Scale Level Research Articles

Motor development and functional ability for children with cerebral palsy: A new tool for functional measure

The paucity of adequate tool available for documenting therapeutic effectiveness surfaces as major problem. An initiation is being taken to develop an appropriate tool which can evaluate motor development and functional ability of children with Cerebral palsy appropriate to Indian culture and society. Aim: To develop an assessment tool for analysing motor development and functional ability of children with Cerebral palsy. Objectives: (i) To develop Psychometric property and evaluate the psychometric property of the tool. (ii) To check the reliability and validity of the tool developed. Material and method: Tool development was conducted in three phases, Phase 1- development of 64 items in three domains. Expert review was undertaken and correction of the content was done through discussion with experts. Phase 2- content validity and face validity have been established. Phase 3 - concurrent validity, has been established by corelating with GMFM. Result: 64 items were generated under three stages: Infant (20), Toddler (36) and Preschooler (8). Content validity index at item level and Scale level were significantly high (> 0.80) for agreement in Clarity, Essential and Relevancy. The face validity of the tool was evaluated. Each item was under full agreement category (90% -100%) in formatting, clarity, and appropriateness of the item for children with CP. Test-retest, interrater and concurrent validity of the tool is significantly acceptable. Conclusion: The new tool may be considered as an effective measure which is suitable in children with CP.

Patient-Reported Indicator Surveys (PaRIS): measuring patient reported experiences and outcomes across populations and health systems

Abstract We aimed to develop and test the performance of a questionnaire for adults (aged 45 or older) with one or more chronic conditions who use primary/ambulatory care across populations and health systems in multiple countries. Candidate scales and items were identified through a systematic process supported by international stakeholders (PaRIS Patient Advisory Panel, Technical Advisory Community and Working Party members of participating countries). Four instruments for each domain, covering patient reported outcome measures (PROMs), patient reported experience measures (PREMs), health behaviours, and health and health care capabilities, were shortlisted using predefined criteria and evaluated using the EMPRO method. A modified Delphi supported selecting a core instrument for each domain and additional relevant scales/items. Consultations took place with the stakeholders to confirm the suitability of the proposed questionnaire. The questionnaire was evaluated through cognitive testing and further modified accordingly. The survey was piloted in a Field Trial. Psychometric evaluation was conducted with data from a Field trial on an item level and scale level. Out of 217 instruments, the Delphi resulted in consensus on a core instrument for each main domain and additional questions to ensure comprehensiveness. The cognitive testing of the draft survey (17 languages, 20 countries) confirmed that most questions were interpreted as intended. The version of the survey developed for the field trial included 118 questions. The field trial psychometric evaluation was based on 10,145 patients, across 18 countries. The questionnaire performed well at item level and at scale level. Performance in terms of structure and validity was good overall. A revised version of the patient questionnaire was created with 115 items. A comprehensive questionnaire has been constructed based on the PaRIS survey framework for people living with chronic conditions and following an inclusive approach.

Exploring the role of AI-driven chatbots in patient care: a critical evaluation amidst healthcare staff shortages

