Functional Scale Research Articles

Does acupuncture combined with MOTOmed movement therapy have a better rehabilitation effect on post-stroke hemiplegia patients? A systematic review and meta-analysis

ABSTRACT Background Combinations of rehabilitation therapies are widely used in patients with post-stroke hemiplegia. A combination of acupuncture and MOTOmed had been shown to promote the recovery of post-stroke hemiplegia patients. We conducted a systematic review of evidence from studies that investigated the use of acupuncture combined with MOTOmed for rehabilitation of patients with post-stroke hemiplegia. Objective To estimate the rehabilitation effect of acupuncture combined with MOTOmed movement therapy in patients with post-stroke hemiplegia. Methods Randomized controlled trials (RCTs) of acupuncture combined with MOTOmed movement therapy in patients with post-stroke hemiplegia were retrieved from nine databases. Risk-of-bias assessments were conducted using the Cochrane Risk-of-bias Tool. Meta-analysis of outcome measures was performed using RevMan 5.4 software. And we followed the PRISMA 2020 guidelines. Results Eighteen studies involving 1637 participants were included. Compared with conventional rehabilitation, acupuncture, or MOTOmed movement therapy alone, acupuncture combined with MOTOmed movement therapy increased the scores of Fugl-Meyer Assessment Scale-lower extremity (FMA-LE), Berg Balance Scale (BBS), Functional Ambulation Categories scale (FAC), Maximal Walking Speed test (MWS), gait parameters of 3D gait analysis, Barthel Index (BI), Modified Barthel Index (MBI), total effective rate, and the levels of neurotrophic factors (NGF, BDNF and NT-3) in serum, while reduced the scores of Clinic Spasticity Index (CSI) and National Institutes of Health Stroke Scale-Lower Extremity (NIHSS-LE) (p < 0.05 for all). Conclusion Acupuncture combined with MOTOmed movement therapy has better efficacy than conventional rehabilitation, acupuncture, or MOTOmed alone in patients with post-stroke hemiplegia. This combination therapy can promote the rehabilitation of these patients.

Establishing the Patient Acceptable Symptoms State for the Boston Carpal Tunnel Questionnaire in a Postoperative Carpal Tunnel Surgery Population.

Threshold scores for patient acceptable symptom state (PASS) represent the score beyond which a patient considers themselves "well." We aimed to determine PASS thresholds for the symptom severity scale (SSS) and functional status scale (FSS) of the Boston Carpal Tunnel Questionnaire in a sample of patients 1 year following carpal tunnel release. Adults (≥ 18 years) from a single, tertiary-care academic institution were contacted 12 ± 1 months after carpal tunnel release. The Boston Carpal Tunnel Questionnaire and two PASS anchor questions were administered via REDCap-one queried acceptability of their current symptoms, and the other queried function. Participants were classified as being in an acceptable symptom state ("PASS(+)") if they answered "very satisfied" or "somewhat satisfied," whereas those responding "neither satisfied nor dissatisfied," "somewhat dissatisfied," or "very dissatisfied" were classified as "PASS(-)." Threshold values were calculated using three methods: (1) the mean score for PASS(+) participants, (2) the 75th percentile score for PASS(+) patients, and (3) the Youden Index determined using receiver operating curve (ROC) analysis to maximize sensitivity and specificity. The 153 patients included in the study had a mean age of 60 ± 15 years and 60% (94/153) were women. At a mean follow-up of 1.0 ± 0.1 years, SSS and FSS scores were significantly lower (better) for PASS(+) than PASS(-) patients for both anchor questions. PASS estimates ranged from <1.4 to <1.8 for the SSS and from <1.3 to <1.5 for the FSS. All ROC curves produced excellent discrimination (area under the curve > 0.8). We propose PASS thresholds of 1.8 for the SSS and 1.5 for the FSS, derived by the Youden or ROC method, which showed excellent discrimination between PASS(+) and PASS(-) patients. These threshold values can be used to assess whether patient populations have achieved an adequate symptom and functional state.

Interstitial HDR brachytherapy for anal cancer-results and quality of life.

