Impaired Movement Research Articles

Characteristics of patients diagnosed with psychogenic non-epileptic seizures (PNES) who request reinstatement of their driving privileges.

Patients who experience seizures, including PNES, are usually advised to discontinue driving, or have their driving privileges revoked until a determined period of seizure-freedom is achieved. In this retrospective study, patients with PNES who requested driving privileges or reported having resumed driving were compared to those who did not on measures of depression, anxiety, PTSD, and cognitive flexibility/motor speed. DiagnosisofPNESwasconfirmedwithvideo-EEG.Demographicand clinical dataand requests for reinstatement of driving privileges (requiring 6 or more months seizure freedom) and reports of decisions to resume driving were noted. Tests of motor speed and hand eye coordination and self-report questionnaires of depression, anxiety and PTSD administered as part of neuropsychological assessment were analyzed. A total of 403 patients with PNES evaluated in 2010-2020 were identified. Of those, 365 patients were eligible for inclusion, and of those, 60 applied for driving privileges or reported that they resumed driving. When the two groups were compared, the group that applied for driving privileges or decided to resume driving was significantly less depressed (p=0.001) when tested than the group that did not. Furthermore, a significant difference was seen in measures of motor performance between those who requested to resume driving and those who did not (DKEFS T1, p=0.006, DKEFS T2, p=0.001, DKEFS T3, p=0.002, DKEFS T4, p=0.001; GPT dominant, p=0.05, GPT non-dominant, p=0.003). Driving a motor vehicle is a useful measure of improvement for PNES because patients with seizures are required to discontinue driving until seizure-freedom is achieved. This study revealed that lower levels of depression and better fine motor functioning were associated with reported seizure-freedom and driving resumption. Depression is commonly associated with diminished performance (slower motor response times and impaired fine motor movements) on tests of motor functioning, both of which may result in less interest in pursuing permission to resume driving. These findings suggest that mood symptoms (and associated performance on measures of motor speed and coordination) may have prognostic significance in patients diagnosed with PNES. This also suggests that timely treatment of depression in newly diagnosed patients with PNES may be indicated.

Velopharyngeal Insufficiency and Impaired Tongue Movement Indicate Neuromuscular Disorders: A 10-Year Statistical Study in a Single Tertiary Institution

Objectives: This study aimed to determine the positive predictive value of our NMD Suspicion Criteria in the diagnosis of NMDs. Other clinical factors routinely examined in our voice and swallowing examinations were also investigated to see if they had a significant association with the diagnosis of NMDs. Methods: This study retrospectively investigated the medical charts of patients who visited our Voice and Swallowing outpatient clinic between 2013 and 2022. Patients with previously diagnosed NMDs were excluded from the analysis. Among the remaining patients, we included those that were referred to neurologists for further evaluation due to suspicion of having an NMD based on the NMD Suspicion Criteria. The patients were then divided into groups according to the status of their diagnosis within 2 years of referral as “diagnosed”, “denied”, or “observed”. These three groups of patients were then compared according to the following clinical findings; velopharyngeal insufficiency (VPI), tongue atrophy, impaired tongue movement, dysarthria, vocal fold mobility impairment, dysphagia, involuntary movement, gait disturbances, weight loss, and a sense of fatigue in order to see if they were significantly associated with the diagnosis of NMDs. Results: Of 3769 outpatients without a confirmed diagnosis of NMDs, 37 were referred to neurologists for suspected NMDs, and 19 (51%) were diagnosed with NMDs. VPI and impaired tongue movement were significant diagnostic factors for NMDs (p = 0.014, 0.033). VPI during speech (p = 0.045) was more strongly associated with the diagnosis of NMDs than VPI during swallowing (p = 0.076). Fatigue was a significant related factor for other diseases (non-NMDs) causing Voice and Swallowing problems (p = 0.049). Conclusions: In the outpatient clinic setting, suspicion of NMD should be raised, particularly when VPI and impaired tongue movement are observed, prompting a thorough assessment of velopharyngeal closure during both speech and swallowing.