Abstract Background Amidst the backdrop of staff shortages in healthcare systems, patients and their families are increasingly turning to chatbots, powered by Large Language Models (LLMs), for information about their medical conditions. These AI-driven chatbots, capable of generating human-like responses across a broad range of topics, have become a prevalent tool in the healthcare landscape. Given the proliferation of these chatbots, it is crucial to evaluate the quality and accuracy of the responses they provide. Methods We selected five freely accessible chatbots (Bard, Microsoft Copilot, PiAI, ChatGPT, and ChatSpot) for our study. These chatbots were posed questions spanning three medical fields: cardiology, cardio-oncology, and cardio-rheumatology. The responses generated by the chatbots were then compared against established guidelines from the European Society of Cardiology, American Academy of Dermatology, and American Society of Clinical Oncology. In addition to the content, the readability of the responses was evaluated using four different readability scales: the Flesch Reading Scale, Gunning Fog Scale Level, Flesch-Kincaid Grade Level, and Dale-Chall Score. To assess the accuracy of the responses in accordance with the medical guidelines, two independent medical professionals rated them on a 3-point Likert scale (0 - incorrect, 1 - partially correct or incomplete, 2 - correct). This allowed us to gauge the compliance of the chatbot responses with the medical guidelines. Results Results: In our study, we posed a total of 45 questions to each of the chatbots. Out of the five chatbots, Microsoft Copilot, PiAI, and ChatGPT were able to respond to all the questions. The length of the responses varied, with PiAI providing the shortest average response length of 7.26 words, and Bard providing the longest at 18.9 words. In terms of readability, the Flesch Reading Ease Scale scores ranged from 17.67 (ChatGPT) to 39.34 (Bard), indicating the relative complexity of the responses. The Flesch-Kincaid Grade Level, which reflects the academic grade level required to comprehend the text, ranged from 14.02 (PiAI) to 15.97 (ChatGPT). The Gunning Fog Scale Level, another measure of readability, varied from 15.77 (Bard) to 19.73 (ChatGPT). Lastly, the Dale-Chall Score, which assesses the understandability of the text, ranged from 10.24 (Bard) to 11.87 (ChatGPT). These results highlight the variability in the readability and complexity of responses generated by different chatbots. Readability analysis is presented in table 1. Conclusion This study indicates that chatbots vary in length, quality and readability. They answer each question in their way, based on data they have pulled from the network. Our data suggests that people who want information from a chatbot need to be careful and verify the answers they get.

Progress Toward Estimating the Minimal Clinically Important Difference of Intelligibility: A Crowdsourced Perceptual Experiment.

The purpose of the current study was to estimate the minimal clinically important difference (MCID) of sentence intelligibility in control speakers and in speakers with dysarthria due to multiple sclerosis (MS) and Parkinson's disease (PD). Sixteen control speakers, 16 speakers with MS, and 16 speakers with PD were audio-recorded reading aloud sentences in habitual, clear, fast, loud, and slow speaking conditions. Two hundred forty nonexpert crowdsourced listeners heard paired conditions of the same sentence content from a speaker and indicated if one condition was more understandable than another. Listeners then used the Global Ratings of Change (GROC) Scale to indicate how much more understandable that condition was than the other. Listener ratings were compared with objective intelligibility scores obtained previously via orthographic transcriptions from nonexpert listeners. Receiver operating characteristic (ROC) curves and average magnitude of intelligibility difference per level of the GROC Scale were evaluated to determine the sensitivity, specificity, and accuracy of potential cutoff scores in intelligibility for establishing thresholds of important change. MCIDs derived from the ROC curves were invalid. However, the average magnitude of intelligibility difference derived valid and useful thresholds. The MCID of intelligibility was determined to be about 7% for a small amount of difference and about 15% for a large amount of difference. This work demonstrates the feasibility of the novel experimental paradigm for collecting crowdsourced perceptual data to estimate MCIDs. Results provide empirical evidence that clinical tools for the perception of intelligibility by nonexpert listeners could consist of three categories, which emerged from the data ("no difference," "a little bit of difference," "a lot of difference"). The current work is a critical step toward development of a universal language with which to evaluate changes in intelligibility as a result of neurological injury, disease progression, and speech-language therapy.

33 Use of CHU Ste. Justine online resources prior to visiting the Emergency Department for less-urgent, acute febrile illness

