Lower Functional Level Research Articles

Fixed effect estimates of student-teacher racial or ethnic matching in U.S. elementary schools

We used student fixed effects and statistical controls to investigate whether U.S. elementary students (N = 18,170) displayed greater academic achievement, social-emotional behavior, or executive functioning and were more likely to receive gifted or special education services when taught by teachers of the same race or ethnicity. We observed mostly null effects for student-teacher racial or ethnic matching across the study's 12 dependent measures in analyses adjusting for Type 1 error. Matching resulted in lower science achievement (effect size [ES]= -.03 SD) for the full sample. Matching resulted in fewer internalizing problem behaviors (ES = 0.18 SD) for Black students. We observed null effects for Hispanic students. Robustness checks including those stratified by race or ethnicity and biological sex or by prior levels of low or high level of achievement, behavior, or executive functioning largely supported the study's null findings. Exceptions were that matching resulted in fewer externalizing problem behaviors (ES = 0.22 SD) for Black girls and lower academic achievement (ES range = -0.04 to -0.14 SD) and fewer externalizing and internalizing problem behaviors (ES range = 0.24 to 0.33 SD) for students who had previously displayed low levels of academic, behavioral, or executive functioning. Collectively, the analyses provide limited support for student-teacher racial or ethnic matching as a school-based policy to address educational disparities in U.S. elementary schools.

TYPE I HEREDITARY ANGIOEDEMA ASSOCIATED WITH SERPING1 GENE MUTATION

<h3>Introduction</h3> Type I hereditary angioedema (HAE) is characterized by recurrent episodes of swelling of the skin, gastrointestinal tract, and upper airway. Here we present a child with chronic abdominal pain who was found to have a novel deleterious variant in the serine protease inhibitor 1 (<i>SERPING1</i>) gene resulting in autosomal dominant (AD) HAE. <h3>Case Description</h3> The patient is a 9-year-old boy with a history of behavioral changes during febrile illnesses and IgA deficiency who presented with chronic abdominal pain and headaches. He was previously diagnosed with pediatric acute-onset neuropsychiatric syndrome (PANS) at another facility. He had a longstanding history of daily episodes of abdominal pain. He had no personal or family history of angioedema. Laboratory results showed low C4 complement levels (7 mg/dL), which prompted a workup for HAE. Lown C4 was confirmed on multiple occasions and the patient had low C1 esterase inhibitor protein and functional levels. Targeted genetic testing showed a "likely pathogenic" variant in SERPING1 c.1481G>A (p.Arg494Gln). An immune workup showed no abnormality except for partial IgA deficiency with negative anti-IgA antibodies. He was started on prophylactic plasma-derived concentrate of C1 esterase inhibitor with resolution of his symptoms. <h3>Discussion</h3> HAE should be considered in the differential of patients with chronic unexplained abdominal pain even with a negative personal and family history of HAE. The combination of low C4 complement levels, decreased C1 esterase inhibitor levels and excellent response to plasma-derived C1 esterase inhibitors confirm the deleterious effect of the c.1481G>A <i>SERPING1</i> variant and the diagnosis of type I HAE.

Aptitudes, Capabilities, and Interests of Children with Autism Spectrum Disorder

Some individuals with autism spectrum disorder (ASD), may display some areas of talent that are in contrast with their overall low level of general functioning. The aim of this study was to investigate the frequency of special abilities (aptitudes, capabilities, and interests) in a sample population of individuals with ASD. One in ten persons with ASD has special abilities in varying degrees. Researchers used to consider special abilities unimportant. However, this is an area of research for scientists and educators who are making attempts to understand the complexities and intricacies of the human mind. There have been reports of individuals who have intellectual disabilities and challenges, yet possess extraordinary abilities in reading, arithmetic, calendar calculations, art, or music. The study investigates the percentage and frequency of special abilities as reported by parents and teachers in a sample population of individuals with ASD in Singapore using a quantitative methodology. Parents and teachers were given questionnaires to ascertain this occurrence.

