Smartphone-based remote assessment of upper extremity function for multiple sclerosis using the Draw a Shape Test.

OBJECTIVE: Smartphone devices may enable out-of-clinic assessments in chronic neurological diseases. We describe the Draw a Shape (DaS) Test, a smartphone-based and remotely administered test of Upper Extremity (UE) function developed for people with multiple sclerosis (PwMS). This work introduces DaS-related features that characterise UE function and impairment, and aims to demonstrate how multivariate modelling of these metrics can reliably predict the 9-Hole Peg Test (9HPT), a clinician-administered UE assessment in PwMS. APPROACH: The DaS Test instructed PwMS and healthy controls (HC) to trace predefined shapes on a smartphone screen. A total of 93 subjects (HC, n = 22; PwMS, n = 71) contributed both dominant and non-dominant handed DaS tests. PwMS subjects were characterised as those with normal (nPwMS, n = 50) and abnormal UE function (aPwMS, n = 21) with respect to their average 9HPT time (≤ or > 22.7 (s), respectively). L 1-regularization techniques, combined with linear least squares (OLS, IRLS), or non-linear support vector (SVR) or random forest (RFR) regression were investigated as functions to map relevant DaS features to 9HPT times. MAIN RESULTS: It was observed that average non-dominant handed 9HPT times were more accurately predicted by DaS features (r 2 = 0.41, [Formula: see text] 0.05; MAE: 2.08 ± 0.34 (s)) than average dominant handed 9HPTs (r 2 = 0.39, [Formula: see text] 0.05; MAE: 2.32 ± 0.43 (s)), using simple linear IRLS ([Formula: see text] 0.01). Moreover, it was found that the Mean absolute error (MAE) in predicted 9HPTs was comparable to the variability of actual 9HPT times within HC, nPwMS and aPwMS groups respectively. The 9HPT however exhibited large heteroscedasticity resulting in less stable predictions of longer 9HPT times. SIGNIFICANCE: This study demonstrates the potential of the smartphone-based DaS Test to reliably predict 9HPT times and remotely monitor UE function in PwMS.

Ex vivo assessment of cellular immune function - applications in patient care and clinical studies.

Cellular ex vivo assays have a broad range of applications in patient care and clinical studies, especially when they are standardized and highly sensitive. As compared to analyses by molecular genetics such as the single nucleotide polymorphism (SNP) testing, they are usually more global. These assays partly mimic the in vivo situation, relying on a complex interaction of various immune cells. For example, they can be used to determine modulation of alloresponses by treatment or underlying disease, diagnose and quantify primary and secondary cellular immunodeficiency, follow-up vaccination responses, measure adoptive transfer of virus-specific immunity via hematopoietic stem cell or liver transplantation, assess allergy, antimicrobial immunity and also rare effector/memory cells directed against tumor antigens. This review will first shortly describe various cellular in vitro methods and then present applications, summarizing some own studies performed within the last 18 years.

Factors contributing to the success of folic acid public health campaigns.

BACKGROUND: Studies in the 1990s have found that periconceptional dietary folate, supplementation of folic acid or supplemental multivitamins containing folic acid, help prevent neural tube defect (NTDs) if taken at the right time. This literature review assesses the extant folic acid public health campaigns literature and identifies some common variables used in folic acid consumption campaign evaluations. METHODS: This review was part of a larger study that searched PUBMED, PsycINFO and Embase from 1976 to 2010 to identify articles related to the psychosocial and economic impact of NTDs (especially spina bifida) on patients and caregivers. RESULTS: Awareness of folic acid levels prior to conception improved post-campaign from 6 to 41%. Knowledge about consumption and correct periconceptional use of folic acid also improved. However, in most studies more than 50% of women did not take folic acid as prescribed. Many factors were associated with or without taking folic acid post-campaign, including incomplete outreach, prior awareness and knowledge, closeness to pregnancy, demographics and other personal characteristics. CONCLUSIONS: Sustained campaigning to maintain awareness about and promote periconceptional consumption of folic acid in order to reduce the incidence of NTDs is clearly needed. Additional initiatives could complement existing public health strategies.

Assessment of chromium tripicolinate supplementation and dietary protein level on growth, carcass, and blood criteria in growing pigs.

