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BACKGROUND: The Observable Movement Quality scale for patients with low back pain (OMQ-LBP) is a newly developed measurement instrument for use in primary care settings of physical and exercise therapists to assess movement quality (MQ) of patients with low back pain (LBP). OBJECTIVE: This study aims to determine validity, reliability and feasibility of the OMQ-LBP. The OMQ-LBP consists of a standardized movement circuit (performed twice) consisting of five daily activities problematic for LBP patients, which are scored with an 11-item observation list. METHODS: Construct validity was determined by testing seven hypotheses on associations between constructs (n = 85 patients with LBP) and four hypotheses on known group differences (n = 85 patients with LBP and n = 63 healthy controls; n = 35 matched participant-patients having VAS-pain ≥ 20 mm during and/or after both circuits and healthy controls). Internal consistency was analyzed with Cronbach's alpha (n = 85 patients with LBP). For inter- and intra-rater reliability Intraclass Correlation Coefficient (ICC) values were examined (n = 14 therapists: seven primary care physical therapists and seven exercise therapists). Additionally, content validity and feasibility were determined using thematic analysis of a brief interview with participants, patients (n = 38) and therapists (n = 14). RESULTS: After Bonferroni correction 2/7 associations between constructs and 2/4 significant group differences were confirmed. Cronbach's alpha was 0,79. The ICC-values of interrater reliability of the OMQ-LBP total score and the duration score were 0.56 and 0.99 and intra-rater reliability 0.82 and 0,93, respectively. Thematic analysis revealed five themes. Three themes elucidate that both patients and therapists perceived the content of the OMQ-LBP as valid. The fourth theme exhibits that OMQ-LBP provides a clear and unambiguous language for MQ in patients with LBP. Theme 5 depicts that the OMQ-LBP seems feasible, but video recording is time-consuming. CONCLUSIONS: The OMQ-LBP is a promising standardized observational assessment of MQ during the five most problematic daily activities in patients with LBP. It is expected that uniform and objective description and evaluation of MQ add value to clinical reasoning and facilitate uniform communication with patients and colleagues.
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Dolor de la Región Lumbar , Humanos , Dolor de la Región Lumbar/diagnóstico , Dolor de la Región Lumbar/terapia , Reproducibilidad de los Resultados , Modalidades de Fisioterapia , Técnicos Medios en Salud , Atención Primaria de SaludRESUMEN
This study aimed to investigate the genetics of rearing success (RS) in laying hens. Four rearing traits: clutch size (CS), first week mortality (FWM), rearing abnormalities (RA), and natural death (ND), were included as factors determining RS. Pedigree, genotypic, and phenotypic records of 4 purebred genetic lines of White Leghorn layers were available for 23,000 rearing batches obtained between 2010 and 2020. FWM and ND showed little or no variation amongst the 4 genetic lines over the years 2010-2020, whereas an increase was observed for CS and a decrease for RA. To determine whether these traits were heritable, genetic parameters for each trait were estimated, using a Linear Mixed Model. Heritabilities within lines were low (0.05-0.19 for CS, 0.01-0.04 for FWM, 0.02-0.06 for RA, 0.02-0.04 for ND, and 0.01-0.07 for RS). Additionally, genome wide association study was done to scan the genomes of the breeders to reveal single nucleotide polymorphisms (SNPs) associated with these traits. Manhattan plots indicated the existence of 12 different SNPs having a significant effect on RS. Thus, the identified SNPs will increase the understanding of the genetics of RS in laying hens.
