Artykuły w czasopismach: „Motor age (1902)”

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Alexandrov, A. V., A. A. Smirnov, P. V. Goncharuk, V. V. Rybchenok i R. A. Khagurov. "Prognosis of traumatic ulnar, median and radial nerves injuries in children: systematic review and meta-analysis". Issues of Reconstructive and Plastic Surgery 25, nr 4 (2.02.2023): 6–14. http://dx.doi.org/10.52581/1814-1471/83/01.

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Objective. Damage to peripheral nerves has a strong impact on the life of patients, as the absence during the care provided can lead to disability. It is important to determine the prognostic factors that affect the outcome of the disease.Material and methods. During the initial selection, 1902 publications (PubMed) and 675 results were found using the Google Scholar database. From the initially identified search results, an analysis of 5 papers was carried out.Results. The total number of patients with peripheral nerve injuries of the upper extremities was 120. The average age of patients is (9.1 ± 1.5) years old. The conducted meta-analysis of the difference in the average values of recovery of motor function of peripheral nerves after surgery showed: the final increase in the recovery rate of motor function, depending on age, was 0.47 (0.08–0.87) %, p < 0.02; the final increase in the recovery rate of motor function, depending on the level of damage, was 0.71 (0.27–1.13) %, p < 0.02.Conclusion. The obtained results showed the prognostic value of such indicators as age at the time of surgery and the level of damage. Thus, we can confidently say that the smaller the age of the child and the more distal the level of damage, the better results can be expected after surgery.

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Schorman, Rob. "“This Astounding Car for $1,500”: The Year Automobile Advertising Came of Age". Enterprise & Society 11, nr 3 (wrzesień 2010): 468–523. http://dx.doi.org/10.1017/s1467222700009277.

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In 1906, a writer declared that it remained an “unsolved problem whether the automobile is to prove a fad like the bicycle, or a lasting factor in the industry of the country.” A few years later, concerned with the possibility of overproduction and market saturation, auto executives and other commentators were writing articles for the advertising trade press with titles like “Why Auto Production Must Be Curtailed” and “The Fading of the Automobile Rainbow.” Considering that by the early twenty-first century, the United States had a population of nearly 300 million people and an average of 2.1 registered motor vehicles per household, it is difficult to appreciate how uncertain the industry’s status seemed in its early years. Yet although contemporary observers may not have known it, in many ways by the end of 1908 the foundation stoneswere already in place for a hundred years of automotive economic and cultural preeminence in the United States. Two events from that year are well known as harbingers of the industry’s future. In September, General Motors was established, and in October, Ford introduced its Model T to the nation's auto dealers. In time, these developments had a profound impact on American automobile manufacture and management.

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Tolmachev, Georgii A., Valerii G. Makarov, Igor G. Tsvenger i Aureliya V. Tolmacheva. "COMPARISON OF INDUCTION MOTOR PARAMETERS ESTIMATION METHODS". Vestnik Chuvashskogo universiteta, nr 2 (25.06.2024): 151–59. http://dx.doi.org/10.47026/1810-1909-2024-2-151-159.

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It is known that induction motors are mostly applied type of motors in industry. Therefore, their digital twin development remains relevant. One of the main issues during digital twin development is induction motor parameters determination. There are a number of methods to determine these parameters with varying degree of accuracy. The purpose of the study is to find an induction motor parameters estimation method which allows one to create a digital twin of actual induction motor. Methods. MATLAB software was used to create induction motor simulation model in phase coordinates. To determine induction motor parameters via catalogue data, the methods suggested by the following authors were used: Kravchik A.E. (1982), Moshchinskii Yu.A. (1998), Myasovskii V.A. (2020). The object of research is the induction motor AIRM80A6U3 whose actual performance characteristics were obtained during experiment. Results. Using the developed mathematical model, and methods to determine the parameters of the induction motor via catalogue data, simulation has been applied to compare actual performance characteristics and those obtained as a result of simulation. To improve results accuracy, a series of experiments was performed for stator winding phase resistance identification. The most accurate method was chosen and obtained data were included in it. The paper contains graphical images for visual comparison of simulated and actual induction motor performance characteristics. Maximum relative and integrated errors are the convergence criteria of the model and real motor. These errors are tabulated for visual reference. By analyzing simulated induction motor performance characteristics, current, speed and maximum relative and integrated errors, a method was determined which identifies induction motor parameters with highest accuracy. Moreover, using that method with precise resistances of the stator winding makes it possible to reduce the speed integral and relative error by 2.5 times. Conclusions. A comparison of the results shows good convergence, which allows the method to be used for modeling induction motor drive systems.

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Luerssen, Thomas G., Melville R. Klauber i Lawrence F. Marshall. "Outcome from head injury related to patient' age". Journal of Neurosurgery 68, nr 3 (marzec 1988): 409–16. http://dx.doi.org/10.3171/jns.1988.68.3.0409.

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✓ A series of 8814 head-injured patients admitted to 41 hospitals in three separate metropolitan areas were prospectively studied. Of these, 1906 patients (21.6%) were 14 years of age or less. This “pediatric population” was compared to the remaining “adult population” for mechanism of injury, admission Glasgow Coma Scale score, motor score, blood pressure, pupillary reactivity, the presence of associated injuries, and the presence of subdural or epidural hematoma. The relationship of each of these factors was then correlated with posttraumatic mortality. Except for patients found to have subdural hematoma and those who were profoundly hypotensive, the pediatric patients exhibited a significantly lower mortality rate compared to the adults, thus confirming this generally held view. This study indicates that age itself, even within the pediatric age range, is a major independent factor affecting the mortality rate in head-injured patients.

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Solomin, S. A., I. R. Shmidt i I. G. Galantyuk. "The experience of used Korteksin preparation in complex treatment disease vein Gilles de la Tourette in children". Bulletin of Siberian Medicine 7, nr 5-2 (30.12.2008): 391–92. http://dx.doi.org/10.20538/1682-0363-2008-5-2-391-392.

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The disease Gilles de la Tourette (generalized teak, disease or syndrome Tourette and others) — respecting rare organic disease of the encephalon, revealing presence varied hyperkinesias and vocals of the breaches.Under observation was found 26 children at age with 7 before 14 years with different degree evidence motor and vocals frustration at period with 2002 on 2007. Of them boys 21 (80,7%), girls 5 (19,2%). All children got the traditional treatment by used our department with addition of Korteksin preparation in medical drug blockade in points Vg 15, 16. Korteksin in complex treatment disease Gilles de la Tourette promotes more quick and more long removal motor and vocals frustration.

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Hahn, Robert A. "Survival in Adversity: Trends in Mortality Among Blacks in the United States, 1900–2010". International Journal of Health Services 50, nr 4 (25.05.2020): 387–95. http://dx.doi.org/10.1177/0020731420925289.

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The goal of this study was to analyze trends in black age-adjusted mortality rates (AADR) from 1900 through 2010 and to propose explanations. Analyses included a descriptive study of trends in AADR from major causes for blacks and age-specific all-cause mortality at each decade. In 1900, all-cause AADRs were higher for blacks than whites. Over the century, differences decreased substantially. Reductions mortality were greatest among young people, lowest among older adults. Deaths from infectious diseases showed the greatest decrease. Heart disease mortality among blacks increased from 1920 to 1950, then decreased by 2010. For men and women, AADRs for cancer rose to a peak in 1990, then declined. Stroke mortality decreased steadily for males and females. AADRs from unintentional injuries (not including motor vehicle injury) decreased gradually. Despite widespread societal resistance, blacks have made substantial gains in a wide range of social determinants of health, such as civil rights, education, employment, income, and housing. Substantial gains remain to be made.

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Bilkish, Umme Sayeeda, Md Jahangir Hossain, Murshida Afruz, Chowdhury Foyzur Rob, Md Gulam Mustofa i Chowdhury ABM Bodrudduza. "Causes of low back pain (LBP) in women without pregnancy, in relation to different age groups during the reproductive period, are primarily treated as musculoskeletal disorders: a retrospective study". MOJ Orthopedics & Rheumatology 16, nr 3 (13.05.2024): 72–82. http://dx.doi.org/10.15406/mojor.2024.16.00667.

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Introduction: Low back pain (LBP) is a musculoskeletal disorder of several causes that can mess up the spine. It is characterized by pain, stiffness or muscle tension and is usually localized in the lumber region. – During their working years, people frequently experience low back pain. Approximately 84% of adults experience LBP once or more during their lifetime. In Bangladesh, wt. related prevalence of LBP is 18.5% and age group 18-34 years prevalence are 10.5% and >55 years 27.8%, average 19.2%, which is more in women 27.2% than men. Pain in the soft tissue of the back is extremely common among adults and often affects individuals during their working years. LBP in women, is strongly linked to hormonal and reproductive factors, the work environment and lifestyle. Females frequently experience lower abdominal and back pain at reproductive age, usually due to PMS, PMDD, dysmenorrhea, endometriosis, pregnancy, menopause, muscle spasms, arthritis, UTI, PID, HTN, DM, obesity, multiple C/S tracts and lower abdominal operations, all of which cause RAD, osteoporosis, vertebral and intervertebral disc diseases (PLID, herniation, slipping etc.). The L4 and L5 neural arches are involved in the transmission of a considerable load. Therefore, the joints between the articular facets of L4 and L5,- are sites of LBP. Low back pain (LBP) was diagnosed by history and clinical examination according to the Pain Scale. To determine the cause of HELLP syndrome/causes by routine investigations and sometimes abdominal ultrasonography (USG), magnetic resonance imaging (MRI) is needed. Treatment of LBP depends on the cause. When a definite lesion is not found, the patient should be informed and reassured about the treatment of LBP. Purpose/Objective of the study: To identify the causes of LBP and prevalence of LBP in women of reproductive age excluding pregnant individuals and establish referral guidelines. Methodology: This was a retrospective (observational) cross sectional study jointly conducted by Orthopedics and Gynecology Expertise in the North-East region, named the Sylhet Division of Bangladesh. Female patients were considered to be of reproductive age for the last three (3) years (2020 - 2022) at the Z&J fellows medical institution. The data were collected from the medical records of computer databases with preset questionnaires and written informed consent. The 1st part of the questionnaire consisted of questions about the causes of LBP, and the 2nd part consisted of LBP-related questionnaires. Patients were selected by the inclusion and exclusion criteria. The data were analyzed with SPSS 25.0 statistical software, MS Word and Excel version 2010. Descriptive statistics were analyzed, i.e. - frequency, central tendency and dispersion, i.e. range, standard deviation and variance. Tests of “proportions” and “significance” were performed via sample t-tests and ANOVA. Statistical data analysis was used to evaluate the correlation of LBP incidence and intensity (%) with age, BMI, disease status, marital status, obstetric history, working history and posture of reproductive-age women. Summary: LBP has multiple causes. In retrospective studies, there is no way to predict the prevalence of causes rather, the prevalence of causes can be determined before patients are affected. In our study, we explored the causes of LBP in women according to age, BMI, local and systemic diseases, marital history, obstetric history, working history and posture. The prevalence of LBP was greater in the 41-50 years age group (34.7%) and in the 20-30 years age group (34.2%). Moreover, overweight and obesity are associated with LBP. Overall 5.3% and 12.8% of the participants were overweight and obese, respectively, and were aged >20-30 years with LBP. Patient age, BMI, disease status, marital status, obstetric history and working history had no effect on any of the patients, but some patients had LBP; overweight, obesity, age group and working posture had direct effects on LBP incidence (p>0.05). LBP is more common in women- than in men and may be due to household activities and a greater frequency of visceral pain during menstruation, pregnancy and labor. Conclusion: Low back pain (LBP) can occur in multiple physical conditions in women of reproductive age except during pregnancy and can disrupt the back tissues of the lumbosacral region. Women are more susceptible to LBP because of menstrual and obstetric factors. A diagnosis was made by obtaining a meticulous detailed medical history, performing a physical examination and performing proper investigations. The causal parameters revealed that LBP had no effect on any of the patients, but women of reproductive age may suffer from LBP due to differences in cause.

