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Background and Objectives: Decreased or loss of ABO blood group antigen expression has been observed in acute myeloid leukaemia (AML) patients. We studied the clinical significance of this group in AML patients. Materials and Methods: This was a retrospective, single‐centre cohort study in which the data were retrieved from April 2009 to December 2019. A total of 1592 AML patients with normal ABO blood group antigen (Group I) and 65 patients of decreased or loss of ABO blood group antigen (Group II) group were enrolled. Data were collected at the time of initial admission for pathological diagnosis. To interrogate the underlying mechanism, publicly available The Cancer Genome Atlas AML data were downloaded. Results: Group II consisted of 3.9% (65/1657) of AML patients. The 90‐day survival (D90) probability was higher for Group II with a mean survival of 86.4 days compared to 80.6 days for Group I (p = 0.047). Group II had higher haematocrit (28.6 vs. 27.4%) and lower d‐dimer, fibrinogen degradation production and C‐reactive protein. Publicly available data revealed that among 11 CpG methylation sites within the ABO gene, 4 sites with elevated methylation level were associated with improved D90 survival probability and demonstrated an inverse correlation with ABO gene expression. Lower expression of the ABO gene showed improved survival trends for D90 (p = 0.058) and 180‐day survival (p = 0.072). Conclusion: AML with decreased expression or loss of ABO blood group showed better early survival during D90. Transfusion support for this subgroup of AML patients should be meticulously performed considering serum typing. [ABSTRACT FROM AUTHOR]

Background: The association between leukapheresis (LK) as a treatment option for hyperleukocytosis (HL) in patients with acute myeloid leukemia (AML) remains controversial. Methods: Data were extracted from the electronic medical record for 2801 patients with AML between April 2009 and December 2019. LK was performed when the leukocyte count was ≥100 × 109/L at the time initial bone marrow examination. Results: A comparison between the patients with HL in the non‐LK (n = 1579) and LK (n = 208) groups revealed survival probabilities (%) of 93.2% and 90.4% (P =.130) for day 30 (D30), 85.4% and 84.2% (P =.196) for D60, and 83.6% and 80.8% (P =.258) for D90, respectively. After propensity score matching, a comparison between the patients with HL in the non‐LK (n = 192) and LK (n = 192) groups revealed survival probabilities (%) of 83.9% and 91.2% (P =.030) for D30, 75.0% and 84.9% (P =.015) for day 60 (D60), and 62.4% and 81.3% (P =.034) for day 90 (D90), respectively. After D150, the observed effect of LK appeared to be mitigated without a survival benefit. Discussion: LK was associated with improved early survival outcomes at D30, D60, and D90 among patients with AML exhibiting HL. Thus, it may be considered a treatment option for reducing cell mass in such patients. [ABSTRACT FROM AUTHOR]

Acute myeloid leukemia (AML) is a clinical emergency requiring treatment and results in high 30-day (D30) mortality. In this study, the prediction of D30 survival was studied using a machine learning (ML) method. The total cohort consisted of 1700 survivors and 130 non-survivors at D30. Eight clinical and 42 laboratory variables were collected at the time of diagnosis by pathology. Among them, six variables were selected by a feature selection method: induction chemotherapy (CTx), hemorrhage, infection, C-reactive protein, blood urea nitrogen, and lactate dehydrogenase. Clinical and laboratory data were entered into the training model for D30 survival prediction, followed by testing. Among the tested ML algorithms, the decision tree (DT) algorithm showed higher accuracy, the highest sensitivity, and specificity values (95% CI) of 90.6% (0.918–0.951), 70.4% (0.885–0.924), and 92.1% (0.885–0.924), respectively. DT classified patients into eight specific groups with distinct features. Group 1 with CTx showed a favorable outcome with a survival rate of 97.8% (1469/1502). Group 6, with hemorrhage and the lowest fibrinogen level at diagnosis, showed the worst survival rate of 45.5% (25/55) and 20.5 days. Prediction of D30 survival among AML patients by classification of patients with DT showed distinct features that might support clinical decision-making. [ABSTRACT FROM AUTHOR]

Introduction/Aims: Neuralgic amyotrophy (NA) is a multifocal neuropathy involving the nerves of the upper extremity, limiting functional capability and reducing range of motion. The reachable workspace (RWS) is a computerized three‐dimensinal analysis system that evaluates the relative surface area (RSA) of an individual's arm reachability and has shown utility in several neuromuscular disorders. The aims of this study were to examine the ability of the RWS to quantitatively detect limitations in upper extremity active range of motion in patients with NA, and correlate these with other upper extremity functional outcome measures. Methods: Forty‐seven patients with NA and 25 healthy age‐ and sex‐matched controls were measured with the RWS. Study participants' RSAs were correlated with scores on the Shoulder Rating Questionnaire (SRQ), the Disabilities of Arm Shoulder and Hand (DASH) questionnaire, and upper extremity strength measurements using hand‐held dynamometry. Results: Patients with NA showed significantly lower values in the affected arm for all quadrants (except for the ipsilateral lower quadrant) and total RSA compared with controls (P < 0.001). We found moderate correlations between the reachable workspace, the DASH questionnaire result (r = −0.415), and serratus anterior muscle strength (r = 0.414). Discussion: RWS is able to detect limitations in active range of motion of the affected arm in patients with NA, and is moderately correlated with upper extremity functional measures. RWS can demonstrate impairment of the affected upper extremity in NA and it has potential as a clinical outcome measure. [ABSTRACT FROM AUTHOR]

