Scale Values Research Articles

Clinical phenotypes of patients with acute stroke: a secondary analysis.

Stroke is a leading cause of mortality worldwide and a major cause of disability having a high burden on patients, society, and caregiving systems. This study was conducted to investigate the presence of clusters of in-hospital patients with acute stroke based on demographic and clinical data. Cluster analysis reveals patterns in patient characteristics without requiring knowledge of a predefined patient category or assumptions about likely groupings within the data. We performed a secondary analysis of open-access anonymized data from patients with acute stroke admitted to a hospital between December 2019 to June 2021. In total, 216 patients (78; 36.1% men) were included in the analytical dataset with a mean (SD) age of 60.3 (14.4). Many demographic and clinical features were included in the analysis and the Barthel Index on discharge was used for comparing the functional recovery of the identified clusters. Hierarchical clustering based on the principal components identified two clusters of 109 and 107 patients. The clusters were different in the Barthel Index scores on discharge with the mean (SD) of 39.3 (29.3) versus 62.6 (29.4); t (213.87) = -5.818, P <0.001, Cohen's d (95%CI) = -0.80 (-1.07, -0.52). A logistic model showed that age, systolic blood pressure, pulse rate, D-dimer blood level, low-density lipoprotein, hemoglobin, creatinine concentration, the National Institute of Health Stroke Scale value, and the Barthel Index scores on admission were significant predictors of cluster profiles (all P ≤0.029). There are two clusters in hospitalized patients with acute stroke with significantly different functional recovery. This allows prognostic grouping of hospitalized acute stroke patients for prioritization of care or resource allocation. The clusters can be recognized using easily measured demographic and clinical features.

Social network site use and materialistic values: the roles of self-control and self-acceptance

BackgroundWhile prior studies have established a close association between the use of social network sites (SNSs) and materialistic values, there is limited understanding of the mediating and moderating mechanisms related to important self-related processes, such as self-control and self-acceptance. This paper explores whether and how these factors play a role in comprehending online behavior. One could state that frequent SNS use may pose a risk of virtual addiction, may be related to decreased self-control capacity, and may increase attention to material information on SNS, thereby making it more likely that users affiliate with behaviors associated with materialistic values. In contrast, self-acceptance, as a stable self-process indicating a genuine alignment with one’s true self and the ability to make decisions based on inner needs, may be related with reduced engagement in complex information on SNSs. Consequently, this could serve as a buffer against excessive SNS use and its potential associations with issues of self-control and materialistic values.MethodsA total of 706 Chinese college students were surveyed in a cross-sectional study. They completed self-report questionnaires including the WeChat use intensity scale, the Material Value Scale, the Trait Self-control Scale, and the Self-acceptance Questionnaire. A moderated mediation model was examined to test predictions.ResultsSNS use intensity was positively associated with materialistic values, and self-control partially mediated this association. That is, higher intensity SNS users are more likely lower in self-control, which relates to stronger materialistic values. In addition, the indirect effect through self-control was moderated by self-acceptance, such that this indirect effect was significant only for individuals with low levels of self-acceptance.ConclusionsThis study reveals that self-acceptance may be a protective factor that helps to mitigate excessive SNS use and its potential effects on self-control and materialistic values. It further suggests that psychological interventions targeting the enhancement of self-acceptance and self-control could hold promise in alleviating the negative association between SNS use and materialistic values.

The Translation and Psychometric Evaluation of the Persian Version of the Neuropsychological Vertigo Inventory