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Patlidanon, Jutima, Parnchat Pukrushpan, Supharat Jariyakosol i Pokpong Praneeprachachon. "Long-term outcome following bilateral lateral rectus recession for intermittent exotropia". Asian Biomedicine 8, nr 4 (1.08.2014): 565–68. http://dx.doi.org/10.5372/1905-7415.0804.328.

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Abstract Background: Bilateral lateral rectus recession is the most common surgical treatment of intermittent exotropia in children. Success rates in previous studies differ because longer follow-up periods may change success rate as the eyes drift out with time. Initial overcorrection was thought to be appropriate management, but the preferred initial postoperative deviation has not been well quantified. Objective: To study long-term outcomes (≥3 years) of bilateral lateral rectus recession for intermittent exotropia and to evaluate factors influencing long-term success. Methods: This retrospective descriptive study reviews patients with intermittent exotropia who underwent bilateral lateral rectus recession with a minimum follow up of 3 years. Long-term motor outcome was classified as good (within 8 prism diopters (PD) of esodeviation and 10 PD of exodeviation), acceptable (exodeviation 11-20 PD), and poor (esotropia >8 PD or exotropia >20 PD). Stereoacuity testing pre- and postoperatively was used to evaluate sensory outcome. Correlation between long-term outcome and various pre- and postoperative factors were analyzed. Results: A total of 59 patients met the selective inclusion criteria. The mean age at time of surgery was 7.1 years with a mean follow-up time of 4.5 years. At the time of the last visit, 69% (41 patients) had good outcomes, 24% (14 patients) had acceptable outcomes, and 7% (4 patients) had poor outcomes. Initial postoperative ocular deviation significantly correlated with long-term outcome (P < 0.05). Mean initial postoperative ocular deviation of patients with good outcome was esodeviation 12.7 PD (range ortho to esodeviation 25 PD). In 45 patients whose stereoacuity could be assessed, 58% (26 patients) had stereoacuity improvement. Conclusion: Good long-term motor outcome can be achieved in 69% of patients following bilateral lateral rectus recession for intermittent exotropia. Initial postoperative ocular deviation correlated with long-term motor success.

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Gantois, Petrus, Vanessa C. M. Pinto, Kezianne R. de Castro, Paulo V. João, Paulo M. S. Dantas i Breno Guilherme G. A. T. Cabral. "Skeletal age and explosive strength in young volleyball players". Brazilian Journal of Kinanthropometry and Human Performance 19, nr 3 (24.08.2017): 331. http://dx.doi.org/10.5007/1980-0037.2017v19n3p331.

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Identifying diferent anthropometric, physiological and motor aspects is essential to obtain success in sports practice. However, these components may be developed in same age subjects diferently, in part due biological development. he aim of the study was compare and correlate the explosive strength to biological maturation by sex, obtained by estimation of skeletal age based on anthropometric variables. he sample consisted of 239 subjects of both sexes, aged 10 to 13 years. Maturation was assessed by skeletal age predictive equation and upper and lower limbs explosive strength using medicine ball throw test and vertical jump, respectively. Skeletal age was assessed by skeletal age using a predictive anthropometrical based equation. Upper and lower limbs explosive strength were evaluated by medicine ball throwing test and vertical jump test, respectively. Post hoc analysis showed delayed biological development subjects had worst medicine ball throwing test performance than accelerated boys (p=0.001; d=0.96) and girls (p< 0.01; d= 2.01); regarding to vertical jump test, worst performance was also detected to maturational delayed boys when compared to accelerated ones (p=0.24; d=1.1) and girls (p=0.007; d=0.75). Regression analysis showed skeletal age explained variance of 36% and 19.2% for boys and 45.2% and 16.1% for girls upper and lower limbs explosive strength. Skeletal age is positively related to upper and lower limbs explosive strength and show higher performance for accelerated biological development young players when compared to delayed ones, independently from sex.

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Piatysotska, Svitlana, Leonid Podrіgalo, Vyacheslav Romanenko, Yana Zhernovnikova, Nataliia Dolgopolova i Andrii Yefremenko. "Comparative analysis of motor functional asymmetry indicators in athletes of cyclic sports, martial arts, and esports". Physical Education of Students 27, nr 4 (30.08.2023): 212–20. http://dx.doi.org/10.15561/20755279.2023.0408.

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Background and Study Aim. Understanding and assessing functional asymmetry among athletes is pivotal, as it has the potential to reveal hidden strengths and weaknesses that can profoundly influence competitive performance. Study Aim: to perform a comparative analysis of functional asymmetry indicators among athletes in cyclic sports (short track), martial arts (karate, taekwondo), and esports (CS:GO). Material and Methods. The study involved athletes of martial arts (n=10, age 18.9±0.12, experienced athletes), elite players of semi-professional CS:GO teams (n=10, age 19.2±0.50), and short track athletes (n=10, age 19±0.09, experienced athletes). The functional asymmetry was determined using a specialized program for iOS tablets. Results. Esports athletes a higher number of taps during the test within a given unit of time. They also exhibit shorter reaction times and have briefer tap durations using both their right and left hands, in comparison to athletes specializing in other disciplines. Across all three specializations, athletes display minimal disparities between their right and left hands regarding tap count, reaction time, and tap duration at each of the six test stages. The variance in tap count ranges from 0 to 1.40 times, while reaction time differs by 0 to 2.33 milliseconds, and tap duration varies between 1.53 to 8.69 milliseconds. Conclusions. The exploration of motor functional asymmetry holds significant importance in analyzing the motor skills and perceptual-motor capabilities of athletes across diverse sports and proficiency levels. A comparison of functional asymmetry metrics among athletes from three distinct specializations affirmed the similarity in outcomes across all measures. This suggests that elite athletes possess a heightened level of movement coordination and symmetry in their execution between their right and left hands. The advanced level of sports training contributes to the balanced enhancement of intermuscular coordination, further positively impacting visual-motor reaction times.

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Lebedev, A. V. "Demographic characteristics of patients with motor neuron disease subject to conditions of large industrial city in West Siberia". Bulletin of Siberian Medicine 8, nr 3(2) (28.06.2009): 61–66. http://dx.doi.org/10.20538/1682-0363-2009-3(2)-61-66.

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78 patients with motor neuron disease (MND) were examined. Prevalence of MND in urban population of Novosibirsk on 2008/01/01 is 3,46 per 100 000 of population. In majority of patients amyotrophic lateral sclerosis (ALS) was revealed — 76 people (97,4%); primary lateral sclerosis was revealed in 1 case (1,3%), progressive bulbar paralysis was revealed also in 1 case (1,3%). There were 63 men (80,8%) and 15 women (19,2%) (ratio is 4,2 : 1,0). There was no people younger than 27 years for the moment when first symptoms of the disease were revealed. The major age group was 41 to 60 years (66 people — 84,6%).

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Widyawati, Evita, Byba Suhita i Indasah Indasah. "THE EFFECTIVENESS OF GAME BRAIN STIMULATION ON PRE-SCHOOL CHILD DEVELOPMENT IN PAUD BABUSSALAM DS. PANDEAN KAB. TRENGGALEK". JOURNAL FOR QUALITY IN PUBLIC HEALTH 1, nr 1 (19.01.2018): 13–20. http://dx.doi.org/10.30994/jqph.v1i1.2.

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Development child in age preschool very important. Because on age this required for process development self and concept self in himself. In times this for support growth and its development required appropriate stimulation with age and is no make depressed on children. The objective was Knowing effectiveness stimulation brain games to preschooldevelopment child in PAUD BabussalamDesa Pandean KabupatenTrenggalek. The design used in research was quasi-experimental design. Population was child preschool in PAUD BabussalamDesa Pandean KabupatenTrenggalek. The sample ware 26 respondents on simple random sampling. Variables Independent research was stimulation brain games and variable dependent was development motor. Data collected with using DDST, then the data was analyzed use test Wilcoxon with level significance α ≤ 0, 05. Results research show that brain stimulation affects the game on significant on smooth motoric (p = 0.025), and coarse motor(p = 0.046), but no influence on development language (p = 0.317) and psychosocial (p = 0.317). Before given the brain game, many respondents have DDST normal value as much as 21 respondents (80.8%), and the suspect five respondents (19.2%), while after given brain game that suspect DDST value decreases became one respondent (3.8%). Results test statistics use Wilcoxon Signed Test Range obtained that p = 0.046, which means that affects the brain game on significant DDST against children. Conclusion from research this was Brain Game is effective in improving the ability of Childhood Development Pre-School.

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Fisher, C. M. "1985 Silversides Lecture: Unusual Vascular Events in the Territory of the Posterior Cerebral Artery". Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 13, nr 1 (luty 1986): 1–7. http://dx.doi.org/10.1017/s031716710003571x.

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ABSTRACT:There is an unusual type of vascular episode in the territory of the posterior cerebral artery which remains relatively unknown. Ten cases are presented in which a posterior cerebral artery deficit developed suddenly in dramatic fashion with headache, visual symptoms, sensory and motor deficits and signs of third nerve involvement. Nine of the patients were female and one was male. Seven were under the age of 33. In all instances there was a permanent neurologic sequela, usually a hemianopia. A similar case was described in 1901. The nature of the underlying process remains obscure, but the evidence favors accompanied migraine in which a particularly severe attack results in permanent damage. The term “catastrophic migraine” is suggested.

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Balamutova, N., E. Bloshenko i N. Boreyko. "Change of indexes of breathing and circulation of blood at loading of step - rising power for young swimmers". Scientific Journal of National Pedagogical Dragomanov University. Series 15. Scientific and pedagogical problems of physical culture (physical culture and sports), nr 12(120) (25.12.2019): 10–13. http://dx.doi.org/10.31392/npu-nc.series15.2019.12(120)19.02.

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The positive is well – proven numerous researches influence swimming on the health of occupying. Therefore question about affecting of employments swimming organism of young swimmers it is necessary to examine taking into account individual of anatomical and physiological features. The aim of the real research was a study of influence of physical activities of step - rising power on breathing and circulation of blood of youths 15-16, regularly visitant a section on swimming. A result of research of indexes of breathing and circulation of blood at the set loading allows describing functional possibilities of youths - swimmers. It was well - proven that the system of preparation of young swimmers was built taking into account age anatomical and physiological features of their organism, and physical activities were adequate to their physiological development. Modern living conditions are characterized by rapid development of automation of production and information technologies, which deprives a person of motor activity. Swimming is one of the most effective means of motor activity that positively influences the functional state of the cardiovascular and respiratory system. Numerous studies have already shown the positive effect of swimming on the health of the practitioners. It should not be forgotten that despite the significant differences in the functional state of the apparatus of external respiration and blood circulation in young swimmers and their peers - not athletes, the organism in both of them has not yet reached maturity and their age development and formation occurs in accordance with a single general biological regularities. Therefore, the question of the impact of swimming lessons on the body of young swimmers should be considered not only in terms of the impact on it of the specific features of the aquatic environment and the requirements of modern training, but also taking into account anatomical and physiological features.