MR study on white matter injury in patients with acute diquat poisoning

To explore the microstructural damage of white matter in acute diquat (DQ) poisoning patients using diffusion kurtosis imaging (DKI) and Tract-based Spatial Statistics (TBSS). This study included 19 DQ poisoning patients and 19 age-matched controls. MRI was performed using a 3.0 T Philips Achieva scanner with sequences including 3D T1WI, T2WI, DWI, 3D T2WI-FLAIR, and DKI (3 b-values, 15 directions). DICOM to NIFTI image form conversion was done using MRIcron's Dcm2niigui, followed by motion and eddy current correction with FSL to create a brain mask. Scalar indicators (MK, AK, RK, FAK) were calculated with DKE software. TBSS was used for spatial normalization, skeletonization, and projection of DKI indices for group analysis with TFCE for multiple comparison correction (P < 0.025). After the screening and enrollment process, 19 DQ-poisoned patients and 19 healthy volunteers were analyzed. No significant age or sex differences were found between groups. For Mean Kurtosis (MK), the right corticospinal tract showed a significant difference with a mean difference of 0.21 (95 % CI: 0.15-0.27) and P = 0.000503. Axial Kurtosis (AK) in the left superior longitudinal fasciculus had a mean difference of 0.18 (95 % CI: 0.12-0.24) and P = 0.0024. Fractional Anisotropy of Kurtosis (FAK) in the right corticospinal tract showed a mean difference of 0.19 (95 % CI: 0.13-0.25) and P = 0.0000318. Axial Kurtosis (AK) positively correlated with blood drug levels (r = 0.52, P < 0.05). Seven patients developed subcortical leukodystrophy, mainly in the frontal parietal lobe, with possible insular lobe involvement. DQ poisoning primarily damages the right corticospinal tract, right cingulate gyrus, and left superior longitudinal fasciculus, potentially causing movement and visual impairments. The injury involves demyelination and axonal degeneration, with asymmetrical damage between hemispheres. The left superior longitudinal fasciculus injury is dose-dependent, and unlike prior studies, dopaminergic nuclei were unaffected. The frontal parietal lobe is predominantly affected, with some insular lobe involvement in DQ poisoning patients.

Voice Therapy Method for Post-Thyroidectomy Syndrome

Objectives: This study aimed to demonstrate the effectiveness of Voice Therapy for Post- Thyroidectomy Syndrome (VT-PTS). The primary cause of PTS is the impairment of vertical movement in the larynx due to adhesion of the infrahyoid muscles or laryngeal-tracheal structures. Methods: The study included 12 participants (2 males and 10 females) diagnosed with PTS by a laryngologist. All participants reported subjective voice problems and were recommended for voice therapy by a speech-language pathologist. Participants were randomly assigned to the study. The VT-PTS program consisted of VT-1 (direct voice therapy conducted by a speech-language pathologist) and VT-2 (self-practice at home). Voice assessments included acoustic analyses (F0, jitter, shimmer, NHR, maximum pitch, minimum pitch, and pitch range) and subjective voice evaluations (K-VHI-10, K-VFI, and TVQ). Results: Acoustic analyses indicated significant increases in F0 (&lt;i&gt;p&lt;/i&gt;=.014), maximum pitch (&lt;i&gt;p&lt;/i&gt;&lt;.001), and pitch range (&lt;i&gt;p&lt;/i&gt;&lt;.001) following VT-1 and VT-2. According to the Bonferroni correction, jitter (&lt;i&gt;p&lt;/i&gt;=.046) and shimmer (&lt;i&gt;p&lt;/i&gt;=.017) were not statistically significantly reduced. The K-VHI-10 (&lt;i&gt;p&lt;/i&gt;=.003), K-VFI (&lt;i&gt;p&lt;/i&gt;=.014), and TVQ (&lt;i&gt;p&lt;/i&gt;=.002) also demonstrated significant decreases after VT-2. Conclusion: VT-PTS showed significant improvements in both objective and subjective voice evaluations, demonstrating its effectiveness in addressing voice problems in PTS. Notably, it was highly effective in addressing pitch-related problems, which are the primary voice problems in PTS. This study is valuable as it provides evidence- based support for speech-language pathologists in treating PTS in clinical fields. Future research should try non-face-to-face voice therapy and the development of applications to support post-surgical self-practice.

Parkinson's Disease Prediction: An Attention-Based Multimodal Fusion Framework Using Handwriting and Clinical Data.