Abstract Background Over the past 20 years, visits to paediatric emergency departments (EDs) across Canada have steadily increased, with a higher proportion of presentations for lower acuity symptoms. Many paediatric institutions’ websites now provide information and recommendations for caregivers on common illnesses and reasons for seeing healthcare providers or going to the ED. Increasing the use of internet resources may improve health literacy and hopefully decrease ED use for lower acuity presentations like uncomplicated viral illness. Objectives The objective of this study was to assess whether caregivers presenting with children with lower acuity at triage were aware of and using the online resources provided by our paediatric institution to help with at-home management of febrile illnesses and to guide their decision to present to the ED. Design/Methods This was a cross-sectional study in a tertiary care university-affiliated paediatric ED in an urban setting. Participants were a convenience sample of caregivers of children 6 months to 17 years old with a fever 72 hours or less and triaged low acuity (Canadian Triage and Acuity Scale levels 3 to 5). Caregivers of children with underlying significant systemic illness were excluded. Consenting participants completed two questionnaires. The first questionnaire included demographic data, information on baseline internet utilisation, use of general online health information and our institutions’ website specifically, and whether use of those resources influenced their decision to present to the ED. After browsing dedicated web materials developed by our institution (“Before going to the emergency room” and “Fever”), questionnaire 2 asked for feedback on the website. Results From April to July 2023, 100 caregivers participated in the study (response rates questionnaires 1 and 2: 80% and 70%, respectively) (Table 1). Half (49%) of caregivers researched their child’s symptoms prior to coming to the ED (Table 2). Approximately one third (39%) of respondents were aware that our institution provided online information for caregivers about common symptoms and when to present to the ED. Half (51%) of caregivers who completed questionnaire 2 said they would not have come to the ED if they had read these resources prior (Table 3). Many (66%) respondents reported they would be “likely/very likely” to look up their child’s symptoms on the institutional website before going to the ED in the future. Conclusion Half of caregivers presenting to the ED for their child’s lower-acuity febrile illness conducted research on their child’s symptoms prior to visiting the ED and most were influenced in their decision to come to ED by what they found. Most caregivers were not aware that our institution had online resources available. Promotion of the institutional resources available to parents may empower parents to manage common symptoms at home and prevent ED visits for lower-acuity illness.

Providing quality-assessed and standardised soil data to support global mapping and modelling (WoSIS snapshot 2023)

Abstract. Snapshots derived from the World Soil Information Service (WoSIS) are served freely to the international community. These static datasets provide quality-assessed and standardised soil profile data that can be used to support digital soil mapping and environmental applications at broad scale levels. Since the release of the preceding snapshot in 2019, refactored ETL (extract, transform and load) procedures for screening, ingesting and standardising disparate source data have been developed. In conjunction with this, the WoSIS data model was overhauled, making it compatible with the ISO 28258 and Observations and Measurements (O&M) domain models. Additional procedures for querying, serving and downloading the publicly available standardised data have been implemented using open software (e.g. GraphQL API). Following up on a short discussion of these methodological developments we discuss the structure and content of the “WoSIS 2023 snapshot”. A range of new soil datasets was shared with us, registered in the ISRIC World Data Centre for Soils (WDC-Soils) data repository and subsequently processed in accordance with the licences specified by the data providers. An important effort has been the processing of forest soil data collated in the framework of the EU-HoliSoils project. We paid special attention to the standardisation of soil property definitions, description of the soil analytical procedures and standardisation of the units of measurement. The 2023 snapshot considers soil chemical properties (total carbon, organic carbon, inorganic carbon (total carbonate equivalent), total nitrogen, phosphorus (extractable P, total P and P retention), soil pH, cation exchange capacity and electrical conductivity) and physical properties (soil texture (sand, silt and clay), bulk density, coarse fragments and water retention), grouped according to analytical procedures that are operationally comparable. Method options are defined for each analytical procedure (e.g. pH measured in water, KCl or CaCl2 solution, molarity of the solution, and soil / solution ratio). For each profile we also provide the original soil classification (i.e. FAO, WRB and USDA system with their version) and pedological horizon designations as far as these have been specified in the source databases. Three measures for “fitness for intended use” are provided to facilitate informed data use: (a) positional uncertainty of the profile's site location, (b) possible uncertainty associated with the operationally defined analytical procedures and (c) date of sampling. The most recent (i.e. dynamic) dataset, called wosis_latest, is freely accessible via various web services. To permit consistent referencing and citation, we also provide a static snapshot (in this case, December 2023). This snapshot comprises quality-assessed and standardised data for 228 000 geo-referenced profiles. The data come from 174 countries and represent more than 900 000 soil layers (or horizons) and over 6 million records. The number of measurements for each soil property varies (greatly) between profiles and with depth, this generally depending on the objectives of the initial soil sampling programmes. In the coming years, we aim to gradually fill gaps in the geographic distribution of the profiles, as well as in the soil observations themselves, this subject to the sharing of a wider selection of “public” soil data by prospective data contributors; possible solutions for this are discussed. The WoSIS 2023 snapshot is archived and freely available at https://doi.org/10.17027/isric-wdcsoils-20231130 (Calisto et al., 2023).