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Рiatysotska, Svitlana, Leonid Podrіgalo, Vyacheslav Romanenko, Andrii Yefremenko, Yuliia Petrenko i Hanna Poltoratska. "A Study of Motor Functional Asymmetry Indicators in Different Sportsmanship Level Esports Athletes". Physical Education Theory and Methodology 23, nr 4 (30.08.2023): 628–35. http://dx.doi.org/10.17309/tmfv.2023.4.19.

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Purpose. to research and analyze of the indicators of functional asymmetry in different sportsmanship level esports athletes. Methods. the study involved 20 middle-aged athletes (18±1.53) years old, divided into groups according to their sportsmanship. Group 1: elite players of semi-professional teams in CS:GO and DOTA 2 disciplines, n=10, age (19.2±0.50) years. Group 2: amateur CS:GO and DOTA 2 players, n=10, age (18.2±1.04) years. The functional asymmetry of the movements of the upper limbs was determined using a special program for tablet computers running iOS, developed at the departments of martial arts, computer science and biomechanics of the KhSAPC. Results. It has been established that in terms of the number of clicks per unit of time, elite esports athletes are dominated by amateurs by 5.54% on the left and 5.14% on the right hand; in terms of visual motor reaction time, elite esports athletes prevail by 5.54% on the left hand and 5,07% on the right hand; elite esports athletes showed a 13.3% shorter left-hand click duration, but amateurs showed a 6,83% shorter right-hand click duration. Conclusions. Players with a higher level of preparedness tend to have less asymmetrical movements. In the proposed test, elite athletes demonstrate a greater number of movements per unit of time; at the 2nd stage of testing, the differences are significant (p<0.05). At the same time, the reaction time of more skilled players is less than that of amateurs; at the 2nd and 4th stages of the test, the differences are significant (p<0.05). Indicators of functional asymmetry of movements of the upper limbs informatively characterize the level of preparedness of esports athletes and can be included in the program for monitoring the physical condition of players in cybersport.

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Cliff, Dylan P., Anthony D. Okely, Leif M. Smith i Kim McKeen. "Relationships between Fundamental Movement Skills and Objectively Measured Physical Activity in Preschool Children". Pediatric Exercise Science 21, nr 4 (listopad 2009): 436–49. http://dx.doi.org/10.1123/pes.21.4.436.

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Gender differences in cross-sectional relationships between fundamental movement skill (FMS) subdomains (locomotor skills, object-control skills) and physical activity were examined in preschool children. Forty-six 3- to 5-year-olds (25 boys) had their FMS video assessed (Test of Gross Motor Development II) and their physical activity objectively monitored (Actigraph 7164 accelerometers). Among boys, object-control skills were associated with physical activity and explained 16.9% (p = .024) and 13.7% (p = .049) of the variance in percent of time in moderate-to-vigorous physical activity (MVPA) and total physical activity, respectively, after controlling for age, SES and z-BMI. Locomotor skills were inversely associated with physical activity among girls, and explained 19.2% (p = .023) of the variance in percent of time in MVPA after controlling for confounders. Gender and FMS subdomain may influence the relationship between FMS and physical activity in preschool children.

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Pearson, Iona, Stella A. Glasmacher, Judith Newton, Emily Beswick, Arpan R. Mehta, Richard Davenport, Siddharthan Chandran i Suvankar Pal. "The Prevalence and Management of Saliva Problems in Motor Neuron Disease: A 4-Year Analysis of the Scottish Motor Neuron Disease Register". Neurodegenerative Diseases 20, nr 4 (2020): 147–52. http://dx.doi.org/10.1159/000514615.

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Introduction: Saliva problems are common and distressing for people with motor neuron disease (pwMND). Despite clinical guidelines for assessment and treatment, management of saliva problems has received little research attention. Objective: We aimed to investigate the prevalence of saliva problems in pwMND, their association with clinical factors, and their management practice using a highly curated population-based register for motor neuron disease (MND) with 99% case ascertainment. Methods: We conducted an analysis of pwMND diagnosed between January 2015 and October 2019 using the Scottish MND Register (CARE-MND [Clinical, Audit, Research, and Evaluation of MND]). The association between clinical factors and saliva problems was investigated using univariate and multivariable logistic regression; results are reported as odds ratio (OR) and 95% confidence intervals. A survey of health-care professionals involved in the care of pwMND was performed to contextualize the findings. Results: 939 pwMND were included. Prevalence of saliva problems was 31.3% (294). Bulbar onset (OR 9.46 [4.7, 19.2]; p < 0.001) but not age, sex, time to diagnosis, or MND subtype were independently associated with the presence of saliva problems in multivariable regression, and 52.7% (155) of those with saliva problems received pharmacological management. The most commonly used medications were hyoscine, amitriptyline, carbocisteine, glycopyrrolate, and atropine. Evidence base (8, 72.7%) and local guidelines (10, 90.9%) were cited as the most important factors influencing treatment decision by survey respondents (n = 11). Conclusion: Saliva problems are common and associated with bulbar onset MND. A substantial proportion of pwMND with saliva problems did not receive recommended treatments. Future research is required to determine the relative efficacy of individual pharmacological treatments.

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Oludara, Mobolaji, Olufemi Idowu, Nasiru Ibrahim, Ibrahim Mustafa, Abdulwahab Ajani, Rufai Balogun i Babatunde Solagberu. "Emergency Medical Services Outcome Assessment in Lagos, Nigeria: Review of Cases of ‘’Brought in Dead‘’ Patients". Open Access Macedonian Journal of Medical Sciences 2, nr 2 (15.06.2014): 253–56. http://dx.doi.org/10.3889/oamjms.2014.041.

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BACKGROUND: This study sets out to establish a database of BID patients presenting at the Lagos State University Teaching Hospital (LASUTH).METHOD: A retrospective study of consecutive ‘’Brought in Dead‘’ (BID) patients seen from April to November 2011 at the surgical emergency room of the Lagos State University Teaching Hospital (LASUTH) was done using a validated questionnaire.RESULTS: A total of 144 BID patients were seen during the study period. There were 112 males or 78% and 32 females or 22% of the total (M:F=3:1). The age group with the largest number of victims was the 31-40 age groups; and there were 37 patients (30.8% of 120 cases captured under age group). Trauma also accounted for 104 patients (72.2%) with 52 (36.1%, 50% of trauma cases) of these caused by Road traffic injuries (RTI), and Gunshot injuries accounting for 21 (14.6%, 20.2% of trauma cases). Among the Trauma BID cases from RTI, 4-wheeled vehicles accounted for 20 cases (19.2%, 40% of RTI), whilst motor cycle injuries accounted for 12 cases (11.5%, 24% of RTI).CONCLUSION: The study shows that road traffic injuries and gunshot injuries, accounted for 70% of BID cases presenting at LASUTH. Majority of cases of RTI are from 4 wheeler vehicles (40%) and motorcycles (24%).

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Leontiev, A. N. "Mental Development in Early Childhood". Cultural-Historical Psychology 16, nr 2 (2020): 118–24. http://dx.doi.org/10.17759/chp.2020160213.

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This is the first English translation of the paper of the prominent Soviet scholar Alexey Nikolaevich Leontiev (1903—1979) published in 1948. The paper introduces the author’s ideas on mental and personality development in preschool children based on the research results of his close colleagues under his leadership during the 1930-s and 1940-s. It embraces the conditions and features of the development of the hierarchy of motives in preschoolers which underlies the emergence of volitional behaviour at this age. Evidence is provided for the role of the motivational structure in the volitional regulation of such cognitive processes as perception, memory and in the emergence of children’s control of their motor processes. It demonstrates that the motives of the child of the preschool age get subordinated when the child is engaged in the social interaction with the participation of an adult. In a brief preface to this publication, E.E. Sokolova highlights the context of the author’s work, the continuity of his ideas of the activity theory with Vygotsky’s approach, and emphasizes a nontrivial approach in Leontiev’s school to mental development as rooted in the total activity of the subject rather than in the brain processes

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Chowdhury, Rajib Nayan, Md Enayet Hussain, Md Nahidul Islam, Mostafa Hosen, AFM Al Masum Khan, Md Ferdous Mian, ATM Hasibul Hasan, Md Badrul Alam Mondal i Quazi Deen Mohammad. "An audit of patients referred for nerve conduction study in a tertiary care hospital in Bangladesh". Journal of Dhaka Medical College 23, nr 1 (26.03.2015): 102–8. http://dx.doi.org/10.3329/jdmc.v23i1.22703.

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Background: To examine the pattern and burden of neurologic disorders at electrophysiology lab of a tertiary care centre. Methodology: This retrospective chart review was carried out from the records and notes of electrophysiology lab in National Institute of Neurosciences and Hospital (NINS) from January to December 2013. A total of 1372 patients were evaluated with nerve conduction study (NCS) and electromyography (EMG) during this period. Result: Majority of the patients (67.6%) presented after forty with a mean age at presentation of 48.11±17.3 years. The male patients (55.2%) predominated. Carpal tunnel syndrome (CTS) was the most common condition (19.2%) observed, followed by different form of polyneuropathy namely Guillain Barre Syndrome (GBS) (6.04% with 50% being Acute inflammatory demyelinating polyneuropathy (AIDP), chronic inflammatory demyelinating polyneuropathy (CIDP) (3.27%), sensory motor polyneuropathy 3.13% and multifocal acquired motor axonopathy (MAMA) 2.55%. Though plexopathy and radiculopathy were rare (1.09 and 0.94% respectively), anterior horn cell disease was not that uncommon (8.73%). Disorders of muscle and neuromuscular junction (myasthenia gravis) were seen in 5.1% and 1.89% patient. Other various conditions (e.g. stroke, cerebral palsy, myelopathy) were observed in 10.05%. NCS and EMG were found to be normal in 270 patients (19.6%). Conclusion: Wide ranges of neurological problems are often referred to electrophysiology lab. Where ever the facilities and expert hands are available, these tests can help in diagnosing and classifying these cases. DOI: http://dx.doi.org/10.3329/jdmc.v23i1.22703 J Dhaka Medical College, Vol. 23, No.1, April, 2014, Page 102-108

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Klykken, Lindsey W., Brian G. Pietrosimone, Kyung-Min Kim, Christopher D. Ingersoll i Jay Hertel. "Motor-Neuron Pool Excitability of the Lower Leg Muscles After Acute Lateral Ankle Sprain". Journal of Athletic Training 46, nr 3 (1.05.2011): 263–69. http://dx.doi.org/10.4085/1062-6050-46.3.263.

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Context: Neuromuscular deficits in leg muscles that are associated with arthrogenic muscle inhibition have been reported in people with chronic ankle instability, yet whether these neuromuscular alterations are present in individuals with acute sprains is unknown. Objective: To compare the effect of acute lateral ankle sprain on the motor-neuron pool excitability (MNPE) of injured leg muscles with that of uninjured contralateral leg muscles and the leg muscles of healthy controls. Design: Case-control study. Setting: Laboratory. Patients or Other Participants: Ten individuals with acute ankle sprains (6 females, 4 males; age = 19.2 ± 3.8 years, height = 169.4 ± 8.5 cm, mass = 66.3 ±11.6 kg) and 10 healthy individuals (6 females, 4 males; age = 20.6 ± 4.0 years, height = 169.9 ± 10.6 cm, mass = 66.3 ± 10.2 kg) participated. Intervention(s): The independent variables were group (acute ankle sprain, healthy) and limb (injured, uninjured). Separate dependent t tests were used to determine differences in MNPE between legs. Main Outcome Measure(s): The MNPE of the soleus, fibularis longus, and tibialis anterior was measured by the maximal Hoffmann reflex (Hmax) and maximal muscle response (Mmax) and was then normalized using the Hmax:Mmax ratio. Results: The soleus MNPE in the ankle-sprain group was higher in the injured limb (Hmax:Mmax = 0.63; 95% confidence interval [CI], 0.46, 0.80) than in the uninjured limb (Hmax:Mmax = 0.47; 95% CI, 0.08, 0.93) (t6 = 3.62, P = .01). In the acute ankle-sprain group, tibialis anterior MNPE tended to be lower in the injured ankle (Hmax:Mmax = 0.06; 95% CI, 0.01, 0.10) than in the uninjured ankle (Hmax:Mmax = 0.22; 95% CI, 0.09, 0.35), but this finding was not different (t9 = −2.01, P = .07). No differences were detected between injured (0.22; 95% CI, 0.14, 0.29) and uninjured (0.25; 95% CI, 0.12, 0.38) ankles for the fibularis longus in the ankle-sprain group (t9 = −0.739, P = .48). We found no side-to-side differences in any muscle among the healthy group. Conclusions: Facilitated MNPE was present in the involved soleus muscle of patients with acute ankle sprains, but no differences were found in the fibularis longus or tibialis anterior muscles.