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Pollos , Estudio de Asociación del Genoma Completo , Animales , Femenino , Pollos/genética , Estudio de Asociación del Genoma Completo/veterinaria , Genotipo , Genoma , FenotipoRESUMEN
The objective of this study was to compare 3-breed rotational crossbred (CB) cows of the Montbéliarde, Viking Red, and Holstein (HO) breeds with HO cows fed 2 alternative diets for dry matter intake (DMI), fat plus protein production (CFP), body weight (BW), body condition score (BCS), feed efficiency, and residual feed intake (RFI) from 46 to 150 days in milk (DIM) during first lactation. The CB cows (n = 17) and HO cows (n = 19) calved from September 2019 to March 2020. Cows were fed either a traditional total mixed ration diet (TRAD) or a higher fiber, lower starch total mixed ration diet (HFLS). The HFLS had 21% more corn silage, 47% more alfalfa hay, 44% less corn grain, and 43% less corn gluten feed than the TRAD. The 2 diets were analyzed for dry matter content, crude protein, forage digestibility, starch, and net energy for lactation. The BW and BCS were recorded once weekly. Daily milk, fat, and protein production were estimated from twice monthly milk recording with random regression. Measures of efficiency were CFP per kilogram of DMI and DMI per kilogram of BW. The RFI from 46 to 150 DIM was the residual error from regression of DMI on milk energy, metabolic BW, and the energy required for change in BW. Statistical analysis of all variables included the fixed effects of diet, breed group, and the interaction of diet and breed group. The CB cows fed HFLS had less DMI (-12%) and lower DMI/BW (-14%) compared with the HO cows fed TRAD. For CFP, CB and HO cows were not different when fed TRAD or HFLS. Furthermore, the CB cows fed HFLS had higher BW (+50 kg) compared with HO cows fed HFLS. The CB cows fed TRAD had higher BCS than HO cows fed TRAD and HO cows fed HFLS (+0.46 and +0.62, respectively). The HO cows fed TRAD had more DMI (+14%) and lower CFP per kilogram of DMI (-12%) compared with the HO cows fed HFLS. In addition, mean RFI from 46 to 150 DIM was lower and more desirable for CB cows fed HFLS (-120.0 kg) compared with HO cows fed TRAD (85.3 kg). Dairy producers may feed either TRAD or HFLS to CB cows without loss of CFP.
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Alimentación Animal , Fitomejoramiento , Animales , Bovinos , Femenino , Alimentación Animal/análisis , Peso Corporal , Dieta/veterinaria , Ingestión de Alimentos , Glútenes , Lactancia , Leche/metabolismo , Almidón/metabolismoRESUMEN
In this study, a data driven approach was used by applying linear regression and machine learning methods to understand animal related and environmental factors affecting hatchability. Data was obtained from a parent stock and grand-parent stock hatchery, including 1,737 batches of eggs incubated in the years 2010-2018. Animal related factors taken into consideration were strain (white vs. brown strain), breeder age, and egg weight uniformity at the start of incubation, whereas environmental factors considered were length of egg storage before incubation, egg weight loss during incubation and season. Effects of these factors on hatchability were analyzed with 3 different models: a linear regression (LR) model, a random forest (RF) model and a gradient boosting machine (GBM) model. In part one of the study, hatchability was predicted and the performance of the models in terms of coefficient of determination (R2) and root mean square error (RMSE) was compared. The ensemble machine learning models (RF: R2 = 0.35, RMSE = 8.41; GBM: R2 = 0.31, RMSE = 8.67) appeared to be superior than the LR model (R2 = 0.27, RMSE = 8.92) as indicated by the higher R2 and lower RMSE. In part 2 of the study, effects of these factors on hatchability were investigated more into detail. Hatchability was affected by strain, breeder age, egg weight uniformity, length of egg storage and season, but egg weight loss didn't have a significant effect on hatchability. Additionally, four 2-way interactions (breeder age × egg weight uniformity, breeder age × length of egg storage, breeder age × strain, season × strain) were significant on hatchability. It can be concluded that hatchability of parent stock and grand-parent stock layer breeders is affected by several animal related and environmental factors, but the size of the predicted effects varies between the methods used. In this study, 3 models were used to predict hatchability and to analyze effects of animal related and environmental factors on hatchability. This opens new horizons for future studies on hatchery data by taking the advantage of applying machine learning methods, that can fit complex datasets better than LR and applying statistical analysis.
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Pollos , Óvulo , Animales , Estaciones del AñoRESUMEN
BACKGROUND: Ethiopia has one of the worst podoconiosis rates in the world, affecting >1.5 million patients. We present our ethnographic film 'Tigist, the story of a girl with podoconiosis' and its potential use in tackling podoconiosis. METHODS: We conducted visual ethnography, consisting of video-recorded participant observations and interviews with seven patients, three healthcare workers and two podoconiosis experts. RESULTS: We acquired video recordings of social moments, the state of podoconiosis patients' bodies and minds, their emotions and the impact of poverty. CONCLUSIONS: Our film allows for an intensified understanding of patients' daily experiences with podoconiosis, potentially impacting care, awareness and medical teaching programs.