While anal cancer is avery rare oncological diagnosis representing less than 2% of lower gastrointestinal tract cancers, the incidence has doubled in the past 20years. Radical radiochemotherapy with sequential or simultaneous boost is now the standard treatment modality. Interstitial HDR brachytherapy is one of the boost application options. Implementation of new radiotherapy techniques has resulted in improved therapeutic outcomes; however, it is still associated with acute and especially late toxicity. Gastrointestinal disorders and sexual dysfunction are the most frequent factors affecting the long-term quality of cured patients' lives. Atotal of 96patients consecutively treated between 2000 and 2022 with external beam radio-/chemotherapy and an interstitial brachytherapy boost for histologically verified nonmetastatic anal squamous cell carcinoma were evaluated. The median follow-up time was 15.4 years (range 13.4-17.3 years). The primary objective of the study was to assess local control (LC) and quality of life (QoL). The Czech versions of internationally validated EORTC questionnaires were used to evaluate life quality-the basic EORTC QOL-C30v.3 and the specific QOL-ANL27 questionnaire. Local control was 85.5% at 5years, 83.4% at 10years, 83.4% at 15years, and 83.4% at 20years, and there was no dependence on clinical stage. The most common forms of acute toxicity were cutaneous and hematological but were gastrointestinal for late toxicities. In the evaluation of quality of life, 80.5% of patients alive at the time participated. In the EORTC quality of life questionnaire C30v.3, patients rated the functional scale score as 86.2 points (standard deviation [SD] = 12.6) and the symptom score as 15.5 points (SD = 12.5). The global health score achieved 68.4 points (SD = 23.6). The most common symptoms were fatigue with 25.6 points (SD = 20.2) and diarrhea with 19.0 points (SD = 27.8). In the QOL-ANL27 questionnaire, symptom scales assessing bowel symptoms were scored 27.5 points (SD = 19) in non-stoma patients and 11.9 points (SD = 17.2) in stoma patients. In the single-item symptom scales, the highest scores were rated for frequency of urination with 26.4 points (SD = 30.8), need to be close to atoilet with 22.4 points (SD = 27.3), and self-cleaning more often with 25.3 points (SD = 31.8). In the functional scales assessing sex life and interest, men and women reported scores of 45.2 (SD = 23) and 45.5 points (SD = 19), respectively. Boost with interstitial HDR brachytherapy is an established safe method of anal cancer treatment, with excellent results and limited late toxicity. Functioning scales were rated relatively highly in QoL questionnaires, and the overall global health score was comparable to published data. Gastrointestinal difficulties, fatigue, and sexual dysfunction dominated the symptom scales in our cohort.

An international core outcome set for primary progressive aphasia (COS-PPA): Consensus-based recommendations for communication interventions across research and clinical settings.

Interventions to treat speech-language difficulties in primary progressive aphasia (PPA) often use word accuracy as a highly comparable outcome. However, there are more constructs of importance to people with PPA that have received less attention. Following Core Outcome Set Standards for Development Recommendations (COSSTAD), this study comprised: Stage 1 - systematic review to identify measures; Stage 2 - consensus groups to identify important outcome constructs for people with PPA (n=82) and care partners (n=91); Stage 3 - e-Delphi consensus with 57 researchers. The systematic review identified 84 Outcome Measurement Instruments. Core outcome constructs identified included: (1) Participate in conversations with family and friends, (2) get words out, (3) be more fluent, (4) convey a message by any means, and (5) understand what others are saying. Researchers were unable to reach a consensus on measurement instruments. Further work is required to develop appropriate measurement instruments that address all core outcome constructs important to key stakeholders. We introduce new symptom-led perspectives on primary progressive aphasia (PPA). The focus is on non-fluent/agrammatic (nfvPPA) and semantic (svPPA) variants. Foregrounding of early and non-verbal features of PPA and clinical trajectories is featured. We introduce a symptom-led staging scheme for PPA. We propose a prototype for a functional impairment scale, the PPA Progression Planning Aid.