Housing Defect Assessment through Household Scale and General Contractor Level

Housing Defect Assessment through Household Scale and General Contractor Level

학교폭력 가해자에 대한 경찰다이버전 정책 기반 다중체계치료 사례연구

Objectives This purpose of the study was conducted to explore the effectiveness of Multisystemic Therapy for school violence perpetrators as part of the police diversion policy. Methods The subject of the study was a 14-year-old male student who was reported to have school violence, which is extortion and intimidation, and was released on the condition of participating MST. In accordance with the multisystemic therapy manual, five key goals were derived by analyzing risk factors for adolescents' problematic behaviors through evaluation of various systems surrounding him. An intervention strategies were established to achieve the core goals(i.e., stop smoking and alcohol, controlled use of SNS, making pro-social friends, stay away from delinquents, promoting positive parenting skills of parents). The essential parts of MST as like the therapy team, the visiting service, and weekly supervision were implemented. In order to measure pre-post changes, Children Behavior Checklist 6-18, the Parenting Stress Index, the Parenting Attitude Test, and the MMPI-A were conducted. The package of scales was implemented at 3 points as pre-time, post-time, and 8 months follow-up. Results First of all, the level of the externalization problem scale of CBCL 6-18, which was at the clinical range at the pre-test, recovered to the level of the normal range in the post-test, and these results were maintained even at the 8 months follow-up. Regarding MMPI-A, the score was lowered by nearly 2 standard deviations in the scale of Pd compared to pre-test. Then, parenting stress decreased and positive parenting attitudes of parents increased. In addition, all the five core goals were achieved. Conclusions The results of this study showed that multisystemic therapy for school violence perpetrator can help decrease adolescents’ problematic behaviors including school violence.

‘Slim pickings?’: Extreme large recruitment events may induce density-dependent reductions in growth for Alaska sablefish (Anoplopoma fimbria) with implications for stock assessment

Growth processes mediate survival and fecundity within fish populations, which are fundamental in regulating population dynamics. Therefore, accurate estimates of population scale and sustainable exploitation levels in contemporary fishery stock assessment models rely heavily on understanding and accurately characterizing growth processes. However, empirical studies that relate population-level changes in growth patterns to observable ecosystem and population conditions remain scarce. In particular, few studies directly consider the influence of intra-specific competition (i.e., cohort effects) on growth variability, and its associated implications for stock assessment estimates. Focusing on Alaska sablefish as a case study, we illustrate how multiple unprecedented large recruitment events since 2014 resulted in density-dependent declines in growth on the population-level scale, using a state-space growth model. Furthermore, we demonstrate how incorporating cohort-specific growth variability within the Alaska sablefish stock assessment model resulted in substantial differences in estimates of spawning biomass and recommended harvest levels. Overall, results from this study underscore the significance of cohort effects on growth processes and their implications for stock assessment models and associated harvest recommendations.

The Influence of Human Resources, Business Scale, Business Age, Accounting Training and Education Level on the Use of Accounting Information in MSMEs in Kudus Regency

The Influence of Human Resources, Business Scale, Business Age, Accounting Training and Education Level on the Use of Accounting Information in MSMEs in Kudus Regency

Driving economic transition: The impact of cross-border e-commerce policy on the upgrading of service industry structure

Cross-border e-commerce, as an innovative format and model of international trade, plays a crucial role in accelerating the transformation and upgrading of industrial structures, and shaping a modern economic framework. Using panel data from 260 prefecture-level cities in China from 2003 to 2019, this study investigates the impact of the cross-border e-commerce comprehensive pilot area (CBECCPA) policy on the upgrading of service industry structure and its mechanisms using the staggered difference-in-differences (DID) method. The results show that the CBECCPA policy can significantly promote the upgrading of service industry structure. The mechanism analysis reveals that the CBECCPA policy can promote the upgrading of service industry structure by clustering service industry enterprises, bolstering urban innovation, and increasing the scale of trade. Heterogeneity analysis indicates that the impact of the CBECCPA policy on the information transmission, software, and information technology service industry is more pronounced and the policy effect is stronger for those with a lower level of service industry structure and for pilot areas with higher levels of development, developmental foundation, developmental scale, and developmental innovation. Furthermore, the policy effect varies significantly across cities. This study provides empirical evidence and policy insights into the role of the CBECCPA in the upgrading of service industry structure.