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Elefantiasis , Antropología Cultural , Estudios Transversales , Elefantiasis/prevención & control , Etiopía , Femenino , HumanosRESUMEN
BACKGROUND: Fear of movement (kinesiophobia) after an acute cardiac hospitalization (ACH) is associated with reduced physical activity (PA) and non-adherence to cardiac rehabilitation (CR). PURPOSE: To investigate which factors are related to kinesiophobia after an ACH, and to investigate the support needs of patients in relation to PA and the uptake of CR. METHODS: Patients were included 2-3 weeks after hospital discharge for ACH. The level of kinesiophobia was assessed with the Tampa Scale for Kinesiophobia (TSK-NL Heart). A score of > 28 points is defined as 'high levels of kinesiophobia' (HighKin) and ≤ 28 as 'low levels of kinesiophobia' (LowKin). Patients were invited to participate in a semi-structured interview with the fear avoidance model (FAM) as theoretical framework. Interviews continued until data-saturation was reached. All interviews were analyzed with an inductive content analysis. RESULTS: Data-saturation was reached after 16 participants (median age 65) were included in this study after an ACH. HighKin were diagnosed in seven patients. HighKin were related to: (1) disrupted healthcare process, (2) negative beliefs and attitudes concerning PA. LowKin were related to: (1) understanding the necessity of PA, (2) experiencing social support. Patients formulated 'tailored information and support from a health care provider' as most important need after hospital discharge. CONCLUSION: This study adds to the knowledge of factors related to kinesiophobia and its influence on PA and the uptake of CR. These findings should be further validated in future studies and can be used to develop early interventions to prevent or treat kinesiophobia and stimulate the uptake of CR.
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Rehabilitación Cardiaca , Ejercicio Físico/psicología , Miedo , Cardiopatías/rehabilitación , Hospitalización , Movimiento , Cooperación del Paciente , Trastornos Fóbicos/etiología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Cardiopatías/fisiopatología , Cardiopatías/psicología , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Trastornos Fóbicos/diagnóstico , Trastornos Fóbicos/psicología , Investigación Cualitativa , Factores de RiesgoRESUMEN
The Medicines Evaluation Board (MEB) grants market authorisation for medicinal products in the Netherlands. The European Medicines Agency (EMA) coordinates the evaluation and safeguarding of medicinal products in the European Union. The core task of the MEB is to evaluate the quality of every medicinal product for which marketing authorisation is applied for by the manufacturer, and to assess the risk - efficacy balance of the product concerned. There are three different procedures that a manufacturer can follow: (a) the national procedure; (b) the decentralised procedure or mutual recognition procedure; (c) the centralised procedure. After marketing authorisation has been granted, the MEB ensures pharmacovigilance in cooperation with partners such as the Netherlands Pharmacovigilance Centre (Lareb). The MEB determines the text of the package leaflet, the packaging and the Summary of Product Characteristics (SmPC). The MEB checks the warnings that are sent out by manufacturers if important new information about a medicinal product becomes available.
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Seguridad de Productos para el Consumidor/normas , Aprobación de Drogas/organización & administración , Legislación de Medicamentos/normas , Farmacovigilancia , Unión Europea , Regulación Gubernamental , Humanos , Países Bajos , Preparaciones Farmacéuticas/normasRESUMEN
With the increasing availability of large amounts of data in the livestock domain, we face the challenge to store, combine and analyse these data efficiently. With this study, we explored the use of a data lake for storing and analysing data to improve scalability and interoperability. Data originated from a 2-day animal experiment in which the gait score of approximately 200 turkeys was determined through visual inspection by an expert. Additionally, inertial measurement units (IMUs), a 3D-video camera and a force plate (FP) were installed to explore the effectiveness of these sensors in automating the visual gait scoring. We deployed a data lake using the IMU and FP data of a single day of that animal experiment. This encompasses data from 84 turkeys for which we preprocessed by performing an 'extract, transform and load' (ETL-) procedure. To test scalability of the ETL-procedure, we simulated increasing volumes of the available data from this animal experiment and computed the 'wall time' (elapsed real time) for converting FP data into comma-separated files and storing these files. With a simulated data set of 30 000 turkeys, the wall time reduced from 1 h to less than 15 min, when 12 cores were used compared to 1 core. This demonstrated the ETL-procedure to be scalable. Subsequently, a machine learning (ML) pipeline was developed to test the potential of a data lake to automatically distinguish between two classses, that is, very bad gait scores v. other scores. In conclusion, we have set up a dedicated customized data lake, loaded data and developed a prediction model via the creation of an ML pipeline. A data lake appears to be a useful tool to face the challenge of storing, combining and analysing increasing volumes of data of varying nature in an effective manner.