Rehabilitation of a quadruple amputee with leukemia: A challenging endeavor

Making a person with quadruple amputation walk again is a challenging task for the rehabilitation team. Quadruple amputation secondary to symmetrical peripheral gangrene is a rare clinical scenario posing challenges in rehabilitation. Literature regarding rehabilitation of persons with multiple amputations is limited. This case describes the rehabilitation of a 57-year-old lady suffering from acute myeloid leukaemia who underwent quadruple amputation. She had undergone bilateral transtibial and bilateral transradial amputation after vasopressor-induced symmetrical peripheral gangrene. In view of expected guarded level of functional independence, ambulatory independence was the primary goal at admission to Department of PMR. The various steps taken in rehabilitation and modifications made to assistive devices are described in this article. Challenges faced during various phases of training, and subsequent ambulation are detailed in this article. Overcoming limitations, the client was made to be an indoor ambulator with appropriate prostheses and mobility aids. She was partially independent for activities of daily life after in-patient rehabilitation. The background of leukaemia and subsequent chemotherapy also affected the rehabilitation of this patient. Although various studies have described cases of quadruple amputation rehabilitation achieving functional independence and ambulation, the absence of specific guidelines and protocols make rehabilitation of persons with multiple amputations inefficient. This case study also shows the need for personalized goal setting for persons with multiple amputations. Realistic goal setting, psychological counselling, and an interdisciplinary approach are imperative in rehabilitation of persons with quadruple amputation. Flexible functional scales specific to persons with multiple amputations are necessary to evaluate such persons objectively. Studies with larger sample size, longer follow-ups, and comprehensive review of existing literature are needed to standardize rehabilitation of quadruple amputation and evaluate the various factors that may affect rehabilitation outcome.

The In-Vivo Medial and Lateral Collateral Elongation Correlated with Knee Functional Score and Joint Space Following Unicompartmental Knee Arthroplasty.

The medial collateral ligament (MCL) and lateral collateral ligament (LCL) are paramount for joint stability. Their elongation patterns may change during fixed-bearing and mobile-bearing unicompartmental knee arthroplasty (FB and MB UKA). This study aims to explore the relationship between the elongation of MCL, LCL, and changes in joint space, as well as their correlation with functional scale scores during FB and MB UKA. We hypothesize that MCL and LCL have different elongation patterns in UKA patients, and there is a correlation between elongation and joint space and functional scores. The study recruited 24 patients undergoing UKA on a unilateral knee (13 FB and 11 MB). A dual fluoroscopic imaging system was employed to assess in-vivo knee kinematics during static standing and single-leg lunge. The superficial and deep MCL (sMCL, dMCL) and LCL were divided into anterior, medium, and posterior portions. The virtual ligament method quantified in-vivo ligament lengths. Analysis focused on the correlation of normalized ligament lengths with functional scores and joint space. 1. LCL Elongation in FB UKA: There is a significant increase in LCL elongation during early and mid-flexion of the single-leg lunge (p < 0.05). 2. MCL Elongation in MB UKA: Both sMCL and dMCL exhibit significant elongation during early and mid-flexion of the single-leg lunge (p < 0.05). 3. Correlation with Functional Scores: Differences in collateral ligament elongation in FB UKA are significantly correlated with the OKS and KSS, highlighting the impact on functional outcomes. In MB UKA, differences in ligament elongation are significantly correlated with the FJS. 4. Joint Space Correlation: There is a significant correlation between the elongation of the anterior and medium portions of dMCL and joint space in the surgical compartment during mid- and deep flexion (30-100 °, p < 0.05, r > 0.64). The study reveals distinct ligament elongation patterns between UKA and native knees in LCL for FB UKA and MCL for MB UKA. These patterns are associated with knee functional scores. Moreover, dMCL elongation correlates significantly with the joint space for MB UKA during middle and deep flexion phases. III; prospective retrospective cohort study.

