ASTRAL-R score predicts non-recanalisation after intravenous thrombolysis in acute ischaemic stroke.

Intravenous thrombolysis (IVT) as treatment in acute ischaemic strokes may be insufficient to achieve recanalisation in certain patients. Predicting probability of non-recanalisation after IVT may have the potential to influence patient selection to more aggressive management strategies. We aimed at deriving and internally validating a predictive score for post-thrombolytic non-recanalisation, using clinical and radiological variables. In thrombolysis registries from four Swiss academic stroke centres (Lausanne, Bern, Basel and Geneva), patients were selected with large arterial occlusion on acute imaging and with repeated arterial assessment at 24 hours. Based on a logistic regression analysis, an integer-based score for each covariate of the fitted multivariate model was generated. Performance of integer-based predictive model was assessed by bootstrapping available data and cross validation (delete-d method). In 599 thrombolysed strokes, five variables were identified as independent predictors of absence of recanalisation: Acute glucose > 7 mmol/l (A), significant extracranial vessel STenosis (ST), decreased Range of visual fields (R), large Arterial occlusion (A) and decreased Level of consciousness (L). All variables were weighted 1, except for (L) which obtained 2 points based on β-coefficients on the logistic scale. ASTRAL-R scores 0, 3 and 6 corresponded to non-recanalisation probabilities of 18, 44 and 74 % respectively. Predictive ability showed AUC of 0.66 (95 %CI, 0.61-0.70) when using bootstrap and 0.66 (0.63-0.68) when using delete-d cross validation. In conclusion, the 5-item ASTRAL-R score moderately predicts non-recanalisation at 24 hours in thrombolysed ischaemic strokes. If its performance can be confirmed by external validation and its clinical usefulness can be proven, the score may influence patient selection for more aggressive revascularisation strategies in routine clinical practice.

Impact of examinees' stereopsis and near visual acuity on laparoscopic virtual reality performance.

PURPOSE: Laparoscopic surgery represents specific challenges, such as the reduction of a three-dimensional anatomic environment to two dimensions. The aim of this study was to investigate the impact of the loss of the third dimension on laparoscopic virtual reality (VR) performance. METHODS: We compared a group of examinees with impaired stereopsis (group 1, n = 28) to a group with accurate stereopsis (group 2, n = 29). The primary outcome was the difference between the mean total score (MTS) of all tasks taken together and the performance in task 3 (eye-hand coordination), which was a priori considered to be the most dependent on intact stereopsis. RESULTS: The MTS and performance in task 3 tended to be slightly, but not significantly, better in group 2 than in group 1 [MTS: -0.12 (95 % CI -0.32, 0.08; p = 0.234); task 3: -0.09 (95 % CI -0.29, 0.11; p = 0.385)]. The difference of MTS between simulated impaired stereopsis between group 2 (by attaching an eye patch on the adominant eye in the 2nd run) and the first run of group 1 was not significant (MTS: p = 0.981; task 3: p = 0.527). CONCLUSION: We were unable to demonstrate an impact of impaired examinees' stereopsis on laparoscopic VR performance. Individuals with accurate stereopsis seem to be able to compensate for the loss of the third dimension in laparoscopic VR simulations.

Efeitos ambientais e genéticos sobre peso, perímetro escrotal e escores de avaliação visual à desmama em bovinos da raça Canchim

Os efeitos de ano e época de nascimento, propriedade, sexo do bezerro, regime alimentar, idade do bezerro e idade da vaca ao parto, os efeitos aditivos direto e materno da raça Charolesa e o efeito de heterose materna entre as raças Charolesa e zebu foram avaliados pelo método dos quadrados míninos sobre características de importância econômica, como peso, perímetro escrotal e escores visuais de conformação frigorífica, de umbigo e de pelame à desmama em bovinos da raça Canchim. Utilizaram-se dados de 12.334 animais Canchim nascidos de 1999 a 2005. O ano e a época de nascimento, a propriedade, o regime alimentar e a idade da vaca ao parto (linear e quadrático) tiveram efeitos significativos sobre todas as características estudadas. Houve efeitos do sexo sobre o peso do bezerro à desmama e o escore de umbigo; da idade do bezerro sobre peso, perímetro escrotal e escores de conformação frigorífica e de pelame; e das proporções de Charolês no bezerro e na mãe sobre o peso, a conformação frigorífica e a qualidade de pelagem; e da heterozigose materna sobre peso, perímetro escrotal e escores de conformação frigorífica e de umbigo. Os efeitos aditivos diretos da raça Charolesa como desvio do zebu foram negativos sobre peso, conformação frigorífica e qualidade da pelagem à demama, enquanto os efeitos aditivos maternos foram positivos. Os efeitos heteróticos maternos foram positivos sobre peso, perímetro escrotal e escores de conformação frigorífica e de umbigo. em geral, essas fontes de variação devem ser consideradas nas estimativas de parâmetros genéticos e nas avaliações genéticas dos animais Canchim para as características estudadas.