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Macrodatos , Caminata , Animales , Marcha , PavosRESUMEN
Objective: To explore driving performance and driving safety in patients with cervical dystonia (CD) on a simulated lane tracking, intersections and highway ride and to compare it to healthy controls. Design: This study was performed as an explorative between groups comparison. Participants: Ten CD patients with idiopathic CD, 30 years or older, stable on botulinum toxin treatment for over a year, holding a valid driver's license and being an active driver were compared with 10 healthy controls, matched for age and gender. Main outcome measures: Driving performance and safety, measured by various outcomes from the simulator, such as the standard deviation of the lateral position on the road, rule violations, percentage of line crossings, gap distance, and number of collisions. Fatigue and driving effort were measured with the Borg CR-10 scale and self-perceived fitness to drive was assessed with Fitness to Drive Screening. Results: Except for a higher percentage of line crossings on the right side of the road by controls (median percentage 2.30, range 0.00-37.00 vs. 0.00, range 0.00-9.20, p = 0.043), no differences were found in driving performance and driving safety during the simulator rides. Fatigue levels were significantly higher in CD patients just before (p = 0.005) and after (p = 0.033) the lane tracking ride (patients median fatigue levels before 1.5 (range 0.00-6.00) and after 1.5 (range 0.00-7.00) vs. controls median fatigue levels before and after 0.00 (no range). No significant differences were found on self-perceived fitness to drive. Conclusion: In patients with CD there were no indications that driving performance or driving safety were significant different from healthy controls in a simulator. Patients reported higher levels of fatigue both before and after driving compared to controls in accordance with the non-motor symptoms known in CD.
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The wheat leaf rust fungus, Puccinia triticina, is found in the major wheat growing regions of the world and is a leading cause of yield loss in wheat. Populations of P. triticina are highly variable for virulence to resistance genes in wheat and adapt quickly to resistance genes in wheat cultivars. The objectives of this study were to determine the genetic relatedness of worldwide collections of P. triticina using restriction site associated genotyping by sequencing. A total of 558 isolates of P. triticina from wheat producing regions in North America, South America, Europe, the Middle East, Ethiopia, Russia, Pakistan, Central Asia, China, New Zealand, and South Africa were characterized at 6745 single nucleotide loci. Isolates were also tested for virulence to 20 near-isogenic lines that differ for leaf rust resistance genes. Populations that were geographically proximal were also more closely related for genotypes. In addition, groups of isolates within regions that varied for genotype were similar to groups from other regions, which indicated past and recent migration across regions. Isolates from tetraploid durum wheat in five different regions were highly related with distinct genotypes compared to isolates from hexaploid common wheat. Based on a molecular clock, isolates from durum wheat found only in Ethiopia were the first to diverge from a common ancestor form of P. triticina that is found on the wild wheat relative Aegilops speltoides, followed by the divergence of isolates found worldwide that are virulent to durum wheat, and then by isolates found on common wheat.