Hip Arthroscopy for Femoroacetabular Impingement Syndrome in High-Level Athletes: A 10-Year Follow-up.

Arthroscopic treatment for femoroacetabular impingement syndrome (FAIS) has previously been reported to have favorable short-term results in high-level athletes. Less is known about long-term outcomes. To report outcomes 10 years after hip arthroscopy for FAIS in high-level athletes using validated patient-reported outcome measures (PROMs). Case series; Level of evidence, 4. Patients who underwent hip arthroscopy between November 2011 and January 2013 were included in a local hip arthroscopy registry and completed preoperative PROMs. At 10-year follow-up, the same PROMs were completed. Inclusion criteria were age <40 years at time of surgery, no prior hip surgeries, and a pre-symptomatic Hip Sports Activity Scale (HSAS) level of 7 or 8. The exclusion criterion was total hip arthroplasty at follow-up. The PROMs included the international Hip Outcome Tool-12 items (iHOT-12), the Copenhagen Hip and Groin Outcome Score (HAGOS), visual analog scale (VAS) for overall hip function, European Quality of Life-5 Dimensions questionnaire (EQ-5D) and European Quality of Life-visual analog scale (EQ-VAS), HSAS, and a single question on patient satisfaction. The rates of patients achieving minimal important change and reporting Patient Acceptable Symptom State (PASS) were reported for HAGOS and iHOT-12. For iHOT-12, preoperative results were compared with 1, 5, and 10-year follow-ups. A total of 45 patients (34 men, 11 women; 70 hips; mean age 24.4 years at time of surgery) were included, with 77 patients eligible for inclusion. Significant improvements (P < .001) were seen at 10-year follow-up in all HAGOS subscales: Symptoms, Pain, Daily Activity, Sports, Physical Activity, Quality of Life (50.3 vs 78.6, 59.2 vs 86.8, 65.9 vs 88.8, 37.1 vs 81.1, 24.4 vs 81.1, 32.1 vs 79.3), iHOT-12 (40.1 vs 81.6), EQ-5D (0.59 vs 0.89), EQ-VAS (65.6 vs 80.4), and VAS for overall hip function (48 vs 79). For iHOT-12, the largest change was seen between preoperative and 1-year follow-up values, with consistent results over time. There was no statistically significant difference between HSAS levels preoperatively and at 10-year follow-up (HSAS level 4), with 24% of patients reporting a HSAS level 7 or 8 at the follow-up. Of the patients, 93% reported satisfaction with the surgery. PASS was achieved in 82% for iHOT-12, with a range of 76% to 91% for HAGOS subscales. Furthermore, 93% exceeded the minimal important change for iHOT-12, and a range of 67% to 84% for HAGOS. In a high-level athletic population, significant improvements in long-term outcomes are reported after hip arthroscopy for FAIS, with patients reporting a high satisfaction rate. The results also show that the largest improvement occurs within the first postoperative year, with results being maintained for 10 years.

Proximal Hamstring Avulsions: Surgical Versus Conservative Treatment Using a Shared Decision-Making Strategy

