Sex differences in the detection of motor unit action potentials identified using high-density surface electromyography

Sex-related disparities in force production of humans have been widely observed. Previous literature has attributed differences in peripheral traits, such as muscle size, to explain these disparities. However, less is known about potential sex-related differences in central neuromuscular traits and many comparable studies, not exploring sex-related differences, exhibit a selection-bias in the recruitment of subjects making the generalization of their findings difficult. Utilizing high-density electromyography arrays and motor unit (MU) decomposition, the aim of the current study is to compare MU yield and discharge properties of the tibialis anterior between male and female humans. Twenty-four subjects (10 females) performed two submaximal (20%) isometric dorsiflexion contractions. On average, males yielded nearly twice the amount of MUs as females. Further, females had significantly higher MU discharge rate, lower MU action potential amplitude, and lower MU action potential frequency content than males despite similar levels of torque and MU discharge variability. These findings suggest differences in central neuromuscular control of force production between sexes; however, it is unclear how lower yield counts affect the accuracy of these results.     

FitSpace Explorer: An algorithm to evaluate multidimensional parameter space in fitting kinetic data

Fitting several sets of kinetic data directly to a model based on numerical integration provides the best method to extract kinetic parameters without relying on the simplifying assumptions required to achieve analytical solutions of rate equations. However, modern computer programs make it too easy to enter an overly complex model, and standard error analysis grossly underestimates errors when a system is underconstrained and fails to reveal the full degree to which multiple parameters are linked through the complex relationships common in kinetic data. Here we describe the application of confidence contour analysis obtained by measuring the dependence of the sum square error on each pair of parameters while allowing all remaining parameters to be adjusted in seeking the best fit. The confidence contours reveal complex relationships between parameters and clearly outline the space over which parameters can vary (the “FitSpace”). The utility of the method is illustrated by examples of well-constrained fits to published data on tryptophan synthase and the kinetics of oligonucleotide binding to a ribozyme. In contrast, analysis of alanine racemase clearly refutes claims that global analysis of progress curves can be used to extract the free energy profiles of enzyme-catalyzed reactions.     

Time intervals to care and health service use experiences of uninsured cancer patients treated under public financing in Mexico City

BackgroundThe present study assesses the time intervals from symptom discovery to treatment start and describes the health service use experiences of uninsured patients with cancer of the breast, cervix uteri, testicle, and prostate before their arrival to the cancer hospital.MethodsThis cross-sectional study included 1468 patients who were diagnosed between June 2016 and May 2017 and received treatment for the selected cancers in two of the largest public cancer hospitals in Mexico City, financed through Seguro Popular. Data was collected through a survey administered via face-to-face interviews with patients and a review of their medical files.ResultsThe median time between detection (symptom discovery or first abnormal screening test) and treatment start was 6.6 months. For all types of cancer, the longest interval was the diagnostic interval –between the first use of healthcare services and the confirmation of cancer. Less than 20% cancer patients were diagnosed in the earliest stages that are associated with the best chances of long-term survival. The participants described a high use of private services for their first consultation, the use of several different types of health services and multiple consultations before arrival to the cancer centers, and 35% perceived being misdiagnosed by the first doctor they consulted.ConclusionsMost cancer patients treated in the two largest public institutions available for the uninsured faced long delays to get diagnosed and started treatment at advanced stages. Strengthening quality and access for effective early cancer diagnosis and treatment is key to improve patient outcomes in low and middle-income settings.     

Generalized prediction intervals for treatment effects in random‐effects models

This article derives generalized prediction intervals for random effects in linear random‐effects models. For balanced and unbalanced data in two‐way layouts, models are considered with and without interaction. Coverage of the proposed generalized prediction intervals was estimated in a simulation study based on an agricultural field experiment. Generalized prediction intervals were compared with prediction intervals based on the restricted maximum likelihood (REML) procedure and the approximate methods of Satterthwaite and Kenward and Roger. The simulation study showed that coverage of generalized prediction intervals was closer to the nominal level 0.95 than coverage of prediction intervals based on the REML procedure.     

