Development and validation of the Spanish abbreviated version of the Transsexual Voice Questionnaire for Male-to-Female Transsexuals. / Desarrollo y validación de la versión abreviada del Transsexual Voice Questionnaire for Male-to-Female Transsexuals en español.

OBJECTIVE: The aim of this study was to create and validate an abbreviated version of the Spanish Transsexual Voice Questionnaire for Male-to-Female Transsexuals (SvTVQMtF). SETTING: The study was conducted by two referral hospitals for voice feminization surgery and by a university department of psychology and speech therapy, all in Spain. SUBJECTS AND METHODS: We prospectively studied 51 male-to-female transsexuals who underwent voice feminization surgery between January 2017 and December 2018. The SvTVQMtF was completed before and after surgery, and the 10 items with the greatest variation were selected by clinical consensus of an expert panel to develop the short version of the SvTVQMtF (SvTVQMtF-10). The correlation between the total score and the score for each item on the SvTVQMtF and the SvTVQMtF-10 was studied. The internal consistency of the SvTVQMtF-10 was analysed. RESULTS: Good correlation (Pearson coefficient above .90) was found between the two questionnaires. A significant correlation was found between the total SvTVQMtF-10 score and the score for each item. A significant negative correlation was found between the SvTVQMtF and fundamental frequency after voice feminization surgery. Cronbach's α was .79. CONCLUSION: The SvTVQMtF-10 is a valid short version of the SvTVQMtF and can be used to quantify voice-related quality of life in MtF transsexuals.

A multivariate geostatistical framework for combining multiple indices of abundance for disease vectors and reservoirs: a case study of rattiness in a low-income urban Brazilian community.

A key requirement in studies of endemic vector-borne or zoonotic disease is an estimate of the spatial variation in vector or reservoir host abundance. For many vector species, multiple indices of abundance are available, but current approaches to choosing between or combining these indices do not fully exploit the potential inferential benefits that might accrue from modelling their joint spatial distribution. Here, we develop a class of multivariate generalized linear geostatistical models for multiple indices of abundance. We illustrate this novel methodology with a case study on Norway rats in a low-income urban Brazilian community, where rat abundance is a likely risk factor for human leptospirosis. We combine three indices of rat abundance to draw predictive inferences on a spatially continuous latent process, rattiness, that acts as a proxy for abundance. We show how to explore the association between rattiness and spatially varying environmental factors, evaluate the relative importance of each of the three contributing indices and assess the presence of residual, unexplained spatial variation, and identify rattiness hotspots. The proposed methodology is applicable more generally as a tool for understanding the role of vector or reservoir host abundance in predicting spatial variation in the risk of human disease.

Argyrophilic grain disease presenting as behavioral frontotemporal dementia.

Argyrophilic grain disease (AgD) is a frequent late-onset 4R tauopathy of old age characterized by the presence of profuse spindle-shaped argyrophilic grains (AGs). It is a neurodegenerative disorder that is clinically characterized by a slow progressive amnestic mild cognitive impairment similar to Alzheimer's disease. In rare instances, it is characterized as a behavioral-variant frontotemporal dementia (bv-FTD). In this study, we report a case with typical clinical and neuroimaging features of bv-FTD, who had autopsy findings consistent with a definitive diagnosis of AgD. We suggest that AgD might be included in the differential diagnosis of patients presenting with bv-FTD.
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Using fine-scale spatial genetics of Norway rats to improve control efforts and reduce leptospirosis risk in urban slum environments.

The Norway rat (Rattus norvegicus) is a key pest species globally and responsible for seasonal outbreaks of the zoonotic bacterial disease leptospirosis in the tropics. The city of Salvador, Brazil, has seen recent and dramatic increases in human population residing in slums, where conditions foster high rat density and increasing leptospirosis infection rates. Intervention campaigns have been used to drastically reduce rat numbers. In planning these interventions, it is important to define the eradication units - the spatial scale at which rats constitute continuous populations and from where rats are likely recolonizing, post-intervention. To provide this information, we applied spatial genetic analyses to 706 rats collected across Salvador and genotyped at 16 microsatellite loci. We performed spatially explicit analyses and estimated migration levels to identify distinct genetic units and landscape features associated with genetic divergence at different spatial scales, ranging from valleys within a slum community to city-wide analyses. Clear genetic breaks exist between rats not only across Salvador but also between valleys of slums separated by <100 m-well within the dispersal capacity of rats. The genetic data indicate that valleys may be considered separate units and identified high-traffic roads as strong impediments to rat movement. Migration data suggest that most (71-90%) movement is contained within valleys, with no clear source population contributing to migrant rats. We use these data to recommend eradication units and discuss the importance of carrying out individual-based analyses at different spatial scales in urban landscapes.

A Comparative Assessment of Track Plates to Quantify Fine Scale Variations in the Relative Abundance of Norway Rats in Urban Slums.