Neurodegenerative diseases (NGD) encompass a range of progressive neurological conditions, such as Alzheimer's disease (AD) and Parkinson's disease (PD), characterised by the gradual deterioration of neuronal structure and function. This degeneration manifests as cognitive decline, movement impairment, and dementia. Our focus in this investigation is on PD, a neurodegenerative disorder characterized by the loss of dopamine-producing neurons in the brain, leading to motor disturbances. Early detection of PD is paramount for enhancing quality of life through timely intervention and tailored treatment. However, the subtle nature of initial symptoms, like slow movements, tremors, muscle rigidity, and psychological changes, often reduce daily task performance and complicate early diagnosis. To assist medical professionals in timely diagnosis of PD, we introduce a cutting-edge Multimodal Diagnosis framework (PMMD). Based on deep learning techniques, the PMMD framework integrates imaging, handwriting, drawing, and clinical data to accurately detect PD. Notably, it incorporates cross-modal attention, a methodology previously unexplored within the area, which facilitates the modelling of interactions between different data modalities. The proposed method exhibited an accuracy of 96% on the independent tests set. Comparative analysis against state-of-the-art models, along with an in-depth exploration of attention mechanisms, highlights the efficacy of PMMD in PD classification. The obtained results highlight exciting new prospects for the use of handwriting as a biomarker, along with other information, for optimal model performance. PMMD's success in integrating diverse data sources through cross-modal attention underscores its potential as a robust diagnostic decision support tool for accurately diagnosing PD.

Dynamic Digital Radiography (DDR) in the Diagnosis of a Diaphragm Dysfunction.

Dynamic digital radiography (DDR) is a recent imaging technique that allows for real-time visualization of thoracic and pulmonary movement in synchronization with the breathing cycle, providing useful clinical information. A 46-year-old male, a former smoker, was evaluated for unexplained dyspnea and reduced exercise tolerance. His medical history included a SARS-CoV-2 infection in 2021. On physical examination, decreased breath sounds were noted at the right-lung base. Spirometry showed results below predicted values. A standard chest radiograph revealed an elevated right hemidiaphragm, a finding not present in a previous CT scan performed during his SARS-CoV-2 infection. To better assess the diaphragmatic function, a posteroanterior DDR study was performed in the standing position with X-ray equipment (AeroDR TX, Konica Minolta Inc., Tokyo, Japan) during forced breath, with the following acquisition parameters: tube voltage, 100 kV; tube current, 50 mA; pulse duration of pulsed X-ray, 1.6 ms; source-to-image distance, 2 m; additional filter, 0.5 mm Al + 0.1 mm Cu. The exposure time was 12 s. The pixel size was 388 × 388 μm, the matrix size was 1024 × 768, and the overall image area was 40 × 30 cm. The dynamic imaging, captured at 15 frames/s, was then assessed on a dedicated workstation (Konica Minolta Inc., Tokyo, Japan). The dynamic acquisition showed a markedly reduced motion of the right diaphragm. The diagnosis of diaphragm dysfunction can be challenging due to its range of symptoms, which can vary from mild to severe dyspnea. The standard chest X-ray is usually the first exam to detect an elevated hemidiaphragm, which may suggest motion impairment or paralysis but fails to predict diaphragm function. Ultrasound (US) allows for the direct visualization of the diaphragm and its motion. Still, its effectiveness depends highly on the operator's experience and could be limited by gas and abdominal fat. Moreover, ultrasound offers limited information regarding the lung parenchyma. On the other hand, high-resolution CT can be useful in identifying causes of diaphragmatic dysfunction, such as atrophy or eventration. However, it does not allow for the quantitative assessment of diaphragmatic movement and the differentiation between paralysis and dysfunction, especially in bilateral dysfunction, which is often overlooked due to the elevation of both hemidiaphragms. Dynamic Digital Radiography (DDR) has emerged as a valuable and innovative imaging technique due to its unique ability to evaluate diaphragm movement in real time, integrating dynamic functional information with static anatomical data. DDR provides both visual and quantitative analysis of the diaphragm's motion, including excursion and speed, which leads to a definitive diagnosis. Additionally, DDR offers a range of post-processing techniques that provide information on lung movement and pulmonary ventilation. Based on these findings, the patient was referred to a thoracic surgeon and deemed a candidate for surgical plication of the right diaphragm.