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Enfermedades de las Plantas , Puccinia , Asia , China , Etiopía , Europa (Continente) , Genotipo , Medio Oriente , Nueva Zelanda , América del Norte , Pakistán , Enfermedades de las Plantas/microbiología , Puccinia/genética , Federación de Rusia , Sudáfrica , América del SurRESUMEN
In the Netherlands, approximately 200 to 300 patients are diagnosed with imported malaria every year. The symptoms of malaria are non-specific. The current gold standard for malaria diagnostics is to conduct a thick and thin blood smear. New diagnostic techniques are increasingly applied. At present, the treatment of uncomplicated malaria consists of an artemisinin-based combination therapy (ACT). An alternative treatment for malaria caused by P. vivax,P. knowlesi,P. ovale and P. malariae in the Netherlands is chloroquine. Severe malaria is treated with artesunate intravenously, followed by a full three-day course of oral ACT. Uncomplicated malaria during pregnancy is treated with an ACT (e.g. artemether-lumefantrine) and severe malaria with artesunate intravenously, the latter followed by a full three-day course of oral ACT. There is currently no malaria vaccine available for travellers.
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Antimaláricos/uso terapéutico , Malaria/etnología , Complicaciones Parasitarias del Embarazo/epidemiología , Viaje , Femenino , Humanos , Malaria/tratamiento farmacológico , Vacunas contra la Malaria , Países Bajos/epidemiología , Embarazo , Complicaciones Parasitarias del Embarazo/tratamiento farmacológicoRESUMEN
In the Netherlands, approximately 200 to 300 patients are diagnosed with imported malaria every year. The symptoms of malaria are non-specific. The current gold standard for malaria diagnostics is to conduct a thick and thin blood smear. New diagnostic techniques are increasingly applied. At present, the treatment of uncomplicated malaria consists of an artemisinin-based combination therapy (ACT). An alternative treatment for malaria caused by P. vivax,P. knowlesi,P. ovale and P. malariae in the Netherlands is chloroquine. Severe malaria is treated with artesunate intravenously, followed by a full three-day course of oral ACT. Uncomplicated malaria during pregnancy is treated with an ACT (e.g. artemether-lumefantrine) and severe malaria with artesunate intravenously, the latter followed by a full three-day course of oral ACT. There is currently no malaria vaccine available for travellers.
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Antimaláricos/uso terapéutico , Artemisininas/uso terapéutico , Malaria/tratamiento farmacológico , Viaje , Arteméter/uso terapéutico , Combinación Arteméter y Lumefantrina , Cloroquina/uso terapéutico , Combinación de Medicamentos , Quimioterapia Combinada , Femenino , Humanos , Malaria/diagnóstico , Vacunas contra la Malaria/uso terapéutico , Masculino , Países Bajos , EmbarazoRESUMEN
Many plant pathogenic fungi have a global distribution across diverse ecological zones and agricultural production systems. Puccinia triticina, the wheat leaf rust fungus, is a major pathogen in many wheat production areas of the world. The objective of this research was to determine the genetic relatedness of P. triticina in different worldwide regions. A total of 831 single-uredinial isolates collected from 11 regions were characterized for multilocus genotype at 23 simple sequence repeat loci and for virulence to 20 lines of wheat with single genes for leaf rust resistance. A total of 424 multilocus genotypes and 497 virulence phenotypes were found. All populations had high heterozygosity and significant correlation between virulence and molecular variation, which indicated clonal reproduction. The populations from North America and South America, Central Asia and Russia, and the Middle East and Europe were closely related for multilocus genotypes and many individual isolates from other continental regions were closely related. Twenty-seven multilocus genotypes were found in more than one continental region, and 13 of these had isolates with identical virulence phenotypes. The wide geographic distribution of identical and highly related multilocus genotypes of P. triticina indicated past and more recent migration events facilitated by the spread of clonally produced urediniospores.