FEITOS E PERFIL POPULACIONAL DE IDOSOS NA PRÁTICA DE ATIVIDADES FÍSICAS EM PORTO VELHO – RONDÔNIA

The elderly population has been growing significantly over the years, and with this, there has also been a growing concern about ensuring that these individuals have an active and healthy life. Physical activity is one of the main ways to promote health and quality of life in old age, as it can prevent and treat various health conditions, in addition to improving physical and cognitive function. Based on this, this article aims to analyze the importance of physical activity for health and the benefits that the activity provides to the elderly. The study is descriptive and quantitative in nature and was carried out in the city of Porto Velho, Rondônia, at the Physiotherapy Clinic of the São Lucas Educational Center and SESC/RO Social Service of Commerce Rondônia. It is important to note that the study included male and female elderly people, aged 60 years and older. In addition, two questionnaires were used to produce the data: one about general information based on daily habits and a description of physical exercises and the benefits achieved. Complementary data information about risk factors, weight, height and lifestyle changes. It is worth noting that a sociodemographic questionnaire was applied, along with a functional test scale to assess the physical fitness of the elderly, the Berg Balance Scale and the Modified Baecke Questionnaire for the Elderly. And the guardians signed the free and informed consent form (ICF). The data were collected through the evaluation instruments that were tabulated in the Microsoft Excel program for statistical analysis. The research evaluated 60 participants, predominantly women (93.3%), aged between 60 and 90 years, most living in the urban area. In terms of health, 31 of the participants reported regular perception and 62% had 2 to 3 comorbidities. The majority did not smoke (58 participants) and did not consume alcohol (52 of the 60 participants). Regarding Covid-19, 31 had been infected, but only 1 required intubation. On the Berg Scale, 98.3% of the elderly demonstrated good balance when standing for 2 minutes without support, and 44 of 60 were able to pick up objects from the floor independently. However, 60% suffered two or more falls and 40% reported moderate or extreme fear of falling, while 30% had difficulty standing on one leg for 3 seconds or more. These data reveal a predominance of good functional capacities, but with significant limitations in relation to falls and comorbidities. The completion of this study contributed to a greater understanding of the importance of physical activity in the lives of the elderly, considering that physical activity is an element that can contribute to the promotion of health, physical and mental well-being and functional capacity of the elderly, demonstrating that regular exercise not only improves muscle strength and balance, but also significantly reduces the risk of falls, one of the main challenges faced by this population. The data obtained highlight the need for interventions that encourage physical activity, since many elderly people consider themselves active, but only a minority performs exercises regularly. Therefore, the implementation of physical exercise programs is essential to prevent chronic diseases, improve quality of life and promote functional independence among the elderly, contributing to healthy and active aging.

Psychometric properties of a COVID-19 health literacy scale in a sample of German school principals applying Rasch analysis.

During the COVID-19 pandemic, health literacy was found to be an asset to manage health-related information. The HLS-COVID-Q22 has been developed to measure COVID-19 health literacy. External validation needs to be assessed in different populations to verify the questionnaire's functioning. The present study aimed to evaluate the psychometric properties of the HLS-COVID-Q22 in a sample of German school principals. The sample consisted of 2187 German school principals who completed the HLS-COVID-Q22 online from April to March 2021. The data was analyzed using Rasch analysis, applying the Partial Credit Model for polytomous data. Dimensionality, item fit statistics and rating scale functioning was tested. Values for item difficulty and person ability as well as reliability indices were computed. Unidimensionality could be confirmed. The rating scale categories worked as intended, participants used every rating step category. Generally, item fit was verified. One item showed potential misfit but could remain in the questionnaire as excluding the item did not reduce reliability. A person separation index of 3.41 and person reliability of 0.92 showed excellent differentiation between COVID-19 health literacy levels. Furthermore, the values for item separation of 20.08 and item reliability of 1.0 indicate good construct validity. The German version of the HLS-COVID-Q22 appears to be a reliable measurement tool for the target population. Evidence for construct, statistical and fit validity was collected. Future studies need to test additional types of validity like convergent and divergent validity to further evaluate the questionnaire. Moreover, the psychometric properties of the translated versions of the HLS-COVID-Q22 should be compared using Rasch analysis.

QOL-14. HEALTH-RELATED QUALITY OF LIFE AND COGNITIVE FUNCTIONING IN SURVIVORS OF OLIGODENDROGLIOMA: AN INTERNATIONAL CROSS-SECTIONAL INVESTIGATION

Abstract BACKGROUND Patients with oligodendroglioma have a relatively favourable prognosis. Treatment modalities used vary, and the long-term impacts of the tumour itself and its treatment on health-related quality of life (HRQOL) and cognition remain largely unclear. We investigated associations between treatment and functioning of oligodendroglioma patients. METHODS In this international cross-sectional observational study, patients with oligodendroglioma (IDH-mutant and 1p/19q-codeleted) diagnosed ≥5 years ago, were recruited through the European Organisation for Research and Treatment of Cancer (EORTC) networks. Diagnosis and treatment data were collected from medical records; patients completed outcomes for HRQOL (EORTC QLQ-C30; BN20), self-reported cognitive functioning (MOS Cognitive Complaints Scale) and cognitive tests (HVLT-R, TMT, COWAT). Associations between HRQOL and cognition outcomes, and clinical variables (time since diagnosis; progression; tumour location; treatments delivered; current medication; Karnofsky Performance Status (KPS)) were explored with regression analyses. RESULTS 242 oligodendroglioma patients on average 9.9 years post-diagnosis (sd=4.3, range=5.0-26.3) took part from 33 sites across 9 countries. Patients were M=52 years old (sd=12, range=23-78), the majority were men (N=145; 60%). Higher KPS, no radiotherapy (ever), no current medication (anxiolytics/sedatives; antidepressants; dexamethasone) were associated with better generic HRQOL outcomes (QLQ-C30 functioning scale models; R2 range 0.068-0.371, all p&amp;lt;.001). Higher KPS, fewer recurrences, no radiotherapy treatment (ever), and no current antidepressant use were linked to better disease-specific HRQOL (BN20 multi-item scale models; R2 range 0.067-0.246, p&amp;lt;0.001). Fewer subjective cognitive complaints were associated with higher KPS and no current antipsychotic medication (R2=0.153, p&amp;lt;0.001). Better KPS, right hemispheric tumours, longer time since diagnosis, no chemotherapy (ever), no radiotherapy (ever), and no current medications (dexamethasone; antipsychotics) were predictive of better cognitive functioning (R2 range 0.056-0.248, p&amp;lt;0.001). CONCLUSION In oligodendroglioma survivors, better HRQOL and cognitive outcomes appeared consistently linked with higher KPS, no current medication use, and never having received radiotherapy. Additionally, better cognitive outcomes were associated with no chemotherapy treatment.