Parâmetros genéticos de escore visual do umbigo em bovinos da raça Nelore

Foram utilizados 128.700, 44.227, 90.383, 47.506, 42.619, 45.057, 17.666 e 27.181 dados, respectivamente, de peso à desmama (PD), peso ao sobreano (PS), escore de umbigo à desmama (UD), escore de umbigo à desmama de macho (UDM), escore de umbigo à desmama de fêmea (UDF), escore de umbigo ao sobreano (US), escore de umbigo ao sobreano de macho (USM) e escore de umbigo ao sobreano de fêmea (USF) com o objetivo de estimar parâmetros genéticos de escore visual do umbigo e as respectivas correlações genéticas com as características de crescimento - peso à desmama e peso ao sobreano -, em bovinos da raça Nelore, aplicando-se um modelo animal em análises uni e bicaracterísticas. As estimativas de herdabilidade (h²) para as características UD, UDM, UDF, US, USM, USF, PD e PS foram de 0,14±0,01; 0,18±0,02; 0,15±0,01; 0,26±0,01; 0,32±0,03; 0,27±0,02, 0,29±0,01 e 0,27±0,02, respectivamente, em análises unicaracterísticas. em análises bicaracterísticas, as estimativas de h² para UD, US, PD e PS foram de 0,15, 0,27, 0,29 e 0,45, respectivamente. As correlações genéticas estimadas entre UDM e UDF, entre USM e USF e entre UD e US foram positivas e altas, as correlações genéticas entre escore do umbigo e características de crescimento foram todas positivas e de magnitudes de baixa a moderada.

Genetic analysis of visual scores and their relationships to mature female weight in Nellore breed

Dados de 79.884 animais da raça Nelore foram utilizados para estimar parâmetros genéticos e avaliar as relações entre os escores de conformação, precocidade e musculatura obtidos à desmama e ao sobreano e o peso das fêmeas à idade adulta. Utilizou-se o método da máxima verossimilhança restrita, em análise multicaracterísticas, com modelo que incluiu os efeitos genéticos aditivos direto e residual, como aleatórios, e os efeitos fixos de grupo de contemporâneos e, como covariáveis, a idade do animal à pesagem e a idade da mãe ao parto (exceto para o peso das fêmeas à idade adulta). Os grupos contemporâneos à desmama foram definidos pelas variáveis: sexo, rebanho, ano e mês de nascimento, grupo de manejo ao nascimento e à desmama. Na definição de grupo contemporâneo ao sobreano também foi incluída a variável grupo de manejo ao sobreano. Para o peso das fêmeas à idade adulta, o grupo de contemporâneos foi composto por rebanho, ano de nascimento, grupo de manejo ao sobreano, ano e estação da pesagem. Os efeitos genético materno e de ambiente permanente materno também foram incluídos no modelo para análise dos escores de conformação, precocidade e musculatura à desmama. As estimativas de herdabilidade direta obtidas foram 0,18 ± 0,02 para o escore de conformação; 0,21 ± 0,01 para o escore de precocidade; 0,22 ± 0,01 para o escore de musculatura à desmama e 0,24 ± 0,01 para o escore de conformação; 0,27 ± 0,01 para o escore de precocidade; e 0,26 ± 0,01 para o escore de musculatura ao sobreano e 0,42 ± 0,02 para o peso das fêmeas à idade adulta. As correlações genéticas estimadas entre os escores visuais medidos à desmama e ao sobreano foram positivas, variando de média a alta magnitude (0,56 ± 0,03 a 0,85 ± 0,01). Por outro lado, as correlações genéticas estimadas entre os escores visuais e o peso das fêmeas à idade adulta foram positivas e moderadas, variando de 0,21 ± 0,03 a 0,35 ± 0,03. Os resultados obtidos indicam que a seleção de animais com maiores escores visuais, principalmente ao sobreano, deve promover aumento do peso das fêmeas à idade adulta.