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Enfermedades de las Plantas , Triticum , Asia Central , Europa (Continente) , Genotipo , Medio Oriente , América del Norte , Enfermedades de las Plantas/microbiología , Federación de Rusia , América del Sur , Triticum/microbiologíaRESUMEN
Fertility of the dairy cow relies on complex interactions between genetics, physiology, and management. Mathematical modeling can combine a range of information sources to facilitate informed predictions of cow fertility in scenarios that are difficult to evaluate empirically. We have developed a stochastic model that incorporates genetic and physiological data from more than 70 published reports on a wide range of fertility-related traits in dairy cattle. The model simulates pedigree, random mating, genetically correlated traits (in the form of breeding values for traits such as hours in estrus, estrous cycle length, age at puberty, milk yield, and so on), and interacting environmental variables. This model was used to generate a large simulated data set (200,000 cows replicated 100 times) of herd records within a seasonal dairy production system (based on an average New Zealand system). Using these simulated data, we investigated the genetic component of lifetime reproductive success (LRS), which, in reality, would be impractical to assess empirically. We defined LRS as the total number of times, during her lifetime, a cow calved within the first 42 d of the calving season. Sire estimated breeding values for LRS and other traits were calculated using simulated daughter records. Daughter pregnancy rate in the first lactation (PD_1) was the strongest single predictor of a sire's genetic merit for LRS (R2 = 0.81). A simple predictive model containing PD_1, calving date for the second season and calving rate in the first season provided a good estimate of sire LRS (R2 = 0.97). Daughters from sires with extremely high (n = 99,995 daughters, sire LRS = +0.70) or low (n = 99,635 daughters, sire LRS = -0.73) LRS estimated breeding values were compared over a single generation. Of the 14 underlying component traits of fertility, 12 were divergent between the 2 lines. This suggests that genetic variation in female fertility has a complex and multifactorial genetic basis. When simulated phenotypes were compared, daughters of the high LRS sires (HiFERT) reached puberty 44.5 d younger and calved â¼14 d younger at each parity than daughters from low LRS sires (LoFERT). Despite having a much lower genetic potential for milk production (-400 L/lactation) than LoFERT cows, HiFERT cows produced 33% more milk over their lifetime due to additional lactations before culling. In summary, this simulation model suggests that LRS contributes substantially to cow productivity, and novel selection criteria would facilitate a more accurate prediction at a younger age.
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Cruzamiento , Bovinos/fisiología , Fertilidad/genética , Reproducción/genética , Animales , Bovinos/genética , Femenino , Variación Genética , Masculino , Modelos Genéticos , Nueva Zelanda , Selección GenéticaRESUMEN
The low energy electronic structure of the copper dimer has been re-investigated using non-linear four-wave mixing spectroscopy and high level ab initio calculations. In addition to the measurement of the previously reported A, B, and C electronic states, a new state denoted A' is identified with T0 = 20 100.4090(16) cm-1 (63Cu2). Rotational analysis of the A'-X (0,0) and (1,0) transitions leads to the assignment of A' 1u. Ab initio calculations present the first theoretical description of the low energy states of the copper dimer in Hund's case (c) and confirm the experimental assignment. The discovery of this new low energy excited state emphasizes that spin-orbit coupling is significant in states with d-hole electronic configurations and resolves a decades-long mystery in the initial assignment of the A state.
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The available knowledge of the electronically excited states of the copper dimer is limited. This is common for transition metals, as the high density of states hinders both experimental assignment and computation. In this work, two-color resonant four-wave mixing spectroscopy was applied to neutral Cu2 in the gas phase. The method yielded accurate positions of individual rovibrational lines in the I-X and J-X electronic systems. This revealed the term symbols for the I and J states as 1Πu (1u) and 1Σu+ (0u+), respectively. For the 63Cu2 isotopologue, accurate molecular constants were obtained. The characterization of the J state finally allowed decisive determination of its electron configuration. The J state is obtained from the ground state by promotion of a 3dπg electron into the weakly bonding 4pπu molecular orbital. From the data analysis, lifetimes of the I state (between 10 ps and 5 ns) and J state (66 ns) were inferred.
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Vibrational levels of the recently observed high-spin transition (1 Πu5-1 Πg5) of dicarbon [P. Bornhauser et al., J. Chem. Phys. 142, 094313 (2015)] are explored by applying non-linear double-resonant four-wave mixing and laser-induced fluorescence methods. The deperturbation of the d Πg3, υ = 8 and 1 Πg5, υ = 3 states results in accurate molecular constants for the υ = 3 "dark" quintet state. In addition, the spin-orbit interaction constant is determined and parameters for the upper Swan level d Πg3, υ = 8 are improved. The first excited vibrational state of 1 Πu5 is observed by performing perturbation-assisted intersystem crossing via "gateway" states in the d Πg3, υ=6â¼1 Πg5,υ= 0 system. The rotationally resolved spectra yield 11 transitions to 1 Πu5, υ = 1 that include four spin-substates. Data reduction results in accurate molecular constants of this vibrational level in the shallow potential energy surface of this state. Finally, υ = 1 and 2 of the lower quintet state (1 Πg5) are measured by performing perturbation-assisted double-resonant excitation to the 1 Πu5, υ = 0 state and observing dispersed fluorescence. The obtained molecular constants are compared with high level ab initio computations at the multi-reference configuration interaction (MRCI) level of theory by using a large correlation consistent basis set or, alternatively, by applying the computationally less demanding method of explicitly correlated multi-reference configuration interaction (MRCI-F12). The spectroscopic accuracy of both methods is evaluated by comparison with the experimental findings.