The odour emitted from the high-tannin fab bean flour (Vicia faba var. minor), was characterized by headspace solid-phase microextraction/gas chromatography-mass spectrometry (HS-SPME/GC–MS). The relative odour activity value (ROAV) was used to monitor the changes in key volatile compounds in the flour during short-term storage at different temperature conditions. The key flavour compounds of freshly milled flour included hexanal, octanal, nonanal, decanal, 3-methylbutanal, phenyl acetaldehyde, (E)-2-nonenal, 1-hexanol, phenyl ethyl alcohol, 1-octen-3-ol, β-linalool, acetic acid, octanoic acid, and 3-methylbutyric acid; these are oxidative degradation products of unsaturated fatty acids and amino acids. Despite the low lipid content of faba beans, the abundances of aldehydes arising during room temperature storage greatly contributed to the flavour of the flour due to their very low odour thresholds. Two of the key volatiles responsible for beany flavour in flour (hexanal, nonanal) increased greatly after 2 weeks of storage at room temperature or under refrigerated conditions. These volatile oxidation products may arise as a result of enzymatic activity on unsaturated fatty acids, and was seen to be arrested by freezing the flour. [ABSTRACT FROM AUTHOR]

Background: Sleep is an important component of neurorehabilitation. This study evaluates sleep quality in the acute inpatient rehabilitation setting and is the first to compare sleep quality in acute rehabilitation versus the acute care hospital and home settings. Objective: To assess patient sleep quality in the acute inpatient rehabilitation setting. Design Cross‐sectional survey study. Setting: Acute inpatient rehabilitation unit. Patients Seventy‐three patients admitted to the acute rehabilitation unit participated in the study. Interventions: A validated sleep questionnaire was provided on admission regarding sleep at home and in the acute care hospital. The questionnaire was repeated on discharge from the acute rehabilitation unit regarding sleep during their rehabilitation admission. Main Outcome Measures: Visual analog scale of sleep depth, falling asleep, number of awakenings, percentage of time awake, and quality of sleep were obtained through use of the Richards‐Campbell Sleep Questionnaire. These values were averaged to obtain "overall sleep perception." An additional question on environmental noise was added. Scores ranged from 0 for "worst sleep possible" to 100 for "best sleep possible." Results: Patients reported significantly better sleep in all domains and overall in the acute rehabilitation unit compared to the acute care hospital, with the exception of percentage of time awake. Patients also reported significantly better sleep depth but worse noise in the acute rehabilitation unit when compared to home. Similarly, patients reported significantly better sleep in all domains and overall at home in comparison to the acute care hospital with the exception of percentage of time awake. Conclusions: Patient in the acute rehabilitation unit experience sleep quality that matches their experience at home and exceeds that in the hospital. [ABSTRACT FROM AUTHOR]

Background: This study examines the correlation, and clinical meaningfulness, between reachable workspace outcome and reported activities of daily living (ADL) function of individuals with facioscapulohumeral dystrophy (FSHD). Methods: Twenty‐one FSHD subjects with various disease severity (clinical severity scores 1‐4) underwent reachable workspace evaluation and completed the Quality of Life in Neurological Disorders (NeuroQoL) upper extremity questionnaire. Spearman and receiver operator curve analyses were performed. Results: Moderate correlation was found between NeuroQoL scores and total (ρ = 0.7609; P <.01), and upper‐quadrants relative surface areas (RSAs) (ρ = 0.6969; P <.01). Five specific items (ie, shirt on, shirt off, use spoon, pull on pants, pick‐up clothes) demonstrated even higher correlations with total (ρ = 0.8397; P <.01) and above shoulder (ρ = 0.8082; P <.01) RSAs. A total RSA cuffoff value of 0.70 would achieve 100% sensitivity and 94% specificity (area under the curve = 0.975). Conclusions: Reachable workspace values identify when individuals have difficulties performing ADLs at home. This information improves patient monitoring, and clinical decision making by enabling more timely recommendations for medications, assistive devices, or considerations for clinical trial enrollments. [ABSTRACT FROM AUTHOR]

