Sue Leurgans

Bio: Sue Leurgans is an academic researcher from Rush University Medical Center. The author has contributed to research in topics: Dementia & Cognitive decline. The author has an hindex of 84, co-authored 324 publications receiving 27324 citations. Previous affiliations of Sue Leurgans include Marquette University & Rush University.

Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results.

Abstract: We present a clinimetric assessment of the Movement Disorder Society (MDS)-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS). The MDS-UDPRS Task Force revised and expanded the UPDRS using recommendations from a published critique. The MDS-UPDRS has four parts, namely, I: Non-motor Experiences of Daily Living; II: Motor Experiences of Daily Living; III: Motor Examination; IV: Motor Complications. Twenty questions are completed by the patient/caregiver. Item-specific instructions and an appendix of complementary additional scales are provided. Movement disorder specialists and study coordinators administered the UPDRS (55 items) and MDS-UPDRS (65 items) to 877 English speaking (78% non-Latino Caucasian) patients with Parkinson's disease from 39 sites. We compared the two scales using correlative techniques and factor analysis. The MDS-UPDRS showed high internal consistency (Cronbach's alpha = 0.79-0.93 across parts) and correlated with the original UPDRS (rho = 0.96). MDS-UPDRS across-part correlations ranged from 0.22 to 0.66. Reliable factor structures for each part were obtained (comparative fit index > 0.90 for each part), which support the use of sum scores for each part in preference to a total score of all parts. The combined clinimetric results of this study support the validity of the MDS-UPDRS for rating PD.

Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): Process, format, and clinimetric testing plan.

Abstract: This article presents the revision process, major innovations, and clinimetric testing program for the Movement Disorder Society (MDS)-sponsored revision of the Unified Parkinson's Disease Rating Scale (UPDRS), known as the MDS-UPDRS. The UPDRS is the most widely used scale for the clinical study of Parkinson's disease (PD). The MDS previously organized a critique of the UPDRS, which cited many strengths, but recommended revision of the scale to accommodate new advances and to resolve problematic areas. An MDS-UPDRS committee prepared the revision using the recommendations of the published critique of the scale. Subcommittees developed new material that was reviewed by the entire committee. A 1-day face-to-face committee meeting was organized to resolve areas of debate and to arrive at a working draft ready for clinimetric testing. The MDS-UPDRS retains the UPDRS structure of four parts with a total summed score, but the parts have been modified to provide a section that integrates nonmotor elements of PD: I, Nonmotor Experiences of Daily Living; II, Motor Experiences of Daily Living; III, Motor Examination; and IV, Motor Complications. All items have five response options with uniform anchors of 0 = normal, 1 = slight, 2 = mild, 3 = moderate, and 4 = severe. Several questions in Part I and all of Part II are written as a patient/caregiver questionnaire, so that the total rater time should remain approximately 30 minutes. Detailed instructions for testing and data acquisition accompany the MDS-UPDRS in order to increase uniform usage. Multiple language editions are planned. A three-part clinimetric program will provide testing of reliability, validity, and responsiveness to interventions. Although the MDS-UPDRS will not be published until it has successfully passed clinimetric testing, explanation of the process, key changes, and clinimetric programs allow clinicians and researchers to understand and participate in the revision process.

The role of dynamic three-dimensional trunk motion in occupationally-related low back disorders. The effects of workplace factors, trunk position, and trunk motion characteristics on risk of injury.

