318), associations were replicated at 12q14 within MSRB3-WIF1 (discovery and replication; rs17178006; P = 5.3 × 10(-11)) and at 12q24 near HRK-FBXW8 (rs7294919; P = 2.9 × 10(-11)). Remaining associations included one SNP at 2q24 within DPP4 (rs6741949; P = 2.9 × 10(-7)) and nine SNPs at 9p33 within ASTN2 (rs7852872; P = 1.0 × 10(-7)); along with the chromosome 12 associations, these loci were also associated with hippocampal volume (P < 0.05) in a third younger, more heterogeneous sample (n = 7,794). The SNP in ASTN2 also showed suggestive association with decline in cognition in a largely independent sample (n = 1,563). These associations implicate genes related to apoptosis (HRK), development (WIF1), oxidative stress (MSR3B), ubiquitination (FBXW8) and neuronal migration (ASTN2), as well as enzymes targeted by new diabetes medications (DPP4), indicating new genetic influences on hippocampal size and possibly the risk of cognitive decline and dementia.
Since 2000, international organisations such as the UN, NATO and the EU, but also countries, have started to apply what has been called the comprehensive approach to crisis management. This article ...unpacks this comprehensive approach implemented by the Dutch in Uruzgan province, Afghanistan. It first borrows and expands a conceptual framework developed by De Coning and Friis. Subsequently, it maps the different sorts of coherence in the mission by applying the framework. It shows how in practice there was not one single comprehensive approach, but many different forms of interaction between a number of organisational units. Each interaction had its own distinct issues and its own level of coherence. The level of coherence differed depending on the level at which the interaction took place - strategic at headquarters level versus operational at field level - and at what point in the mission it happened - in most cases it moved towards more cohesion.
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