There are a lack of quantitative measures for clinically assessing upper limb function. Conventional biomechanical performance measures are restricted to specialist labs due to hardware cost and complexity, while the resulting measurements require specialists for analysis. Depth cameras are low cost and portable systems that can track surrogate joint positions. However, these motions may not be biologically consistent, which can result in noisy, inaccurate movements. This paper introduces a rigid body modelling method to enforce biological feasibility of the recovered motions. This method is evaluated on an existing depth camera assessment: the reachable workspace (RW) measure for assessing gross shoulder function. As a rigid body model is used, position estimates of new proximal targets can be added, resulting in a proximal function (PF) measure for assessing a subject's ability to touch specific body landmarks. The accuracy, and repeatability of these measures is assessed on ten asymptomatic subjects, with and without rigid body constraints. This analysis is performed both on a low-cost depth camera system and a gold-standard active motion capture system. The addition of rigid body constraints was found to improve accuracy and concordance of the depth camera system, particularly in lateral reaching movements. Both RW and PF measures were found to be feasible candidates for clinical assessment, with future analysis needed to determine their ability to detect changes within specific patient populations. [ABSTRACT FROM AUTHOR]

Purpose: Recently, the utility of the Kinect sensor-based reachable workspace analysis system for measuring upper extremity outcomes of neuromuscular and musculoskeletal diseases has been demonstrated. Here, we investigated its usefulness for assessing upper extremity dysfunction in breast cancer patients.Methods: Twenty unilateral breast cancer patients were enrolled. Upper extremity active range of motion was captured by the Kinect sensor, and reachable workspace relative surface areas (RSAs) were obtained. The QuickDASH was completed to assess upper extremity disability. General and breast cancer-specific quality of life (QOL) were assessed by the EORTC QLQ-C30 and EORTC QLQ-BR23.Results: The total RSA ratio of the affected and unaffected sides ranges from 0.64 to 1.11. Total RSA was significantly reduced on the affected versus unaffected side (0.659 ± 0.105 vs. 0.762 ± 0.065; p = 0.001). Quadrant 1 and 3 RSAs were significantly reduced (0.135 ± 0.039 vs. 0.183 ± 0.040, p < 0.001; 0.172 ± 0.058 vs. 0.217 ± 0.031, p = 0.006). Total RSA of the affected side was strongly correlated with the numeric pain rating scale during movement (r = - 0.812, p < 0.001) and moderately with the QuickDASH (r = - 0.494, p = 0.027). Further, quadrant 3 RSA was correlated with EORTC QLQ-C30 role functioning (r = 0.576, p = 0.008) and EORTC QLQ-BR23 arm symptoms (r = - 0.588, p = 0.006) scales.Conclusions: The Kinect sensor-based reachable workspace analysis system was effectively applied to assess upper extremity dysfunction in breast cancer patients. This system could potentially serve as a quick and simple outcome measure that provides quantitative data for breast cancer patients. [ABSTRACT FROM AUTHOR]

The proximate composition, digestibility, and functional properties of micronized, pre-germinated, and untreated yellow pea flours were investigated. The three flours had comparable proximate composition. Foaming capacity and solubility at pH 7 were lower in the treated flours compared with the untreated flours. Water holding capacity (WHC) and fat absorption capacity (FAC) were both improved in the micronized flour and only FAC in the pre-germinated flour. The degree of hydrolysis of the flours pre-hydrolyzed with bromelain, trypsin, or papain ranged between 8.89 and 19.80%. Pre-hydrolysis resulted in partial reduction in the molecular weight (MW) of the proteins and extensive reduction after in vitro protein digestion. The hydrolysates had lower trypsin inhibitor and higher total phenol and phytic acid contents than the flours. Practical applications The use of yellow pea and other pulses is hampered by their low protein digestibility due to the presence of anti-nutritional factors and protein complexation with carbohydrates. Milder processing techniques have become attractive alternative to overcome these attributes. The results from this study suggest that micronization, pre-germination, and/or pre-hydrolysis can be conveniently used to modify the nutritional and functional properties and bioactive potential of yellow pea flours. This could markedly influence value, diversify use, and competitiveness of yellow pea. [ABSTRACT FROM AUTHOR]

Replacement of animal proteins could be interesting for the food industry because it allows long-term cost savings, among other reasons. Replacing egg/milk protein (50-100 wt%) by lentil protein ( LP) was evaluated on angel cake/muffin quality. The replacement did not significantly affect final product volume, neither the muffins nor the angel food cakes. LP did not affect dough formation and contributed to hold crumb structure building an entangled network in both cake products. In addition, angel cakes and muffins containing LP had significantly lower baking loss than the control. Inferior quality for angel cakes and muffins containing LP was observed regarding hardness and chewiness that increased upon storage, compared to the control. For sensory evaluation in angel cakes, appearance of LP formulations showed lower scores than the control, likely due to the change of crumb colour. Other attributes were not significantly impacted by LP presence. For muffins, M-100- LPC formulation showed significant differences with the control for most of the attributes, except appearance and flavour. Indeed, consumers preferred muffins with 100% egg/milk protein replacement, which received higher acceptability scores than control. They also appreciated the 'nutty' flavour and moisture of angel cake with 50% egg protein replacement. This research suggests that lentil protein can totally or partially substitute egg/milk protein as foam and emulsion stabiliser in cakes, producing products with satisfactory quality. [ABSTRACT FROM AUTHOR]