Abstract: Current ergonomic techniques for controlling the risk of occupationally-related low back disorder consist of static assessments of spinal loading during lifting activities. This may be problematic because several biomechanical models and epidemiologic studies suggest that the dynamic characteristics of a lift increase spine loading and the risk of occupational low back disorder. It has been difficult to include this motion information in workplace assessments because the speed at which trunk motion becomes dangerous has not been determined. An in vivo study was performed to assess the contribution of three-dimensional dynamic trunk motions to the risk of low back disorder during occupational lifting in industry. More than 400 repetitive industrial lifting jobs were studied in 48 varied industries. Existing medical and injury records in these industries were examined so that specific jobs historically categorized as either high-risk or low-risk for reported occupationally-related low back disorder could be identified. A triaxial electrogoniometer was worn by workers and documented the three-dimensional angular position, velocity, and acceleration characteristics of the lumbar spine while workers lifted in these high-risk or low-risk jobs. Workplace and individual characteristics were also documented for each of the repetitive lifting tasks. A multiple logistic regression model was developed, based on biomechanical plausibility, and indicated that a combination of five trunk motion and workplace factors distinguished between high and low risk of occupationally-related low back disorder risk well (odds ratio: 10.7). These factors included 1) lifting frequency, 2) load moment, 3) trunk lateral velocity, 4) trunk twisting velocity, and 5) the trunk sagittal angle. This analysis implies that by suitably varying these five factors observed during the lift collectively, the odds of high-risk group membership may decrease by almost 11 times. The predictive power of this model was found to be more than three times greater than that of current lifting guidelines. This study, though not proving causality, indicates an association between the biomechanical factors and low back disorder risk. This model could be used as a quantitative, objective measure to design the workplace so that the risk of occupationally-related low back disorder is minimized.

The neuropathology of probable Alzheimer disease and mild cognitive impairment.

Abstract: Background Mixed pathologies are common in older persons with dementia. Little is known about mixed pathologies in probable AD and about the spectrum of neuropathology in mild cognitive impairment (MCI).

Cox-Type Regression Analysis for Large Numbers of Small Groups of Correlated Failure Time Observations

Abstract: The Cox regression model has been used extensively to analyze survival data. For data that consist of large numbers of small groups of correlated failure time observations, we show that the standard maximum partial likelihood estimate of the regression coefficient in the Cox model is still consistent and asymptotically normal. However, the corresponding standard variance-covariance estimate may no longer be valid due to the dependence among members in the groups. In this article, a correct variance-covariance estimate that takes account of the intra-group correlation is proposed. Power comparisons are performed to show the advantage of the new proposal. Examples are provided for illustration.

Tensor Decompositions and Applications

Abstract: This survey provides an overview of higher-order tensor decompositions, their applications, and available software. A tensor is a multidimensional or $N$-way array. Decompositions of higher-order tensors (i.e., $N$-way arrays with $N \geq 3$) have applications in psycho-metrics, chemometrics, signal processing, numerical linear algebra, computer vision, numerical analysis, data mining, neuroscience, graph analysis, and elsewhere. Two particular tensor decompositions can be considered to be higher-order extensions of the matrix singular value decomposition: CANDECOMP/PARAFAC (CP) decomposes a tensor as a sum of rank-one tensors, and the Tucker decomposition is a higher-order form of principal component analysis. There are many other tensor decompositions, including INDSCAL, PARAFAC2, CANDELINC, DEDICOM, and PARATUCK2 as well as nonnegative variants of all of the above. The N-way Toolbox, Tensor Toolbox, and Multilinear Engine are examples of software packages for working with tensors.

Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy

Abstract: Background Diabetic nephropathy is the leading cause of end-stage renal disease. Interruption of the renin–angiotensin system slows the progression of renal disease in patients with type 1 diabetes, but similar data are not available for patients with type 2, the most common form of diabetes. We assessed the role of the angiotensin-II–receptor antagonist losartan in patients with type 2 diabetes and nephropathy. Methods A total of 1513 patients were enrolled in this randomized, double-blind study comparing losartan (50 to 100 mg once daily) with placebo, both taken in addition to conventional antihypertensive treatment (calcium-channel antagonists, diuretics, alpha-blockers, beta-blockers, and centrally acting agents), for a mean of 3.4 years. The primary outcome was the composite of a doubling of the base-line serum creatinine concentration, end-stage renal disease, or death. Secondary end points included a composite of morbidity and mortality from cardiovascular causes, proteinuria, and the rate of prog...

Convergence of Probability Measures

Abstract: Convergence of Probability Measures. By P. Billingsley. Chichester, Sussex, Wiley, 1968. xii, 253 p. 9 1/4“. 117s.