Selective retinoid X receptor agonism promotes functional recovery and myelin repair in experimental autoimmune encephalomyelitis

Evidence that myelin repair is crucial for functional recovery in multiple sclerosis (MS) led to the identification of bexarotene (BXT). This clinically promising remyelinating agent activates multiple nuclear hormone receptor subtypes implicated in myelin repair. However, BXT produces unacceptable hyperlipidemia. In contrast, IRX4204 selectively activates the retinoid X receptor (RXR). Given compelling links between RXR activation and increased myelin repair, we employed IRX4204 to investigate the impact of RXR agonism alone on functional recovery in mice subjected to experimental autoimmune encephalomyelitis (EAE). Since gait deficits are common in MS, we used machine learning to obtain highly sensitive and reliable measurements of sagittal hindleg joint movements for mice walking on a treadmill. IRX4204 not only blocked the progressive loss of knee and ankle movements but also reversed joint movement impairments in EAE mice. Our biochemical, transcriptional and histological measurements in spinal cord suggest these gait improvements reflect increased axon survival and remyelination and reduced inflammation. Using microglia, astrocytes and oligodendrocyte progenitor cells, we present additional data suggesting that IRX4204 may act on multiple glial subtypes to orchestrate myelin repair. These results inform the discovery of restorative neural therapeutics for MS by demonstrating that selective RXR agonism is sufficient for effective myelin repair. Moreover, our findings support the therapeutic potential of IRX4204 to promote functional recovery in MS.

Влияние острой токсичности бисфенола А на поведение и локомоторную активность Danio rerio

The results of evaluating the effects of acute exposure of Danio rerio to bisphenol A solutions on behavioral traits and locomotor activity using the open field test are presented. It was found that bisphenol A in the exposure aquariums resulted in impaired movement, hyperactivity, increased mucus secretion, and increased gill cover movements. Fish not exposed to the pollutant in the open field test spent most of their time near the edges of the aquarium, exhibiting moderate exploratory activity. Bisphenol A in the open field test at concentrations greater than 1 mg/l caused a significant increase in mean locomotor speed (to 11.1 cm/s) and a decrease in inactivity time (to 9.9 s). The indices of locomotor activity in Danio rerio, significantly altered by bisphenol A, showed a clear concentration-effect relationship: for inactivity time in the inner circle, R² = 0.6765, and in the outer ring, R² = 0.7140; for movement speed in the inner circle, R² = 0.4365, and in the outer ring, R² = 0.4011. Acute toxicity of bisphenol A resulted in the development of anxiety-like behavior in fish, characterized by hyperactivity, increased exploratory activity, and decreased thigmotaxis.

Role of RNA m6A reader YTHDF2 in neurodegeneration of the aged mice

Objective: To investigate the role of RNA m6A reader YTHDF2 in neurodegeneration of the aged mice. Methods: Eighteen 18-month-old control C57BL/6 mice and 22 Ythdf2 conditional knockout (cKO) mice of the same age (that exhibited significant aging characteristics) were used. Five pairs of mice were used for morphological analysis. Thirteen control mice and 17 cKO mice were used for behavioral experiments. Immunofluorescence analysis was performed to detect the expression of YTHDF2 in the brains of 18-month-old C57BL/6 mice. After establishing the neural progenitor cell-specific knockout mice of Ythdf2, their phenotypes were analyzed through comparison of body weight, brain weight and H&E staining. Subsequently, immunohistochemistry and immunofluorescence analyses were used to detect the expression of various neural cell-specific markers in the aged control mice and Ythdf2 cKO mice. Finally, behavioral tests, including the open field test, new object recognition, and water maze, were used to assess the levels of anxiety, depression, learning and memory abilities. Results: Immunofluorescence staining showed that YTHDF2 was mainly expressed in the neurons. Compared with the age-matched control mice, there was no significant change in the body weight of the Ythdf2 cKO mice, but the brain weight decreased significantly (P<0.05). The immunostaining showed that Ythdf2 cKO mice had fewer neurons, fewer astrocytes with defective morphology, more microglia and activation of microglia (P<0.05). Behavioral tests showed that the aged Ythdf2 cKO mice exhibited impaired movement, learning and memory abilities (P<0.05). Conclusions: YTHDF2 is mainly expressed in the neurons of the aged brain. Conditional knockout of Ythdf2 causes quantitative and structural abnormalities in hippocampal neuronal cells, and impairs motor ability and learning and memory of the aged mice, suggesting that YTHDF2 plays an important role in neurodegeneration of the aged mice.

