Rating Scale Analysis Research Articles

Improvement of image quality applying iterative scatter correction for grid-less skeletal radiography in trauma room setting.

Iterative reconstruction is well established for CT. Plain radiography also takes advantage of iterative algorithms to reduce scatter radiation and improve image quality. First applications have been described for bedside chest X-ray. A recent experimental approach also provided proof of principle for skeletal imaging. To examine clinical applicability of iterative scatter correction for skeletal imaging in the trauma setting. In this retrospective single-center study, 209 grid-less radiographs were routinely acquired in the trauma room for 12 months, with imaging of the chest (n = 31), knee (n = 111), pelvis (n = 14), shoulder (n = 24), and other regions close to the trunk (n = 29). Radiographs were postprocessed with iterative scatter correction, doubling the number of images. The radiographs were then independently evaluated by three radiologists and three surgeons. A five-step rating scale and visual grading characteristics analysis were used. The area under the VGC curve (AUCVGC) quantified differences in image quality. Images with iterative scatter correction were generally rated significantly better (AUCVGC = 0.59, P < 0.01). This included both radiologists (AUCVGC = 0.61, P < 0.01) and surgeons (AUCVGC = 0.56, P < 0.01). The image-improving effect was significant for all body regions; in detail: chest (AUCVGC = 0.64, P < 0.01), knee (AUCVGC = 0.61, P < 0.01), pelvis (AUCVGC = 0.60, P = 0.01), shoulder (AUCVGC = 0.59, P = 0.02), and others close to the trunk (AUCVGC = 0.59, P < 0.01). Iterative scatter correction improves the image quality of grid-less skeletal radiography in the clinical setting for a wide range of body regions. Therefore, iterative scatter correction may be the future method of choice for free exposure imaging when an anti-scatter grid is omitted due to high risk of tube-detector misalignment.

Application of Rasch Rating Scale Model to Analysis of Fear of Missing Out a Smartphone

The presence of smartphones is one of the technological advancements that have contributed greatly to changes in social behavior. This led to the inception of the Fear of Missing Out (FoMO) smartphone device. The purpose of this study therefore was to determine the right instrument to measure the FoMO smartphone by analyzing response points obtained from respondents. The study sample consisted of three groups of test subjects, from large city, small town and villages with n values of 226, 248, and 55 respectively. The data in this study were obtained using the 5-point Likert scale politomy data from a Fear of Missing out scale instrument, distributed online. The research data were analyzed using the Rasch model by testing rating scale analysis through Threshold. The results showed that the rating scale answered choices turned into a 3-point Likert scale with those not right, less right, and very right.

Measurement of Children’s Real-Time Physical Activity Enjoyment Using a New Visual Analog Scale

Background: This study validated the How(e) Happy Scale (HHS) for measuring children's real-time physical activity (PA) enjoyment across PA type, intensity, sex, and weight status and compared state versus trait enjoyment. Methods: Children's (N = 31; 9.7 [1.7]y) PA intensity was measured during sport, play, and locomotive PA. Following each activity, children rated their perceived state (HHS) of enjoyment across 4 constructs (social engagement). Questionnaires measured trait PA enjoyment prior to play. Rasch Rating Scale analysis assessed model-data fit and probability distribution of HHS responses. Analyses of variance compared state versus trait PA enjoyment across main effects, and correlations assessed relationships between measured PA intensity versus state and trait PA enjoyment. Results: Trait PA enjoyment was neither different across sex and weight status nor correlated with PA intensity (r = -.16 to .22). By contrast, HHS responses differed across sex, weight status, and PA type and intensity and correlated with PA type (r = -.56 to -.28) and intensity (r = -.29 to -.32). HHS responses were ordered along the probability curve and showed good infit (0.76-1.22) and outfit (0.71-1.28) statistics and good person (r = .62) and item (r = .88) reliability. Conclusion: HHS is valid for detecting differences in real-time enjoyment across PA type and intensity in all children.

