Abstract Objective Upper extremity function reflects disease progression in multiple sclerosis (MS). This study evaluated the feasibility, validity and sensitivity to change of remote dexterity assessments applying human pose estimation to patient-uploaded videos. Methods A discovery cohort of 50 adults with MS recorded “selfie” videos of self-care tasks at home: buttoning, brushing teeth, and eating. Kinematic data were extracted using MediaPipe Hand pose estimation software. Clinical comparison tests were: grip and pinch strength, 9 hole peg test (9HPT), and vibration, and patient-reported dexterity assessments (ABILHAND). Feasibility and acceptability were evaluated (Health-ITUES framework). A validation cohort (N=35) completed 9HPT and videos. Results The modality was feasible: 88% of the 50 enrolled participants uploaded ≥3 videos, and 74% completed the study. It was also usable: assessments easy to access (95%), platform easy to use (97%), and tasks representative of daily activities (86%). The buttoning task revealed 4 metrics with strong correlations with 9HPT (nondominant: r=0.60-0.69, dominant: r=0.51-0.57, p<0.05) and ABILHAND (r=-0.48, p=0.05). Retest validity at 1 week was stable (r>0.8). Cross-sectional correlations between video metrics and 9HPT were similar at 6 months, and in the validation cohort (nondominant: r=0.46, dominant: r=0.45, p<0.05). Over 6 months, pinch strength (5.8 to 5.0kg/cm 2 , p=0.05) and self-reported pinch (ABILHAND) decreased marginally. While only 15% participants worsened by 20% on 9HPT, 70% worsened in key buttoning video metrics. Interpretation Patient-uploaded videos represent a novel, patient-centered modality for capturing dexterity that appears valid and sensitive to change, enhancing its potential to be disseminated for neurological disease monitoring and treatment.
Contaminants of Emerging Concern (CECs) can be measured in waters across the United States, including the tributaries of the Great Lakes. The extent to which these contaminants affect gene expression in aquatic wildlife is unclear. This dataset presents the full hepatic transcriptomes of laboratory reared fathead minnows (Pimephales promelas) caged at multiple sites within the Milwaukee Estuary area of concern and control sites. Following 4 days of in situ exposure, liver tissue was removed from males at each site for RNA extraction and sequencing, yielding a total of 116 samples from which libraries were prepared, pooled, and sequenced. For each exposure site, 179 chemical analytes were also assessed. These data were created with the intention of inviting research on possible transcriptomic changes observed in aquatic species exposed to CECs. Access to both full sequencing reads of animal samples as well as water contaminant data across multiple Great Lakes sites will allow others to explore the health of these ecosystems, in support of the aims of the Great Lakes Restoration Initiative.
Quantitative adverse outcome pathways (qAOPs) describe quantitative response-response relationships that can predict the probability or severity of an adverse outcome for a given magnitude of chemical interaction with a molecular initiating event. However, the taxonomic domain of applicability for these predictions is largely untested. The present study began defining this applicability for a previously described qAOP for aromatase inhibition leading to decreased fecundity developed using data from fathead minnow (Pimephales promelas). This qAOP includes quantitative response-response relationships describing plasma 17β-estradiol (E2) as a function of plasma fadrozole, plasma vitellogenin (VTG) as a function of plasma E2, and fecundity as a function of plasma VTG. These quantitative response-response relationships simulated plasma E2, plasma VTG, and fecundity measured in female zebrafish (Danio rerio) exposed to fadrozole for 21 days but not these responses measured in female Japanese medaka (Oryzias latipes). However, Japanese medaka had different basal levels of plasma E2, plasma VTG, and fecundity. Normalizing basal levels of each measurement to equal those of female fathead minnow enabled the relationships to accurately simulate plasma E2, plasma VTG, and fecundity measured in female Japanese medaka. This suggests that these quantitative response-response relationships are conserved across these three fishes when considering relative change rather than absolute measurements. The present study represents an early step toward defining the appropriate taxonomic domain of applicability and extending the regulatory applications of this qAOP.
Fatigue is a major "invisible" symptom in people with multiple sclerosis (PwMS), which may affect speech. Automated speech analysis is an objective, rapid tool to capture digital speech biomarkers linked to functional outcomes.