Liens entre le déclin sensoriel et cognitif dans le vieillissement normal : revue critique de la littérature et apports de l’approche incarnée et située de la cognition

Biological aging impacts many organs including sensory's ones and the brain, and thus, cognition. Research has shown that the sensory and cognitive decline are positively correlated. The main data from this literature are firstly reviewed in the present article. Then, the four main hypotheses that are generally proposed to explain these associations are presented. According to them, sensory decline is supposed to cause cognitive decline, or vice-versa, or these concomitant changes result from the general alteration of the nervous system. However, none of them seems able to account for all of the existing data. Moreover, the precise mechanisms that may drive these associations remain to be clarified. The rest of the article is then dedicated to the embodied and situated cognition approach as it provides a particularly interesting and adequate framework to account for these links. Indeed, according to this approach, cognitive representations are grounded in their sensorimotor properties. In other words, cognitive functioning is not conceived as detached from sensory functioning, but instead directly dependent of it. Representations are thus thought to emerge from the sensorimotor simulation of the properties involved in these representations. Therefore, sensory decline should directly impact cognitive performance. It is then hypothesized that older adults have low-resolution representations decreasing the signal on noise ratio of traces, increasing sensorimotor interferences and thus decreasing cognitive performance. This approach leads to consider low and high levels of sensory and perceptual functioning, which are both impaired in aging. Therefore, the repercussion of the sensory-perceptual decline is not only valid for present processing, but also extend to all past knowledge. Several predictions are then proposed on (1) the link between high-level perceptual functioning and cognitive functioning in older adults; (2) the possible interaction in young adults between sensory and high-level perceptual functioning as a function of the level of interference of the material involved; (3) the possible link between the motor and cognitive functioning in older adults. The clinical consequences in terms of cognitive stimulation of such a perspective will close the article. It is proposed to develop a stimulation program based on pattern separation mechanism to better process sensory interference in order to train older adults to improve cognitive precision and thus performance.

The relationship between sensory experiences and social functioning in children with autism spectrum disorder

Objective: This study was undertaken to substantiate the connection between sensory experiences and social functioning among 142 children ages 4–10 years with autism spectrum disorder. Methods: Using an online cross-sectional survey, mothers’ perceptions of sensory and social characteristics of their children on parent-reported measures of sensory experiences and social functioning were collected. Findings: Using SPSS software to follow the related descriptive statistics and correlational analysis, the results indicated that children had different levels of challenging sensory experiences and social interaction difficulties. It was revealed that higher intensities of sensory issues were associated with lower levels of functioning and greater social interaction difficulties. Further analysis revealed that less awkward, unpleasant experiences in the auditory and tactile sensory functioning correlated with less social difficulties. Conclusions: Given that no causal relationship could be drawn in this study, the findings complemented those of earlier studies, which suggest engagement in social interactions may be correlated with sensory response patterns.

Thriving through adversity: The role of passion and emotions in the resilience process.

Two cross-sectional (Studies 1, N=283 and 2, N=275) and one prospective (Study 3, N=238) studies investigated the role of passion (for academia) and emotions in the process of resilience in the education domain and in life in general. Participants were examined when facing a stressful situation related to their passion for academia (end-of-term exam period and a timed education task). All three studies showed that harmonious passion, through its positive relationship with positive emotions, was positively associated with high positive outcomes in the education domain (satisfaction with one's studies, subjective and objective performance in one's studies) and in life in general via the subjective evaluation of one's life and general health indicators (subjective vitality and fewer negative physical symptoms). On the other hand, obsessive passion was related to mixed effects on resilience. Specifically, obsessive passion related to low levels of functioning (Studies 1 and 3) and also hindered the positive outcomes (Studies 1-3) through its positive relationships with positive and negative emotions, respectively. In sum, under stress, harmonious passion facilitates high resilience across life domains, whereas obsessive passion yields low resilience across the life or no resilience at all.