ETWST: An Extension to the Timed Water Swallow Test for Increased Dysphagia Screening Accuracy.

We aimed to fine-tuning the Timed Water Swallow Test (TWST) screening procedure to provide the most reliable prediction of the Flexible Endoscopic Evaluation of Swallowing (FEES) assessment outcomes, with age, sex, and the presence of clinical signs of dysphagia being considered in the assessment. Participants were healthy people and patients with suspected dysphagia. TWST performance and participants' reported dysphagia symptoms were assessed in terms of their utility in predicting the outcome of a FEES assessment the same day. The FEES assessors were blinded to the nature of the TWST performance. The water swallowing capacity levels and clinical observations during a screening performance that were indicative of dysphagia/no symptoms in FEES were determined. Convergent validity was assessed as the agreement with the Functional Oral Intake Scale (FOIS) in the FEES assessment. TWST predicted FEES findings (aspiration and dysphagia) with a sensitivity of 72 and 45% and a specificity of 75% and 80%, respectively. Extended analysis of the TWST procedure (eTWST) identified aspiration (sensitivity = 92%, specificity = 62%) and dysphagia (sensitivity = 70%, and specificity = 72%) more accurately and showed a high correlation with FOIS (ɸ = 0.37). Excellent inter-rater reliability was further observed (Kw = 0.83). The extended evaluation of TWST performance has superior criterion validity to that of TWST. eTWST displayed high convergent validity and excellent interrater reliability. We therefore believe that eTWST can be highly relevant for clinical dysphagia screening.

The effect of home exercises with kinesiotaping on pain, functionality, and work performance in bus drivers with non-specific neck pain.

Clinical research on the management and rehabilitation of work-related upper spinal pain in bus drivers is sparse, indicating a gap in knowledge and treatment strategies. This highlights the growing need for innovative approaches to rehabilitation programs in this area. To examine the effects of kinesio taping (KT) on pain, functionality, and work performance in bus drivers experiencing neck pain. The study involved 44 participants who were randomised into two different groups: the exercise group (n= 22) and the kinesio tape group (n= 22), with participants in both groups undertaking exercise interventions. Evaluations were made before and after 6 weeks of treatment. At the end of the 6-week, the participants' ROM, pain evaluations and functional scales were evaluated with disability, and work functionality. Neck pain severity decreased in both groups (p< 0.001 for each value), but there was no difference between the groups (p: 0.071). When disability scores were evaluated, improvement was noted in both groups (p: 0.001 for each value), but no statistically significant difference was found (p: 0.754). When the improvements in ROM values before and after the treatment were examined, the difference between the groups was recorded only in the neck extension ROM value (p: 0.011). Significant improvement was noted in all sub-steps of job performance in both groups (p< 0.05). KT added to ergonomic training and home exercise programmes is effective in controlling work-related musculoskeletal pain in drivers with neck pain. However, the addition of KT to exercise therapy was found to be no more effective than exercise therapy alone in improving pain control, functionality and work performance.