Studying turn performance, trunk control, and mobility in acute stroke subjects: a cross-sectional study.

Stroke leads to various impairments like motor deficits, impaired trunk control and restricted mobility. However, rehabilitation professionals often underestimate the fundamental function of turning, which is essential for daily living activities like walking, cooking, or performing household chores. Impaired turning can be attributed to motor deficits post-stroke, resulting in restricted mobility and impaired trunk movement. Therefore, the present study aimed to determine the relationship between turn performance, trunk control, and mobility in stroke patients. A total of 63 first-time supratentorial stroke (i.e., anterior circulation stroke) patients aged 18-90 years were recruited for the study. Turn performance was assessed by asking patients to walk for 10 feet comfortably, then take a 180° turn and return to the starting position. In addition, the duration and number of steps were recorded. Following this, the Trunk Impairment Scale (TIS) and Stroke Rehabilitation Assessment of Movement (STREAM) were used to assess trunk impairment and mobility, respectively. The group turn performance was analyzed using the Kruskal-Wallis test with a post hoc Mann-Whitney U test for between-group comparisons. The turn duration and turn steps were correlated with age, trunk control, and mobility using Spearman's rank correlation. A regression analysis was performed to determine the association of turn performance with age, trunk control, and mobility among stroke patients. Thirty stroke patients had turning difficulty, and 33 did not. Hence, they were categorized into the turning difficulty (TD) and non-turning difficulty (NTD) groups. When correlated with turn duration and the number of steps taken by the stroke patients while turning, the STREAM and TIS scores revealed a significant negative correlation (p < 0.001). The subjects' age showed a significant positive correlation with the turn duration and number of steps taken by stroke patients while turning (p < 0.001). A significant association was also found between turn performance and age and trunk control. However, there was no significant association between turn performance and mobility. The observed associations highlight the complexity of turning ability and trunk control necessary to complete a turn safely. Additionally, with advancing age, turn performance and turning movement are compromised in stroke patients. This indicates that turning difficulty is more pronounced in older individuals with stroke.

TIGAR coordinates senescence-associated secretory phenotype via lysosome repositioning and α-tubulin deacetylation

TP53-induced glycolysis and apoptosis regulator (TIGAR) regulates redox homeostasis and provides the intermediates necessary for cell growth by reducing the glycolytic rate. During cellular senescence, cells undergo metabolic rewiring towards the glycolytic pathway, along with the development of the senescence-associated secretory phenotype (SASP), also known as the secretome. We observed that TIGAR expression increased during replicative senescence following the in vitro expansion of human mesenchymal stromal cells (MSCs) and that TIGAR knockout (KO) decreased SASP factors and triggered premature senescence with decelerated progression. Additionally, TIGAR KO impaired flexible lysosomal movement to the perinuclear region and decreased the autophagic flux of MSCs. Research on the mechanism of lysosomal movement revealed that, while native senescent MSCs presented low levels of Ac-α-tubulin (lysine 40) and increased sirtuin 2 (SIRT2) activity compared with those in growing cells, TIGAR KO-MSCs maintained Ac-α-tubulin levels and exhibited decreased SIRT2 activity despite being in a senescent state. The overexpression of SIRT2 reduced Ac-α-tubulin as a protein target of SIRT2 and induced the positioning of lysosomes at the perinuclear region, restoring the cytokine secretion of TIGAR KO-MSCs. Furthermore, TIGAR expression was positively correlated with SIRT2 activity, indicating that TIGAR affects SIRT2 activity partly by modulating the NAD+ level. Thus, our study demonstrated that TIGAR provides a foundation that translates the regulation of energy metabolism into lysosome positioning, affecting the secretome for senescence development. Considering the functional value of the cell-secretome in aging-related diseases, these findings suggest the feasibility of TIGAR for the regulation of secretory phenotypes.

The Effect of Scapular Orientation on Measures of Rotator Cuff Tendon Impingement: A Simulation Study.

