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Evaluation of Objective Methods for Analyzing Ipsilateral Motor Evoked Potentials in Stroke Survivors with Chronic Upper Extremity Motor Impairment
No full textObjective. Ipsilateral motor evoked potentials (iMEPs) are believed to represent cortically evoked excitability of uncrossed brainstem-mediated pathways. In the event of extensive injury to (crossed) corticospinal pathways, which can occur following a stroke, uncrossed ipsilateral pathways may serve as an alternate resource to support the recovery of the paretic limb. However, iMEPs, even in neurally intact people, can be small, infrequent, and noisy, so discerning them in stroke survivors is very challenging. This study aimed to investigate the inter-rater reliability of iMEP features (presence/absence, amplitude, area, onset, and offset) to evaluate the reliability of existing methods for objectively analyzing iMEPs in stroke survivors with chronic upper extremity (UE) motor impairment. Approach. Two investigators subjectively measured iMEP features from thirty-two stroke participants with chronic UE motor impairment. Six objective methods based on standard deviation (SD) and mean consecutive differences (MCD) were used to measure the iMEP features from the same 32 participants. IMEP analysis used both trial-by-trial (individual signal) and average-signal analysis approaches. Inter-rater reliability of iMEP features and agreement between the subjective and objective methods were analyzed (percent agreement-PA and intraclass correlation coefficient-ICC). Main results. Inter-rater reliability was excellent for iMEP detection (PA \u3e 85%), amplitude, and area (ICC \u3e 0.9). Of the six objective methods we tested, the 1SD method was most appropriate for identifying and analyzing iMEP amplitude and area (ICC \u3e 0.9) in both trial-by-trial and average signal analysis approaches. None of the objective methods were reliable for analyzing iMEP onset and offset. Results also support using the average-signal analysis approach over the trial-by-trial analysis approach, as it offers excellent reliability for iMEP analysis in stroke survivors with chronic UE motor impairment. Significance. Findings from our study have relevance for understanding the role of ipsilateral pathways that typically survive unilateral severe white matter injury in people with stroke
How Engineering Students Learn and are Impacted by Empathy Training: A Multi-Year Study of an Empathy Program Focused on Disability and Technology
No full textMeasurable results of efforts to teach empathy to engineering students are sparse and somewhat mixed. This study’s objectives are (O1) to understand how empathy training affects students’ professional development relative to other educational experiences, (O2) to track empathy changes due to training over multiple years, and (O3) to understand how and what students learn in empathy training environments
Movement Disorders in Relapsing and Progressive MS: A Comprehensive Prospective Evaluation of a Large Real-Life Cohort
No full textBackground: Recent studies suggest that movement disorders are common in early MS. However, the frequency and clinical characteristics of movement disorders at all stages of MS remain unknown. Objectives: To evaluate the frequency, clinical characteristics, and anatomical generators of movement disorders in relapsing and progressive MS. Methods: We conducted a prospective study of adult MS patients from 2016 to 2022 at a neuroimmunology clinic. Patients were evaluated for demyelination-related movement disorders via a survey and focused examination. We classified movement disorders based on phenomenology and identified anatomic correlates according to lesion locations and relation to relapses. Findings were compared between relapsing and progressive MS. Results: Of 327 patients, 211 (64.5 %) had demyelination-related movement disorders (median age 35.3, Q1 28.5, Q3 44.8; 72.5 % female). Spinal movement disorders were the most common and occurred in 177 patients (54.1 %). Brainstem/cerebellar movement disorders occurred in 59 (18 %), and striatal/thalamic movement disorders occurred in 8 (2.4 %). The most common movement subtypes were tonic spasms (39.4 %) and tremor (24.5 %). We observed 21 cases (6.4 %) in which movement disorders represented a new relapse including the first attack of the disease. Patients with progressive MS were more likely to have demyelination-related movement disorders (chi square, p \u3c 0.001), including spinal (chi square, p = 0.0003), brainstem/cerebellar (chi square, p = 0.009), and striatal/thalamic movement disorders (fisher exact, p = 0.03). Discussion: Demyelination-related movement disorders are very common in all stages of MS, especially in patients with progressive disease and those with spinal lesions. In some, movement disorders may be the presenting symptom of the disease
Applying an Intergenerational Lens to the Associations Between Childhood Intimate Partner Violence Exposure, Child Maltreatment, and Adolescent Dating Violence Perpetration
No full textReports estimate that approximately 35 percent of U.S. adolescents have dated or are currently dating, making the fact that over a third of those youth have reported experiencing some form of adolescent dating violence (ADV) in their relationships, incredibly concerning. An estimated 31 percent (~4.5 million) of dating youth report perpetrating ADV and 35 percent (~5.1 million) report ADV victimization. Childhood exposure to intimate partner violence (eIPV) and child maltreatment have both been linked with the experience of ADV, however, results vary greatly across studies, particularly regarding ADV perpetration. This study is additive by improving upon ADV measurement limitations from past studies, considering co-occurring child maltreatment and eIPV as a predictor of ADV, and drawing from theory in the selection of protective factors. Applying social learning theory and the intergenerational transmission of violence model, this study examines the mediating effect of dating violence acceptability on the links between childhood eIPV, child maltreatment, and ADV perpetration using structural equation modeling. Preliminary findings indicate significant relations between co-occurrence (child maltreatment & eIPV) and ADV, as well as eIPV alone and ADV. Mediation by youth acceptability of dating violence was not identified. The results of this study provide additional evidence of significant relations between childhood violence exposures and ADV perpetration, and higher prevalence rates of all violence types than previously found in the literature, emphasizing the need for prevention and intervention