Non-planar corrections in ABJM theory from quantum M2 branes

The quantization of semiclassical strings in AdS spacetimes yields predictions for the strong-coupling behaviour of the scaling dimensions of the corresponding operators in the planar limit of the dual gauge theory. Finding non-planar corrections requires computing string loops (corresponding to torus and higher genus surfaces), which is a challenging task. It turns out that in the case of the Uk(N) × U−k(N) ABJM theory there is an alternative approach: one may semiclassically quantize M2 branes in AdS4 × S7/ℤk which are wrapped around the 11d circle of radius 1/k = λ/N . Such M2 branes are the M-theory generalization of the strings in AdS × CP3. In this work, we show that by expanding in large M2 brane tension T2 ~ kN\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$ \\sqrt{kN} $$\\end{document} for fixed k, followed by an expansion in large k, we can predict the large λ asymptotics of the non-planar corrections to the dimensions of the dual ABJM operators. As a specific example, we consider the M2 brane configuration that generalizes the long folded string with large spin in AdS4, and compute the 1-loop correction to its energy. This calculation allows us to determine non-planar corrections to the universal scaling function or cusp anomalous dimension. We extend our analysis to the semiclassical M2 branes that generalize the “short” and “long” circular strings with two equal angular momenta in CP3. The “short” M2 brane corresponds to a dual operator whose dimension at strong coupling scales as ∆ ∼ λ1/4 + …, and we derive the leading non-planar correction to it.

Hindi version of the lower extremity functional scale: a study of translation, validation and cross-cultural adaptation

BACKGROUND: Lower Extremity Function Scale (LEFS) serves as a patient-reported outcome measure, used to evaluate the functional status of lower extremity in different musculoskeletal conditions. It was originally developed in English language (E-LEFS) and numerous translations in different languages are available to measure its usability among different cultures. OBJECTIVES: To translate the English version of the Lower Extremity Function Scale (E-LEFS) into Hindi language and to evaluate its content validity, cross-cultural adaptation along with the concurrent validity and reliability. METHOD: Process of forward and backward translation was carried out by two bilingual translators and a physiotherapist after obtaining developer’s approval, for which the Beaton guidelines were used. For the content validation, Delphi method of was employed in which 12 field experts of more than 5 years of experience participated. Cultural adaptation procedures were then carried out with 12 patients, who reported in out-patient department of the hospital through convenience sampling who were asked about whether the H-LEFS was well understood by the patients. Their responses were recorded as positive and negative responses. This process was followed by concurrent validation which was conducted by comparing the scores with the SF-36 scale, involving 30 patients with activity limitation in their daily life. Lastly, 50 patients were recruited for intra-rater reliability testing. RESULT: The scale was successfully translated and verified by the bi-lingual language experts. Content validity came out to be significant with each item scoring more than 0.92. Nearly all items, excluding item no. 8, 16, 17, 18, and 19 received universal agreement with a content validity ratio of 1. The average scale-level validity stood at 0.98, indicating excellent level of validity and the scale was found to be well adapted by the native people as out of 12 patients, 10 patients provided 100% positive response. Concurrent validation using Pearson’s correlation coefficient came out excellent with the values of 0.993 for E-LEFS and 0.890 for SF-36. Cronbach's alpha and ICC values were calculated as 1.00 for Intra-rater reliability. CONCLUSION: LEFS was well translated into Hindi language with an excellent content and concurrent validity and is found to be highly reliable. Hence, it is recommended for the usage of native Hindi speaking population.

The importance of stochasticity in determining galaxy emissivities and UV LFs during cosmic dawn and reionization

The stochastic nature of star formation and photon propagation in high-redshift galaxies can result in sizable galaxy-to-galaxy scatter in their properties. Ignoring this scatter by assuming mean quantities can bias estimates of their emissivity and corresponding observables. We constructed a flexible, semi-empirical model, sampling scatter around the following mean relations: (i) the conditional halo mass function (CHMF); (ii) the stellar-to-halo mass relation (SHMR); (iii) the galaxy star formation main sequence (SFMS); (iv) the fundamental metallicity relation (FMR); (v) the conditional intrinsic luminosity; and (vi) the photon escape fraction. In our fiducial model, ignoring scatter in these galaxy properties overestimates the duration of the Epoch of Reionization (EoR), delaying its completion by $ z 1--2. We quantified the relative importance of each of the above sources of scatter in determining the ionizing, soft-band X-ray, and Lyman Werner (LW) emissivities as a function of scale and redshift. We find that scatter around the SFMS is important for all bands, especially at the highest redshifts where the emissivity is dominated by the faintest, most "bursty" galaxies. Ignoring this scatter would underestimate the mean emissivity and its standard deviation computed over 5 cMpc regions by factors of up to sim 2--10 at $5 z 15$. The scatter around the X-ray luminosity to star formation rate and metallicity relation is important for determining X-ray emissivity, accounting for roughly half of its mean and standard deviation. The importance of scatter in the ionizing escape fraction depends on its functional form, while scatter around the SHMR contributes at the level of sim 10--20&lt;!PCT!&gt;. Other sources of scatter have a negligible contribution to the emissivities. Although scatter does flatten the UV luminosity functions, shifting the bright end by 1--2 magnitudes, the level of scatter in our fiducial model is insufficient to fully explain recent estimates from JWST photometry (consistent with previous studies). We conclude that models of the EoR should account for the burstiness of star formation, while models for the cosmic 21cm signal should additionally account for scatter in intrinsic X-ray production.