Using an in vitro model of ischemic stroke we treated differentiated SH-SY5Y cells to oxygen-glucose deprivation (OGD) followed by a reperfusion period where normal growth conditions were restored. Cells undergoing OGD exhibited significant cell death as measure by propidium iodide staining. However, cells treated with exogenous extracellular DJ-1 during reperfusion exhibited significant rescue from OGD-induced cell death. [ABSTRACT FROM AUTHOR]

Our objective was to evaluate longitudinal changes in Microsoft Kinect measured upper extremity reachable workspace relative surface area (RSA) versus the revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R), ALSFRS-R upper extremity sub-scale and Forced Vital Capacity (FVC) in a cohort of patients diagnosed with amyotrophic lateral sclerosis (ALS). Ten patients diagnosed with ALS (ages 52–76 years, ALSFRS-R: 8–41 at entry) were tested using single 3D depth sensor, Microsoft Kinect, to measure reachable workspace RSA across five visits spanning one year. Changes in RSA, ALSFRS-R, ALSFRS-R upper extremity sub-scale, and FVC were assessed using a linear mixed model. Results showed that upper lateral quadrant RSA declined significantly in one year by approximately 19% (p <0.01) while all other quadrants and total RSA did not change significantly in this time-period. Simultaneously, ALSFRS-R upper extremity sub-scale worsened significantly by 25% (p <0.01). In conclusion, upper extremity reachable workspace RSA as a novel ALS outcome measure is capable of objectively quantifying declines in upper extremity ability over time in patients with ALS with more granularity than other common outcome measures. RSA may serve as a clinical endpoint for the evaluation of upper extremity targeted therapeutics. [ABSTRACT FROM AUTHOR]

Introduction: The Kinect-based reachable workspace relative surface area (RSA) is compared with the performance of upper limb (PUL) assessment in Duchenne muscular dystrophy (DMD).Methods: 29 individuals with DMD (ages: 7-23; Brooke: 1-5) underwent both Kinect-based reachable workspace RSA and PUL assessments. RSAs were also collected from 24 age-matched controls. Total and quadrant RSAs were compared with the PUL total, shoulder-, middle-, and distal-dimension scores.Results: The total reachable workspace RSA correlated well with the total PUL score (Spearman ρ = -0.602; P < 0.001), and with each of the PUL dimensional scores: shoulder (ρ = -0.624; P < 0.001), middle (ρ = -0.564; P = 0.001), and distal (ρ = -0.630; P < 0.001). With quadrant RSA, reachability in a particular quadrant was closely associated with respective PUL dimensional-level function (lateral-upper quadrant for shoulder-, lateral-upper/lower quadrants for middle-, and lateral-lower quadrant for distal-level function).Conclusions: This study demonstrates concurrent validity of the reachable workspace outcome measure (RSA) with the DMD-specific upper extremity outcome measure (PUL). [ABSTRACT FROM AUTHOR]

Introduction: Reachable workspace is a measure that provides clinically meaningful information regarding arm function. In this study, a Kinect sensor was used to determine the spectrum of 3-dimensional reachable workspace encountered in a cross-sectional cohort of individuals with amyotrophic lateral sclerosis (ALS).Methods: Bilateral 3D reachable workspace was recorded from 10 subjects with ALS and 17 healthy controls. The data were normalized by each individual's arm length to obtain a reachable workspace relative surface area (RSA). Concurrent validity was assessed by correlation with scoring on the ALS Functional Rating Score-revised (ALSFRSr).Results: The Kinect-measured reachable workspace RSA differed significantly between the ALS and control subjects (0.579 ± 0.226 vs. 0.786 ± 0.069; P < 0.001). The RSA demonstrated correlation with ALSFRSr upper extremity items (Spearman correlation ρ = 0.569; P = 0.009). With worsening upper extremity function, as categorized by the ALSFRSr, the reachable workspace also decreased progressively.Conclusions: This study demonstrates the feasibility and potential of using a novel Kinect-based reachable workspace outcome measure in ALS. [ABSTRACT FROM AUTHOR]