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Cockburn, Myles G., Ann S. Hamilton, John Zadnick, Wendy Cozen i Thomas M. Mack. "Development and Representativeness of a Large Population-Based Cohort of Native Californian Twins". Twin Research 4, nr 4 (1.08.2001): 242–50. http://dx.doi.org/10.1375/twin.4.4.242.

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AbstractWe have established a large cohort of twins to facilitate studies of the role of genetics and environment in the development of disease. The cohort has been derived from all multiple births occurring in California between 1908–82 (256,616 in total). We report here on our efforts to contact these twins and their completion of a detailed 16 page risk factor questionnaire. Addresses of the individuals were obtained by linking the birth records with the California Department of Motor Vehicles (DMV) roster of licensees. To date this has been completed for twins born between 1908 and 1972 (200,589 individuals). The linkage has revealed 112,468 matches and, because of less complete DMV records in some years, was less successful in older females than in younger females and all males. Over 41,000 twins have participated by completing the questionnaire. Based on estimates of numbers of individuals receiving a questionnaire, we estimate our crude response rate to be between 42.2% and 49.6%, highest among females in their 40s (62.8%). We describe the representativeness of the twins in the original birth cohort, those identified by the linkage, and those completing the questionnaire. Compared to the 1990 resident population of California-born resident singletons, the respondents were of similar age, sex, race and residential distribution (for although we were able to locate fewer older females, they had a higher response rate), but were less likely to have been educated for more than 12 years. We provide a brief synopsis of studies nested within this cohort. We also elucidate our plans for expanding the cohort in the near future.

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Obukhova, A. V., N. N. Koberskaya i D. A. Artemev. "Motor-speech disorders in a patient with a vertebrobasilar stroke affected by coronavirus infection (clinical observation)". Meditsinskiy sovet = Medical Council, nr 10 (12.08.2021): 154–62. http://dx.doi.org/10.21518/2079-701x-2021-10-154-162.

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Amidst the growing coronavirus infection (COVID-19) pandemic, there is increasing evidence of the development of neurological complications of this disease and, especially, acute cerebrovascular accidents, and what is more, an increase in incidence rates of strokes is noted in the patients under the age of 50, who did not have risk factors for cerebrovascular diseases. The article examines several potential mechanisms that determine the relationships between ischemic stroke and COVID-19. A clinical case of the development of ischemic stroke in the vertebrobasilar system affected by the coronavirus infection is presented. The causal relationship between coronavirus infection and vascular catastrophe is discussed. In the described case, COVID-19 contributed to the decompensation of the patient’s associated risk factors. A feature of the described case is the delayed development of a rare motor disorder in the form of Holmes tremor and combined speech disorders (dysarthria and aftereffects of motor aphasia) in the patient. Holmes tremor is an unusual type of tremor characterized by a combination of rest, postural, and action tremors that predominantly affects the proximal limbs. This symptom is named after the British neurologist Gordon Holmes, who described a series of cases of an unusual variant of tremulous hyperkinesis in 1904. The article discusses the pathogenesis issues of the development of this condition and provides clinical criteria for Holmes tremor. This is a rather rare symptom, there are no data on large studies of this disorder in the literature, and it is mainly described in small series of clinical cases. The efficacy of Akatinol Memantine in the treatment of post-stroke speech disorders is discussed, and the rationale for prescribing this drug in the management of patients with post-stroke speech disorders is presented.

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Sorrell, Lexy, Angela King, Jemma Inches, Jane Rideout, Robert Sneyd, Christopher Kobylecki, Ray Chaudhuri, Richard Walker, Hannah Martin i Camille Carroll. "110 Outcome and mortality of hospital admission with COVID-19 for individuals with parkinsonian syndromes". Journal of Neurology, Neurosurgery & Psychiatry 93, nr 9 (12.08.2022): e2.62. http://dx.doi.org/10.1136/jnnp-2022-abn2.154.

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ObjectiveTo evaluate features of Parkinson’s disease (PD) and atypical Parkinson’s syndromes (APS) associated with poor outcome and mortality in people with COVID-19 in a hospital setting.BackgroundPrevious studies have demonstrated increased mortality of COVID-19 in people with PD. However, it is not known whether this is associated with disease-related factors (eg autonomic dysfunc- tion, dysphagia).MethodsAn online survey tool captured anonymised patient data from hospital admission records of people with PD and APS who tested positive for COVID-19 between February 2020 and July 2021. We will use Cox proportional hazards and linear regression models to evaluate which characteristics are associ- ated with mortality, increased care requirement and more severe COVID-19 infection. Models will be adjusted for known associations with poor outcome, such as co-morbidities, age and sex.ResultsData were collected from 556 admissions from 21 UK sites: 66.2% male; median (IQR) age 80 (11) years; median disease duration 5 (7) years. 19.2% were asymptomatic, 28.8% had mild symptoms and 52.5% required respiratory support. 38.3% died within 4 weeks of a positive COVID-19 test. Preliminary Kaplan-Meier curves suggest that co-existing dementia, marked motor fluctuations and more advanced Hoehn and Yahr stage may be associated with 28-day mortality. Full statistical analysis is in progress.ConclusionsIdentification of Parkinson’s features associated with poor in-hospital COVID-19 outcome will allow a more informed discussion relating to individual COVID-19 risk.

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Foley, Charlene, i Orla G. Killeen. "Musculoskeletal anomalies in children with Down syndrome: an observational study". Archives of Disease in Childhood 104, nr 5 (24.11.2018): 482–87. http://dx.doi.org/10.1136/archdischild-2018-315751.

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BackgroundMusculoskeletal complications of Down syndrome (DS) are common but infrequently reported. The combination of ligamentous laxity and low muscle tone contributes to increased risk of a number of musculoskeletal disorders and a delay in acquisition of motor milestones. The primary aim of this study was to describe musculoskeletal anomalies reported in a national cohort of children with DS.MethodsThis was an observational study. Children with DS, aged 0–21 years, were invited to attend a musculoskeletal assessment clinic conducted by a paediatric physician. Relevant musculoskeletal history and clinical findings were documented.ResultsOver an 18-month period, 503 children with DS were examined (56% male). The median age was 8.1 years (0.6–19.2). Pes planus was almost universal, occurring in 91% of the cohort. A range of other musculoskeletal anomalies were observed, with inflammatory arthritis (7%) and scoliosis (4.8%) occurring most frequently after pes planus. Delay in ambulation was common; the median age to walk was 28 months (12–84).ConclusionChildren with DS are at increased risk of a number of potentially debilitating musculoskeletal problems. These conditions can present in variable manners or be completely asymptomatic. Pes planus is common; therefore, early consideration of orthotics and lifelong appropriate supportive footwear should be considered. Delayed ambulation is frequently noted. A significant proportion of children with DS have arthritis; however, despite a high prevalence, it is often missed, leading to delayed diagnosis. An annual musculoskeletal assessment for all children with DS could potentially enable early detection of problems, allowing for timely multidisciplinary team intervention and better clinical outcomes.

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Jacob, Anju Susan, Sanjith Aaron, Sunithi Mani, Kundavaram Paul Prabhakar Abhilash, Ajay Kumar Mishra, Samuel George Hansdak, Ramya Iyyadurai i in. "Posterior Circulation Strokes – Clinico-Radiological Features and Predictors of Outcome at 6 Months". CHRISMED Journal of Health and Research 10, nr 3 (2023): 252–59. http://dx.doi.org/10.4103/cjhr.cjhr_43_22.

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Introduction: Posterior circulation stroke (PCS) is often diagnosed late and long-term outcomes have not been described in South India. We wished to study clinical features, long-term outcomes, and independent predictors of the same. Materials and Methods: We conducted a prospective cohort study in PCS patients from January 2014 to May 2017. Morbidity and mortality at discharge, at 3 months and 6 months was studied. Univariate and multivariate analysis of predictors of poor outcome as well as the survival analysis was computed. Results: We recruited 291 PCS during the study period; prevalence of PCS among all strokes was 12.9% in 2014. The mean age was 53.34 years (standard deviation 13.34). Young strokes constituted 28.8%. The common comorbidities were hypertension 72%, diabetes mellitus 52.6%, smoking 38.5%, and dyslipidemia 32.6%. The common presenting symptoms were giddiness 79%, unsteadiness 75.35%, ataxia 56%, motor deficits 48.8% and nausea and vomiting 43%. Most were Ischemic strokes (86.5%); 10.3% gave a history of preceding TIAs. Common arteries involved were posterior cerebral 45%, posterior inferior cerebellar 38%, and basilar artery 19.2%. Among ischemic strokes, large artery atherosclerosis was 50.8%. Dysphagia was seen in 32.6% and sepsis in 19.2%; post stroke pain in 23%, followed by cognition decline in 10.3%. Bad outcome (modifies Rankins score 4–6) was 16.8% at discharge, 16.4% at 1 month, 14.4% at 3 months, and 13.8% at 6 months. Independent predictors of bad outcomes at 6 months were baseline National Institute of Health Stroke Scale (NIHSS) score (Odds ratio [OR] 1615.59 confidence interval [CI] 27.64–94447.7), invasive ventilation (OR 7.77 CI 1.57–38.43), sepsis (OR 17.22 CI 1.45–204.08), and basilar artery involvement (OR 19.98 CI 1.67–238.81). Baseline NIHSS scores between 0 and 5 suggest a good outcome while scores more than 13 suggest a bad outcome at 6 months. At 6 months, half are unemployed. Conclusions: The prevalence, clinical features, and comorbidities were also similar to previous studies. There was good survival at 6 months. NIHSS score is useful in predicting poor outcomes.

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Trefan, L., R. Houston, G. Pearson, R. Edwards, P. Hyde, I. Maconochie, RC Parslow i A. Kemp. "Epidemiology of children with head injury: a national overview". Archives of Disease in Childhood 101, nr 6 (14.03.2016): 527–32. http://dx.doi.org/10.1136/archdischild-2015-308424.

