Multivariate analysis of the Fugl-Meyer outcome measures assessing the effectiveness of GENTLE/S robot-mediated stroke therapy

Background: Robot-mediated therapies offer entirely new approaches to neurorehabilitation. In this paper we present the results obtained from trialling the GENTLE/S neurorehabilitation system assessed using the upper limb section of the Fugl-Meyer ( FM) outcome measure. Methods: We demonstrate the design of our clinical trial and its results analysed using a novel statistical approach based on a multivariate analytical model. This paper provides the rational for using multivariate models in robot-mediated clinical trials and draws conclusions from the clinical data gathered during the GENTLE/S study. Results: The FM outcome measures recorded during the baseline ( 8 sessions), robot-mediated therapy ( 9 sessions) and sling-suspension ( 9 sessions) was analysed using a multiple regression model. The results indicate positive but modest recovery trends favouring both interventions used in GENTLE/S clinical trial. The modest recovery shown occurred at a time late after stroke when changes are not clinically anticipated. Conclusion: This study has applied a new method for analysing clinical data obtained from rehabilitation robotics studies. While the data obtained during the clinical trial is of multivariate nature, having multipoint and progressive nature, the multiple regression model used showed great potential for drawing conclusions from this study. An important conclusion to draw from this paper is that this study has shown that the intervention and control phase both caused changes over a period of 9 sessions in comparison to the baseline. This might indicate that use of new challenging and motivational therapies can influence the outcome of therapies at a point when clinical changes are not expected. Further work is required to investigate the effects arising from early intervention, longer exposure and intensity of the therapies. Finally, more function-oriented robot-mediated therapies or sling-suspension therapies are needed to clarify the effects resulting from each intervention for stroke recovery.

Rejoinder to 'Performance of different synchronisation measures in real data: A case study on electroencephalograhic signals

We agree with Duckrow and Albano [Phys. Rev. E 67, 063901 (2003)] and Quian Quiroga et al. [Phys. Rev. E 67, 063902 (2003)] that mutual information (MI) is a useful measure of dependence for electroencephalogram (EEG) data, but we show that the improvement seen in the performance of MI on extracting dependence trends from EEG is more dependent on the type of MI estimator rather than any embedding technique used. In an independent study we conducted in search for an optimal MI estimator, and in particular for EEG applications, we examined the performance of a number of MI estimators on the data set used by Quian Quiroga et al. in their original study, where the performance of different dependence measures on real data was investigated [Phys. Rev. E 65, 041903 (2002)]. We show that for EEG applications the best performance among the investigated estimators is achieved by k-nearest neighbors, which supports the conjecture by Quian Quiroga et al. in Phys. Rev. E 67, 063902 (2003) that the nearest neighbor estimator is the most precise method for estimating MI.

Comment on "Performance of different synchronization measures in real data: A case study on electroencephalographic signals"

We agree with Duckrow and Albano [Phys. Rev. E 67, 063901 (2003)] and Quian Quiroga [Phys. Rev. E 67, 063902 (2003)] that mutual information (MI) is a useful measure of dependence for electroencephalogram (EEG) data, but we show that the improvement seen in the performance of MI on extracting dependence trends from EEG is more dependent on the type of MI estimator rather than any embedding technique used. In an independent study we conducted in search for an optimal MI estimator, and in particular for EEG applications, we examined the performance of a number of MI estimators on the data set used by Quian Quiroga in their original study, where the performance of different dependence measures on real data was investigated [Phys. Rev. E 65, 041903 (2002)]. We show that for EEG applications the best performance among the investigated estimators is achieved by k-nearest neighbors, which supports the conjecture by Quian Quiroga in Phys. Rev. E 67, 063902 (2003) that the nearest neighbor estimator is the most precise method for estimating MI.

Long chain n-3 PUFA-rich meal reduced postprandial measures of arterial stiffness

Background & aims The consumption of long chain n − 3 polyunsaturated fatty acids (LC n − 3 PUFA) is known to be cardio-protective. Data on the influence of LC n − 3 PUFA on arterial stiffness in the postprandial state is limited. The aim of this study was to investigate the acute effects of a LC n − 3 PUFA-rich meal on measures of arterial stiffness. Methods Twenty-five healthy subjects (12 men, 13 women) received a control and a LC n − 3 PUFA-rich meal on two occasions in a random order. Arterial stiffness was measured at baseline, 30, 60, 90, 120, 180 and 240 min after meal consumption by pulse wave analysis and digital volume pulse to derive an augmentation index and a stiffness index respectively. Blood samples were taken for measurement of lipids, glucose and insulin. Results Consumption of the LC n − 3 PUFA-rich meal had an attenuating effect on augmentation index (P = 0.02) and stiffness index (P = 0.03) compared with the control meal. A significant treatment effect (P = 0.036) was seen for plasma non-esterified fatty acids concentrations. Conclusions These data indicate that acute LC n − 3 PUFA-rich meal consumption can improve postprandial arterial stiffness. This has important implications for the beneficial properties of LC n − 3 PUFA and cardiovascular risk reduction.