Introduction: It is not known whether a reduction in reachable workspace closely reflects loss of upper extremity strength in facioscapulohumeral muscular dystrophy (FSHD). In this study we aimed to determine the relationship between reachable workspace and quantitative upper extremity strength measures.Methods: Maximal voluntary isometric contraction (MVIC) testing of bilateral elbow flexion and shoulder abduction by hand-held dynamometry was performed on 26 FSHD and 27 control subjects. In addition, Kinect sensor-based 3D reachable workspace relative surface areas (RSAs) were obtained. Loading (500-g weight) effects on reachable workspace were also evaluated.Results: Quantitative upper extremity strength (MVIC of elbow flexion and shoulder abduction) correlated with Kinect-acquired reachable workspace RSA (R = 0.477 for FSHD, P = 0.0003; R = 0.675 for the combined study cohort, P < 0.0001). Progressive reduction in RSA reflected worsening MVIC measures. Loading impacted the moderately weak individuals the most with additional reductions in RSA.Conclusions: Reachable workspace outcome measure is reflective of upper extremity strength impairment in FSHD. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction: An innovative upper extremity 3-dimensional (3D) reachable workspace outcome measure acquired using the Kinect sensor is applied toward Duchenne/Becker muscular dystrophy (DMD/BMD). The validity, sensitivity, and clinical meaningfulness of this novel outcome measure are examined. Methods: Upper extremity function assessment (Brooke scale and NeuroQOL questionnaire) and Kinect-based reachable workspace analyses were conducted in 43 individuals with dystrophinopathy (30 DMD and 13 BMD, aged 7-60 years) and 46 controls (aged 6-68 years). Results: The reachable workspace measure reliably captured a wide range of upper extremity impairments encountered in both pediatric and adult, as well as ambulatory and non-ambulatory individuals with dystrophinopathy. Reduced reachable workspaces were noted for the dystrophinopathy cohort compared with controls, and they correlated with Brooke grades. In addition, progressive reduction in reachable workspace correlated directly with worsening ability to perform activities of daily living, as self-reported on the NeuroQOL. Conclusion: This study demonstrates the utility and potential of the novel sensor-acquired reachable workspace outcome measure in dystrophinopathy. Muscle Nerve 52:344-355, 2015 [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction: A depth-ranging sensor (Kinect) based upper extremity motion analysis system was applied to determine the spectrum of reachable workspace encountered in facioscapulohumeral muscular dystrophy (FSHD). Methods: Reachable workspaces were obtained from 22 individuals with FSHD and 24 age- and height-matched healthy controls. To allow comparison, total and quadrant reachable workspace relative surface areas (RSAs) were obtained by normalizing the acquired reachable workspace by each individual's arm length. Results: Significantly contracted reachable workspace and reduced RSAs were noted for the FSHD cohort compared with controls (0.473 ± 0.188 vs. 0.747 ± 0.082; P < 0.0001). With worsening upper extremity function as categorized by the FSHD evaluation subscale II + III, the upper quadrant RSAs decreased progressively, while the lower quadrant RSAs were relatively preserved. There were no side-to-side differences in reachable workspace based on hand-dominance. Conclusions: This study demonstrates the feasibility and potential of using an innovative Kinect-based reachable workspace outcome measure in FSHD. Muscle Nerve 51: 168-175, 2015 [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate cerebrovascular reactivity (CVR) of major arterial vascular territories, particularly in the contralateral hemodynamically unaffected hemisphere, in patients with unilateral internal carotid artery (ICA) steno-occlusive disease compared to control subjects with risk factors for cerebrovascular disease. Methods: In this retrospective observational study, twenty-seven patients with right-sided unilateral ICA steno-occlusive disease (age range, 25 to 91 years; 17 males) and twenty-one patients with left-sided unilateral ICA steno-occlusive disease (age range, 24 to 83 years; 14 males) and 41 control subjects were studied. CVR was quantitated as the change in blood oxygen level dependent (BOLD) MRI signal (as a surrogate of cerebral blood flow), in response to a consistently applied step change in the arterial partial pressure of carbon dioxide (PaCO2). The CVR of each major arterial vascular territory was assessed in the ipsilateral hemodynamically affected hemisphere and compared to the corresponding territory in the contralateral hemisphere. Results: In patients, a significant reduction in CVR was observed in the ipsilateral anterior circulation compared to that of the corresponding territory on the contralateral side (0.027 ± 0.083 vs. 0.109 ± 0.066% BOLD change/ mm Hg, p < 0.0001) and to controls (0.195 ± 0.054% BOLD change/mm Hg, p < 0.0001). The CVR of the contralateral anterior circulation was reduced on average by 50% compared to controls (p < 0.0001). Conclusions: The implication of these findings is that unilateral carotid stenosis affects the vascular reserve of both sides of the brain compared to control subjects. This indicates that the collateral blood flow support from the contralateral to the ipsilateral hemisphere comes at a cost of reduced reserve capacity in the contralateral hemisphere. The findings suggest that there may be a reduction in functional hyperemia associated with neuronal activation, not only affecting the hemisphere ipsilateral to an occlusion, but also the hemisphere contralateral to an occlusion. It remains to be determined if 'stealing' from the 'rich' to support the 'poor' has clinical consequences over the long term. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Currently no biological or radiological marker is available to identify patients at risk of delayed ischemic deficit (DIND) after aneurysmal subarachnoid hemorrhage (aSAH). We hypothesized whether MR-based quantitative assessment of cerebrovascular reserve (CVR) would detect early radiological markers of vasospasm and DIND. This manuscript describes our initial experience with this population. Five patients with aSAH underwent blood-oxygen level dependent-MRI (BOLD-MRI) with CO2 challenge for assessment of whole brain CVR. Patients were examined as soon as possible after aneurysm treatment. We obtained good quality anatomical and functional images without complications. Initial anatomical cerebrovascular imaging showed no vasospasm in all patients. Two patients had abnormal CVR-MRI tests and both developed DIND. Of the 3 others with normal CVR-MRI, one developed posterior circulation DIND. One patient with a normal CVR-MRI developed angiographic vasospasm but no DIND. Changes in CVR maps as early as 36 h after hemorrhage had good spatial correlation with delayed ischemia during short-term follow-up. Our series shows that MRI with CO2 challenge is feasible in this difficult population. Further developments might allow BOLD-MRI with CO2 challenge to identify patients at risk and provide anatomical correlation with future DIND, opening a new venue for prophylactic treatments. Further study is warranted in a larger patient cohort. J. Magn. Reson. Imaging 2014;40:972-979. © 2013 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Background Fibre intake among North Americans is currently less than half the recommended amount. Consumers are interested in food products that could promote weight loss and improve health. Consequently, evaluation of unique fibre sources with potential gut-mediated benefits for metabolic health warrants investigation. Our objective is to assess the effects of yellow pea fibre supplementation on weight loss and gut microbiota in an overweight and obese adult population. Methods/design In a double blind, placebo controlled, parallel group study, overweight and obese (BMI = 25- 38) adults will be randomized to either a 15 g/d yellow pea fibre supplemented group or isocaloric placebo group for 12 weeks (n = 30/group). The primary outcome measure is a change in body fat from baseline to 12 weeks. Secondary outcomes include glucose tolerance, appetite regulation, serum lipids and inflammatory markers. Anthropometric data (height, weight, BMI, and waist circumference) and food intake (by 3-day weighed food records) will be measured at baseline and every 4 weeks thereafter. Subjective ratings of appetite will be recorded by participants at home on a weekly basis using validated visual analogue scales. At week 0 and at the end of the study (week 12), an ad libitum lunch buffet protocol for objective food intake measures and dual-energy X-ray absorptiometry (DXA) scan for body composition will be completed. Participants will be instructed not to change their exercise habits during the 12 week study. Glucose and insulin will be measured during an oral glucose tolerance test at weeks 0 and 12. Levels of lipids and CRP will be measured and inflammatory markers (adiponectin, leptin, TNF-α, IL-6 and IL-8) in the serum will be quantified using Milliplex kits. Mechanisms related to changes in gut microbiota, serum and fecal water metabolomics will be assessed. Discussion Globally the development of functional foods and functional food ingredients are critically needed to curb the rise in metabolic disease. This project will assess the potential of yellow pea fibre to improve weight control via gut-mediated changes in metabolic health in overweight and obese adults. [ABSTRACT FROM AUTHOR]