Qualitative analysis and reproducibility assessment of the Scalp Itch Numeric Rating Scale among patients with moderate to severe plaque psoriasis of the scalp

Background: Pruritus is a prevalent and bothersome symptom of scalp psoriasis. Validated scales assessing scalp itch are needed to evaluate treatment efficacy.Objective: To evaluate comprehensibility and reproducibility of the Scalp Itch Numeric Rating Scale (NRS), a novel scale being used in a phase 3 study of apremilast.Methods: The Scalp Itch NRS, Modified Whole Body Itch NRS, Global Assessment of Psoriasis Severity-Scalp (GAPS-S), and Global Impression of Change-Scalp Itch (GIC-SI) were assessed among patients with moderate to severe scalp psoriasis. Convergent validity and test–retest reliability between two visits (7 ± 3 days apart) were assessed using intra-class and Spearman’s correlations.Results: Patients found the Scalp Itch NRS easy to use and understand. Convergent validity (Modified Whole Body Itch NRS Visit 1: rs = 0.71, Visit 2: rs = 0.92, p< .0001; GAPS-S Visit 1: rs = 0.62, Visit 2: rs = 0.63, p< .0001), and consistency with changes (Modified Whole Body Itch NRS: rs = 0.69, p< .0001; GAPS-S: rs = 0.42, p = .0029) were demonstrated. The Scalp Itch NRS showed strong test–retest reliability (intra-class correlation coefficient = 0.87; rs = 0.89). Change scores on the Scalp Itch NRS were consistent with change scores on the GIC-SI.Conclusions: The Scalp Itch NRS is a valid and reproducible measure of scalp itch in patients with moderate to severe scalp psoriasis.ClinicalTrials.gov: NCT03123471.

Assessment of Acute Pain Management and Associated Factors among Emergency Surgical Patients in Gondar University Specialized Hospital Emergency Department, Northwest Ethiopia, 2018: Institutional Based Cross-Sectional Study.

Background Adequate pain management has led to increased comfort in emergency patients, reducing morbidity and improving long term outcomes. Different pain management modalities have been applied in the emergency department among which systemic analgesia is commonly used by preceding a nerve block. Several factors have been associated with poor pain management in low resource setting areas. We aimed to determine pain management modalities and associated factors among emergency surgical patients. Patients and Methods After obtaining ethical approval from Ethical Review Committee, 203 volunteer patients were enrolled. Institutional based cross-sectional prospective study was conducted from April to May 2018 in Gondar University Specialized Hospital Emergency Department. The severity of pain was measured through Numerical Rating Scale and statistical analysis was performed using SPSS statistical package version 23. Descriptive statistics cross-tab and binary logistics were performed to identify factors related to pain management in emergency department. Results A total of 203 patients, 138 (68%) males and 65 (32%) females with response rate of 94%, participated in this study. Among them, 66% patients received analgesia within two hours of ED presentation with a mean ± SD of 61.0 ± 34.1 minutes. 70.4 % of patients complained of moderate and severe pain after receiving analgesia. There was a significant difference between trauma and nontrauma patients in mean time of analgesia receiving and residual pain severity (p < 0.001). Age, trauma, physician pain assessment, and severity of pain were the predicting factors for analgesia delivery. Conclusion The overall practice of pain management in Gondar University Specialized Hospital Emergency Department was not adequate. Therefore, it is vital to implement an objective pain assessment method and documentation of the pain severity to improve pain management practice.

Parkinson's Disease Motor Subtypes Show Different Responses to Long-Term Subthalamic Nucleus Stimulation.

Background and purpose: Subthalamic nucleus deep brain stimulation (STN DBS) is well established for the treatment of advanced Parkinson’s disease (PD), substantially improving motor symptoms, quality of life, and reducing the long-term need for dopaminergic medication. However, whether chronic STN DBS produces different effects on PD motor subtypes is unknown. This retrospective study aimed to evaluate the long-term effects of STN DBS on the PD motor subtypes.Methods: Eighty patients undergoing STN DBS were included. The Unified Parkinson’s Disease Rating Scale (UPDRS) analysis was performed in “On” and “Off” medication/“On” and “Off” stimulation conditions. The patients were classified as akinetic-rigid type (ART), tremor-dominant type (TDT), and mixed type (MT) based on the preoperative UPDRS III subscores in the “Off” medication state. Preoperative and postoperative comparisons were performed.Results: After 4.9 years, STN DBS produced significant improvement in the UPDRS III total scores and subscores of tremor, rigidity, and bradykinesia in the “Off” medication state in the ART group, less improvement in the MT group, and the least improvement in the TDT group. The UPDRS II and III total scores and other subscores failed to improve during the “On” medication state. However, all groups improved substantially, and the improvement in tremor was sustained for both the “On” and “Off” medication states after years. Long-term STN DBS failed to improve swallowing and speech in all the subtypes.Conclusion: The data confirms that PD is heterogeneous. Long-term STN DBS produced the best effects on bradykinesia/rigidity in the “Off” medication state and on tremor in the “On” and “Off” medication states. There were differences in the response by each group, but some of the differences could be explained by the fact that more severe symptoms at baseline tend to have greater improvement. The findings support the idea that ART mainly involves the basal ganglia-thalamo-cortical pathway, whereas TDT involves a different circuit, likely the cerebellar-thalamo-cortical pathway.