Análise comparativa do uso da tabela fonética do português brasileiro cantado por cantores argentinos com e sem o uso de um recurso áudio visual

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Equivalência métrica do Disease Activity Score (DAS 28) e Juvenile Arthritis Disease Activity Score (JADAS) na artrite idiopática juvenil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estudo genético quantitativo da qualidade da carcaça e da carne e suas associações com as características de avaliação visual na raça Nelore

Pós-graduação em Genética e Melhoramento Animal - FCAV

Comparação entre o Disease Activity Score-28 e o Juvenile Arthritis Disease Activity Score na artrite idiopática juvenil

Introduction: the assessment of the activity of rheumatoid arthritis and juvenile idiopathic arthritis is made by means of different tools, respectively DAS-28 and JADAS.Objective: To compare DAS-28 and JADAS with scores of 71, 27 and 10 joint counts in juvenile idiopathic arthritis.Method: A secondary analysis of a phase III placebo-controlled trial, testing safety and efficacy of abatacept was conducted in 8 patients with 178 assessment visits. Joint count scores for active and limited joints, physician's and parents'global assessment by 0-10 cm Visual Analog Scale, and erythrocyte sedimentation rate normalized to 0-10 scale, in all visits. The comparison among the activity indices in different observations was made through Anova or adjusted gamma model. The paired observations between DAS-28 and JADAS 71, 27 and 10, respectively, were analyzed by linear regression.Results: There were significant differences among individual measures, except for ESR, in the first four months of biological treatment, when five of the eight patients reached ACR-Pedi 30, with improvement. The indices of DAS-28, JADAS 71, 27 and 10 also showed significant difference during follow-up. Linear regression adjusted model between DAS-28 and JADAS resulted in mathematical formulas for conversion: [DAS-28 = 0.0709 (JADAS 71) + 1.267] (R-2 = 0.49); [DAS-28 = 0.084 (JADAS 27) + 1.7404] (R-2 = 0.47) and [DAS-28 = 0.1129 (JADAS-10) + 1.5748] (R-2 = 0.50).Conclusion: The conversion of scores of DAS-28 and JADAS 71, 27 and 10 for this mathematical model would allow equivalent application of both in adolescents with arthritis. (C) 2014 Elsevier Editora Ltda. All rights reserved.

Long-term impact of treated congenital toxoplasmosis on quality of life and visual performance

Background: Long-term evolution of congenital toxoplasmosis is not documented. We assessed the outcome of treated congenital toxoplasmosis in a cohort of adult individuals who had undergone ante- and postnatal treatment to provide information for pediatricians and parents on the evolution of the disease. Methods: We conducted a questionnaire study on 126 adults with congenital toxoplasmosis (mean age: 22.2 years; age range: 18–31 years) monitored regularly until the time of inclusion. The main outcome measures were quality of life (Psychological General Well-Being Index) and visual function (VF14 questionnaire), and the outcomes were correlated with disease-specific factors. Results: Of the 102 patients (80.9%) who were finally included in the study, 12 (11.8%) presented neurologic effects and 60 (58.8%) manifested ocular lesions; in the latter category, 13 individuals (12.7%) had reduced visual function. The overall global quality-of-life score (74.7 ± 14.2) was close to the expected normal range for the general population (73.7 ± 15.3). Overall, visual function was only slightly impaired (M = 97.3; 95% confidence interval, 95.8–98.8). Although disease-independent critical life circumstances were associated with a reduced Psychological General Well-Being Index, this index was not influenced by any of the clinical characteristics of congenital toxoplasmosis. Neurologic pathologies, reduced visual acuity, foveal location of the retinal lesion, and squinting contributed to decreased visual function at follow-up. Conclusions: Our data reveal that treated congenital toxoplasmosis has little effect on the quality of life and visual function of the affected individuals. These encouraging findings may help to alleviate the anxiety of affected individuals and their parents.

Visual histological grading system for the evaluation of in vitro-generated neocartilage

Here we present the development of a visual evaluation system for routine assessment of in vitro-engineered cartilaginous tissue. Neocartilage was produced by culturing human articular chondrocytes in pellet culture systems or in a scaffold-free bioreactor system. All engineered tissues were embedded in paraffin and were sectioned and stained with Safranin O-fast green. The evaluation of each sample was broken into 3 categories (uniformity and intensity of Safranin O stain, distance between cells/amount of matrix produced, and cell morphology), and each category had 4 components with a score ranging from 0 to 3. Three observers evaluated each sample, and the new system was independently tested against an objective computer-based histomorphometry system. Pellets were also assessed biochemically for glycosaminoglycan (GAG) content. Pellet histology scores correlated significantly with GAG contents and were in agreement with the computer-based histomorphometry system. This system allows a valid and rapid assessment of in vitro-generated cartilaginous tissue that has a relevant association with objective parameters indicative of cartilage quality.