The impact of hypertension on mortality and the risk of developing geriatric syndromes

Background. Hypertension (HTN) is a major risk factor for the development of cardiovascular disease in young and middle age, however, data on its effect on cardiovascular risk in older adults are contradictory. Objective. To evaluate the impact of high blood pressure on mortality and the course of major geriatric syndromes in the population aged 65 years and older. Design and methods. The prospective cohort Crystal study (2 examinations, 9 years of follow-up), the cross-sectional cohort Eucalyptus study. Sample: a random sample of community-dwelling older adults aged 65 and older (n = 1007). Main parameters: blood pressure, analysis of drug treatment, medical history, laboratory tests, comprehensive geriatric assessment. Results. HTN has been identified as a risk factor for myocardial infarction, cognitive decline, slow gait speed and low muscle strength. However, in people with frailty and slow gait speed, the presence of HTN was associated with a lower risk of all-cause mortality. The lowest risk of all — cause mortality in participants with a slow gait speed was found with systolic blood pressure 140-159 mm Hg [risk ratio (95 % confidence interval) 0,049 (0,009-0,283)], with frailty — with systolic blood pressure 160-180 mm Hg [risk ratio (95 % confidence interval) = 0,109 (0,016-0,758)]. Conclusions. HTN retains its negative predictive value in older adults and is associated with an increased risk of cardiovascular complications, decreased cognitive and physical functions, but a lower risk of mortality in people with frailty and a low level of physical function. An individual approach and an obligatory assessment of the level of physical function in older patients are required when prescribing antihypertensive therapy.

Comorbid Depression and Diabetes Are Associated with Impaired Health-Related Quality of Life in Chronic Kidney Disease Patients.

Given the increasing prevalence of chronic kidney disease (CKD) and its impact on health care, it is important to better understand the multiple factors influencing health-related quality of life (HRQOL), particularly since they have been shown to affect CKD outcomes. Determinants of HRQOL as measured by the validated Kidney Disease Quality of Life questionnaire (KDQOL) and the Patient Health Questionnaire depression screener (PHQ-9) were assessed in a routine CKD patient sample, the Greifswald Approach to Individualized Medicine (GANI_MED) renal cohort (N = 160), including a wide range of self-reported data, sociodemographic and laboratory measures. Compared to the general population, CKD patients had lower HRQOL indices. Dialysis was associated with (1) low levels of physical functioning, (2) increased impairments by symptoms and problems, and (3) more effects and burden of kidney disease. HRQOL is seriously affected in CKD patients. However, impairments were found irrespective of eGFR decline and albuminuria. Rather, the comorbid conditions of depression and diabetes predicted a lower HRQOL (physical component score). Further studies should address whether recognizing and treating depression may not only improve HRQOL but also promote survival and lower hospitalization rates of CKD patients.

Monitoring Physical Behavior in Rehabilitation Using a Machine Learning–Based Algorithm for Thigh-Mounted Accelerometers: Development and Validation Study

Background Physical activity is emerging as an outcome measure. Accelerometers have become an important tool in monitoring physical behavior, and newer analytical approaches of recognition methods increase the degree of details. Many studies have achieved high performance in the classification of physical behaviors through the use of multiple wearable sensors; however, multiple wearables can be impractical and lower compliance. Objective The aim of this study was to develop and validate an algorithm for classifying several daily physical behaviors using a single thigh-mounted accelerometer and a supervised machine-learning scheme. Methods We collected training data by adding the behavior classes—running, cycling, stair climbing, wheelchair ambulation, and vehicle driving—to an existing algorithm with the classes of sitting, lying, standing, walking, and transitioning. After combining the training data, we used a random forest learning scheme for model development. We validated the algorithm through a simulated free-living procedure using chest-mounted cameras for establishing the ground truth. Furthermore, we adjusted our algorithm and compared the performance with an existing algorithm based on vector thresholds. Results We developed an algorithm to classify 11 physical behaviors relevant for rehabilitation. In the simulated free-living validation, the performance of the algorithm decreased to 57% as an average for the 11 classes (F-measure). After merging classes into sedentary behavior, standing, walking, running, and cycling, the result revealed high performance in comparison to both the ground truth and the existing algorithm. Conclusions Using a single thigh-mounted accelerometer, we obtained high classification levels within specific behaviors. The behaviors classified with high levels of performance mostly occur in populations with higher levels of functioning. Further development should aim at describing behaviors within populations with lower levels of functioning.