Early identification of stimulant treatment responders, partial responders and non-responders using objective measures in children and adolescents with hyperkinetic disorder

Background: The aim of this study was to evaluate stimulant medication response following a single dose of methylphenidate (MPH) in children and young people with hyperkinetic disorder using infrared motion analysis combined with a continuous performance task (QbTest system) as objective measures. The hypothesis was put forward that a moderate testdose of stimulant medication could determine a robust treatment response, partial response and non-response in relation to activity, attention and impulse control measures. Methods: The study included 44 children and young people between the ages of 7-18 years with a diagnosis of hyperkinetic disorder (F90 & F90.1). A single dose-protocol incorporated the time course effects of both immediate release MPH and extended release MPH (Concerta XL, Equasym XL) to determine comparable peak efficacy periods post intake. Results: A robust treatment response with objective measures reverting to the population mean was found in 37 participants (84%). Three participants (7%) demonstrated a partial response to MPH and four participants (9%) were determined as non-responders due to deteriorating activity measures together with no improvements in attention and impulse control measures. Conclusion: Objective measures provide early into prescribing the opportunity to measure treatment response and monitor adverse reactions to stimulant medication. Most treatment responders demonstrated an effective response to MPH on a moderate testdose facilitating a swift and more optimal titration process.

Multiple diversity measures to identify complementary conservation areas for the Baja California peninsular cacti

The Baja California Peninsula is home to 85 species of cacti, of which 54 are endemic, highlighting its importance as a cactus diverse region within Mexico. Many species are under threat due to collection pressure and habitat loss, but ensuring maximal protection of cacti species requires a better understanding of diversity patterns. We assessed species richness, endemism, and phylogenetic and morphological diversity using herbarium records and a molecular phylogeny for 82 species of cacti found in the peninsula. The four diversity measures were estimated for the existing nature reserve network and for 314 hexagrids of 726 km2. Using the hexagrid data, we surveyed our results for areas that best complement the current protected cacti diversity in the Baja California Peninsula. Currently, the natural reserve network in Baja shelters an important amount of the cacti diversity (74% of the species, 85.9% of the phylogenetic diversity, 76% of endemics and all the growth forms). While species richness produced several solutions to complement the diversity protected, by identifying priority species (endemic species with high contribution to overall PD) one best solution is reported. Three areas (San Matías, Magdalena and Margarita Islands and El Triunfo), selected using species richness, PD and endemism, best complement the diversity currently protected, increasing species richness to 89%, PD to 94% and endemism to 89%, and should be considered in future conservation plans. Two of these areas could be included within nature reserves already established.

Corporate social performance and stock returns: UK evidence from disaggregate measures

This study examines the relation between corporate social performance and stock returns in the UK. We closely evaluate the interactions between social and financial performance with a set of disaggregated social performance indicators for environment, employment, and community activities instead of using an aggregate measure. While scores on a composite social performance indicator are negatively related to stock returns, we find the poor financial reward offered by such firms is attributable to their good social performance on the environment and, to a lesser extent, the community aspects. Considerable abnormal returns are available from holding a portfolio of the socially least desirable stocks. These relationships between social and financial performance can be rationalized by multi-factor models for explaining the cross-sectional variation in returns, but not by industry effects.

Different risk measures: different portfolio compositions?

Traditionally, the measure of risk used in portfolio optimisation models is the variance. However, alternative measures of risk have many theoretical and practical advantages and it is peculiar therefore that they are not used more frequently. This may be because of the difficulty in deciding which measure of risk is best and any attempt to compare different risk measures may be a futile exercise until a common risk measure can be identified. To overcome this, another approach is considered, comparing the portfolio holdings produced by different risk measures, rather than the risk return trade-off. In this way we can see whether the risk measures used produce asset allocations that are essentially the same or very different. The results indicate that the portfolio compositions produced by different risk measures vary quite markedly from measure to measure. These findings have a practical consequence for the investor or fund manager because they suggest that the choice of model depends very much on the individual’s attitude to risk rather than any theoretical and/or practical advantages of one model over another.