Adjustment of Prediction Intervals in Nonlinear Regression

By treating the nonlinear model as if it were linear in the parameterization θ in the neighbourhood of the least squares estimate θC, two-sided nominally-q-prediction intervals can be constructed by applying the usual linear model theory. The quadratic approximation of the expected coverage of the prediction intervals is derived for a p-parameter nonlinear model. An adjustment of the nominally-q-prediction intervals is proposed. It is shown that, to the extent that quadratic approximation is adequate, the actual expected coverage of the adjusted prediction intervals is q.     

Nonlinear Relationships in the Patterns of Neuronal Spiking in Cortical Neurons

The pattern of neuronal spiking of cortical neurons was investigated in an awake nonimmobilized rabbit. Thecharacteristics of the interspike intervals (total numberof intervals, mean interval, mean-square deviation) and of the burst (group) activity (burst number, mean spikefrequency in a burst, mean spike number for a burst, meanburst duration) were considered. Nonlinear relationshipbetween the values of mean interspike intervals and thenumber of spike bursts was found. A number of functionswere applied to describe the observed phenomena. On thebasis of regression analysis two populations of corticalneurons with distinct neuronal spiking patterns wereidentified. Bursts occur at a higher rate in one populationthan the other, although both populations exhibit burstsand are otherwise indistinguishable.     

Adjusting for selection bias in assessing treatment effect estimates from multiple subgroups

This paper discusses a number of methods for adjusting treatment effect estimates in clinical trials where differential effects in several subpopulations are suspected. In such situations, the estimates from the most extreme subpopulation are often overinterpreted. The paper focusses on the construction of simultaneous confidence intervals intended to provide a more realistic assessment regarding the uncertainty around these extreme results. The methods from simultaneous inference are compared with shrinkage estimates arising from Bayesian hierarchical models by discussing salient features of both approaches in a typical application.     

Factors Associated With Insulin Pump Discontinuation in Adults With Diabetes: A Time-to-Invent Analysis and Prediction Model

ObjectiveInsulin pump discontinuation has mostly been studied in children and adolescents living with diabetes. We aimed to assess the rate of insulin pump continuation in a population of adult patients with diabetes, at 18 months after initiation; determine the factors associated with pump discontinuation; and develop a simple prediction model.MethodsThis single-center, retrospective study included all adult patients with type 1 diabetes or type 2 diabetes who started insulin pump treatment between January 2015 and June 2018. The exclusion criteria were pregnancy, short-term pregnancy plans, and insulin pump discontinuation within the previous 6 months. The probability of insulin pump continuation after 18 months was estimated using the Kaplan-Meier method. Factors associated with insulin pump discontinuation were studied using a Cox regression model, and an exponential model was built for prediction purposes.ResultsThe study included 315 patients. The mean age was 41 years, the mean duration of diabetes was 16 years, 50% were men, 74% had type 1 diabetes, and the mean hemoglobin A1c level was 9.1% (76 mmol/mol). After 18 months, the rate of insulin pump continuation was 0.80 (95% Confidence Interval (CI), 0.76-0.85). By multivariate analysis, the occurrence of severe hypoglycemia in the previous year was associated with insulin pump discontinuation (hazard ratio, 2.42; 95% CI, 1.30-4.51), while other factors did not reach statistical significance.ConclusionInsulin pump discontinuation occurred in 20% of patients at 18 months after initiation and was mainly associated with a recent history of severe hypoglycemia. The type of diabetes and glycemic control at baseline were not associated with treatment discontinuation.     

Inter-menstrual intervals in captive bonobosPan paniscus

In this study we provide new data on the duration of the inter-menstrual intervals of six captive female bonobos (Pan paniscus). We found that the mean duration of the inter-menstrual interval was about 34 days. This lies close to the average value of 37 days that has been reported for common chimpanzees (Pan troglodytes).     

ESTIMATING SEA OTTER REPRODUCTIVE RATES

Abstract: Sea otters may give birth in any month of the year, so obtaining reproductive rates by observation is difficult. Reproductive rates may be estimated directly (births per otter-year observed) or by determining the time interval between births. Both methods give the same result for long sequences of observations, but field data are limited to shorter periods. Monte Carlo simulations were conducted to compare the two approaches, and showed that the interval method overestimates true reproductive rates.