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BackgroundThe National Confidential Enquiry describes the epidemiology of children admitted to hospital with head injury.MethodChildren (<15 years old) who died or were admitted for >4 h with head injury were identified from 216 UK hospitals (1 September 2009 to 28 February 2010). Data were collected using standard proformas and entered on to a database. A descriptive analysis of the causal mechanisms, child demographics, neurological impairment, CT findings, and outcome at 72 h are provided.ResultsDetails of 5700 children, median age 4 years (range 0–14.9 years), were analysed; 1093 (19.2%) were <1 year old, 3500 (61.4%) were boys. There was a significant association of head injury with social deprivation 39.7/100 000 (95% CI 37.0 to 42.6) in the least deprived first quintile vs. 55.1 (95% CI 52.1 to 58.2) in the most deprived fifth quintile (p<0.01). Twenty-four children died (0.4%). Most children were admitted for one night or less; 4522 (79%) had a Glasgow Coma Scale score of 15 or were Alert (on AVPU (Alert, Voice, Pain, Unresponsive)). The most common causes of head injury were falls (3537 (62.1%); children <5 years), sports-related incidents (783 (13.7%); median age 12.4 years), or motor vehicle accidents (MVAs) (401 (7.1%); primary-school-aged children). CT scans were performed in 1734 (30.4%) children; 536 (30.9%) were abnormal (skull fracture and/or intracranial injury or abnormality): 269 (7.6%) were falls, 82 (10.5%) sports related and 100 (25%). A total of 357 (6.2%) children were referred to social care because of child protection concerns (median age 9 months (range 0–14.9 years)).ConclusionsThe data described highlight priorities for targeted age-specific head injury prevention and have the potential to provide a baseline to evaluate the effects of regional trauma networks (2012) and National Institute of Health and Care Excellence (NICE) head injury guidelines (2014), which were revised after the study was completed.

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Antunes, Isadora, Kátia Sheylla Malta Purim, Luara Leticia Grande, Nathália Cristina Alberton, Tatiana Francinne Regis Navarro i Thereza Cristina d’Ávila Winckler. "Dermatoses in parkinsonism: the importance of multidisciplinary follow-up". Revista da Associação Médica Brasileira 65, nr 6 (czerwiec 2019): 791–95. http://dx.doi.org/10.1590/1806-9282.65.6.791.

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Summary Parkinsonism is characterized by bradykinesia with rigidity and/or resting tremor, in addition to non-motor symptoms, which include dermatological manifestations. The objective of this study is to evaluate the main dermatoses in patients with parkinsonism found at the Philanthropic Association of Curitiba - PR. A cross-sectional descriptive study was carried out with the application of a questionnaire and dermatological evaluation of the patients. The sample consisted of 386 patients and was composed mainly by men (55.4%), between 60-74 years old (51.6%), with complete primary education (45.3%), disease diagnosis time between 5-10 years (35%) and in use of medication (96.6%). The most prevalent dermatoses were pigmented nevus (36.3%), warts (25.1%), actinic keratosis (22%), seborrheic keratosis (21.5%), seborrheic dermatitis (20.5%), and rosacea (19.2%). Among the 13 cases (3.4%) of malignant cutaneous neoplasms confirmed by biopsy, 2 were melanomas. Regarding patients’ sex, there was a higher prevalence of inflammatory dermatoses (OR 1.64, 95% CI 1.08-2.51, p = 0.025) and benign cutaneous neoplasms (OR 1.77, 95% CI 1.16-2.69, p = 0.01) in men. As to age, patients aged between 60-74 years had more pre-malignant skin lesions (OR 2.60, 95% CI 1.05-6.44, p <0.001) and seborrheic keratosis (OR 2.52, 95% CI 1.02-6.25, p = 0.001) and, in those older than 75 years, actinic keratosis was more frequent (OR 5.43, 95% CI 2.17-13.6, p <0.001). The results of the study show that it is fundamental to dermatologically evaluate and monitor these patients, aiming at diagnosis and early treatment of lesions, especially of skin cancer.

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Giaquinta, Simonetta, Bartolomeo Rossi, Marta Pillon, Elisa Carraro, Alessandra Biffi i Elisabetta Viscardi. "QOL-32. Patients treated for malignant brain tumor in the first three years of life: clinical sequelae". Neuro-Oncology 24, Supplement_1 (1.06.2022): i141. http://dx.doi.org/10.1093/neuonc/noac079.515.

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Abstract BACKGROUND: Pediatric Central Nervous System tumors are the most common solid tumors in children with a higher incidence rate in the first years of life. Patients treated for brain tumor are at high risk of sequelae. In the first years of life, brain immaturity increases the risk of developing these complications. OBJECTIVE: The goal of this study was to evaluate the medium and long term sequelae of malignant brain tumor treatment in patients diagnosed in the first three years of life and to correlate these sequelae with tumor histology, localization and treatment. PATIENTS AND METHODS: Forty - nine children with aggressive brain tumor diagnosed in the first three years of life followed in the Pediatric Hematology and Oncology Department of Padua between January 2000 and December 2020 were enrolled in this study. We evaluated features, such as age at onset, tumor localization, neurosurgical resection, histology, treatment and patient outocome. From May to September 2021 we clinically evaluated 16 of them who survived to treatment and we identified the presence of visual impairment, hearing loss, endocrine dysfunctions and neurological deficits in them. RESULTS: The most common sequelae in our patient population is motor impairment (30.8%), followed by endocrine dysfunction (23%), visual impairment (19.2%), epilepsy (11.6%), cranial nerve palsy (7.7%) and hearing loss (7.7%). In this study epilepsy is significantly associated with supratentorial tumors and endocrine dysfunction with high dose chemotherapy. CONCLUSIONS: Our data and recent literature confirm the high incidence of tumor and treatment sequelae in these patients. Therefore, since diagnosis, a multidisciplinary evaluation and management are necessary for improving patients’ prognosis.

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Nakao, Hidetoshi, Masakazu Imaoka, Mitsumasa Hida, Ryota Imai, Fumie Tazaki, Takeshi Morifuji, Masashi Hashimoto i Misa Nakamura. "Correlation of medial longitudinal arch morphology with body characteristics and locomotive function in community-dwelling older women: A cross-sectional study". Journal of Orthopaedic Surgery 29, nr 2 (1.05.2021): 230949902110155. http://dx.doi.org/10.1177/23094990211015504.

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Purpose: This cross-sectional study aimed to investigate the effects of foot arch deformities on physical characteristics, muscular strength, and motor function in older women depending on the presence or absence of pain. Methods: Overall, 145 community-dwelling women aged 65 to 90 years were included in this study. We measured the foot arch height ratio (AHR, dorsal height/truncated foot length) and classified participants with AHR values above, below, or within 1.5 standard deviations into the high-arched group (HAG), Low-Arched Group (LAG), or normal-arched group (NAG), respectively. We also compared body characteristics (age, height, weight, body mass index (BMI), and skeletal mass index), muscle strength (handgrip strength and intrinsic foot strength (IFS)), and locomotive function (two-step value and gait speed) among the three groups. Results: Locomotive examination and muscle strength showed significant differences among the three groups only in the presence of pain; in the two-step test, HAG, NAG, and LAG values were 0.98 cm/cm, 1.19 cm/cm, and 1.18 cm/cm, respectively. The IFS measured 19.2 N, 24.2 N, 31.0 N, respectively, in the HAG, NAG, and LAG. Conclusion: This study suggests that decreased IFS affects the mobility function of high-arched feet in older women. Although there was no significant difference in the evaluation of pain, HAG showed the highest average value, which is considered to contribute to the decreased two-step value. It has been suggested that a high-arched foot in the presence of pain is associated with IFS weakness and may affect the decline of mobility function in older women.

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Cardoso, Ricardo Galesso, Carina Fontana Francischini, Jorge Michel Ribera, Ricardo Vanzetto i Gustavo Pereira Fraga. "Helicopter emergency medical rescue for the traumatized: experience in the metropolitan region of Campinas, Brazil". Revista do Colégio Brasileiro de Cirurgiões 41, nr 4 (sierpień 2014): 236–44. http://dx.doi.org/10.1590/0100-69912014004003.

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OBJECTIVE: To analyze the profile of patients served by the air medical rescue system in the Metropolitan Region of Campinas, evaluating: triage and mobilization criteria; response time; on-site care and transport time; invasive procedures performed in the Pre-Hospital Care (PHC); severity of patients; morbidity and mortality.METHODS: We conducted a prospective, descriptive study in which we analyzed medical records of patients rescued between July 2010 and December 2012. During this period, 242 victims were taken to the HC-Unicamp. Of the 242 patients, 22 were excluded from the study.RESULTS: of the 220 cases evaluated, 173 (78.6%) were male, with a mean age of 32 years. Blunt trauma was the most prevalent (207 cases - 94.1%), motorcycle accidents being the most common mechanisms of injury (66 cases - 30%), followed by motor vehicle collisions (51 cases - 23.2%). The average response time was 10 ± 4 minutes and the averaged total pre-hospital time was 42 ± 11 minutes. The mean values of the trauma indices were: RTS = 6.2 ± 2.2; ISS = 19.2 ± 12.6; and TRISS = 0.78 ± 0.3. Tracheal intubation in the pre-hospital environment was performed in 77 cases (35%); 43 patients (19.5%) had RTS of 7.84 and ISSd"9, being classified as over-triaged. Of all patients admitted, the mortality was 15.9% (35 cases).CONCLUSION: studies of air medical rescue in Brazil are required due to the investments made in the pre-hospital care in a country without an organized trauma system. The high rate of over-triage found highlights the need to improve the triage and mobilization criteria.

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Namanja, Alice, i Vincent Samuel Phiri. "Quality of life of primary caregivers of children living with cerebral palsy at two clinics in Blantyre, Malawi". Malawi Medical Journal 34, nr 3 (5.10.2022): 176–83. http://dx.doi.org/10.4314/mmj.v34i3.6.

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Introduction In Malawi, Primary Caregivers (PCGs) of children living with Cerebral Palsy report challenges such as physical strain and lack of resources that affect care giving. Although such experiences affect the PCGs’ Quality of Life (QoL), there is paucity of data for Malawi. Understanding their QoL would inform establishment of holistic intervention(s) tailored to meet their needs. Therefore, the purposes of this study were to determine QoL of PCGs of the children who were receiving rehabilitation at Queen Elizabeth Central Hospital (QECH) and Feed the Children (FtC), to identify PCG’s and children’s socio-demographic factors that may attribute to the perceived QoL, and to compare the PCGs’ QoL between the sites. Methods A cross-sectional study was conducted from January to April 2019 on 142 PCGs of children aged between 2 and 18 years of age. All PCGs who were employed for the child-care, or had a chronic sickness were excluded. QoL was assessed using the World Health Organization Brief questionnaire, with a cut-off point of <60% for poor QoL. The severity of children’s impairments was assessed using Gross Motor Function Classification System. Descriptive and inferential statistics were conducted to analyze the data. The PCGs’ age, sex, marital status and level of education, and child’s severity of impairment were compared with QoL. Results The majority of PCGs (61.30%) had poor QoL, and there was no significant difference in overall QoL of the PCGs between the sites (p<0.31). The PCGs at QECH had significantly higher physical domain mean scores than at FtC (U=1906, p<0.01). The overall QoL differed significantly across the marital statuses of the PCGs (p<0.03). Conclusion The study has established that most PCGs at both sites possess poor QoL. However, there is need to investigate how the rehabilitation institutions and workers influence the QoL of the PCGs within and between the facilities.

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Walton, Samuel R., Donna K. Broshek, Jason R. Freeman, Jay Hertel, J. Patrick Meyer, Nicholas K. Erdman i Jacob E. Resch. "Institutionally Based ImPACT Test® Normative Values May Differ from Manufacturer-Provided Normative Values". Archives of Clinical Neuropsychology 35, nr 3 (11.11.2019): 275–82. http://dx.doi.org/10.1093/arclin/acz068.