Background and Aim: Experiencing dizziness/vertigo is often an indication of dysfunction in the vestibular system. Recent findings show a connection between peripheral vestibular dysfunction and cognitive impairments. The Neuropsychological Vertigo Inventory (NVI) can assess physical, emotional, and cognitive issues in individuals with dizziness/vertigo. The aim of this research was to translate, cultural adaptation and evaluation of the reliability and validity of NVI to Persian. Methods: In this descriptive-analytical study, the NVI scale was translated and adapted to the Iranian cultural context following the international quality of life assessment protocol for translation and equivalence. After obtaining face validity, the scale was administered to 140 patients with peripheral vestibular system dysfunction and 70 control group (age between 25 and 80 years). After one week, 50 participants were asked to complete the questionnaire again. Eventually, reliability was evaluated with both methods of internal consistency and test-retest reproducibility. Results: Out of the 28 items in the NVI scale, 3 items were modified to better align with the cultural conditions of Iranians. The impact scores for most items in this scale were found to be higher than 1.5. The Cronbach’s alpha coefficient values for the overall scale (0.90) and test-retest reliability with intra-class correlation coefficient for the overall scale (0.91) were confirmed. Conclusion: The Persian version of NVI scale demonstrates excellent validity and reliability, and it exhibits a high level of content alignment with the original version. Therefore, it can be a useful tool to better understand the physical, emotional and cognitive disturbances in patients with vertigo/dizziness. Keywords: Validity; reliability; dizziness; vertigo; vestibular dysfunction; neuropsychological vertigo inventory

The Value of the COVID-19 Yorkshire Rehabilitation Scale in the Assessment of Post-COVID among Residents of Long-Term Care Facilities.

The COVID-19 Yorkshire Rehabilitation Scale (C19-YRS) is a patient-reported outcome measure designed to assess the long-term effects of COVID-19. The scale was validated and is commonly used in the general population. In this study, we assess the utility of the C19-YRS in evaluating the post-COVID burden among residents of long-term care facilities with a mean age of 79. C19-YRS and Barthel index evaluations were performed among 144 residents of long-term care facilities reporting new or worsened symptoms or functioning three months after convalescence from COVID-19. The C19-YRS-based screening showed that 70.9% of COVID-19 convalescents had ≥1 complaint three months after recovery. The highest C19-YRS-scored symptoms (indicating a higher burden) were breathlessness, fatigue, and cognitive and continence problems; however, symptomatology was very heterogeneous, revealing a high complexity of the disease in older persons. The mean total C19-YRS score was higher in hospitalized patients (n = 78) than in the outpatient group (n = 66) (p = 0.02). The functioning subscale of the C19-YRS strongly correlated with the Barthel index, with r = -0.8001 (p < 0.0001). A moderately strong correlation existed between retrospectively reported C19-YRS-based functioning and the Barthel index score reported before illness (r = 0.7783, p < 0.0001). The C19-YRS is instrumental in evaluating the consequences of COVID-19 among long-term-care residents. The assessment allows for a broad understanding of rehabilitation needs.

Impact of frailty, biomarkers and basic biochemical parameters on outcomes of comatose patients in status epilepticus: a single-center prospective pilot study

BackgroundStatus epilepticus (SE) is a severe acute condition in neurocritical care with high mortality. Searching for risk factors affecting the prognosis in SE remains a significant issue. The primary study’s aim was to test the predictive values of the Clinical Frailty Scale (CFS) and the Modified 11-item Frailty Index (mFI-11), the biomarkers and basic biochemical parameters collected at ICU on the Glasgow Outcome Scale (GOS) assessed at hospital discharge (hosp), and three months later (3 M), in comatose patients with SE. The secondary aim was to focus on the association between the patient’s state at admission and the duration of mechanical ventilation, the ICU, and hospital stay.MethodsIn two years single-centre prospective pilot study enrolling 30 adult neurocritical care patients with SE classified as Convulsive SE, A.1 category according to the International League Against Epilepsy (ILAE) Task Force without an-/hypoxic encephalopathy, we evaluated predictive powers of CFS, mFI-11, admission Status Epilepticus Severity Score (STESS), serum protein S100, serum Troponin T and basic biochemical parameters on prognosticating GOS using univariate linear regression, logistic regression and Receiver Operating Characteristic (ROC) analysis.ResultsOur study included 60% males, with a mean age of 57 ± 16 years (44–68) and a mean BMI of 27 ± 5.6. We found CFS, mFI-11, STESS, and age statistically associated with GOS at hospital discharge and three months later. Among the biomarkers, serum troponin T level affected GOS hosp (p = 0.027). Serum C-reactive protein significance in prognosticating GOS was found by logistic regression (hosp p = 0.008; 3 M p = 0.004), and serum calcium by linear regression (hosp p = 0.028; 3 M p = 0.015). In relation to secondary outcomes, we found associations between the length of hospital stay and each of the following: age (p = 0.03), STESS (p = 0.009), and serum troponin T (p = 0.029) parameters.ConclusionsThis pilot study found promising predictive powers of two frailty scores, namely CFS and mFI-11, which were comparable to age and STESS predictors regarding the GOS at hospital discharge and three months later in ICU patients with SE. Among biomarkers and biochemical parameters, only serum troponin T level affected GOS at hospital discharge.