Mechanical impingement of the rotator cuff tendons against the acromion (subacromial) and glenoid (internal) during shoulder motions has long been thought to contribute to tears. Clinically, the risk for impingement is thought to be influenced by scapular movement impairments. Therefore, our purpose was to determine the extent to which simulated changes in scapular orientation impact the proximity between the rotator cuff tendon footprint and the acromion and glenoid during scapular plane abduction. Specifically, shoulder kinematics were tracked in 25 participants using a high-speed biplane videoradiography system. Scapular movement impairments were simulated by rotating each participant's scapula from their in vivo orientation about the scapular axes (±2°, ±5°, and ±10°). Subacromial and internal proximities were described using minimum distances, proximity center locations, and prevalence of contact. Statistical parametric mapping was used to investigate the extent to which these measures were impacted by simulated changes in scapular orientation. Simulated changes in scapular orientation significantly altered proximity patterns in a complex manner that depended on the impingement mechanism, humerothoracic elevation angle, and magnitude of the simulated change. Clinicians should be mindful of these factors when interpreting the potential effects during a clinical examination.

Motor imagery technique for motor recovery of hand among sub-acute stroke patient: A randomized controlled trial

Stroke is the second leading cause of death globally, with a rising prevalence in line with increasing life expectancy. Hemiparesis, affecting up to 85% of stroke survivors, leads to impaired arm and hand movement, reduced strength, and limited coordination, significantly affecting daily activities. Despite rehabilitation efforts, many stroke survivors face persistent functional limitations or permanent disabilities. Intensive rehabilitation is often costly and constrained by the limited number of therapy sessions available in many centers. Therefore, strategies to enhance functional recovery while minimizing resource use are crucial. One promising approach is motor imagery (MI), a cognitive rehearsal of physical actions aimed at improving motor function. MI has been shown to activate similar brain areas as actual movement, such as the premotor cortex and supplementary motor area. While evidence supports MI's potential for enhancing motor recovery, clinical guidelines remain insufficient. This study aims to evaluate the effectiveness of motor imagery for improving hand function in subacute stroke patients. The primary objective is to assess the impact of MI on motor recovery using the Chedoke Arm and Hand Activity Inventory over a 4-week period.

Estimating Indicators for Assessing Knee Motion Impairment During Gait Using In-Shoe Motion Sensors: A Feasibility Study.

Knee joint function deterioration significantly impacts quality of life. This study developed estimation models for ten knee indicators using data from in-shoe motion sensors to assess knee movement during everyday activities. Sixty-six healthy young participants were involved, and multivariate linear regression was employed to construct the models. The results showed that eight out of ten models achieved a "fair" to "good" agreement based on intra-class correlation coefficients (ICCs), with three knee joint angle indicators reaching the "fair" agreement. One temporal indicator model displayed a "good" agreement, while another had a "fair" agreement. For the angular jerk cost indicators, three out of four attained a "fair" or "good" agreement. The model accuracy was generally acceptable, with the mean absolute error ranging from 0.54 to 0.75 times the standard deviation of the true values and errors less than 1% from the true mean values. The significant predictors included the sole-to-ground angles, particularly the foot posture angles in the sagittal and frontal planes. These findings support the feasibility of estimating knee function solely from foot motion data, offering potential for daily life monitoring and rehabilitation applications. However, discrepancies in the two models were influenced by the variance in the baseline knee flexion and sensor placement. Future work will test these models on older and osteoarthritis-affected individuals to evaluate their broader applicability, with prospects for user-tailored rehabilitation applications. This study is a step towards simplified, accessible knee health monitoring through wearable technology.

Evaluation of Finger Movement Impairment Level Recognition Method Based on Fugl-Meyer Assessment Using Surface EMG

Subjectivity has been an inherent issue in the conventional Fugl-Meyer assessment, which has been the focus of impairment-level recognition in several studies. This study continues our previous work on the use of EMG to recognize finger movement impairment levels. In contrast to our previous work, this study provided a better and more reliable recognition result with improved experimental settings, such as an increased sampling frequency, EMG channels, and extensive patient data. This study employed two data processing mechanisms, inter-subject cross-validation (ISCV) and data-scaled inter-subject cross-validation (DS-ISCV), resulting in two evaluation methods. The machine learning algorithms employed in this study were SVM, random forest (RF), and multi-layer perceptron (MLP). MLP_ISCV achieved the highest average recall score of 0.73 across impairment levels in the spherical grasp task. Subsequently, the highest average recall score of 0.72 among non-majority classes was achieved by SVM_DS-ISCV in the mass extension task. The cross-validation result shows that the proposed method effectively handled the imbalanced dataset without being biased toward the majority class. The proposed method demonstrated the potential to assist doctors in clarifying the subjective assessment of finger movement impairment levels.