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Abstract Objective The necessity for pre-injury baseline computerized neurocognitive assessments versus comparing post-concussion outcomes to manufacturer-provided normative data is unclear. Manufacturer-provided norms may not be equivalent to institution-specific norms, which poses risks for misclassifying the presence of impairment when comparing individual post-concussion performance to manufacturer-provided norms. The objective of this cohort study was to compare institutionally derived normative data to manufacturer-provided normative values provided by ImPACT® Applications, Incorporated. Method National Collegiate Athletic Association Division 1 university student athletes (n = 952; aged 19.2 ± 1.4 years, 42.5% female) from one university participated in this study by completing pre-injury baseline Immediate Post-Concussion Assessment and Cognitive Test (ImPACT) assessments. Participants were separated into 4 groups based on ImPACT’s age and gender norms: males <18 years old (n = 186), females <18 years old (n = 165), males >19 years old (n = 361) or females >19 years old (n = 240). Comparisons were made between manufacturer-provided norms and institutionally derived normative data for each of ImPACT’s clinical composite scores: Verbal (VEM) and Visual (VIM) Memory, Visual Motor Speed (VMS), and Reaction Time (RT). Outcome scores were compared for all groups using a Chi-squared goodness of fit analysis. Results Institutionally derived normative data indicated above average performance for VEM, VIM, and VMS, and slightly below average performance for RT compared to the manufacturer-provided data (χ2 ≥ 20.867; p < 0.001). Conclusions Differences between manufacturer- and institution-based normative value distributions were observed. This has implications for an increased risk of misclassifying impairment following a concussion in lieu of comparison to baseline assessment and therefore supports the need to utilize baseline testing when feasible, or otherwise compare to institutionally derived norms rather than manufacturer-provided norms.

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Thorpe, Deborah E., Jane E. Alty i Peter A. Kempster. "Health at the writing desk of John Ruskin: a study of handwriting and illness". Medical Humanities 46, nr 1 (31.07.2019): 31–45. http://dx.doi.org/10.1136/medhum-2018-011600.

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Though John Ruskin (1819–1900) is remembered principally for his work as a theorist, art critic and historian of visual culture, he wrote exhaustively about his health in his correspondence and diaries. Ruskin was prone to recurring depressive and hypochondriacal feelings in his youth and adulthood. In 1871, at the age of 52 years, he developed an illness with relapsing psychiatric and neurological features. He had a series of attacks of brain disturbance, and a deterioration of his mental faculties affected his writing for years before curtailing his career a decade before he died. Previous writers have suggested he had a psychiatric malady, perhaps schizophrenia or schizoaffective disorder. But the more obvious conclusion from a close medical reading of Ruskin’s descriptions of his illness is he had some sort of ‘organic’ brain illness. This paper aims to give insight into the relationship between Ruskin’s state of well-being and the features of his writing through a palaeographical study of his letters and diary entries. We examine the handwriting for physical traces of Ruskin’s major brain illness, guided by the historical narrative of the illness. We also examine Ruskin’s recording of his experiences for what they reveal about the failure of his health and its impact on his work. Ruskin’s handwriting does not have clear-cut pathological features before around 1885, though suggestions of subtle writing deficits were present as early as 1876. After 1887, Ruskin’s handwriting shows fixed pathological signs—tremor, disturbed letter formation and features that reflect a slow and laborious process of writing. These observations are more than could be explained by normal ageing, and suggest the presence of a neurological deficit affecting writing control. Our findings are consistent with conclusions that we drew from the historical record—that John Ruskin had an organic neurological disorder with cognitive, behavioural, psychiatric and motor effects.

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Skouras, Stavros, Jordi Torner, Patrik Andersson, Yury Koush, Carles Falcon, Carolina Minguillon, Karine Fauria i in. "Earliest amyloid and tau deposition modulate the influence of limbic networks during closed-loop hippocampal downregulation". Brain 143, nr 3 (24.02.2020): 976–92. http://dx.doi.org/10.1093/brain/awaa011.

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Abstract Research into hippocampal self-regulation abilities may help determine the clinical significance of hippocampal hyperactivity throughout the pathophysiological continuum of Alzheimer’s disease. In this study, we aimed to identify the effects of amyloid-β peptide 42 (amyloid-β42) and phosphorylated tau on the patterns of functional connectomics involved in hippocampal downregulation. We identified 48 cognitively unimpaired participants (22 with elevated CSF amyloid-β peptide 42 levels, 15 with elevated CSF phosphorylated tau levels, mean age of 62.705 ± 4.628 years), from the population-based ‘Alzheimer’s and Families’ study, with baseline MRI, CSF biomarkers, APOE genotyping and neuropsychological evaluation. We developed a closed-loop, real-time functional MRI neurofeedback task with virtual reality and tailored it for training downregulation of hippocampal subfield cornu ammonis 1 (CA1). Neurofeedback performance score, cognitive reserve score, hippocampal volume, number of apolipoprotein ε4 alleles and sex were controlled for as confounds in all cross-sectional analyses. First, using voxel-wise multiple regression analysis and controlling for CSF biomarkers, we identified the effect of healthy ageing on eigenvector centrality, a measure of each voxel’s overall influence based on iterative whole-brain connectomics, during hippocampal CA1 downregulation. Then, controlling for age, we identified the effects of abnormal CSF amyloid-β42 and phosphorylated tau levels on eigenvector centrality during hippocampal CA1 downregulation. Across subjects, our main findings during hippocampal downregulation were: (i) in the absence of abnormal biomarkers, age correlated with eigenvector centrality negatively in the insula and midcingulate cortex, and positively in the inferior temporal gyrus; (ii) abnormal CSF amyloid-β42 (<1098) correlated negatively with eigenvector centrality in the anterior cingulate cortex and primary motor cortex; and (iii) abnormal CSF phosphorylated tau levels (>19.2) correlated with eigenvector centrality positively in the ventral striatum, anterior cingulate and somatosensory cortex, and negatively in the precuneus and orbitofrontal cortex. During resting state functional MRI, similar eigenvector centrality patterns in the cingulate had previously been associated to CSF biomarkers in mild cognitive impairment and dementia patients. Using the developed closed-loop paradigm, we observed such patterns, which are characteristic of advanced disease stages, during a much earlier presymptomatic phase. In the absence of CSF biomarkers, our non-invasive, interactive, adaptive and gamified neuroimaging procedure may provide important information for clinical prognosis and monitoring of therapeutic efficacy. We have released the developed paradigm and analysis pipeline as open-source software to facilitate replication studies.

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Sharma, Mukul, Robert G. Hart, Eric E. Smith, Jackie Bosch, Fei Yuan, Amparo Casanova, John W. Eikelboom i in. "Rationale, design, and baseline participant characteristics in the MRI and cognitive substudy of the cardiovascular outcomes for people using anticoagulation strategies trial". International Journal of Stroke 14, nr 3 (30.07.2018): 270–81. http://dx.doi.org/10.1177/1747493018784478.

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Background Covert vascular disease of the brain manifests as infarcts, white matter hyperintensities, and microbleeds on MRI. Their cumulative effect is often a decline in cognition, motor impairment, and psychiatric disorders. Preventive therapies for covert brain ischemia have not been established but represent a huge unmet clinical need. Aims The MRI substudy examines the effects of the antithrombotic regimens in COMPASS on incident covert brain infarcts (the primary outcome), white matter hyperintensities, and cognitive and functional status in a sample of consenting COMPASS participants without contraindications to MRI. Methods COMPASS is a randomized superiority trial testing rivaroxaban 2.5 mg bid plus acetylsalicylic acid 100 mg and rivaroxaban 5 mg bid against acetylsalicylic acid 100 mg per day for the combined endpoint of MI, stroke, and cardiovascular death in individuals with stable coronary artery disease or peripheral artery disease. T1-weighted, T2-weighted, T2*-weighted, and FLAIR images were obtained close to randomization and near the termination of assigned antithrombotic therapy; biomarker and genetic samples at randomization and one month, and cognitive and functional assessment at randomization, after two years and at the end of study. Results Between March 2013 and May 2016, 1905 participants were recruited from 86 centers in 16 countries. Of these participants, 1760 underwent baseline MRI scans that were deemed technically adequate for interpretation. The mean age at entry of participants with interpretable MRI was 71 years and 23.5% were women. Coronary artery disease was present in 90.4% and 28.1% had peripheral artery disease. Brain infarcts were present in 34.8%, 29.3% had cerebral microbleeds, and 93.0% had white matter hyperintensities. The median Montreal Cognitive Assessment score was 26 (interquartile range 23–28). Conclusions The COMPASS MRI substudy will examine the effect of the antithrombotic interventions on MRI-determined covert brain infarcts and cognition. Demonstration of a therapeutic effect of the antithrombotic regimens on brain infarcts would have implications for prevention of cognitive decline and provide insight into the pathogenesis of vascular cognitive decline.

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Koh, Hyun Yong, Lacey Smith, Kimberly N. Wiltrout, Archana Podury, Nitish Chourasia, Alissa M. D’Gama, Meredith Park i in. "Utility of Exome Sequencing for Diagnosis in Unexplained Pediatric-Onset Epilepsy". JAMA Network Open 6, nr 7 (20.07.2023): e2324380. http://dx.doi.org/10.1001/jamanetworkopen.2023.24380.

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ImportanceGenomic advances inform our understanding of epilepsy and can be translated to patients as precision diagnoses that influence clinical treatment, prognosis, and counseling.ObjectiveTo delineate the genetic landscape of pediatric epilepsy and clinical utility of genetic diagnoses for patients with epilepsy.Design, Setting, and ParticipantsThis cohort study used phenotypic data from medical records and treating clinicians at a pediatric hospital to identify patients with unexplained pediatric-onset epilepsy. Exome sequencing was performed for 522 patients and available biological parents, and sequencing data were analyzed for single nucleotide variants (SNVs) and copy number variants (CNVs). Variant pathogenicity was assessed, patients were provided with their diagnostic results, and clinical utility was evaluated. Patients were enrolled from August 2018 to October 2021, and data were analyzed through December 2022.ExposuresPhenotypic features associated with diagnostic genetic results.Main Outcomes and MeasuresMain outcomes included diagnostic yield and clinical utility. Diagnostic findings included variants curated as pathogenic, likely pathogenic (PLP), or diagnostic variants of uncertain significance (VUS) with clinical features consistent with the involved gene’s associated phenotype. The proportion of the cohort with diagnostic findings, the genes involved, and their clinical utility, defined as impact on clinical treatment, prognosis, or surveillance, are reported.ResultsA total of 522 children (269 [51.5%] male; mean [SD] age at seizure onset, 1.2 [1.4] years) were enrolled, including 142 children (27%) with developmental epileptic encephalopathy and 263 children (50.4%) with intellectual disability. Of these, 100 participants (19.2%) had identifiable genetic explanations for their seizures: 89 participants had SNVs (87 germline, 2 somatic mosaic) involving 69 genes, and 11 participants had CNVs. The likelihood of identifying a genetic diagnosis was highest in patients with intellectual disability (adjusted odds ratio [aOR], 2.44; 95% CI, 1.40-4.26), early onset seizures (aOR, 0.93; 95% CI, 0.88-0.98), and motor impairment (aOR, 2.19; 95% CI 1.34-3.58). Among 43 patients with apparently de novo variants, 2 were subsequently determined to have asymptomatic parents harboring mosaic variants. Of 71 patients who received diagnostic results and were followed clinically, 29 (41%) had documented clinical utility resulting from their genetic diagnoses.Conclusions and RelevanceThese findings suggest that pediatric-onset epilepsy is genetically heterogeneous and that some patients with previously unexplained pediatric-onset epilepsy had genetic diagnoses with direct clinical implications.

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Killgore, William, Kymberly Henderson-Arredondo, Samantha Jankowski, Salma Patel, Lindsey Hildebrand, Alisa Huskey, David Negelspach i in. "0677 Winding down for the Night: Changes in Thalamocortical Connectivity Before Bed Are Associated with Deeper Sleep". SLEEP 47, Supplement_1 (20.04.2024): A289—A290. http://dx.doi.org/10.1093/sleep/zsae067.0677.