Устойчивое развитие как инструмент обеспечения благополучия жизни человека (публично-правовые аспекты)

The article notes that formal articulation of sustainable development takes place in the full semantic meaning identical to that of international acts or, for lack of a better word, segmentary (primarily in terms of economic and environmental aspects). The author points out that differentiated forms of regulation of sustainable development show diversity, dynamism and ability to adapt to various legal systems. However, it is emphasized that there still remain unavoidable risks of devaluation of sustainable development. The favorable breeding ground for the origination of such risks appears due to differentiated approaches towards the value scale for the assessment of priorities of the correlation of economic growth goals, tasks and ratios, environmental policy angle, social development paths.

Enhanced lignin degradation by Irpex lacteus through expanded sterilization further improved the fermentation quality and microbial community during the silage preservation process

Traditional autoclaving, slow degradation rate and preservation of biomass treated by fungi are the main factors restricting biological treatment. In our previous studies, strains with high efficiency and selective lignin degradation ability were obtained. To further solve the limiting factors of biological treatment, this paper proposed a composite treatment technology, which could replace autoclaves for fungal treatment and improve the preservation and utilization of fungal-pretreated straw. The autoclaved and expanded buckwheat straw were, respectively, degraded by Irpex lacteus for 14 days (CIL, EIL), followed by ensiling of raw materials (CK) and biodegraded straw of CIL and EIL samples with Lactobacillus plantarum for different days, respectively (CP, CIP, EIP). An expansion led to lactic acid bacteria, mold, and yeast of the samples below the detection line, and aerobic bacteria was significantly reduced, indicating a positive sterilization effect. Expansion before I. lacteus significantly enhanced lignin selective degradation by about 6%, and the absolute content of natural detergent solute was about 5% higher than that of the CIL. Moreover, EIL decreased pH by producing higher organic acids. The combination treatment created favorable conditions for ensiling. During ensiling, EIP silage produced high lactic acid about 26.83 g/kg DM and the highest acetic acid about 22.35 g/kg DM, and the pH value could be stable at 4.50. Expansion before I. lacteus optimized the microbial community for ensiling, resulting in EIP silage co-dominated by Lactobacillus, Pediococcus and Weissella, whereas only Lactobacillus was always dominant in CP and CIP silage. Clavispora gradually replaced Irpex in EIP silage, which potentially promoted lactic acid bacteria growth and acetic acid production. In vitro gas production (IVGP) in EIL was increased by 30% relative to CK and was higher than 24% in CIL. The role of expansion was more significant after ensiling, the IVGP in EIP was increased by 22% relative to CP, while that in CIP silage was only increased by 9%. Silage of fungal-treated samples reduced methane emissions by 28% to 31%. The study demonstrated that expansion provides advantages for fungal colonization and delignification, and further improves the microbial community and fermentation quality for silage, enhancing the nutrition and utilization value. This has practical application value for scaling up biological treatment and preserving the fungal-treated lignocellulose.Graphical

Effectiveness of Core Muscle Strengthening in Bus Drivers having Low Back Pain using McGill Pain Questionnaire: Experimental Study