We present work-in-progress on framework for 3D Kinect-based remote motion and function assessment. Tele-MFAsT facilities streaming of data (video, depth, skeleton, and audio) from network-connected Microsoft Kinect cameras that can be utilized to observe a patient remotely during function assessment by a physician or therapist, measure motion trajectories, and joint angles, while taking advantage of tele-presence in a 3D virtual environment. The network architecture also allows for integration with wireless sensors in the future. In this paper we describe Tele-MFAsT application for upper-body range of motion measurements. [ABSTRACT FROM AUTHOR]

BACKGROUND: In clinical evaluation of upper extremity, there is a lack of assessment methods that are quantitative, reliable, and informative of the overall functional capability of an individual. OBJECTIVE: We present new methodology for the assessment of upper extremity impairments based on the concept of 3-dimensional reachable workspace using Microsoft Kinect. METHODS: We quantify the reachable workspace by the relative surface area representing the portion of the unit hemi-sphere that is covered by the hand movement. We examine accuracy of joint positions, joint angles, and reachable workspace computation between the Kinect and motion capture system. RESULTS: The results of our analysis in 10 healthy subjects showed that the accuracy of the joint positions was within 66.3 mm for our experimental protocol. We found that the dynamic angle measurements had relatively large deviations (between 9° to 28°). The acquired reachable workspace envelope showed high agreement between the two systems with high repeatability between trials (correlation coefficients between 0.86 and 0.93). CONCLUSIONS: The findings indicate that the proposed Kinect-based 3D reachable workspace analysis provides sufficiently accurate and reliable results as compared to motion capture system. The proposed method could be promising for clinical evaluation of upper extremity in neurological or musculoskeletal conditions. [ABSTRACT FROM AUTHOR]