Development of the Taiwanese version of the Health Enhancement Lifestyle Profile (HELP-T).

ObjectivesTo develop and validate a Taiwanese version of the Health Enhancement Lifestyle Profile (HELP-T) for community-dwelling older Taiwanese adults (≥ 55 years).MethodsThe original Health Enhancement Lifestyle Profile (HELP) is a 56-item self-report questionnaire measuring various aspects of health-related lifestyles in older adults. The standard cultural-adaptation procedure was used for questionnaire translation and modification. A field test was conducted for culturally specific item selection, rating-scale analysis, and psychometric validation of the HELP-T in a sample of 274 community-dwelling older adults via classical test theory.ResultsThe 59-item HELP-T is culturally adapted from the original 56-item HELP. The original 6-point rating scale was modified to a 3-point scale for easy use by Taiwanese older adults. The HELP-T had good internal consistency (Cronbach’s alpha = 0.82). The test-retest reliability for the total score was high (0.92), and moderate to high (range: 0.57–0.92) for subscales. The construct validity was supported by the significant correlations between each subscale and the total score (Spearman’s rho = 0.41–0.67, p < 0.0001) and by the ability of the scores to significantly discriminate between participants with different levels of self-rated health (p = 0.0001).ConclusionsThe HELP-T is a suitable clinical tool for assessing and monitoring lifestyle risk factors, establishing client-centered lifestyle intervention goals, and determining the outcomes of lifestyle interventions.

Factor Analysis of Adult ADHD Rating Scale ASRS-v1.1 (Persian Translation) in University Students

Background: lack of adequate screening tools for adult ADHD in Iran, we aimed to introduce factor structure of ASRS-V1.1 in Persian form. Method: Persian form of ASRS-V1.1 were filled in 240 university students aged 18-24 years, Cronbach’s alpha coefficient and factor analysis were performed. Results: Cronbach’s alpha coefficient was calculated 0.76 for ASRS. Factor analysis confirmed two factors: attention deficit and hyperactivity. Conclusion: Persian translation of ASRS-V1.1 has adequate internal consistency and two factors structure, in line with original manuscript.

Systemic epothilone D improves hindlimb function after spinal cord contusion injury in rats

Following a spinal cord injury (SCI) a growth aversive environment forms, consisting of a fibroglial scar and inhibitory factors, further restricting the already low intrinsic growth potential of injured adult central nervous system (CNS) neurons. Previous studies have shown that local administration of the microtubule-stabilizing drug paclitaxel or epothilone B (Epo B) reduce fibrotic scar formation and axonal dieback as well as induce axonal growth/sprouting after SCI. Likewise, systemic administration of Epo B promoted functional recovery. In this study, we investigated the effects of epothilone D (Epo D), an analog of Epo B with a possible greater therapeutic index, on fibrotic scarring, axonal sprouting and functional recovery after SCI. Delayed systemic administration of Epo D after a moderate contusion injury (150 kDyn) in female Fischer 344 rats resulted in a reduced number of footfalls when crossing a horizontal ladder at 4 and 8 weeks post-injury. Hindlimb motor function assessed with the BBB open field locomotor rating scale and Catwalk gait analysis were not significantly altered. Moreover, formation of laminin positive fibrotic scar tissue and 5-HT positive serotonergic fiber length caudal to the lesion site were not altered after treatment with Epo D. These findings recapitulate a functional benefit after systemic administration of a microtubule-stabilizing drug in rat contusion SCI.

ANALISIS PERSEPSI APARATUR PEMERINTAH DESA TERHADAP DANA DESA DI KECAMATAN TALANG EMPAT KABUPATEN BENGKULU TENGAH

Meiyudi Ardianto, Neri Susanti; This study aimed to get the perception of the village apparatus to use village funds, the use of the village funds according to the ministerial decree of village No. 08 year of 2016. The study was conducted in Talang Empat district of Central Bengkulu regency with a number of villages as many as 15 villages. This study was used rating scale analysis method by means of questionnaires distributed in each village and direct face with the village government apparatus.The results of the study show the village government organization variable gain the value of 718, variable of the implementation of rural development gain the value of 706 while the community empowerment and development variable gain the value of 690 and rural communities with a value of 713 this means the village government apparatus strongly agreed with these activities. Therefore, the perception of the village government apparatus in accordance with the village government budget. But in fact, the village government apparatus do not fully understand about the use of village funds. This is because the variable of the implementation of the village government and development of rural communities do not use the village fundsKey Words: The village government apparatus, the village funds.