Norway rats (Rattus norvegicus) living in urban environments are a critical public health and economic problem, particularly in urban slums where residents are at a higher risk for rat borne diseases, yet convenient methods to quantitatively assess population sizes are lacking. We evaluated track plates as a method to determine rat distribution and relative abundance in a complex urban slum environment by correlating the presence and intensity of rat-specific marks on track plates with findings from rat infestation surveys and trapping of rats to population exhaustion. To integrate the zero-inflated track plate data we developed a two-component mixture model with one binary and one censored continuous component. Track plate mark-intensity was highly correlated with signs of rodent infestation (all coefficients between 0.61 and 0.79 and all p-values < 0.05). Moreover, the mean level of pre-trapping rat-mark intensity on plates was significantly associated with the number of rats captured subsequently (Odds ratio1.38; 95% CI 1.19-1.61) and declined significantly following trapping (Odds ratio 0.86; 95% CI 0.78-0.95). Track plates provided robust proxy measurements of rat abundance and distribution and detected rat presence even when populations appeared 'trapped out'. Tracking plates are relatively easy and inexpensive methods that can be used to intensively sample settings such as urban slums, where traditional trapping or mark-recapture studies are impossible to implement, and therefore the results can inform and assess the impact of targeted urban rodent control campaigns.

A Two-Year Ecological Study of Norway Rats (Rattus norvegicus) in a Brazilian Urban Slum.

The Norway or brown rat (Rattus norvegicus) is among the most ubiquitous of rodents. However, the lack of studies describing Norway rat populations from tropical areas have limited our understanding regarding their demography and seasonal dynamics. In this study, we describe seasonal pattern in the abundance, reproductive parameters, and morphometrics of Norway rat populations in Salvador, Brazil. Rodents were trapped over four seasonal trapping periods (2013-2014) from three valleys. A total of 802 Norway rats were trapped over the course of the study over 7653 trap-nights. Norway rat abundance was high, but there was no significant differences between seasons. The reproductive parameters (e.g. frequency of pregnant and lactating females) did not show statistical differences between seasons. Female rats collected in the rainy season were heavier and older than females from the dry season. Salvador rats had a high incidence of pregnancy and birth rate (estimated birth rate of 79 young per year) compared to previous studies. The information generated is critical for the understanding of the ecology of Norway rat, the main reservoir of Leptospira in Salvador. However, future studies examining the effect of rodent control programs aimed at reducing populations, and determining rates of recovery, will further clarify our understanding of population dynamics.

Diversity of Cognitive Phenotypes Associated with C9ORF72 Hexanucleotide Expansion.

For diagnostic purposes, we screened for the C9ORF72 mutation in a) 162 FTLD cases, and b) 145 cases with other diagnoses but with some frontotemporal features or manifestations previously reported in C9 carriers. Ten cases (onset 50 to 75 years) harbored the expansion: seven had FTLD syndromes (4.3% of total, 11% of familial cases), and three (2%) had a different diagnosis. All positive cases had family history of dementia, psychiatric disease, or ALS, but only 20% of families with mixed FTLD/ALS phenotypes carried the expansion. Language impairment was the most common symptom, followed by behavioral changes, memory deficits, and parkinsonism. C9ORF72 mutation has a low frequency in our dementia series and very diverse clinical manifestations.

Familial benign frontotemporal deterioration with C9ORF72 hexanucleotide expansion.

BACKGROUND: In recent years, a benign variant of frontotemporal lobar degeneration (FTLD) has been recognized, with a particularly slow progression of cognitive deficits and scarce frontotemporal atrophy or hypoperfusion in neuroimaging studies. Patients with FTLD have been considered "phenocopies," with an underlying nondegenerative neurologic process. RESULTS: We report the first family with three affected members having benign FTLD associated with C9ORF72 gene hexanucleotide expansion. Onset of symptoms occurred during the fifth decade, with naming and memory problems as the main features. Two siblings have stabilized at mild cognitive impairment or incipient dementia for more than a decade, and remain quite independent for their activities of daily living at the current ages of 69 and 65 years, respectively. Their mother's cognitive deterioration evolved slowly during >30 years. CONCLUSION: This family demonstrates that a benign evolution can be part of the growing spectrum of clinical phenotypes associated with neurodegenerative diseases caused by the C9ORF72 hexanucleotide expansion. Screening of this genetic marker should be considered in cases with this slow deterioration, especially if there is a family history.

Metric properties of the mini-mental Parkinson and SCOPA-COG scales for rating cognitive deterioration in Parkinson's disease.

UNLABELLED: Parkinson's disease (PD) is a chronic neurodegenerative disorder that causes cognitive impairment and dementia in ∼30% of patients. OBJECTIVE: Compare metric qualities of Mini-Mental Parkinson (MMP) and scales for outcomes in Parkinson's disease-cognition (SCOPA-COG) with respect to their relative reliability, validity and ability to predict symptoms (mobility, quality of life, social repercussions, and mood) in PD patients. Outpatients (n=123, 78 males/45 females) diagnosed with PD were included in the study. A multilevel (hierarchical) modeling analysis was performed along with tests of reliability and validity to ascertain which of the two models better predicts symptoms related to PD. RESULTS: The MMP differed significantly between patients with Hoehn and Yahr (H&Y) stages 1, 2 or versus 4/5 (grouped together). The SCOPA-COG showed differences only between patients in H&Y stages 2 versus 4/5. Both scales were dependent on educational background and age. The SCOPA-COG had a higher coefficient of variation (0.303) than the MMP (0.184), indicating that it was the more discriminative of the two. CONCLUSIONS: The SCOPA-COG has some advantages over the MMP, the most important being a greater discriminative ability. Multilevel hierarchical analysis clarified the necessity of stratifying the PD population according to educational background, years of illness, and H&Y stage when using these scales.