ABSTRACT Contemporary natural history data in Duchenne muscular dystrophy (DMD) is needed to assess care recommendations and aid in planning future trials. Methods The Cooperative International Neuromuscular Research Group (CINRG) DMD Natural History Study (DMD-NHS) enrolled 340 individuals, aged 2-28 years, with DMD in a longitudinal, observational study at 20 centers. Assessments obtained every 3 months for 1 year, at 18 months, and annually thereafter included: clinical history; anthropometrics; goniometry; manual muscle testing; quantitative muscle strength; timed function tests; pulmonary function; and patient-reported outcomes/health-related quality-of-life instruments. Results Glucocorticoid (GC) use at baseline was 62% present, 14% past, and 24% GC-naive. In those ≥6 years of age, 16% lost ambulation over the first 12 months (mean age 10.8 years). Conclusions Detailed information on the study methodology of the CINRG DMD-NHS lays the groundwork for future analyses of prospective longitudinal natural history data. These data will assist investigators in designing clinical trials of novel therapeutics. Muscle Nerve, 2013 [ABSTRACT FROM AUTHOR]

Unlabelled: Contemporary natural history data in Duchenne muscular dystrophy (DMD) is needed to assess care recommendations and aid in planning future trials.Methods: The Cooperative International Neuromuscular Research Group (CINRG) DMD Natural History Study (DMD-NHS) enrolled 340 individuals, aged 2-28 years, with DMD in a longitudinal, observational study at 20 centers. Assessments obtained every 3 months for 1 year, at 18 months, and annually thereafter included: clinical history; anthropometrics; goniometry; manual muscle testing; quantitative muscle strength; timed function tests; pulmonary function; and patient-reported outcomes/health-related quality-of-life instruments.Results: Glucocorticoid (GC) use at baseline was 62% present, 14% past, and 24% GC-naive. In those ≥6 years of age, 16% lost ambulation over the first 12 months (mean age 10.8 years).Conclusions: Detailed information on the study methodology of the CINRG DMD-NHS lays the groundwork for future analyses of prospective longitudinal natural history data. These data will assist investigators in designing clinical trials of novel therapeutics. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction: Glucocorticoid (GC) therapy in Duchenne muscular dystrophy (DMD) has altered disease progression, necessitating contemporary natural history studies. Methods: The Cooperative Neuromuscular Research Group (CINRG) DMD Natural History Study (DMD-NHS) enrolled 340 DMD males, ages 2-28 years. A comprehensive battery of measures was obtained. Results: A novel composite functional 'milestone' scale scale showed clinically meaningful mobility and upper limb abilities were significantly preserved in GC-treated adolescents/young adults. Manual muscle test (MMT)-based calculations of global strength showed that those patients <10 years of age treated with steroids declined by 0.4±0.39 MMT unit/year, compared with −0.4±0.39 MMT unit/year in historical steroid-naive subjects. Pulmonary function tests (PFTs) were relatively preserved in steroid-treated adolescents. The linearity and magnitude of decline in measures were affected by maturational changes and functional status. Conclusions: In DMD, long-term use of GCs showed reduced strength loss and preserved functional capabilities and PFTs compared with previous natural history studies performed prior to the widespread use of GC therapy. Muscle Nerve, 2013 [ABSTRACT FROM AUTHOR]

We propose a novel low-cost method for quantitative assessment of upper extremity workspace envelope using Microsoft Kinect camera. In clinical environment there are currently no practical and cost-effective methods available to provide arm-function evaluation in three-dimensional space. In this paper we examine the accuracy of the proposed technique for workspace estimation using Kinect in comparison with a motion capture system. The experimental results show that the developed system is capable of capturing the workspace with sufficient accuracy and robustness. [ABSTRACT FROM AUTHOR]

Both hypoxia and carbon dioxide increase cerebral blood flow (CBF), and their effective interaction is currently thought to be additive. Our objective was to test this hypothesis. Eight healthy subjects breathed a series of progressively hypoxic gases at three levels of carbon dioxide. Middle cerebral artery velocity, as an index of CBF; partial pressures of carbon dioxide and oxygen and concentration of oxygen in arterial blood; and mean arterial blood pressure were monitored. The product of middle cerebral artery velocity and arterial concentration of oxygen was used as an index of cerebral oxygen delivery. Two-way repeated measures analyses of variance (rmANOVA) found a significant interaction of carbon dioxide and hypoxia factors for both CBF and cerebral oxygen delivery. Regression models using sigmoidal dependence on carbon dioxide and a rectangular hyperbolic dependence on hypoxia were fitted to the data to illustrate this interaction. We concluded that carbon dioxide and hypoxia act synergistically in their control of CBF so that the delivery of oxygen to the brain is enhanced during hypoxic hypercapnia and, although reduced during normoxic hypocapnia, can be restored to normal levels with progressive hypoxia. [ABSTRACT FROM AUTHOR]