ОЦЕНКА КАЧЕСТВА ЖИЗНИ ЭВЕНКОВ ПО ОПРОСНИКУ SF–36

The study used the SF-36 questionnaire, suitable for use in the general and clinical populations, to compare health status between populations and between diseases. In the world literature, data on the quality of life of the Evenks according to the SF-36 questionnaire were not found. The quality of life of the Evenks associated with the state of health has been studied. To conduct a survey of the adult population of the village of Zhilinda, a sample representative of gender and age was formed in the amount of 150 people, of which 69 were men (46 %) and 81 were women (54 %). The average age of the surveyed women was 43.3 ± 16.6 years, men - 41.1 ± 16.4 years. Gender comparisons were made. The questionnaire contained the following sections: general information, family income, living conditions, employment, nature of work, satisfaction with medical care and a medical examination card, consisting of sections: physical activity, smoking status, consumption of alcoholic beverages, Rose questionnaire, frequency of consumption of certain foods, quality of life questionnaire. To compare the quality of life of the inhabitants of the village of Zhilinda, the base of population values of the transformed indicators of the SF-36 questionnaire from the city of Yakutsk was used. The inhabitants of Zhilinda revealed low levels of physical functioning. The following factors were associated with decreased physical functioning: female gender, increased age, college education, increased body mass index, low income, and presence of joint/spine pain. Social functioning decreased with dissatisfaction with housing, vitality with low income, general health with an increase in the number of cigarettes smoked. Evenki quality of life can be significantly improved by reducing body weight, quitting smoking, treating diseases of the musculoskeletal system, increasing income and improving living conditions.

When is Surgery Performed? Trends, Demographic Associations, and Phenotypical Characterization of Baseline Patient-Reported Outcomes Before Total Hip Arthroplasty.

Evaluating trends and drivers of baseline patient-reported outcome measures (PROMs) is critical to understanding when patients and providers elect to undergo surgery. We aimed to assess the following: (1) 5-year trends in baseline PROMs pre-THA (total hip arthroplasty) stratified by patient determinants; (2) patient factor associated with poor preoperative hip pain/function; (3) phenotypes of combined pain/function PROMs at baseline; and (4) intersurgeon variability in PROM thresholds at surgery. A prospective cohort of 6,902 primary THAs was enrolled (January 2016 to December 2020). Patient/surgeon details and PROMs were collected at point of care preoperatively. Outcomes included trends (5 years; 20 quarters) in Hip disability and Osteoarthritis Outcome Score (HOOS)-Pain and HOOS-PS (Physical Function Short-Form), stratified by patient demographics. Patients were further classified into phenotype categories of above or equal to median pain/function (P+PS+); below median pain/function (P-PS-); above or equal to median pain but below median function (P+PS-); and below median pain but above or equal to median function (P-PS+). Baseline HOOS-Pain was consistent across the study period (P-trend= .166), while HOOS-PS demonstrated increasing function (P-trend= .015). Such trends were appreciable in males, females, and White (P-trend < .001, each) but not Black patients (P-trend= .67). Higher odds ratio (OR) of low baseline HOOS-Pain and HOOS-PS were detected among females (HOOS-Pain: OR 1.75, 95% confidence interval [CI] 1.55-1.98, P < .001; HOOS-PS: OR 1.56, 95% CI 1.38-1.77, P < .001), Black patients (HOOS-Pain: OR 1.64, 95% CI 1.35-2.82, P < .001; HOOS-PS: OR 1.59, 95% CI 1.34-1.89, P < .001), and smokers (HOOS-Pain: OR 1.56, 95% CI 1.29-1.89, P < .001; HOOS-PS: OR 1.52, 95% CI 1.25-1.85, P < .001). The P-PS- cohort (32.4%) had lowest age (65.2±11.1 years), highest body mass index (31.6±6.9 kg/m2), females (64.8%), Black (15.8%), and current smokers (12.2%). There was significant intersurgeon preoperative PROM variation in HOOS-Pain and HOOS-PS (P < .001, each). In contrast to the general population, Black patients have consistently received THA at lower functional levels throughout the 5-year period. Females, smokers, and Black patients were more likely to have poorer pain and function at THA. PROMs assessment as combined pain-function phenotypes may provide a more comprehensive interpretation of patient status preoperatively.