Background: Surgical treatment of patients with proximal hamstring avulsions provides good results; however, less is known about the outcome in patients who are offered conservative treatment. Purpose: To investigate the effect of surgical or conservative treatment (decided by a shared decision strategy) of proximal hamstring avulsions. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 24 patients with magnetic resonance imaging–verified proximal hamstring avulsion were included and had either surgical treatment (11 patients, 45% women; mean age, 50 ± 16 years) or conservative treatment (13 patients, 46% women; mean age, 50 ± 17 years). At baseline, 6 months and 12 months, all patients answered the Perth Hamstring Assessment Tool (PHAT) (0-100 scale) and Hip Sports Activity Scale (0-8 scale). Patients had their maximal hip extension strength and maximal strength at 30° and 90° of knee flexion measured in newton meters per kilogram using a handheld dynamometer. A minimal important change in PHAT was considered &gt;7 points and a minimal important change in strength was considered &gt;0.15 N·m/kg, respectively. Results: The surgical group had a shorter time from injury to initiation of treatment compared with the conservative group (median: 15 vs 64 days; P = .02). The surgical group had a greater amount of retraction of the tendons compared with the conservative group (3 vs 2 cm; P = .04). From baseline to 12-month follow-up, the surgical and conservative groups improved their mean PHAT scores (35 points [95 CI, 24-45 points] and 20 points [95% CI, 9-31 points], respectively) reaching a median of 79 points (interquartile range [IQR], 66-95 points) in the surgical group and 75 points (IQR, 66-85 points) in the conservative group at the 12-month follow-up. Their Hip Sports Activity Scale levels at 12 months were 3 points (95% CI, 1-4 points) and 1 point (95% CI, 0-3 points) (not significant). Furthermore, the surgical and conservative groups improved their maximal hip extension strength by 0.61 N·m/kg (IQR, 0.42-0.80 N·m/kg) and 0.62 N·m/kg (IQR, 0.13-1.10 N·m/kg), respectively. Their maximal knee flexion strength at 30° improved by 0.52 N·m/kg (IQR, 0.29-0.74 N·m/kg) and 0.32 N·m/kg (IQR, 0.12-0.52 N·m/kg) and their maximal knee flexion strength at 90° improved by 0.28 N·m/kg (IQR, 0.19-0.37 N·m/kg) and 0.22 N·m/kg (IQR, 0.02-0.41 N·m/kg). At the 12-month follow-up, the side-to-side difference in maximal muscle strength was 6% and 7%, respectively, during hip extension and 19% to 25% and 16% to 17%, respectively, during knee flexion. Conclusion: Twelve months after treatment of proximal hamstring avulsion, good clinical outcomes were seen when using a shared decision strategy regardless of whether the strategy led to surgical or conservative treatment.

Development and validation of assessment instruments for cervical collar and spinal board placement in simulated environments for nursing students in the care of polytrauma patients

BackgroundMultiple trauma injuries are the leading cause of death and disability in people under the age of 45 and require prompt and specialised care. However, medical and nursing education programmes do not always include specific training in emergency pre-hospital care, resulting in a lack of basic practical skills in trauma management.ObjectiveTo develop and validate two instruments for assessing nursing students’ competence in cervical collar and spinal board application in simulated pre-hospital emergency scenarios.MethodThis is an instrumental study that involves the development of two assessment instruments and the evaluation of their psychometric properties in a sample of 392 nursing students. Content validity was assessed using expert judgement, by calculating the content validity ratio (CVR) for each item and the scale level content validity index average (S-CVI/Ave) for the instruments. Exploratory factor analysis using the MINRES extraction method and Promax rotation was performed to analyse the performance of the items and structure of the rubrics. Internal consistency was analysed using the Omega coefficient and inter-rater agreement was assessed using Cohen’s Kappa coefficient.ResultsInitially, two rubrics were obtained: one with six items for cervical collar placement (S-CVI/Ave = 0.86) and one with nine items for spinal board placement (S-CVI/Ave = 0.81). Both had a single-factor structure, with all items having factor loadings greater than 0.34 for the cervical collar rubric and 0.56 for the spinal board rubric, except for item 2 of the cervical collar rubric (λ = 0.24), which was subsequently removed. The final cervical collar rubric (five items) had an overall internal consistency of 0.84 and the spinal board rubric had an overall internal consistency of 0.90, calculated using the Omega statistic. The weighted Kappa coefficient for each item ranged from acceptable (0.32) to substantial (0.79). These results show that we have successfully developed two sufficiently valid instruments to assess the immobilisation competencies proposed in the objective of the study.ConclusionWhilst further research is needed to fully establish their psychometric properties, these instruments offer a valuable starting point for evaluating nursing students' competence in cervical collar and spinal board application in simulated pre-hospital scenarios.