Background: This study was developed to determine the effectiveness of core muscle strengthening exercises inreducing low back pain among bus drivers.Purpose: The purpose of the study is to determine the effectiveness of core muscle strengthening exercises inreducing low back pain among bus drivers.Materials and Methods: The research project was conducted as a Quasi experimental study in Saveetha collegeof physiotherapy, Thandalam Chennai and RK Multispecialty physiotherapy clinic, Ayanavaram, Chennai. Theinterventional group received core muscle strengthening exercise for 6 weeks. Following the six-week treatmentperiod, a post-test analysis was performed using the McGill Pain Questionnaire.Study period: from November2022 to July 2023.Results: The values were statistically analysed using paired ‘t-test and the Unpaired ‘t-test. The statistical analysismade with the quantitative data revealed a statistically significant difference before and after the intervention. Thepre-test mean value of the Mc gill questionnaire scale was 55.53 and the post-test value was 19.60. This shows thatthe result value obtained for disability is less after the intervention.Conclusion: From this result, it has been concluded that there is significant reduction in low back pain among busdrivers after the intervention.

Women’s Mental Health During COVID-19 in South Africa

Women’s mental health vulnerability, already a concern before the COVID-19 pandemic, has been exacerbated due to social isolation and restrictions on daily activities. This paper aims to follow a cohort of women from pre - to during the pandemic to determine the change in their mental health using the PHQ-2 scale (a mental health screening tool). Additionally, we investigate whether women with depressive symptoms before the pandemic suffered similarly to those without while controlling for pandemic-related factors. Primarily, we use the Coronavirus Rapid Mobile Survey dataset and apply pooled ordered logit and fixed effects ordered logit models. We find that the value of the PHQ-2 scale significantly increased during the first period of the pandemic and then eased over time. Interestingly, the behaviour of the individual scale items differed over time. This result questions the internal reliability of the scale during the pandemic and the importance of analysing the scale items individually. Furthermore, being depressed before the pandemic increases the probability of ‘depressive feelings’ and does not matter for ‘anhedonia’. Other factors increasing the probability of mental health disorders are taking care of children for 13–24 h a day and living with a person who has gone hungry. In contrast, wearing a mask and living in a grant-receiving household decreases the probability. These findings inform future researchers of the unexpected behaviour of scales and policymakers of the vulnerability of women’s mental health during unprecedented times, given their vital role in increasing the well-being of future generations.

Double blind randomized placebo-controlled study of the efficacy and safety of proroxan in the complex therapy of generalized anxiety disorder

Introduction. The clinical picture of generalized anxiety disorder is characterized by diffuse anxiety, muscle tension and multiple symptoms of hyperactivity of the sympathetic part of the autonomic nervous system. As an alpha-adrenoblocker, proroxan can reduce the hyperactivity of the autonomic nervous system, thereby reducing the severity of anxiety and its somatic symptoms.Aim. To evaluate the efficacy of proroxan in the correction of autonomic disorders in patients with generalized anxiety disorder compared to placebo.Materials and methods. 100 people participated in the study: 50 – in the study group received the SSRI escitalopram, 50 – in the control group received SSRI + placebo. The diagnosis of generalized anxiety disorder was made on the basis of ICD-10 criteria. Psychometric assessment using the Montgomery-Asberg scale was performed (only at the screening visit). Weekly psychometric evaluation was performed using the Hamilton anxiety scale, the SCL-90-R scale to assess somatic manifestations of anxiety, and general clinical impression scales (CGI-S disease severity and CGI-I general improvement).Results. In the course of the study, statistically significant decrease in the mean value of CGI-S scale was observed in both groups, however, more pronounced in the proroxan group (p &gt; 0.05); in the CGI-I scale, more pronounced improvement was observed in the first week of treatment in the proroxan group (p &gt; 0.05). The HAM-A scale also showed a more significant reduction in anxiety in the proroxan group than in the placebo group (p &gt; 0.05). The SCL-90-R SOM scale showed a decrease in the mean value in both groups, more pronounced in the proroxan group, which confirms the effect of the drug on autonomic symptoms of anxiety (p &gt; 0.05).Conclusions. The obtained results confirm the superiority of combination therapy with escitalopram and proroxan in the treatment of generalized anxiety disorder compared to monotherapy. The advantages of proroxan were the absence of sedative effect and, in general, good tolerability, absence of withdrawal syndrome and control of vegetative manifestations of anxiety.