Balance of calcium, magnesium and phosphorus in short-rotary cultivations of the forest-steppe

The purpose of research. Give a comparative comprehensive assessment of the balance of phosphorus, Ca and Mg and establish a hierarchy of subordination of balances with the productivity of short-rotation crop rotations for long-term use of organo-mineral fertilizer system using by-products of crops as organic fertilizers for Central Forest-Steppe of Ukraine. Methods. The generally accepted methods of researches were applied: field, laboratory, mathematical methods, comparative-settlement. Research results. Regardless of the structure of short-rotation crop rotation, the balance of Ca and Mg was deficient, and the balance of Ca exceeded the balance of Mg by 4.88 times. The balance of Ca was 1.74 times more stable by the coefficient of variation. Between the components of the phosphorus balance and the balance of Ca revealed 62.5% of correlations of medium and strong level, between the turnover of Mg–9.14%, and between the components of the balance of Ca and Mg revealed 34.7% of paired correlation coefficients, indicating subordination balances in the sequence: Mg next Ca then R. Between the balance of Mg and Ca and performance, the relationship was at a low functional level. The ratio of Ca to Mg in the components of the balances did not exceed the optimal values: in the main products the ratio was 1.3 to 1, and the normalized interval varied from 0.9 to 1 to 1.6 to 1. The widest ratio of Ca to Mg was in by-products 2.3–3.7 to 1 with a normalized interval of 2.7–5.0 to 1. Conclusions. When expanding the ratio of the balance of Ca to Mg &gt; 3 to 1 and when reaching the balance of Ca &gt; 800 kg / ha, the circulation of phosphorus is blocked, which leads to a decrease in crop rotation productivity at the yield of k.o. up to 4.0-4.5 t / ha, and with the narrowing of the ratio of Ca to Mg to 2.5 to 1 and 1.5–2.0 to 1 there is an increase in productivity to 5-6 t / ha and 6.0–7.0 t/ha from 1 hectare. According to the established criterion of the ratio of Ca to Mg in the circulation of macronutrients, crop rotations can be classified according to increased soil protection capacity (Ca to Mg &gt; 3) and crop rotations with high productivity (Ca to Mg &lt;2). Crop rotations with a ratio of Ca to Mg 2.0-3.0 to 1 are intermediate in nature and combine soil protection properties with high productivity.

Three-Dimensional Kinematics during Shoulder Scaption in Asymptomatic and Symptomatic Subjects by Inertial Sensors: A Cross-Sectional Study.

Shoulder kinematics is a measure of interest in the clinical setting for diagnosis, evaluating treatment, and quantifying possible changes. The aim was to compare shoulder scaption kinematics between symptomatic and asymptomatic subjects by inertial sensors. Methods: Scaption kinematics of 27 subjects with shoulder symptomatology and 16 asymptomatic subjects were evaluated using four inertial sensors placed on the humerus, scapula, forearm, and sternum. Mobility, velocity, and acceleration were obtained from each sensor and the vector norm was calculated from the three spatial axis (x,y,Z). Shoulder function was measured by Upper Limb Functional Index and Disabilities of the Arm, Shoulder, and Hand questionnaires. One way ANOVA was calculated to test differences between the two groups. Effect size was calculated by Cohen’s d with 95% coefficient Intervals. Pearson’s correlation analysis was performed between the vector norms humerus and scapula kinematics against DASH and ULFI results in symptomatic subjects. Results: The asymptomatic group showed higher kinematic values, especially in the humerus and forearm. Symptomatic subjects showed significantly lower values of mobility for scapular protraction-retraction (Cohen’s d 2.654 (1.819–3.489) and anteriorisation-posteriorisation (Cohen’s d 1.195 (0.527–1.863). Values were also lower in symptomatic subjects for velocity in all scapular planes of motion. Negative correlation showed that subjects with higher scores in ULFI or DASH had lower kinematics values. Conclusion: Asymptomatic subjects tend to present greater kinematics in terms of mobility, velocity, and linear acceleration of the upper limb, and lower humerus and scapula kinematics in symptomatic subjects is associated with lower levels of function.