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Abstract Introduction According to the arousal hypothesis, insomnia is often the result of excessive cognitive and somatic arousal during the sleep period. Individuals with insomnia show greater cortico-thalamic functional connectivity during waking hours than healthy sleepers. However, prior studies have only examined such connectivity at a static time point without considering dynamic changes in cortico-thalamic connectivity in the hours prior to sleep. Here, we examined the association between changes in cortico-thalamic connectivity across the 4-hours prior to sleep and subsequent overnight sleep parameters measured by polysomnography (PSG) among individuals with insomnia. Methods Twenty participants (12 female; age=26.9, SD=6.6 years) with insomnia symptoms completed two serial resting-state functional connectivity (rsFC) MRI sessions in the early evening (1900-2000 and 2100-2200 hrs.) followed by PSG monitored sleep from 2300 to 0700 in a controlled sleep laboratory. Sleep parameters, including time in wake, N1, N2, N3, total sleep time (TST), sleep efficiency (SE), and rapid eye movement (REM) sleep were entered into a series of seed-to-voxel whole-brain analyses using the CONN Toolbox (v21.a). The seed region comprised bilateral thalami as defined by the Automated Anatomical Labeling Atlas. The correlation between the change in cortico-thalamic connectivity and subsequent time in each sleep stage was calculated. Data were analyzed with peak threshold of p<.005 (uncorrected) and p<.05 False-Discovery-Rate (FDR) cluster correction. Results Greater declines in cortico-thalamic connectivity prior to bedtime were associated with significantly more N3 sleep (i.e., anticorrelated connectivity to left orbitofrontal cortex, middle frontal gyrus, putamen, insula, and medial prefrontal/paracingulate gyrus), and more REM sleep (i.e., anticorrelated connectivity to the left lateral occipital cortex). Interestingly, greater cortico-thalamic connectivity to the bilateral visual cortex and frontal pole during this same pre-sleep period was associated with more time in stage N2 sleep. Changes in connectivity were not associated with wake, N1, TST, or SE. Conclusion Among individuals with insomnia, greater declines in cortico-thalamic connectivity, particularly regions associated with emotion, interoception, and sensory-motor processes, predicted more time in slow-wave sleep, also known as the ‘deep sleep’ stage. Findings support the arousal hypothesis and suggest that interventions that facilitate cortico-thalamic gating may prove useful in facilitating sleep and treating insomnia. Support (if any) USAMRAA: W81XWH2010173

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Drummond, Di, Albert Churella, Francis Desiderio, John Hibbs, Colin Chant, Jacek Wesołowski, Lena Andersson-Skog i in. "Book Reviews: The Great Train Race: Railways and the Franco-German Rivalry, Railroads in the Civil War: The Impact of Management on Victory and Defeat, Automobility: Social Change and the American South, 1909–1939, Transport Lessons from the Fuel Tax Protests of 2000, Transport and Society Series, Suburbanizing the Masses: Public Transport and Urban Development in Historical Perspective, the City and the Railway in Europe, Spår i vägen: Teknikval, politik & spårvägstrafik i Stockholm 1920–2002, Stockholm Papers in the History and Philosophy of Technology TRITA-HOT 2044, Government Birds: Air Transport and the State in Western Europe, the Managed Heart: Commercialization of Human Feeling, Die Semmeringbahn. Der Bau der ersten Hochgebirgsbahn der Welt, Bibliographie der österreichischen Eisenbahnliteratur von den Anfängen bis 1918, the Windermere Ferry: History, Boats, Ferrymen and Passengers, Daily Life in the Age of Sail, Travel in the Byzantine World: Papers from the Thirty-Fourth Spring Symposium of Byzantine Studies, Birmingham, April 2000, Vauxhall Motors and the Luton Economy, 1900–2002, Three Men in a Hupp: Around the World by Automobile, 1910–1912". Journal of Transport History 25, nr 2 (wrzesień 2004): 140–59. http://dx.doi.org/10.7227/tjth.25.2.9.

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Balbi, Gabriele, Dan Bogart, Kurt R. Bell, Koos Bosma, Harry Gregory, Alfred M. Hirt, Felix Jeschke i in. "Book Reviews: Vie e mezzi di comunicazione in Italia e Spagna in età contemporanea (Networks and Means of Communication in Contemporary Italy and Spain), Bristol's Stage Coaches, Wet Britches and Muddy Boots: A History of Travel in Victorian America, Aerocity. Quand l'avion fait la ville (Aerocity: When the Plane Made the City, Paddington Station, Its History and Architecture, Highways, Byways, and Road Systems in the Pre-Modern World, Eastern European Railways in Transition: Nineteenth to Twenty-First Centuries, Companion to Road Passenger Transport History: Public Road Passenger Transport in Great Britain, Ireland, the Channel Islands and the Isle of Man, Autos, Rutas y Turismo: El Automóvil Club Argentino y el Estado (Cars, Roads and Tourism: The Argentinean Motor Club and State, Tales of Transit: Narrative Migrant Spaces in Atlantic Perspective, 1850–1950, Channelling Mobilities: Migration and Globalisation in the Suez Canal and Beyond, 1869–1914, Transport and the Industrial City. Manchester and the Canal Age, 1750–1850, Business of Transatlantic Migration between Europe and the United States, 1900–1914". Journal of Transport History 35, nr 2 (grudzień 2014): 251–70. http://dx.doi.org/10.7227/tjth.35.2.11.

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Valentine, Jane, Sue-Anne Davidson, Natasha Bear, Eve Blair, Lisa Paterson, Roslyn Ward, David Forbes i Catherine Elliott. "A prospective study investigating gross motor function of children with cerebral palsy and GMFCS level II after long-term Botulinum toxin type A use". BMC Pediatrics 20, nr 1 (6.01.2020). http://dx.doi.org/10.1186/s12887-019-1906-8.

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Abstract Background The aim of this study is to contribute to the knowledge base on the long-term outcomes of evidence-based medical interventions used to improve gross motor function in children and adolescents with Cerebral Palsy. Method Prospective cohort study of children with Cerebral Palsy in the birth years 2000–2009 attending a tertiary level service for children with Cerebral Palsy who’s first recorded Gross Motor Function Classification System level was II. Results A total of 40 children were eligible for the study, of whom 28 (72.7%) enrolled. The Botulinum toxin A treatment for this cohort, (median and interquartile ranges) were: total number of lower limb Botulinum toxin A injections 11 (6.7, 5.5); total dose of Botulinum Toxin A per lower limb treatment 6.95 u/kg (4.5, 11); and dose of Botulinum Toxin u/kg/muscle 2.95 (2.2, 4). For all 28 subjects there was a median of 15 (8.5 to 22) Gross Motor Function Classification System level recordings: six of the 28 children (21.4%) improved from level II to level I, the remaining 22 children remained stable at level II (78.6%). In this highly treated population, the average 66 item Gross Motor Function Measure score for the 22 children in level II was 72.55, which is consistent with the mean of 68.5 reported in the original Ontario cohort. Conclusion This cohort study has confirmed that children with Cerebral Palsy, Gross Motor Function level II treated at a young age with repeated doses of Botulinum Toxin A within an integrated comprehensive service, maintain or improve their functional motor level at a later age.

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Shirshova, Elena. "Affective disorders and сognitive impairment in the early stages of Parkinson's disease." Journal of Clinical Practice, 6.05.2022. http://dx.doi.org/10.17816/clinpract100026.

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Parkinson's disease (BP) is the second most important age-related neurodegenerative disease in developed societies after Alzheimer's disease with a prevalence of 41 per 100,000 in the fourth decade of life to more than 1900 per 100,000 people over 80 years old. Parkinson's disease (BP) is the second most important age-related neidgenerative disease in developed societies after Alzheimer's disease with a prevalence of 41 per 100,000 in the fourth decade of life to more than 1900 per 100,000 people over 80 years old. Neurodegeneration associated with Parkinson's disease is likely to occur over several decades before the appearance of motor symptoms. Affective and cognitive some of the most frequent non-engine manifestations of BP diseases that can lead to a variety of adverse outcomes

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Chen, Yuanzhi, Zhong Cheng Luo, Ting Zhang, Pianpian Fan, Rui Ma, Jun Zhang i Fengxiu Ouyang. "Maternal thyroid dysfunction and neuropsychological development in children". Journal of Clinical Endocrinology & Metabolism, 5.10.2022. http://dx.doi.org/10.1210/clinem/dgac577.

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Abstract Context Thyroid hormones are essential for fetal brain development. The potential effects of maternal gestational thyroid dysfunction on offspring neuropsychological development remain inconclusive. Objective To estimate effects of maternal thyroid dysfunction during pregnancy on offspring neuropsychological development in the first two years. Design, participants and methods We prospectively examined 1903 mothers and their children from Shanghai Birth Cohort. Thyroid hormones were assessed at about 12 gestational weeks. Maternal thyroid function was classified into seven categories: euthyroid, overt/subclinical hyperthyroidism, overt/subclinical hypothyroidism, hyperthyroxinemia and hypothyroxinemia. Neuropsychological development was assessed by Ages and Stages Questionnaire at age 6 months, and Bayley Scales at age 24 months. Results Compared with children of euthyroid mothers, maternal overt hypothyroidism was associated with 7.0 points (95% CI 1.7, 12.4) lower scores in personal-social domain in girls aged 6 months, 7.3 points (2.0, 12.6) lower in motor domain, and 7.7 points (1.1, 14.2) lower social-emotional scores in boys at age 24 months; maternal subclinical hypothyroidism was associated with 6.5 points (1.0, 12.1) poorer social-emotional domain in boys at age 6 months, and 7.4 points (0.1, 14.8) poorer adaptive behavior domain in boys at age 24 months; maternal hypothyroxinemia was associated with 9.3 points (3.5, 15.1) lower motor scores in boys at age 24 months; maternal subclinical hyperthyroidism was associated with 6.9 points (0.1, 13.7) lower language scores in girls at age 24 months. Conclusions Maternal overt hypothyroidism, subclinical hypo/hyperthyroidism, and hypothyroxinemia during early pregnancy were associated with weakened neuropsychological development in infancy, and some effects may be sex-specific.

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H.I., Abunaya, J. Devanand i Kannaki L. "STUDY TO COMPARE THE EFFECTIVENESS OF POSTOPERATIVE ANALGESIA USING INTRATHECAL CLONIDINE WITH BUPIVACAINE IN INGUINAL HERNIA SURGERIES". INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH, 1.12.2022, 67–69. http://dx.doi.org/10.36106/ijsr/3111321.

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vBackground: For lower limb and lower abdominal surgeries, the standard anaesthetic technique is subarachnoid block. Adrenaline being the rst spinal adjuvant used to increase the duration and to reduce the toxicity of spinal anaesthesia in 1903. Many drugs have been tried in search for an ideal adjuvant. Recently it was found that use of clonidine in combination with local anaesthetic prolongs the local anaesthetic effect. Aim: To evaluate the duration of post-operative analgesia provided by two varying doses of clonidine with bupivacaine against bupivacaine alone in inguinal hernia surgeries.Materials and Method:It was a double blinded study in which patients were randomly allocated into 3. Group I received only intrathecal bupivacaine 2.5mg. Group II received bupicaine2.5mg + clonidine 30μg. Group III received bupivacaine 2.5mg + clonidine 45μg. Age of patient, Pulse rate, mean arterial pressure, Sensory and motor parameters and duration of analgesia were assessed. Results were analysed using SPSS 20.0 version and the association was tested using Chi square test. Results: The study was conducted in 90 patients with 30 patients each in Group A, B and C. Mean age was 51.6, 53.1 and 56.5 in Group A, B and C respectively. Fall is in pulse rate was more in Group III. Time taken for onset of sensory block and motor blockage was high for group C when compared to other groups with a mean period of 8.9 and 9.4 minutes respectively. The duration of motor blockade and duration of postoperative analgesia was prolonged in groups II and III compared to group I patients. On comparison with 3 groups the p value was statistically signicant for duration of motor blockage and postoperative analgesia (p value 0.001). Conclusion: Increasing the dosage of clonidine will decrease the pulse rate signicantly but Intrathecal clonidine along with bupivacaine signicantly and prolongs the duration of post-operative analgesia.