Correcting images for individual differences in color appearance

AbstractIndividual differences are a prominent feature of normal color vision and range from variations in sensitivity to perception and color naming. Corrections for differences in spectral sensitivity are common, and there is growing interest in calibrating displays for the sensitivity of an individual observer. In contrast, few studies have explored calibrations for aspects of color appearance. We developed a technique for adjusting images based directly on an individual's hue percepts and illustrate the principle of the approach using a set of hue scaling functions measured previously for a large sample of color‐normal observers (Emery et al. PNAS 2023). Colors in an image are mapped onto the average scaling function to define the hue perceived by the average “standard observer.” This hue is then mapped back to the chromaticity that would elicit the same response in any individual observer. With this correction, different observers – each looking at physically different images calibrated for their own hue percepts – should in principle agree on the perceived colors. Adjustments of this kind could be easily implemented on standard displays, because they require only measures of hue percepts and not spectral sensitivity, and could lead to greater consistency in the perception and communication about color across individuals with potentially widely different perceptual experiences of color.

OUTCOME MEASURES FOR CERVICOGENIC DIZZINESS: A META ANALYSIS.

Background: Cervicogenic dizziness (CGD) is a complex condition characterized by dizziness arising from cervical spine disorders. It affects approximately 40% of patients with chronic neck pain and can significantly impact daily activities, quality of life, and mental health. The involvement of cervical structure in vestibular function highlights the need for effective assessment tools. Outcome measures play a crucial role in diagnosing CGD, evaluating treatment effectiveness, and improving patient outcomes. This evolved, focusing on both subjective and objective assessments, including symptom questionnaires, functional scales, and vestibular function tests. Standardized outcome measures are essential for clinical making and guideline development. Objective: The objective of the study is to systematically evaluate and compare the reliability, validity and sensitivity data of various outcome measures of cervicogenic dizziness. Method: The systemic data were searched using PubMed, Scopus, Google scholar, Science direct, PEDro, Cochrane library to identify studies published from the year 2001 up to 2023. Study selection is reported according to PRISMA guidelines. A total of 50 review articles were collected on outcome measures for Cervicogenic Dizziness (CGD). Data extraction included Research, Evidence based study, Literature, Systematic reviews and Meta-analysis articles. Result: This meta-analysis states that outcomes measures for Cervicogenic Dizziness (CGD) show a highly significant difference. Conclusion: After analysis of various articles, it was concluded that diagnosing patients with outcome measures for Cervicogenic Dizziness shows highly significant and improving health care efficiency. This study identified reliable and valid outcome measures for assessing Cervicogenic Dizziness (CGD). Implication: This study findings have significant implication for clinical practice, research, and policy, enhancing diagnosis, treatment and patient outcomes, standardized use of validated outcome measures will inform evidence – based guidelines for Cervicogenic Dizziness.

A 40-week phase 2B randomized, multicenter, double-blind, placebo-controlled study evaluating the safety and efficacy of memantine in amyotrophic lateral sclerosis.

Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative disease with no known cure, limited treatment options with minimal benefits, and significant unmet need for disease modifying therapies. This study investigated memantine's impact on ALS progression, with an additional focus on the effects of memantine on cognitive and behavioral changes associated with the disease. A randomized, double-blind, placebo-controlled clinical trial was conducted from December 2018 to September 2020. ALS patients were enrolled in-person and remotely across 13 sites in the United States. Participants were randomized to memantine (20 mg twice daily) or placebo in a 2:1 ratio and completed 36 weeks of treatment. The primary outcome of disease progression was assessed by the Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R), and blood was collected for biomarker analysis. Of the 99 participants enrolled in the study, 89 were randomized to memantine or placebo (ages 24-83 years, male-to-female ratio ~3:2). Fifty-two participants completed the study treatment with no significant differences in disease progression, biomarker changes (including neurofilament light chain [NfL]), or neuropsychiatric testing noted between the groups. Initial NfL values correlated with the rate of ALSFRS-R decline. In this study, memantine did not impact ALS disease progression or neuropsychiatric symptoms. Trials with remote enrollment may help trial participation and success.