Linking physiology with behaviour: Functional specialisation of the visual field is reflected in gaze patterns during visual search

Based on neurophysiological findings and a grid to score binocular visual field function, two hypotheses concerning the spatial distribution of fixations during visual search were tested and confirmed in healthy participants and patients with homonymous visual field defects. Both groups showed significant biases of fixations and viewing time towards the centre of the screen and the upper screen half. Patients displayed a third bias towards the side of their field defect, which represents oculomotor compensation. Moreover, significant correlations between the extent of these three biases and search performance were found. Our findings suggest a new, more dynamic view of how functional specialisation of the visual field influences behaviour.

Visual and spectral analysis of sleep EEG in acute hemispheric stroke

BACKGROUND: Reports on the effects of focal hemispheric damage on sleep EEG are rare and contradictory. PATIENTS AND METHODS: Twenty patients (mean age +/- SD 53 +/- 14 years) with a first acute hemispheric stroke and no sleep apnea were studied. Stroke severity [National Institute of Health Stroke Scale (NIHSS)], volume (diffusion-weighted brain MRI), and short-term outcome (Rankin score) were assessed. Within the first 8 days after stroke onset, 1-3 sleep EEG recordings per patient were performed. Sleep scoring and spectral analysis were based on the central derivation of the healthy hemisphere. Data were compared with those of 10 age-matched and gender-matched hospitalized controls with no brain damage and no sleep apnea. RESULTS: Stroke patients had higher amounts of wakefulness after sleep onset (112 +/- 53 min vs. 60 +/- 38 min, p < 0.05) and a lower sleep efficiency (76 +/- 10% vs. 86 +/- 8%, p < 0.05) than controls. Time spent in slow-wave sleep (SWS) and rapid eye movement (REM) sleep and total sleep time were lower in stroke patients, but differences were not significant. A positive correlation was found between the amount of SWS and stroke volume (r = 0.79). The slow-wave activity (SWA) ratio NREM sleep/wakefulness was lower in patients than in controls (p < 0.05), and correlated with NIHSS (r = -0.47). CONCLUSION: Acute hemispheric stroke is accompanied by alterations of sleep EEG over the healthy hemisphere that correlate with stroke volume and outcome. The increased SWA during wakefulness and SWS over the healthy hemisphere contralaterally to large strokes may reflect neuronal hypometabolism induced transhemispherically (diaschisis).

Testing visual perception in dementia with Lewy bodies and Alzheimer disease

OBJECTIVE Visuoperceptual deficits are common in dementia with Lewy bodies (DLB) and Alzheimer disease (AD). Testing visuoperception in dementia is complicated by decline in other cognitive domains and extrapyramidal features. To overcome these issues, we developed a computerized test, the Newcastle visuoperception battery (NEVIP), which is independent of motor function and has minimal cognitive load.We aimed to test its utility to identify visuoperceptual deficits in people with dementia. PARTICIPANTS AND MEASUREMENTS We recruited 28 AD and 26 DLB participants with 35 comparison participants of similar age and education. The NEVIP was used to test angle, color, and form discrimination along with motion perception to obtain a composite visuoperception score. RESULTS Those with DLB performed significantly worse than AD participants on the composite visuoperception score (Mann-Whitney U = 142, p = 0.01). Visuoperceptual deficits (defined as 2 SD below the performance of comparisons) were present in 71% of the DLB group and 40% of the AD group. Performance was not significantly correlated with motor impairment, but was significantly related to global cognitive impairment in DLB (rs = -0.689, p <0.001), but not in AD. CONCLUSION Visuoperceptual deficits can be detected in both DLB and AD participants using the NEVIP, with the DLB group performing significantly worse than AD. Visuoperception scores obtained by the NEVIP are independent of participant motor deficits and participants are able to comprehend and perform the tasks.

Tools & Techniques - Statistics: Propensity score techniques.

Propensity score (PS) techniques are useful if the number of potential confounding pretreatment variables is large and the number of analysed outcome events is rather small so that conventional multivariable adjustment is hardly feasible. Only pretreatment characteristics should be chosen to derive PS, and only when they are probably associated with outcome. A careful visual inspection of PS will help to identify areas of no or minimal overlap, which suggests residual confounding, and trimming of the data according to the distribution of PS will help to minimise residual confounding. Standardised differences in pretreatment characteristics provide a useful check of the success of the PS technique employed. As with conventional multivariable adjustment, PS techniques cannot account for confounding variables that are not or are only imperfectly measured, and no PS technique is a substitute for an adequately designed randomised trial.