Scalable O(log2n) Dynamics Control for Soft Exoskeletons

Robotic exoskeletons are being actively applied to support the activities of daily living (ADL) for patients with hand motion impairments. In terms of actuation, soft materials and sensors have opened new alternatives to conventional rigid body structures. In this arena, biomimetic soft systems play an important role in modeling and controlling human hand kinematics without the restrictions of rigid mechanical joints while having an entirely deformable body with limitless points of actuation. In this paper, we address the computational limitations of modeling large-scale articulated systems for soft robotic exoskeletons by integrating a parallel algorithm to compute the exoskeleton’s dynamics equations of motion (EoM), achieving a computation with O(log2n) complexity for the highly articulated n degrees of freedom (DoF) running on p processing cores. The proposed parallel algorithm achieves an exponential speedup for n=p=64 DoF while achieving a 0.96 degree of parallelism for n=p=256, which demonstrates the required scalability for controlling highly articulated soft exoskeletons in real time. However, scalability will be bounded by the n=p fraction.

Social and psychological adaptation of disabled and non-disabled students to learning conditions during war time

Introduction. Students’ socio-psychological adaptation to university life is a serious issue due to extreme living conditions under martial law in Ukraine, which directly affect students’ academic performance, as well as to the possible mobilization of male students in senior years of study. Being a student is quite stressful and it is important to explore the factors that contribute to stress and the ways students can cope with stress and maintain their mental well-being. It is important for students to understand who they are in the context of university environment and to feel included in social groups and communities. Aim: to identify the socio-psychological adaptation of disabled and non-disabled students to the conditions of martial law; to explore the relationship between social and psychological characteristics of students with different disabilities. Methods: K. Rogers and R. Diamond Assessment of Socio-Psychological Adaptation (adaptation by A.K. Osnyctkiy, 2004); PSS-10 (Perceived Stress Scale) (Veldbrecht, 2022); latest research findings and surveys. Results. It was found that students with disabilities had higher "maladaptability", lower "self-acceptance", "emotional comfort" and "dominance" than non-disabled students. The disabled students had "rejection of others" and "internality" below the norm. It was found that all adaption indicators were high in students who had been disabled since childhood, while the students with acquired disabilities had high "adaptability" and "dominance". Students with impaired hearing and/or movement disorders had high levels of all adaptation indicators. Conclusion. The findings may allow better understanding of students' personalities and their adaptive abilities in the conditions of the martial law as well as they can be helpful for improvement of educational programs.

Multiphysics simulations reveal haemodynamic impacts of patient-derived fibrosis-related changes in left atrial tissue mechanics.

Stroke is a leading cause of death and disability worldwide. Atrial myopathy, including fibrosis, is associated with an increased risk of ischaemic stroke, but the mechanisms underlying this association are poorly understood. Fibrosis modifies myocardial structure, impairing electrical propagation and tissue biomechanics, and creating stagnant flow regions where clots could form. Fibrosis can be mapped non-invasively using late gadolinium enhancement magnetic resonance imaging (LGE-MRI). However, fibrosis maps are not currently incorporated into stroke risk calculations or computational electro-mechano-fluidic models. We present multiphysics simulations of left atrial (LA) myocardial motion and haemodynamics using patient-specific anatomies and fibrotic maps from LGE-MRI. We modify tissue stiffness and active tension generation in fibrotic regions and investigate how these changes affect LA flow for different fibrotic burdens. We find that fibrotic regions and, to a lesser extent, non-fibrotic regions experience reduced myocardial strain, resulting in decreased LA emptying fraction consistent with clinical observations. Both fibrotic tissue stiffening and hypocontractility independently reduce LA function, but, together, these two alterations cause more pronounced effects than either one alone. Fibrosis significantly alters flow patterns throughout the atrial chamber, and particularly, the filling and emptying jets of the left atrial appendage (LAA). The effects of fibrosis in LA flow are largely captured by the concomitant changes in LA emptying fraction except inside the LAA, where a multifactorial behaviour is observed. This work illustrates how high-fidelity, multiphysics models can be used to study thrombogenesis mechanisms in patient-specific anatomies, shedding light onto the links between atrial fibrosis and ischaemic stroke. KEY POINTS: Left atrial (LA) fibrosis is associated with arrhythmogenesis and increased risk of ischaemic stroke; its extent and pattern can be quantified on a patient-specific basis using late gadolinium enhancement magnetic resonance imaging. Current stroke risk prediction tools have limited personalization, and their accuracy could be improved by incorporating patient-specific information such as fibrotic maps and haemodynamic patterns. We present the first electro-mechano-fluidic multiphysics computational simulations of LA flow, including fibrosis and anatomies from medical imaging. Mechanical changes in fibrotic tissue impair global LA motion, decreasing LA and left atrial appendage (LAA) emptying fractions, especially in subjects with higher fibrosis burdens. Fibrotic-mediated LA motion impairment alters LA and LAA flow near the endocardium and the whole cavity, ultimately leading to more stagnant blood regions in the LAA.