Nrf2 Deficiency Attenuates Testosterone Efficiency in Ameliorating Mitochondrial Function of the Substantia Nigra in Aged Male Mice.

Reduced testosterone level is a common feature of aging in men. Aging, as a risk factor for several neurodegenerative disorders, shows declined mitochondrial function and downregulated mitochondrial biogenesis and mitochondrial dynamics. Mitochondrial biogenesis and mitochondrial dynamics are crucial in maintaining proper mitochondrial function. Supplementation with testosterone is conducive to improving mitochondrial function of males during aging. Nuclear factor erythroid 2-related factor 2 (Nrf2), a regulator of redox homeostasis, is involved in the ameliorative effects of testosterone supplementation upon aging. To explore Nrf2 role in the effects of testosterone supplementation on mitochondrial function during aging, we studied the efficiency of testosterone supplementation in improving mitochondrial function of Nrf2 knockout- (KO-) aged male mice by analyzing the changes of mitochondrial biogenesis and mitochondrial dynamics. It was found that wild-type- (WT-) aged male mice showed low mitochondrial function and expression levels of PGC-1α, NRF-1\\NRF-2, and TFAM regulating mitochondrial biogenesis, as well as Drp1, Mfn1, and OPA1 controlling mitochondrial dynamics in the substantia nigra (SN). Nrf2 KO aggravated the defects above in SN of aged male mice. Testosterone supplementation to WT-aged male mice significantly ameliorated mitochondrial function and upregulated mitochondrial biogenesis and mitochondrial dynamics, which were not shown in Nrf2 KO-aged male mice due to Nrf2 deficiency. Testosterone deficiency by gonadectomy (GDX) decreased mitochondrial function, downregulated mitochondrial biogenesis, and altered mitochondrial dynamics balance in young male mice. Supplementation with testosterone to Nrf2 KO-GDX mice only ameliorated the alterations above but did not reverse them to sham level. Nrf2 deficiency attenuated testosterone efficiency in ameliorating mitochondrial function in the SN of aged male mice through mitochondrial biogenesis and mitochondrial dynamics to some extent. Activation of Nrf2 might contribute to testosterone-upregulating mitochondrial biogenesis and mitochondrial dynamics in the SN during aging to produce efficient mitochondria for ATP production.

Pretreatment patient-reported cognitive function in patients with diffuse glioma

PurposeCognitive function is frequently assessed with objective neuropsychological tests, but patient-reported cognitive function is less explored. We aimed to investigate the preoperative prevalence of patient-reported cognitive impairment in patients with diffuse glioma compared to a matched reference group and explore associated factors.MethodsWe included 237 patients with diffuse glioma and 474 age- and gender-matched controls from the general population. Patient-reported cognitive function was measured using the cognitive function subscale in the European Organisation for Research and Treatment of Cancer QLQ-C30 questionnaire. The transformed scale score (0–100) was dichotomized, with a score of ≤ 75 indicating clinically important patient-reported cognitive impairment. Factors associated with preoperative patient-reported cognitive impairment were explored in a multivariable regression analysis.ResultsCognitive impairment was reported by 49.8% of the diffuse glioma patients and by 23.4% in the age- and gender-matched reference group (p < 0.001). Patients with diffuse glioma had 3.2 times higher odds (95% CI 2.29, 4.58, p < 0.001) for patient-reported cognitive impairment compared to the matched reference group. In the multivariable analysis, large tumor volume, left tumor lateralization, and low Karnofsky Performance Status score were found to be independent predictors for preoperative patient-reported cognitive impairment.ConclusionsOur findings demonstrate that patient-reported cognitive impairment is a common symptom in patients with diffuse glioma pretreatment, especially in patients with large tumor volumes, left tumor lateralization, and low functional levels. Patient-reported cognitive function may provide important information about patients’ subjective cognitive health and disease status and may serve as a complement to or as a screening variable for subsequent objective testing.