Intranasal Administration of Standardized Extract of Gotu Kola Leaves Against Nitroglycerine-Induced Recurrent Migraine-Like Pain in Rats

The present study aimed to determine the efficacy of intranasal administration of a standardized extract of Gotu kola, i.e., Centella asiatica (L.) Urban (INDCA-NS) with marker triterpenoids for the prevention of nitroglycerine- (NTG)-induced recurrent migraine in rats. Adult rats of both sexes in a group of 12 were administered intraperitoneal NTG (10 mg/kg) on alternate days (D1 to D9) and once daily intranasal solutions of either vehicle (saline, 50 µL/rat/day), sumatriptan (80 µL/rat/day of 12 mg/ml) as positive control, or INDCA-NS (10, 30, or 100 µg/rat/day) for 21 days. Behavioral and biochemical parameters related to concurrent migraine pain (facial expressions on the grimace scale, thermal hyperalgesia, mechanical allodynia, and plasma and brain levels of pituitary adenylate cyclase-activating polypeptide and nitric oxide), and stress (photophobia and cortisol levels in the brain and serum) were measured. The intranasal administration of INDCA-NS prevented NTG-induced migraine-like pain, photophobia, and stress in a dose-dependent manner. At the same time, sumatriptan alleviated pain and anxiety but not photophobia. In conclusion, the intranasal administration of INDCA-NS showed prophylactic efficacy against recurrent NTG-induced migraine pain in rats.

Indications and scientific support for supratentorial unilateral decompressive craniectomy for different subgroups of patients: A scoping review.

Even though supratentorial unilateral decompressive craniectomy (DC) has become the gold standard neurosurgical procedure aiming to provide long term relief of intractable intracranial hypertension, its indication has only been validated by high-quality evidence for traumatic brain injury and malignant middle cerebral artery infarction. This scoping review aims to summarize the available evidence regarding DC for these two recognized indications, but also for less validated indications that we may encounter in our daily clinical practice. A scoping review was conducted on Medline / Pubmed database from inception to present time looking for articles focused on 7 possible indications for DC indications. Studies' level of evidence was assessed using Oxford University level of evidence scale. Studies' quality was assessed using Newcastle-Ottawa scale for systematic reviews of cohort studies and Cochrane Risk of Bias Tool for randomized controlled trials. Two randomized trials (level 1b) reported the possible efficacy of unilateral DC and the mitigated efficiency of bifrontal DC in the trauma setting. Five systematic reviews meta-analyses (level 2a) supported DC for severely injured young patients with acute subdural hematoma probably responsible for intraoperative brain swelling, while one randomized controlled trial (level 1b) showed comparable efficacy of DC and craniotomy for ASH with intraoperative neutral brain swelling. Three randomized controlled trials (level 1b) and two meta-analyses (level 1a and 3a) supported DC efficacy for malignant ischemic stroke. One systematic review (level 3a) supported DC efficacy for malignant meningoencephalitis. One systematic review meta-analysis (level 3a) supported DC efficacy for malignant cerebral venous thrombosis. The mitigated results of one randomized trial (level 1b) did not allow to conclude for DC efficacy for intracerebral hemorrhage. One systematic review (level 3a) reported the possible efficacy of primary DC and the mitigated efficacy of secondary DC for aneurysmal subarachnoid hemorrhage. Too weak evidence (level 4) precluded from drawing any conclusion for DC efficacy for intracranial tumors. To date, there is some scientific background to support clinicians in the decision making for DC for selected cases of severe traumatic brain injury, acute subdural hematoma, malignant ischemic stroke, malignant meningoencephalitis, malignant cerebral venous thrombosis, and highly selected cases of aneurysmal subarachnoid hemorrhage.

How do speech language pathologists use the Schwarz et al. (2015) rubric for read-aloud storybook selection?

ABSTRACT Reading storybooks aloud to prereaders helps them develop oral language skills; but educators struggle to select appropriate storybooks for read alouds. To better understand this selection process, we evaluated how experienced speech language pathologists (SLPs) apply the storybook selection rubric in Schwarz et al.'s (2015). A read-aloud storybook selection system for prereaders at the preschool language level: A pilot study. Journal of Speech, Language, and Hearing Research, 58(4), 1273-1291. doi:10.1044/2015_JSLHR-L-15-0056. That rubric includes: eight book characteristics, one four-level difficulty scale, and exemplar storybooks for each scale level. Using this rubric, 38 SLPs—who had served children at the preschool language level—rated 63 storybooks based on how difficult they thought the storybooks would be for children at the preschool language level to understand when the storybooks were read aloud to them. A principal component analysis identified-among the original eight characteristics a subset of five highly correlated characteristics related to overall text difficulty: vocabulary, story structure, sentence length, book length, and density. We revised the original rubric to include only four storybook characteristics: (a) text difficulty, (b) amount of inferencing, problem-solving, and abstract concepts, (c) familiarity of activities/experiences, and (d) level of support provided by the illustrations. Using quartile values of the text difficulty characteristic, we derived a four-level difficulty scale for the 63 storybooks. The revised storybook selection rubric simplifies the process of selecting appropriate storybooks for read alouds. The revised rubric and SLPs' difficulty ratings of 63 storybooks provide clinicians with a resource ready-made for clinical practice.