Outcomes and prognostic factors in pediatric orbital trapdoor fracture: a multi-center study.

To evaluate clinical presentations, computed tomography (CT) findings, and various prognostic factors affecting the surgical outcomes of trapdoor fractures. This retrospective multi-center study reviewed medical records and orbital CT scans of patients under 21 years old, diagnosed with isolated trapdoor fractures. The study was conducted across multiple medical centers, including emergency and clinical departments in Isfahan, Shiraz, and Tehran-Iran. The characteristics and outcomes following surgical intervention were assessed. 45 patients with isolated trapdoor fractures were included in the study, with a mean age of 11.67 ± 4.69 years, predominantly male (84.4%). Vehicle accidents was the major cause of fractures (31.1%). 44 patients (97.8%) had orbital floor fracture, and one patient (2.2%) had medial wall involvement. Nausea/vomiting were reported in 41 patients (91.1%). Surgical intervention within 2 days, resulted in 85.0% of patients experiencing no postoperative diplopia. Delayed surgery beyond 2 days showed increased odds of diplopia, although not statistically significant. CT scan findings suggested a lower risk of diplopia in patients with soft tissue entrapment compared to muscle involvement (OR: 0.336, 95% CI: 0.077-1.462, p = 0.146). Shorter time to surgery (within 2 days) was significantly associated with normal postoperative eye movements (p = 0.002). Nausea/vomiting were more prevalent in patients with muscle entrapment (p < 0.05). Surgical intervention within 48h is crucial for improving ocular motility following trapdoor fractures. Extraocular symptoms, including nausea/vomiting, should raise suspicion for trapdoor fractures in cases of orbital trauma associated with ocular movement impairment. Not applicable.

Hip joint kinematic assessment in chronic non-specific low back pain patients. A Delphi study

BackgroundChronic nonspecific low back pain (CNSLBP) has been associated with movement impairment (MI) of the hip joint. However, evidence supporting this is inconsistent.Agreement from experts may provide rationale and recommendations for the assessment of the hip joint in the management of CNSLBP patients. ObjectiveGain expert consensus on whether hip MIs are related to CNSLBP, whether they should be assessed and which movement types and directions they recommend. MethodsThrough a three-round e-Delphi process, international experts in the field rated levels of agreement for generated themes pertaining to assessing proposed hip joint MI in individuals with CNSLBP and underlying rationales. Consensus was defined a priori as ≥75% ratings on Likert scales with an IQR≤ 1. ResultsInternational expert panel consisted of a mix of researchers and clinicians with the majority involved in both. Response for round I was 27, round 2 was 21 and round III was 26 individuals.Consensus was achieved for the association of active and passive hip joint MI in CNSLBP and their assessment. 100% agreement was achieved for the rationale regarding compensatory movement of the lumbar spine, and the assessment of passive hip movements, in particular extension. Consensus was also achieved for assessing hip passive flexion, extension, rotations, and abduction, active flexion, extension, and abduction. No agreement was attained regarding passive accessory movement. ConclusionThe assessment of active and passive hip joint MI is regarded by experts as appropriate and informative in the management of and research pertaining to CNSLBP.