Psychosocial functioning as a personal resource promoting a milder course of schizophrenia

Schizophrenia has been shown repeatedly to be associated with a low level of psychosocial functioning. It is assumable that psychosocial functioning is related not only to current, but also to future symptom severity. To test this assumption, a follow-up study with two measurement time points with an interval of 18 months was conducted. In total, 154 inpatients from five psychiatric hospitals with a diagnosis of a schizophrenic disorder took part at both visits. Psychosocial functioning was measured with the Personal and Social Performance Scale (PSP scale) at baseline, and schizophrenic symptoms were assessed with the Positive and Negative Syndrome Scale (PANSS) at baseline and at follow-up. Two PSP subscales, i.e. socially useful activities and control over disturbing and aggressive behavior, turned out to be significant predictors of symptom severity 18 months later. The findings reveal that personal resources in the occupational domain and in adequate interpersonal behavior can have a positive impact on the long-term course of schizophrenia.

Functional outcomes in acute lateral ankle ligament repair using suture tape augmentation

Introduction: Acute lateral ankle injuries are commonly managed conservatively but when repair is done in grade III injuries in the professional athletic population it is repaired using the Broström surgical procedure. Augmentation of this procedure using suture tape has been reported to improve ankle stability and physical patient outcomes. Method: This is a retrospective study of 30 patients with grade II-III anterior talofibular ligament instability, treated with augmented Broström-Gould suture tape procedure. The patients were followed up a minimum of 14.4 months post-surgery using AOFAS and RAND 36-item Short Form scores. We also evaluated ability and time to return to previous level of activity or sport following surgery and rehabilitation. Results: Overall patients showed excellent results, with an average AOFAS score of 92.7. According to the SF-36 scale patients perceived low levels of pain (80.6) and good physical functioning (88.3), with 86.7% of patients in the study being able to return to their previous level of activity or sport on average 10.94 weeks post surgery. Conclusion: Augmented Broström with suture tape showed excellent AOFAS and favourable RAND SF-36 outcomes in the short term with a good indication of functional outcomes in patients’ ability to return to previous levels of activity or sport.

The Influence of Chronic Pain and Catastrophizing on Patient Outcomes in an Athletic Therapy Setting.

Chronic pain is a challenge for Athletic Trainers and Athletic Therapists working in a clinical or university setting. The fear avoidance model, including catastrophizing, is well established in other health professions but is not established in Athletic Training and Athletic Therapy and may affect rehabilitation outcomes. To measure the influence of catastrophizing on rehabilitation outcomes of patients being treated in an Athletic Therapy setting. Prospective single group pre-post design. Student Athletic Therapy clinic. A total of 92 patients were evaluated at initial assessment, and 49 were evaluated at follow-up. All participants completed self-reported function questionnaires to assess level of injury and then received individualized treatments for a variety of musculoskeletal injuries. All measures were completed at initial assessment and at follow-up approximately 6 weeks later. The authors measured function using a variety of patient self-reported functional questionnaires: the Disability of the Arm, Shoulder, and Hand; Lower Extremity Functional Scale; the Neck Disability Index; and the Oswestry Disability Index depending on injury site. Catastrophizing was measured using the Pain Catastrophizing Scale. Function significantly improved from the initial assessment to the follow-up (P > .001). Patients with acute pain experienced a significantly greater improvement in function between the initial assessment and follow-up compared with participants with chronic pain (P = .050). Those with high catastrophizing presented with lower levels of function at initial assessment (66.8%) and follow-up (72.1%) compared with those with low catastrophizing (80.8% and 87.0%, respectively). Similar to other studies in other professions, the function of patients with chronic pain does not improve as much compared with patients recovering from acute pain in an Athletic Therapy setting. It is important to measure patient-reported outcomes to evaluate patient rehabilitation progress. Rehabilitating patients with chronic pain is a challenge, and pain catastrophizing should be evaluated at the initial assessment since catastrophizing is associated with worse function.