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BACKGROUND: Cervical dystonia (CD) is characterized by involuntary muscle contractions causing abnormal postures and/or twisting movements of the head and neck. These motor symptoms can have a major impact on disability. Treatment with botulinum toxin injections aims to reduce motor symptoms, and therefore disability. Despite motor improvements, many patients still experience difficulties with performing daily life activities. To optimize treatment, other factors that determine disability should be identified. OBJECTIVE: To explore and identify clinical characteristics that relate to disability in CD. METHODS: Data on disability, severity of dystonia, anxiety, depression, pain and quality of life of 96 CD patients was analyzed with a principal component analysis (PCA). Multiple regression analysis was performed to determine which components derived from the PCA explain most of the variance in disability. RESULTS: PCA revealed five components (disability, psychiatric features, pain, physical function and severity of dystonia), explaining 74.4% of the variance in disability. Multivariate association between disability and the other components was statistically significant (R2 change 0.433, F change (4-86) = 22.39, p = .000). Psychiatric features had the largest contribution to disability (standardized beta = 0.555, p = 0.000) followed by pain (standardized beta = 0.232 p = 0.004). Physical functioning (standardized beta = 0.059 p = 0.507) and severity of dystonia (standardized beta = -0.001 p = 0.991) had no significant contribution. CONCLUSIONS: In CD patients, psychiatric features and pain are important determinants of disability. Interventions to reduce psychiatric problems and pain should have a more prominent role in the treatment of CD patients in order to improve disability levels.
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Evaluación de la Discapacidad , Personas con Discapacidad , Tortícolis/fisiopatología , Tortícolis/psicología , Adulto , Anciano , Toxinas Botulínicas/uso terapéutico , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos del Humor/etiología , Neurotoxinas/uso terapéutico , Evaluación de Resultado en la Atención de Salud , Dolor/tratamiento farmacológico , Dolor/etiología , Análisis de Componente Principal , Escalas de Valoración Psiquiátrica , Calidad de Vida , Estudios Retrospectivos , Tortícolis/tratamiento farmacológico , Adulto JovenRESUMEN
This study used simulation to evaluate the performance of alternative selection index configurations in the context of a breeding programme where a trait with a non-linear economic value is approaching an economic optimum. The simulation used a simple population structure that approximately mimics selection in dual purpose sheep flocks in New Zealand (NZ). In the NZ dual purpose sheep population, number of lambs born is a genetic trait that is approaching an economic optimum, while genetically correlated growth traits have linear economic values and are not approaching any optimum. The predominant view among theoretical livestock geneticists is that the optimal approach to select for nonlinear profit traits is to use a linear selection index and to update it regularly. However, there are some nonlinear index approaches that have not been evaluated. This study assessed the efficiency of the following four alternative selection index approaches in terms of genetic progress relative to each other: (i) a linear index, (ii) a linear index updated regularly, (iii) a nonlinear (quadratic) index, and (iv) a NLF index (nonlinear index below the optimum and then flat). The NLF approach does not reward or penalize animals for additional genetic merit beyond the trait optimum. It was found to be at least comparable in efficiency to the approach of regularly updating the linear index with short (15 year) and long (30 year) time frames. The relative efficiency of this approach was slightly reduced when the current average value of the nonlinear trait was close to the optimum. Finally, practical issues of industry application of indexes are considered and some potential practical benefits of efficient deployment of a NLF index in highly heterogeneous industries (breeds, flocks and production environments) such as in the NZ dual purpose sheep population are discussed.