Validation of Scores From the High School Version of the Self-Efficacy to Teach Statistics Instrument Using Preservice Mathematics Teachers

Recently adopted state standards for middle grades and high school mathematics content have an increased emphasis on statistical topics. With this change, teacher education programs may need to adapt how they prepare preservice secondary mathematics teachers (PSMTs) to teach statistics and require measures related to statistics teaching to assess the impact of programmatic changes and track teacher growth. Using responses from a sample of 290 PSMTs from 20 institutions across the United States, this study presents validity and reliability evidence for the high school version of the Self-Efficacy to Teach Statistics (SETS-HS), which could be used to assess statistics teaching efficacy. Confirmatory factor analysis results via Rasch modeling support the use of three subscales, which exhibit adequate reliabilities and correspond to the three levels in the Pre-K–12 Guidelines for Assessment and Instruction in Statistics Education endorsed by the American Statistical Association. Item and rating scale analyses indicate that the 46 items and the six-category scale employed in the SETS-HS perform as intended.

Establishing the Validity and Reliability Evidence of Preceptor Assessment of Student Tool

Objective. To evaluate the validity and reliability evidence of the preceptor assessment of student tool (PAST) which was designed to assess doctor of pharmacy (PharmD) student rotation performance. Methods. Evaluation data were loaded into WINSTEPS software to conduct a Rasch rating scale analysis. Validity evidence was examined from construct and content validity perspectives, and reliability was assessed via student and item separation index and reliability coefficient. Data from 435 observations were included in the analysis. Results. All 19 items measured the same construct of interest and the five-point rating scale functioned appropriately and differentiated students' ability. However, the item/person map indicated an absence of items at the end of the measurement continuum. Conclusion. Although adding items at the end of the measurement continuum may be beneficial, PAST showed good validity and reliability evidence when used to evaluate PharmD student rotations and is suitable to assess mastery learning.

Remotely Programmed Deep Brain Stimulation of the Bilateral Subthalamic Nucleus for the Treatment of Primary Parkinson Disease: A Randomized Controlled Trial Investigating the Safety and Efficacy of a Novel Deep Brain Stimulation System

Background: Deep brain stimulation (DBS) is the most commonly performed surgery for the debilitating symptoms of Parkinson disease (PD). However, DBS systems remain largely unaffordable to patients in developing countries, warranting the development of a safe, economically viable, and functionally comparable alternative. Objective: To investigate the efficacy and safety of wirelessly programmed DBS of bilateral subthalamic nucleus (STN) in patients with primary PD. Methods: Sixty-four patients with primary PD were randomly divided into test and control groups (1:1), where DBS was initiated at either 1 month or 3 months, respectively, after surgery. Safety and efficacy of the treatment were compared between on- and off-medication states 3 months after surgery. Outcome measures included analysis of Unified Parkinson's Disease Rating Scale (UPDRS) scores, duration of “on” periods, and daily equivalent doses of levodopa. All patients were followed up both 6 and 12 months after surgery. Results: Three months after surgery, significant decrease in the UPDRS motor scores were observed for the test group in the off-medication state (25.08 ± 1.00) versus the control group (4.20 ± 1.99). Conclusions: Bilateral wireless programming STN-DBS is safe and effective for patients with primary PD in whom medical management has failed to restore motor function.

Edaravone (MCI-186) for the Treatment of Amyotrophic Lateral Sclerosis (ALS): A Posthoc Analysis of Amyotrophic Lateral Sclerosis Functional Rating Scale–Revised (ALSFRS-R) by Domain and Individual Items (P3.130)

Edaravone (MCI-186) for the Treatment of Amyotrophic Lateral Sclerosis (ALS): A Posthoc Analysis of Amyotrophic Lateral Sclerosis Functional Rating Scale–Revised (ALSFRS-R) by Domain and Individual Items (P3.130)

Can Surgical Trainees Achieve Arthroscopic Competence at the End of Training Programs? A Cross-sectional Study Highlighting the Impact of Working Time Directives