Psychometric attributes of the rating scale for gait evaluation in Parkinson's disease.

BACKGROUND: The RSGE-PD-V2.0 is a specific measure for evaluation of gait impairment in PD. OBJECTIVE: To check the RSGE-PD-V2.0 metrics attributes. METHODS: In addition to demographic and historical data of PD, applied assessments were: Hoehn and Yahr staging (H&Y); impact in daily activities with Schwab and England scale (S&E); SCOPA Motor; mental status with Short portable mental status questionnaire (SPMSQ); quality of life with Parkinson's impact scale (PIMS), the Hamilton Depression Rating Scale-6 items (HDRS-6); and, the Clinical Impression of Severity Index-PD (CISI-PD). RESULTS: 151 PD patients were included (n = 102 (67.5%) were male). Most patients were in H&Y stage 3 (n = 78 (51.6%)). Mean of age and duration of disease was 68.4 and 7.6 years respectively. Mean values of L-Dopa doses was 652.6 mg/day. Mean values of SCOPA Motor were 29.1; SPMSQ: 1.8; HADS-6: 9.2; PIMS: 18.7;RSGE-PD-V2.0: 25.4; and, CISI-PD were 10.8. Full computable scores were 100%; Guttman's lambda, 0.954; and the item-total correlation, 0.408-0.830. Correlation coefficients (Spearman's rho) between RSGE-PD-V2.0 and H&Y, S&E, SCOPA Motor, PIMS and CISI-PD, were: 0.62; -0.75; 0.74; 0.46; and, 0.78 respectively. RSGE-PD-V2.0 scale significantly discriminated among PD severity levels (based on H&Y staging) Kruskal-Wallis (p < 0.000). CONCLUSIONS: Metric attributes of the RSGE-PD-V2.0 in this sample of study resulted in has sufficient and suitable satisfactory. We, therefore, believe that RSGE-PD-V2.0 is easy and a useful and recommendable specific tool for measuring gait disease in PD patients.

Psychometric characteristics of PIMS--compared to PDQ-39 and PDQL--to evaluate quality of life in Parkinson's disease patients: validation in Spanish (Ecuadorian style).

OBJECTIVE: Analyze PIMS (Parkinson's impact scale) properties following the recommendations of the Scientific Advisory Committee of the Medical Outcomes Trust. METHODS: An analytical cross-sectional study to evaluate the psychometric qualities and scale assumptions of PIMS: quality of data, acceptability, reliability, validity, internal consistency, and construct validity. RESULTS: The sample included 131 patients with Parkinson's disease (PD), of which 39 (29.7%) were women. Psychometric qualities and scale assumptions, all of them are suitable. CONCLUSIONS: We therefore believe that PIMS is a useful and recommendable specific tool for measuring quality of life in PD patients.

Frequency of cognitive impairment without dementia in patients with stroke: a two-year follow-up study.

BACKGROUND AND PURPOSE: Studies on cognitive impairment without dementia (CIND) after stroke are scarce and there are no widely accepted diagnostic criteria for this condition. The purpose of this study was to determine the frequency of CIND in a hospital cohort before and after stroke during a 2-year follow up according to two alternative operational criteria. METHODS: Three hundred twenty-seven consecutive stroke inpatients were prospectively evaluated with an extensive neuropsychological battery and the Informant Questionnaire of Cognitive Decline in the Elderly (IQCODE) on admission and then at 3, 12, and 24 months after discharge. CIND was established according to two alternative operational criteria: proxy information (a cutoff score of 3.35 in the IQCODE: IQ-c) or to neuropsychologic examination (a score below the sixth percentile in >/=50% of the tests exploring one cognitive domain: NPE-c). RESULTS: A total of 12.6% patients had CIND (IQ-c) before stroke. After 3 months, the CIND frequency was 26.9% (IQ-c) or 19.6% (NPE-c); after 12 months, 39.5% or 26.8%; and after 24 months, 36.6% or 21%. The risk for developing delayed dementia was significantly higher for poststroke patients with CIND diagnosed by IQ-c (OR 8.8), NPE-c (OR 10.3), or both criteria (OR 20.8). CONCLUSIONS: Patients with CIND are frequent before and after stroke and prone to delayed dementia. Both criteria are valid for identifying CIND cases and predicting long-term conversion to dementia, but NPE-c may be more adequate for the long-term follow up and IQ-c for detecting changes from prestroke status.