Background: The concept of reachable workspace is closely tied to upper limb joint range of motion and functional capability. Currently, no practical and cost-effective methods are available in clinical and research settings to provide arm- function evaluation using an individual's three-dimensional (3D) reachable workspace. A method to intuitively display and effectively analyze reachable workspace would not only complement traditional upper limb functional assessments, but also provide an innovative approach to quantify and monitor upper limb function. Methodology/Principal Findings: A simple stereo camera-based reachable workspace acquisition system combined with customized 3D workspace analysis algorithm was developed and compared against a sub-millimeter motion capture system. The stereo camera-based system was robust, with minimal loss of data points, and with the average hand trajectory error of about 40 mm, which resulted to ~5% error of the total arm distance. As a proof-of-concept, a pilot study was undertaken with healthy individuals (n = 20) and a select group of patients with various neuromuscular diseases and varying degrees of shoulder girdle weakness (n = 9). The workspace envelope surface areas generated from the 3D hand trajectory captured by the stereo camera were compared. Normalization of acquired reachable workspace surface areas to the surface area of the unit hemi-sphere allowed comparison between subjects. The healthy group's relative surface areas were 0.618±0.09 and 0.552±0.092 (right and left), while the surface areas for the individuals with neuromuscular diseases ranged from 0.03 and 0.09 (the most severely affected individual) to 0.62 and 0.50 (very mildly affected individual). Neuromuscular patients with severe arm weakness demonstrated movement largely limited to the ipsilateral lower quadrant of their reachable workspace. Conclusions/Significance: The findings indicate that the proposed stereo camera-based reachable workspace analysis system is capable of distinguishing individuals with varying degrees of proximal upper limb functional impairments. [ABSTRACT FROM AUTHOR]

Objective: To investigate the efficacy of acupuncture for the treatment of mild to moderate carpal tunnel syndrome (CTS). Design: Prospective, randomized, placebo-controlled, double-blinded study. Setting: Single-center study. Participants: Forty-one acupuncture-naïve adult subjects with mild to moderate CTS enrolled in the study. Thirty-four subjects completed the study. Methods: Clinical diagnosis of CTS was supported by electrodiagnostic findings. Subjects were randomly assigned to either (1) acupuncture (n = 21) or (2) placebo acupuncture (n = 20) with use of Streitberger placebo acupuncture needles. Both groups received weekly sessions of acupuncture for 6 weeks. Wrist braces were provided to both groups to wear at night, and compliance was monitored. Main Outcome Measurements: The primary outcome measurement was subject-reported change in the Carpal Tunnel Self Assessment Questionnaire (CTSAQ) Symptom and Function scales immediately after and at 2 weeks and 3 months after the final treatment. The secondary outcomes included tip and key pinch strength and combined sensory index. Results: Compared with pretreatment baseline values, subjects in the acupuncture group had 0.58 improvement (P = .03) on the CTSAQ Symptom scale score at 3 months after the last treatment, whereas 0.81 improvement (P = .001) was noted in the placebo acupuncture group. No statistically significant difference was found between the groups treated with acupuncture and placebo acupuncture with respect to improvement in CTS symptoms, function, tip/key pinch, or combined sensory index. Conclusions: To our knowledge, this study is the first randomized, placebo-controlled, double-blinded prospective study of traditional acupuncture for CTS. Both the treatment and placebo groups demonstrated improvements from baseline. Acupuncture was not shown to be superior to placebo acupuncture when used in conjunction with bracing for patients with mild to moderate CTS. [ABSTRACT FROM AUTHOR]

Introduction: Pompe disease is a rare, autosomal recessive disorder caused by deficiency of the glycogen-degrading lysosomal enzyme acid alpha-glucosidase. Late-onset Pompe disease is a multisystem condition, with a heterogeneous clinical presentation that mimics other neuromuscular disorders. Methods: Objective is to propose consensus-based treatment and management recommendations for late-onset Pompe disease. Methods: A systematic review of the literature by a panel of specialists with expertise in Pompe disease was undertaken. Conclusions: A multidisciplinary team should be involved to properly treat the pulmonary, neuromuscular, orthopedic, and gastrointestinal elements of late-onset Pompe disease. Presymptomatic patients with subtle objective signs of Pompe disease (and patients symptomatic at diagnosis) should begin treatment with enzyme replacement therapy (ERT) immediately; presymptomatic patients without symptoms or signs should be observed without use of ERT. After 1 year of ERT, patients' condition should be reevaluated to determine whether ERT should be continued. Muscle Nerve, 2012 [ABSTRACT FROM AUTHOR]

We present a real-time algorithm for human pose detection and tracking from vision-based 3D data and its application to tele-rehabilitation in virtual environments. We employ stereo camera(s) to capture 3D avatars of geographically dislocated patient and therapist in real-time, while sending the data remotely and displaying it in a virtual scene. A pose detection and tracking algorithm extracts kinematic parameters from each participant and determines pose similarity. The pose similarity score is used to quantify patient's performance and provide real-time feedback for remote rehabilitation. [ABSTRACT FROM AUTHOR]