To provide training guidance on procedure numbers by assessing how the number of previously performed arthroscopic procedures relate to both competent and expert performance in simulated arthroscopic shoulder tasks. A cross-sectional study that assessed simulated shoulder arthroscopic performance was undertaken. A total of 45 participants of varying experience performed 2 validated tasks: a simple diagnostic task and a more complex Bankart labral repair task. All participants provided logbook numbers for previously performed arthroscopies. Performance was assessed with the Global Rating Scale and motion analysis. Receiver operating characteristic curve analyses were conducted to identify optimum cut points for task proficiency at both "competent" and "expert" levels. Increasing surgical experience resulted in significantly better performance for both tasks as assessed by Global Rating Scale or motion analysis (P < .0001). Receiver operating characteristic curve analyses demonstrated 52 previous arthroscopies were needed to perform to a competent level at the diagnostic task and 248 to be competent at the complex task. To perform at an expert level, 290 and 476 previous arthroscopies, respectively, were needed. This study provides quantified guidance for arthroscopic training and highlights the positive relationship between arthroscopic case load and arthroscopic competency. We have estimated that the number of arthroscopies required to achieve competency in a basic arthroscopic task exceed those recommended in some countries. These estimates provide useful guidance to those responsible for training program. The numbers to achieve competent arthroscopic performance in the assessed simulated tasks exceed what is recommended and what is possible during surgical training programs in some countries.

Healthy Caregivers-Healthy Children: A Train-the-Trainer (TTT) Implemented Childcare Center-Based Obesity Prevention Program

The purpose of this project is to evaluate the effectiveness of the train-the-trainer (TTT)-implemented “Healthy Caregivers-Healthy Children” (HC2) obesity prevention toolkit on parent and teacher adoption of healthy lifestyle role modeling behaviors, and policy integration in childcare centers. A total of 24 Quality Rating and Improvement System (QRIS) childcare centers were randomized to HC2 or an attention control arm. Treatment centers (n=12) are currently receiving the HC2 program via a TTT model that includes menu modifications, a child-centered curriculum for healthy eating and physical activity, and a parent-and teacher-centered curriculum for healthy meal preparation, reinforced through an adult role-modeling curriculum. Control centers (N=12) are receiving an injury prevention (safety) intervention. Over a quarter of the sample (27%) is overweight/obese. Mean BMI percentile is 60.1% and z score is 0.33. Analysis of the Health Environment Rating Scale showed that at baseline only 59% have water available to drink throughout the day, 13% served vegetables 1xday (20% never), 40% always serve whole grain snacks, 38% spend at least 1.5 hours doing vigorous activity. Lower child BMI was significantly correlated with more daily vegetable servings (R=-.55, p=0.04). Health Environment Rating Scale baseline center-level analysis showed that most centers are not meeting HC2 policy standards (water as beverage choice, fruits/vegetables served daily, at least 120 minutes of physical activity/day, and < ½ hour of screen time per week). center level nutrition behavior, and serving more vegetables in particular, has a positive impact on child healthy weight. implementing standardized nutrition and physical activity policies in childcare centers can have a significant impact on child healthy growth and development.

Mortgage Investment in Osun State: An Evaluation of the Role of Estate Surveyors and Valuers

The determination of value of land and landed properties for all purposes is by virtue of decree No 24 of 1975 the responsibility of an Estate Surveyor and Valuer. Concern has risen over the incursion of non Estate Valuers in Mortgage Valuations and it is perceived that banks are beginning to doubt the Estate Valuer’s opinion. This paper investigates Mortgage investment with respect to the Estate Valuers’ work. A survey research method was adopted for the study. Two different sets of well structured questionnaires were served on 25 practicing Estate Valuers and loan officers in the 22 commercial Banks (respectively) in Osogbo and Ile-Ife of Osun state. The data collected were analyzed using frequencies, charts, mean score, likert rating scale and regression analysis. Findings revealed among other things that majority of the Estate Valuers (47.07%) often adopt cost method in valuation for mortgage purposes. The general consensus was that the Estate Valuers’ figure provides adequate cover for the amount of loan advanced. The regression analysis results indicated a high positive correlation of 0.935 between the variables. Of the four predictors used, only the second predictor (Valuer's do not carry out enough investigation/inspection) significantly predicts Valuer’s work. The study recommends that Estate Valuers should ensure adequate inspection and proper reporting of properties. The Nigerian Institution of Estate Surveyors and Valuers is urged to organize a mandatory educational enlightenment programmes aimed at keeping Estate Valuers abreast with the global trends in valuation practices to enable them satisfy their clients’ expectations.

Evaluating the Psychometric Properties of 3 Depression Measures in a Sample of Persons With Traumatic Brain Injury and Major Depressive Disorder.