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Carpinelli, Luna, Giulia Savarese, Claudio Russo, Giovanna Stornaiuolo, Ettore Luisi, Francesca Pellegrino, Monica Mollo i Maria Teresa Pellecchia. "Caregivers’ Burden in Parkinson’s Disease: A Study on Related Features and Attachment Styles". Human Arenas, 2.06.2023. http://dx.doi.org/10.1007/s42087-023-00350-w.

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Abstract Parkinson’s disease (PD) is a chronic progressive neurological disease clinically characterized by motor and non-motor symptoms, with an increasing impact on the quality of life not only for the patient but also for the caregivers. Twenty-six primary caregivers (female = 19; mean age = 57.04, SD = 10.64) of PD patients were consecutively recruited. Several psychological aspects were verified through clinical screening tests: EQ-5D and PQoL CARER for quality of life, Hospital Anxiety and Depression Scale (HADS), Caregiver Burden Inventory (CBI), Family Strain Questionnaire (FSQ), and Adult Attachment Questionnaire. We found that the burden was generally higher in cohabiting female caregivers of patients with dementia as compared with not cohabiting caregivers. Severe burden emerged in 7.7% of the participants according to the PQoL. The mean score of this scale was higher in cohabiting caregivers. Finally, according to the CBI, 19.2% of the participants suffered from severe burden, with mean scores of the CIB-S and CIB-E subscales higher in cohabitants. Our study highlights the need to investigate more thoroughly the burden of caregivers of PD patients and its associated factors, and to pay more attention to the physical and psychological health of caregivers to improve their quality of life.

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Dei Cas, Alessandra, Raffaella Aldigeri, Alessandro Mantovani, Maria Masulli, Luisa Palmisano, Franco Cavalot, Katia Bonomo i in. "Sex differences in cardiovascular disease and cardiovascular risk estimation in patients with type 1 diabetes". Journal of Clinical Endocrinology & Metabolism, 7.03.2023. http://dx.doi.org/10.1210/clinem/dgad127.

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Abstract Aims Patients with type 1 diabetes (T1D) have higher cardiovascular disease (CVD) risk compared to the general population. This observational study aims to evaluate sex-related differences in CVD prevalence and CVD risk estimates in a large cohort of T1D adults. Materials and Methods We conducted a multicenter, cross-sectional study involving 2,041 T1D patients (mean age 46 years; 44.9% women). In patients without pre-existing CVD (primary prevention), we calculated the Steno type 1 risk engine to estimate the 10-year risk of developing CVD events. Results CVD prevalence (n=116) was higher in men than in women aged ≥55 years (19.2 vs 12.8%, p=0.036), but comparable between the two sexes in those aged <55 years (p=0.91). In patients without pre-existing CVD (n=1,925), mean 10-year estimated CVD risk was 15.4±0.4% without any significant sex difference. However, stratifying this patient group by age, the 10-year estimated CVD risk was significantly higher in men than in women until age 55 years (p<0.001), but this risk equalized after this age. Carotid-artery plaque burden was significantly associated with age ≥55 years and with a medium and high 10-year estimated CVD risk, without any significant sex difference. Diabetic retinopathy and sensory-motor neuropathy were also associated with higher 10-year CVD risk and female sex. Conclusions Both men and women with T1D are at high CVD risk. The 10-year estimated CVD risk was higher in men aged <55 years than in women of similar age, but these sex differences disappeared at age ≥55 years, suggesting that female sex was no longer protective.

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Handley, Sara C., Neha Kumbhat, Barry Eggleston, Elizabeth E. Foglia, Alexis S. Davis, Krisa Van Meurs, Satyan Lakshminrusimha i in. "Exposure to umbilical cord management approaches and death or neurodevelopmental impairment at 22–26 months’ corrected age after extremely preterm birth". Archives of Disease in Childhood - Fetal and Neonatal Edition, 17.10.2022, fetalneonatal—2022–324565. http://dx.doi.org/10.1136/archdischild-2022-324565.

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ObjectiveTo compare death or severe neurodevelopmental impairment (NDI) at 22–26 months’ corrected age (CA) among extremely preterm infants following exposure to different forms of umbilical cord management.DesignRetrospective study.SettingEunice Kennedy ShriverNational Institute of Child Health and Human Development Neonatal Research Network registry.PatientsInfants born <27 weeks’ gestation in 2016–2018 without severe congenital anomalies who received active treatment after birth and underwent neurodevelopmental assessments between 22 and 26 months’ CA.ExposuresImmediate cord clamping (ICC), delayed cord clamping (DCC) or umbilical cord milking (UCM).Main outcomes and measurePrimary composite outcome of death or severe NDI at 22–26 months’ CA, defined as severe cerebral palsy, Bayley-III cognitive/motor composite score <70, bilateral deafness or blindness; individual components were examined as secondary outcomes. Multivariable regression examined associations, adjusting for risk factors identified a priori and potential confounders. Mediation analysis explored the effect of severe intraventricular haemorrhage (IVH) on the exposure-outcome relationship.ResultsAmong 1900 infants, 64.1% were exposed to ICC, 27.8% to DCC and 8.1% to UCM. Compared with ICC-exposed infants, DCC-exposed infants had lower odds of death or severe NDI (adjusted OR 0.64, 95% CI 0.50 to 0.83). No statistically significant differences were observed when comparing UCM with either ICC or DCC, or between secondary outcomes across groups. Association between cord management and the primary outcome was not mediated by severe IVH.ConclusionCompared with ICC, DCC exposure was associated with lower death or severe NDI at 22–26 months’ CA among extremely preterm infants, which was not mediated by severe IVH.

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Darwish, Hoda Salah, Rasha ElShafey i Hanaa Kamel. "Prediction of Motor Recovery after Stroke by Assessment of Corticospinal Tract Wallerian Degeneration Using Diffusion Tensor Imaging". Indian Journal of Radiology and Imaging, 31.05.2021. http://dx.doi.org/10.1055/s-0041-1729671.

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Abstract Aim of the Study To predict motor recovery after stroke by detection of diffusion tensor imaging (DTI) fractional anisotropy (FA) changes of corticospinal tract (CST) and correlate findings with clinical scores to provide more effective treatment and rehabilitation. Subjects and Methods Thirty patients with cerebral stroke were enrolled and underwent conventional magnetic resonance imaging and DTI at admission and 1 month after stroke. Mean diffusivity (MD), FA, FA ratio (rFA), and fiber number (FN) values of CST were calculated at the pons at admission and after 1 month of stroke. Three-dimensional reconstruction of bilateral CST and the structural changes of fibrous bands were observed. Severity of limb weakness was assessed by using the motor sub-index scores of the National Institutes of Health Stroke Scale (NIHSS) at admission, and after 1, 6, and 9 months for severity of limb weakness. Results The mean age of our patients was 61.32 ± 4.34 years, 17/30 (56.6%) were females, and 13/30 (43.4%) were males. In our study, 18/30 (60%) were hypertensive, 19/30 (63.3%) were diabetic, and 12/30 (40%) were smokers. A significant negative correlation was found between rFA and FN in the ipsilateral CST of the cerebral infarction at the rostral part of pons after 1 month of infarction and NIHSS score at 6 months (r = 0.377, p = 0.04 and r = 0.237, p = 0.02, respectively). However, a positive insignificant correlation was found between MD and NIHSS (r = 0.345, p = 0.635). The initial NIHSS score at the time of injury was 19.2 ± 4.3, which changed to 7.9 ± 2.4, 4.6 ± 1.9, and 3.3 ± 1.4 at 1, 6, and 9 months, respectively. Conclusion DTI is a sensitive tool for early detection of Wallerian degeneration in the CST after stroke, and can predict motor performance to provide effective treatment and rehabilitation to improve quality of life.

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Vosoughi, Amir Reza, Reza Fereidooni, Saeedreza Shirzadi, Seyed Alireza Zomorodian i Amir Human Hoveidaei. "Different patterns and characteristics of Talar injuries at two main orthopedic trauma centers in Shiraz, south of Iran". BMC Musculoskeletal Disorders 22, nr 1 (6.07.2021). http://dx.doi.org/10.1186/s12891-021-04486-0.

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Abstract Background Categorizing different injury patterns of the talus, describing demographic data, mechanisms of injury and associated fractures are important issues in orthopedic trauma surgeries. Injuries of the talus require careful attention with appropriate treatment approaches in order to reduce possible complications. Methods In a cross-sectional study, the demographic characteristics, mechanism of injury, fracture type, and associated fractures were compiled from all patients’ files and operation notes with diagnosis of talar injuries from January 2014 to December 2019. Results Among 367 patients, 317 (86.4%) males and 50 (13.6%) females with mean age of 31.8 ± 11.6 years were identified. There were three (0.8%) patients with bilateral talar fractures. The most common mechanism of injury was motor vehicle accident (MVA) (46.1%), followed by falls (43.3%), direct trauma (6.2%) and sport injuries (4.4%). About half of the patients injured in MVAs were motorcyclists. Isolated talar body fractures (21.9%) were more common than isolated talar neck (19.2%) or combined body & neck fractures (14.6%). Isolated lateral process fracture is the most frequent fractured process of the talus (14.3%). Hawkin type IIA (39.2%) was the most common type of talar neck, followed by Hawkin type III (22.3%), type I (21.5%), type IIB (14.6%) and type IV (2.3%). Medial malleolus, fibula and calcaneus were the most common associated fractures, respectively. Conclusions The population that is most affected by talar injury are active young men who are involved in motor vehicle accidents, especially motorcycle crashes, with fracture of body and/or neck of talus being the most common type.

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Ueda, Tomoya, Haruna Asano, Kyoko Tsuge, Kanako Seo, Motoki Sudo, Yuko Fukuda, Yasuyuki Okuda i in. "Effect of wearing diapers on toddler’s gait". Scientific Reports 11, nr 1 (11.10.2021). http://dx.doi.org/10.1038/s41598-021-99583-4.

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AbstractGait maturation in infants develops gradually through several phases. However, external factors such as childrearing practices, especially the wearing of diapers, may affect an infant’s motor development. This study investigated the influence of different bulk stresses on the gait of toddlers wearing a disposable diaper. Twenty-six healthy toddlers (age: 19.2 ± 0.9 months) participated in this study. We measured the joint kinematics (pelvis angle and hip-joint angle) and spatiotemporal parameters (step length and step width) of the toddlers’ gait under four dress conditions (wearing Type A_WET, Type A_DRY, and Type B_WET diapers and naked). Type B_WET had a higher bulk stress than Type A_WET, and Type A_DRY had lower stress than Type A _ WET. Our results indicate that the walk of toddlers when wearing a diaper differs from that when naked. This difference is due to the effect of the bulk of the diaper on the lower limb. A high bulk stress has a greater influence than that of a low bulk stress on joint dynamics and step width. Therefore, our findings suggest that wearing diapers with high bulk stress may inhibit the natural gait patterns of toddlers.

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