Race and ancestry influence the course of multiple sclerosis (MS).Explore clinical characteristics of MS and neuromyelitis optica spectrum disorder (NMOSD) in Asian American patients.Chart review was performed for 282 adults with demyelinating disease who self-identified as Asian at a single North American MS center. Demographics and clinical characteristics were compared to non-Asian MS patients and by region of Asian ancestry.Region of ancestry was known for 181 patients. Most (94.7%) preferred English, but fewer East Asian patients did (80%, p = 0.0001). South Asian patients had higher neighborhood household income (p = 0.002). Diagnoses included MS (76.2%) and NMOSD (13.8%). More patients with NMOSD than MS were East and Southeast Asian (p = 0.004). For MS patients, optic nerve and spinal cord involvement were similar across regions of ancestry. Asian MS patients were younger at symptom onset and diagnosis than non-Asian MS patients. MS Severity Scale scores were similar to non-Asian MS patients but worse among Southeast Asians (p = 0.006).MS severity was similar between Asian American patients and non-Asian patients. Region of ancestry was associated with differences in sociodemographics and MS severity. Further research is needed to uncover genetic, socioeconomic, or environmental factors causing these differences.
Upper extremity function reflects disease progression in multiple sclerosis (MS). This study evaluated the feasibility, validity, and sensitivity to change of remote dexterity assessments applying human pose estimation to patient-uploaded videos.
To explore the clinical presentation of MS and neuromyelitis optica spectrum disorder (NMOSD) in patients of Asian ancestry in the United States.
Background:
Race and ancestry influence the course of demyelinating conditions like Multiple Sclerosis (MS). Asian patients are underrepresented in clinical research in the United States.
Design/Methods:
Demographic, clinical and radiologic data were extracted from the medical record for adults with Asian self-identified race and diagnosis of demyelinating disease cared for at a single North American MS center between 2006/02/06 and 2022/06/09. Descriptive statistics were used to describe the cohort, then demographic and clinical factors were compared according to region of ancestry.
Results:
The cohort included 282 patients from 11 different countries; 73.1% were born in Asia. Most patients (94.7%) preferred English for medical communication, but fewer of East Asian ancestry did (p=0.0001). South Asian ancestry was associated with higher neighborhood household income (p=0.002) and Southeast Asian ancestry with smoking (p=0.08). Diagnoses included MS (76.2%) and NMOSD (13.8%). More patients with NMOSD than MS were of East Asian and Southeast Asian ancestry (p=0.004). For MS patients, levels of optic nerve and spinal cord involvement were similar across regions of ancestry. Most (83.7%) patients were currently on MS treatment (42.3% on antiCD20 therapies). MS Severity Scale (MSSS), while similar to the clinic average. was worse with Southeast Asian ancestry (p=0.006) and also worse with smoking, and lower neighborhood median household income or educational attainment.
Conclusions:
Patients of Asian ancestry are underrepresented in research in the United States. In this cohort, Asian patients with MS were actively treated and disease severity reflected the overall clinic. Both region of origin and neighborhood socioeconomic factors were associated with disease characteristics. Further research is needed to uncover genetic, socioeconomic, or environmental factors accounting for worse MSSS in Southeast Asian patients. Disclosure: Dr. Fan has nothing to disclose. Ms. Alexander has nothing to disclose. Mr. Poole has nothing to disclose. Ms. Wijangco has received research support from National Institutes of Health. Dr. Henson has received personal compensation for serving as an employee of Piedmont Healthcare. An immediate family member of Dr. Henson has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Tempus. Dr. Henson has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for various law firms. Ruth Dobson has nothing to disclose. Dr. Guo has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Bove has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Bove has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Bove has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Bove has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Bove has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genzyme Sanofi. Dr. Bove has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Bove has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Bove has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Jansen. Dr. Bove has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. The institution of Dr. Bove has received research support from Biogen. The institution of Dr. Bove has received research support from Roche Genentech. The institution of Dr. Bove has received research support from Novartis.
The impact of menopause on the brain is not well understood. Hormonal changes, including puberty and pregnancy, influence the onset and course of multiple sclerosis (MS). After menopause, a worsening of MS disease trajectory measured on the clinician-rated Expanded Disability Status Scale (EDSS) was reported in some, but not all, studies. Evaluating the association between menopause and more objective measures of CNS injury is warranted. This study sought to assess the trajectory of objective functional outcomes and disease biomarkers in women with MS before and after menopause in a longitudinal prospective observational cohort.
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