Reliability and Validity of the Turkish Version of the Deglutition Handicap Index.

The Deglutition Handicap Index (DHI) is a self-reported questionnaire focus on dysphagia related quality of life of patients. The present study was aimed to translate the DHI into Turkish, and investigate the reliability and validity of the Turkish version of the DHI (T-DHI). A total of 100 patients with different diagnoses participated. The study was carried out in 3 phases including translation, reliability and validation phases. The translation phase was performed by the forward-backward-forward translation methodology. The internal consistency and test-retest reliability were used for reliability phase. The criterion validity of the T-DHI was investigated for validation phase. The Cronbach's alpha value of the T-DHI was 0.93 of which indicates excellent internal consistency. The Intraclass Correlation Coefficient ranged from 0.96 to 0.99 for test-retest reliability. There was negative and weak correlation between functional subscale score from the T-DHI and the Functional Oral Intake Scale (r=-0.29, p = 0.004), and positive and moderate to strong correlations between total and subscale scores from the T-DHI and the Turkish version of the Eating Assessment Tool (r = 0.67-0.78, p < 0.001) indicating sufficient criterion validity. The T-DHI is a reliable and valid questionnaire to define dysphagia related quality of life of patients. Clinicians could be used the T-DHI during swallowing evaluation part during the management process of deglutition disorders to plan patient centered rehabilitation, improve care and follow up.

The mentor attunement scale: a tool to measure a critical mentoring skill-set

ABSTRACT This article details a two-phase study of the development and validation of a mentor attunement scale (MAS). Phase 1 involved theory-driven generation of 20 items to measure four facets of attunement. Rasch analysis of data collected from 390 youth mentors indicated problematic reverse-coded items, which were eliminated to improve scale functioning. Exploratory Factor Analysis and reliability analysis applied to the same dataset supported this removal, and pointed to an internally consistent, 12-item, one-factor solution, then tested using Confirmatory Factor Analysis (CFA) in the second phase. CFA applied to a second cohort of 453 mentors produced a good fitting, single-factor, 5-item scale. A measurement model consisting of the five attunement items and an existing, 7-item empathy scale was then tested to confirm convergent and discriminant validity. The final solution supported a two-factor, 9-item MAS. Use of the MAS can advance the fragmented conceptualization and measurement of critical mentoring skills.

Five-year long-term functional and quality of life outcomes in total glossectomy survivors.

Total glossectomy is proven to be a superior treatment option for advanced tongue cancer. Despite its efficacy, the procedure is associated with profound morbidity, notably impacting Speech, swallowing, and overall quality of life. Limited therapeutic benefits and the potential for considerable morbidity render total glossectomy a subject of controversy. We performed a multidimensional quality of life evaluation of long-term (more than 5 yrs.) total glossectomy survivors. In this study, we evaluated 25 total glossectomy survivors with comprehensive functional and quality of life outcomes using objective measures (London Speech Evaluation Scale, FOIS, 100ml Water Challenge, FEES) and Patient-reported outcomes (SHI, PSS HN, EORTC QLQ 30 & HN35). EORTC QLQ 30 showed overall good global health status (M = 80 ± 20) and functional scale mean scores ranging from 87 to 91, despite issues in pain (M = 31.6 ± 31), swallowing (M = 23.3 ± 24), and Speech (26.1 ± 1). Speech outcomes revealed 80% with moderate to severe intelligibility impairment. Swallowing outcomes showed 84% requiring special food preparation, 24% exhibiting aspiration, and 72% having pharyngeal residue. Speech outcomes showed 88% having moderate-severe speech impairment, and Patient-reported speech outcomes indicated a mean SHI score of (M = 47.2 ± 42). Patients undergoing total glossectomy report favourable long-term outcomes in global health-related quality of life despite moderate to severe impairments in objective speech and swallowing evaluations. These positive patient-reported outcomes support the consideration of total glossectomy as a viable treatment option if and when required, underscoring the importance of evaluating treatment outcomes through the patient-perceived quality of life.