The Effect of Self-Determination Activities on Communication and Interaction Skills and Academic Success (Grade Point Average) of Students at Risk of Emotional-Behavioral Disorders: A Randomized Controlled Trial

Background: Students with emotional and behavioral disorders (EBD) have lower academic efficiency than students with other disabilities and exhibit high levels of problematic behaviors and low levels of social functioning. This research aims to investigate the impact of self-determination activities on communication skills and scholastic achievement of students at risk of emotional-behavioral disorders. Methods: The study was conducted through a randomized controlled trial during the academic year 2018-2019. The samples included 54 female students (14 to 16 years) at risk of emotional-behavioral disorders from secondary schools in Tehran, Iran. The sampling was conducted through a random cluster method. The applied tools encompass Youth Self-report and Assessment of Communication and Interaction Skills. Academic success was measured by students' grade point average (GPA) in two terms. The intervention was held in 8 sessions of 90 minutes, once a week, after the first term of academic of students for the intervention group and the control group did not receive any intervention during this period. The data were analyzed by SPSS-22, MANCOVA, T-test, and Chi-Square tests. Results: The results of the multivariate analysis of covariance analysis showed self-determination has an impact on communication skills (physicality, information exchange and relations) of students at risk of emotional-behavioral disorders (p<0.05). Comparing the difference between the averages of the two students' means, it was found that there was a significant difference in the two groups after the intervention (p<0.001). Also, after the intervention, there was no significant difference between the two groups but the GPA of students in the intervention group increased from 13.19 to 15.61. Conclusion: The findings suggested self-determination is effective for academic success and communication skills of students at risk of emotional-behavioral disorders and can be used in educational programs for these students.

COMBINATORIAL OPTIMIZATION OF SYSTEMS OF NEURAL NETWORK CRYPTOGRAPHIC DATA PROTECTION

The problem of improving the reliability of cryptographic data protection in neural network systems with flexible configuration is considered. To ensure the possibility of encrypting/decrypting messages it is proposed to use combinatorial optimization methods for the tasks of forming encoded sequences with improved quality indicators for correcting ability, noise immunity, and autocorrelation properties. The basis of combinatorial optimization is the principle of optimal structural relationships, the essence of which is to achieve the maximum diversity of the system under the established restrictions on the number of structural elements and their mutual placement in space-time. It is proposed to use signal-code sequences for neural network data protection, which are characterized by high noise immunity and low level of the autocorrelation function, using various types of optimized code sequences depending on the set of requirements for work under specific conditions, taking into account restrictions on the duration of sending encrypted messages and the presence of noise in communication channels. The system for neural network cryptographic data protection has been developed using encoded signal sequences, where the number of binary characters of different names differs by no more than one character, which minimizes the value of the autocorrelation function of the encoded signal at a fixed bit depth. To ensure high technical and economic indicators of the cryptosystem, it is advisable to equip it with specialized modules of neuro-similar elements of the network with the possibility of training and flexible configuration for cryptographic data encryption. The relationship between the parameters of optimized encoded signal sequences, in which the value of the autocorrelation function is minimized, and the maximum achievable number of detected and corrected errors has been established. It is proposed to use unique properties of combinatorial configurations with a non-uniform distribution of structural elements, which are distinguished by the fact that the set of all ring sums of their numerical values occurs a fixed number of times. A comparative analysis of cryptographic methods for data protection and transfer using non-standard codes built on the so-called IRB code sequences together with other signal-code constructions was carried out.