This study was conducted to evaluate potential interactive effects of supplemental Cr and dietary protein levels in growing pigs. Thirty-six individually penned barrows, 22 to 63 kg, were used in a 2 x 3 factorial arrangement of supplemental Cr (0 or 200 ppb from chromium tripicolinate) and protein level (76, 83, or 90% of lysine requirement). A corn-soybean meal basal diet was designed to supply all mineral and vitamin needs, 90% of the estimated metabolizable energy need, and 76% of the estimated protein need at 70% of ad libitum feed intake. Additional protein to 83 or 90% of the lysine requirement was provided by a soy protein isolate supplement. Growth data were collected for a 50-d period, and pigs were killed at a mean of 63 kg BW. Increasing lysine levels linearly (P < 0.01) increased ADG and liver weight. Lysine level had a quadratic effect on 10th rib backfat thickness (P < 0.05) and cooler shrink (P < 0.01) with the highest responses at the 83% lysine level. Increasing lysine level linearly decreased (P < 0.05) carcass content of ash and lipid and quadratically increased the carcass water content (P < 0.01). Carcass accretion rate showed a linear increase for protein (P < 0.01) and water accretion (P < 0.01). Dry matter composition of the longissimus muscle showed linear increases of ash (P < 0.05) and protein (P < 0.01) and a linear decrease of lipid content (P < 0.01) resulting in a linear increase (P < 0.05) of the protein to lipid ratio based on the increasing lysine levels. Pre-feeding insulin levels were increased (P < 0.05) with increasing level of lysine. One hour post-feeding, a quadratic lysine response for plasma glucose (P < 0.05) was observed with the lowest concentration at 83% lysine. Cr addition increased 10th rib backfat thickness (P < 0.10). There was no Cr x lysine level interaction (P > 0.10) observed for any of the growth or carcass traits. Plasma glucose concentrations pre-feeding were lower for Cr-supplemented pigs (P < 0.01). As expected, increasing protein levels in protein-deficient diets increased protein accretion while decreasing lipid accretion in 22 to 63 kg growing pigs; however, these effects were more clearly seen in the longissimus muscle than in the entire carcass. Supplementation of Cr exerted only minor effects with few Cr x lysine interactions observed in this study.

Assessment of chromium tripicolinate supplementation and dietary energy level and source on growth, carcass, and blood criteria in growing pigs.

Two experiments were conducted to evaluate potential interactive effects of supplemental Cr and dietary energy supply in growing pigs. Experiment 1 used 36 individually penned barrows, 25 to 65 kg, in a 2 x 3 factorial arrangement of supplemental Cr (0 or 200 ppb) and energy level (70, 80, or 90% of ME requirement). A corn-soybean meal basal diet was designed to supply all protein, mineral, and vitamin needs and 70% of the estimated ME need at 70% of ad libitum feed intake. Additional energy to 80% or 90% of the ME requirement was provided by a cornstarch/corn oil blend. In Exp. 2, 30 individually penned barrows, 23 to 68 kg, were used in a 2 x 4 factorial arrangement of supplemental Cr (0 or 200 ppb) and added energy source (none, cornstarch, corn oil, or choice white grease) with basal diets identical to Exp. 1. The various energy sources were added to 90% of the ME requirement. In both experiments, growth data were collected over a 50-d period and pigs were killed at 70.1 kg. Increasing energy levels increased (linear, P < 0.01) ADG, average backfat thickness, 10th rib backfat thickness, and cooler shrink and decreased (linear, P < 0.01) longissimus muscle area in Exp. 1. Carcass composition increased (linear, P < 0.01) in lipid and decreased in protein, water, and protein:lipid ratio in response to increasing ME levels. Similar results were observed in Exp. 2 in response to added energy, regardless of the energy source used. In response to ME, linear increases (P < 0.05) in plasma insulin concentration before feeding and after feeding were observed in Exp. 1. In Exp. 2, plasma insulin concentration was lower for the basal diet before feeding (P < 0.05) and higher for the starch diet after feeding (P < 0.01); insulin:glucose ratio increased (P < 0.01) after feeding for starch compared to oil and fat. No consistent effect of Cr or Cr x ME level on performance or carcass was observed (P > 0.10) in these experiments. Similarly, no Cr effect or Cr x ME interaction (P > 0.10) was observed in plasma glucose or insulin levels. Dietary energy levels markedly affected growth criteria in growing pigs (23 to 68 kg) in these experiments, as anticipated, but supplemental Cr was without effect on performance or carcass responses.

An assessment of dietary folic acid levels during gestation and lactation on reproductive and lactational performance of sows: a cooperative study. S-145 Committee on Nutritional Systems for Swine to Increase Reproductive Efficiency.

Crossbred female swine (n = 393) were used in a multiparity study at five experiment stations to evaluate the effects of dietary supplementation of folic acid (FA) on serum folates status and reproductive performance. The dietary treatments were a corn-soybean meal basal diet (calculated FA, .34 ppm) supplemented with 0, 1, 2, or 4 ppm FA. Experimental diets were fed continuously from a minimum of 21 d before first mating throughout the entire study. At one station, blood samples for radioimmunoassay determination of serum folates concentration were collected by vena cava puncture at mating, d 55 of gestation, d 110 of gestation, and at weaning. Stage of reproduction and dietary FA supplementation affected (P < .005) serum folates concentrations. Serum folates declined from mating to d 55, remained low at d 110, and returned to higher levels at weaning. Linear increases (P < .001) in serum folates with increasing level of dietary FA were observed at each reproductive stage. Over the course of the study, reproductive performance criteria including total pigs born, live pigs at birth and d 21, and individual pig and litter weight at birth and d 21 were not affected (P > .10) by inclusion of FA in the diet. The number of days postweaning to estrus also was not affected by FA treatment. Under the conditions of this experiment, increasing level of FA in the diet had a pronounced effect in attenuating decreased serum folates concentration during gestation but was without benefit to reproductive performance.