Transitions between equilibrium and nonequilibrium phenomena in the description of crystal growth

The close intertwining of equilibrium and nonequilibrium thermodynamic representations and transitions between the two limiting principles of thermodynamics: the second beginning and the principle of least coercion (minimum entropy production in the stationary regime) constitute the main content of phenomenological theories of crystal growth. The difference of basic postulates of two sections of thermodynamics forces to discuss problems of reversibility and irreversibility of time, scales of observed phenomena and rules of conjugation of thermodynamic forces and flows in theories of crystal growth. A variant of the solution of some conjugation problems is shown on the example of the fluctuation model of dislocation crystal growth, which is based on the stationary isothermal process of thermodynamic free energy fluctuations. In the case of the limiting mode of adsorption of impurities on the crystal face according to the Langmuir model, the free energy fluctuations possessing the absence of the memory effect allow us to identify three chemical potentials of building particles that determine the corresponding values of solution supersaturations realized at different scale levels at the growing crystal face containing a helical dislocation. The supersaturations control quasi-equilibrium and nonequilibrium thermodynamic processes that constitute a single dislocation mechanism of crystal growth.

Decoding pain: uncovering the factors that affect the performance of neuroimaging-based pain models.

Neuroimaging-based pain biomarkers, when combined with machine learning techniques, have demonstrated potential in decoding pain intensity and diagnosing clinical pain conditions. However, a systematic evaluation of how different modeling options affect model performance remains unexplored. This study presents the results from a comprehensive literature survey and benchmark analysis. We conducted a survey of 57 previously published articles that included neuroimaging-based predictive modeling of pain, comparing classification and prediction performance based on the following modeling variables-the levels of data, spatial scales, idiographic vs population models, and sample sizes. The findings revealed a preference for population-level modeling with brain-wide features, aligning with the goal of clinical translation of neuroimaging biomarkers. However, a systematic evaluation of the influence of different modeling options was hindered by a limited number of independent test results. This prompted us to conduct benchmark analyses using a locally collected functional magnetic resonance imaging dataset (N = 124) involving an experimental thermal pain task. The results demonstrated that data levels, spatial scales, and sample sizes significantly impact model performance. Specifically, incorporating more pain-related brain regions, increasing sample sizes, and averaging less data during training and more data during testing improved performance. These findings offer useful guidance for developing neuroimaging-based biomarkers, underscoring the importance of strategic selection of modeling approaches to build better-performing neuroimaging pain biomarkers. However, the generalizability of these findings to clinical pain requires further investigation.

Sensitivity analysis of a multi-scale biofuel primary atomization simulation tool

The purpose is to produce a benchmarked commercial Volume of Fluid (VOF)-to-Discrete Phase Modeling (DPM) numerical algorithm using an experimental study of high-viscosity jet fuel blend C-3. Where the mesh resolution was too coarse to resolve sufficient gas-liquid interfacial curvature, the solver automatically converted VOF biofuel phase mass, momentum, and energy into the equivalent DPM biofuel phase at the sub-grid scale level. Particular attention herein was given to the sensitivity of the results to various numerical degrees of freedom related to the local criteria for conversion of a biofuel from VOF to DPM. The proliferation of commercial simulation tools mandates detailed parametric evaluations. It was found that, while instantaneous conversion rates were extremely sensitive to conversion criteria, atomization physics were not sensitive to the conversion rate effects. Also, this flow system exhibited an outstanding dependence on simulated azimuthal angle, rendering lower order models ineffective. Data sampling methods and durations, along with mesh resolution, were explored such that a particular set of parameters provided a validated model.