Managing the Cost of Services for People with Disabilities: International Approach. Part II: Ohio, United States
Full text linkIntroduction: Four years of managing a housing network for people with disabilities prompted a rethinking of the financial management of the services offered. Clients with different needs require diverse professional staff for their home care. Emergency situations require that professionals offering assistance maintain the highest level of education possible. Financial resources often limit the quality of care for people with disabilities. Method: This paper is based on a literature search and on professional experience (Dana Pugh) in the management of a housing program for people with disabilities in Cleveland, Ohio (USA). Findings: In Poland, people with disabilities usually live with their families, and specialized services are offered outside their place of living. However, community housing is being developed to resemble the family home. In the United States, individuals with disabilities often live in housing with specialized basic assistance. To improve living conditions, we suggest stratifying different levels of care to offer specialized services relative to the needs of residents at each level. Discussion: An international approach to the care of people with disabilities allows for a comparison of different methods of service delivery, depending on financial resources, community traditions, and the professional knowledge of care providers. The authors suggest a specific model of service that promotes a high quality of professional knowledge despite financial constraints
Impact of the COVID-19 Pandemic on the Risk of Developing PTSD among the Elderly: A Literature Review
Full text linkThe Baryonic Tully-Fisher Relation. II. Stellar Mass Models
Full text linkWe present new color-ϒ* (mass-to-light ratio) models to convert Wide-field Infrared Survey Explorer W1 fluxes into stellar masses. We outline a range of possible star formation histories and chemical evolution scenarios to explore the confidence limits of stellar population models on the value of ϒ*. We conclude that the greatest uncertainties (around 0.1 dex in ϒ*) occur for the bluest galaxies with the strongest variation in recent star formation. For high-mass galaxies, the greatest uncertainty arises from the proper treatment of bulge-disk separation in which to apply different ϒ* relations appropriate for those differing underlying stellar populations. We compare our deduced stellar masses with those deduced from Spitzer Space Telescope 3.6 μm fluxes and stellar mass estimates in the literature using optical photometry and different ϒ* modeling. We find the correspondence to be excellent, arguing that rest-frame near-IR photometry is still more advantageous than other wavelengths
Super-Resolution Imaging Reveals Resistance to Mass Transfer in Functionalized Stationary Phases
Full text linkChemical separations are costly in terms of energy, time, and money. Separation methods are optimized with inefficient trial-and-error approaches that lack insight into the molecular dynamics that lead to the success or failure of a separation and, hence, ways to improve the process. We perform super-resolution imaging of fluorescent analytes in five different commercial liquid chromatography materials. Unexpectedly, we observe that chemical functionalization can block more than 50% of the material’s porous interior, rendering it inaccessible to small-molecule analytes. Only in situ imaging unveils the inaccessibility when compared to the industry-accepted ex situ characterization methods. Selectively removing some of the functionalization with solvent restores pore access without substantially altering the single-molecule kinetics that underlie the separation and agree with bulk chromatography measurements. Our molecular results determine that commercial “fully porous” stationary phases are over-functionalized and provide an alternative avenue to characterize and direct separation material design from the bottom-up
Prevalence of Sleep Disturbances and Factors Associated Among School Going Children in Uganda, a Cross-Sectional Study
No full textBackground: Sleep disturbances greatly impact children\u27s academic performance and social well-being. This study set out to determine the prevalence of sleep disturbances and factors associated among school going children in Kawempe division, Kampala, Uganda. Methods: In a community cross-sectional study, 548 study participants using random cluster sampling were enrolled. The children start lessons at 8am and end the days classes at 5pm. Random cluster sampling method was used to select participants from the 19 parishes in Kawempe district. Data was collected using a semi-structured questionnaire and Sleep Disturbance Scale for Children (SDSC). Descriptive statistics and multivariate binary logistic regression were performed with a p \u3c 0.05 level of significance, and a 95 % confidence interval as a measure of association between the sleep disturbance. Results: Abnormal total sleep score (T- score \u3e70) was at 3.5 %, and overall, 21.7 % of the children had an abnormal score on at least one SDSC factor. Among the children with sleep disturbances, we noted the following factors; use of an electronic device before bed, sleeping \u3c7 h at night, having unemployed parents and lack of regular parental interaction. Conclusion: Better understanding of sleep disturbances in needed to address challenges associated with sleep among children in Uganda
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