To explore the psychometric properties of 3 widely used measures of depression in a sample of individuals with traumatic brain injury (TBI) and major depressive disorder and refine them to maximize efficiency. Secondary analysis of data from a randomized controlled trial of cognitive-behavioral therapy for depression after TBI. Nationwide recruitment from community and clinical settings. One hundred adults within 10 years of complicated mild to severe TBI. Telephone and in-person cognitive-behavioral therapy. Patient Health Questionnaire-9 (PHQ-9), Symptom Checklist-20, and Hamilton Depression Rating Scale. We used Rasch rating scale analysis and multilevel modeling to investigate the 3 measures. Measurement properties of each of the depression measures were strong. We explored modifications to the rating scales to improve efficiency while retaining strong psychometric characteristics. Correlations among these revised measures were high. Treatment effects of each revised depression measure were compared using a multilevel model, and effect size estimates were comparable among the revised PHQ-9, Symptom Checklist-20, and Hamilton Depression Rating Scale. Although each of the 3 measures demonstrated adequate reliability, the efficiency of all 3 instruments was improved with rating scale analysis. The PHQ-9 required the fewest modifications and functions well as a measure of depression among those with TBI.

The choice of the ability estimate with asymptotically correct standardized person-fit statistics.

Snijders (2001, Psychometrika, 66, 331) suggested a statistical adjustment to obtain the asymptotically correct standardized versions of a specific class of person-fit statistics. His adjustment has been used to obtain the asymptotically correct standardized versions of several person-fit statistics including the lz statistic (Drasgow etal., 1985, Br. J. Math. Stat. Psychol., 38, 67), the infit and outfit statistics (e.g., Wright & Masters, 1982, Rating scale analysis, Chicago, IL: Mesa Press), and the standardized extended caution indices (Tatsuoka, 1984, Psychometrika, 49, 95). Snijders (2001), van Krimpen-Stoop and Meijer (1999, Appl. Psychol. Meas., 23, 327), Magis etal. (2012, J. Educ. Behav. Stat., 37, 57), Magis etal. (2014, J. Appl. Meas., 15, 82), and Sinharay (2015b, Psychometrika, doi:10.1007/s11336-015-9465-x, 2016b, Corrections of standardized extended caution indices, Unpublished manuscript) have used the maximum likelihood estimate, the weighted likelihood estimate, and the posterior mode of the examinee ability with the adjustment of Snijders (2001). This paper broadens the applicability of the adjustment of Snijders (2001) by showing how other ability estimates such as the expected a posteriori estimate, the biweight estimate (Mislevy & Bock, 1982, Educ. Psychol. Meas., 42, 725), and the Huber estimate (Schuster & Yuan, 2011, J. Educ. Behav. Stat., 36, 720) can be used with the adjustment. A simulation study is performed to examine the Type I error rate and power of two asymptotically correct standardized person-fit statistics with several ability estimates. A real data illustration follows.

Unilateral microinjection of acrolein into thoracic spinal cord produces acute and chronic injury and functional deficits

Although lipid peroxidation has long been associated with spinal cord injury (SCI), the specific role of lipid peroxidation-derived byproducts such as acrolein in mediating damage remains to be fully understood. Acrolein, an α-β unsaturated aldehyde, is highly reactive with proteins, DNA, and phospholipids and is considered as a second toxic messenger that disseminates and augments initial free radical events. Previously, we showed that acrolein increased following traumatic SCI and injection of acrolein induced tissue damage. Here, we demonstrate that microinjection of acrolein into the thoracic spinal cord of adult rats resulted in dose-dependent tissue damage and functional deficits. At 24h (acute) after the microinjection, tissue damage, motoneuron loss, and spinal cord swelling were observed on sections stained with Cresyl Violet. Luxol fast blue staining further showed that acrolein injection resulted in dose-dependent demyelination. At 8weeks (chronic) after the microinjection, cord shrinkage, astrocyte activation, and macrophage infiltration were observed along with tissue damage, neuron loss, and demyelination. These pathological changes resulted in behavioral impairments as measured by both the Basso, Beattie, and Bresnahan (BBB) locomotor rating scale and grid walking analysis. Electron microscopy further demonstrated that acrolein induced axonal degeneration, demyelination, and macrophage infiltration. These results, combined with our previous reports, strongly suggest that acrolein may play a critical causal role in the pathogenesis of SCI and that targeting acrolein could be an attractive strategy for repair after SCI.