Combining the Nurse Intuition Patient Deterioration Scale with the National Early Warning Score provides more Net Benefit in predicting serious adverse events: A prospective cohort study in medical, surgical, and geriatric wards

ObjectivesThis prospective cohort study aimed to assess the predictive value of the Nurse Intuition Patient Deterioration Scale (NIPDS) combined with the National Early Warning Score (NEWS) for identifying serious adverse events in patients admitted to diverse hospital wards. Research methodology/designData was collected between December 2020 and February 2021 in a 350-bed acute hospital near Brussels, Belgium. The study followed a prospective cohort design, employing NIPDS alongside NEWS for risk assessment. Patients were monitored for 24 h post-registration, with outcomes recorded. SettingThe study was conducted in a hospital with a Rapid Response System (RRS) and electronic patient record wherein NEWS was routinely collected. Patients admitted to two medical, two surgical, and two geriatric wards were included. Main outcome measuresThe primary outcome included death, urgent code calls, or unplanned ICU transfers within 24 h after NIPDS registration. The secondary outcome comprised rapid response team activations or changes in Do-Not-Resuscitate codes. ResultsIn a cohort of 313 patients, 10/313 and 31/313 patients reached the primary and secondary outcome respectively. For the primary outcome, NIPDS had a sensitivity of 0.900 and specificity of 0.927, while NEWS had a sensitivity of 0.300 and specificity of 0.974. Decision Curve Analysis demonstrated that NIPDS provided more Net Benefit across various Threshold Probabilities. Combining NIPDS and NEWS showed potential for optimizing rapid response systems. Especially in resource-constrained settings, NIPDS could be used as a calling criterion. ConclusionThe NIPDS displayed strong predictive capabilities for adverse events. Integrating NIPDS into existing rapid response systems can objectify nurse intuition, enhancing patient safety. Implications for clinical practiceThe Nurse Intuition Patient Deterioration Scale (NIPDS) is a valuable tool for detecting patient deterioration. Implementing NIPDS alongside traditional scores such as NEWS can improve patient care and safety. The optimal NIPDS threshold to activate rapid response is ≥5.

Hyper-Heuristic Approach for Tuning Parameter Adaptation in Differential Evolution

Differential evolution (DE) is one of the most promising black-box numerical optimization methods. However, DE algorithms suffer from the problem of control parameter settings. Various adaptation methods have been proposed, with success history-based adaptation being the most popular. However, hand-crafted designs are known to suffer from human perception bias. In this study, our aim is to design automatically a parameter adaptation method for DE with the use of the hyper-heuristic approach. In particular, we consider the adaptation of scaling factor F, which is the most sensitive parameter of DE algorithms. In order to propose a flexible approach, a Taylor series expansion is used to represent the dependence between the success rate of the algorithm during its run and the scaling factor value. Moreover, two Taylor series are used for the mean of the random distribution for sampling F and its standard deviation. Unlike most studies, the Student’s t distribution is applied, and the number of degrees of freedom is also tuned. As a tuning method, another DE algorithm is used. The experiments performed on a recently proposed L-NTADE algorithm and two benchmark sets, CEC 2017 and CEC 2022, show that there is a relatively simple adaptation technique with the scaling factor changing between 0.4 and 0.6, which enables us to achieve high performance in most scenarios. It is shown that the automatically designed heuristic can be efficiently approximated by two simple equations, without a loss of efficiency.

Psychometric properties of the Bengali-Translated Occupational Self-Assessment Short Form

Introduction: The Occupational Self-Assessment-Short Form (OSA-SF) is a client-centered instrument designed to assess goal setting and intervention planning for adults with a client-centered approach. This study aimed to assess the psychometric properties of the Bengali-translated Occupational Self-Assessment-Short Form (BOSA-SF), which could enable occupational therapists to evaluate the occupational competence and value of Bengali adults. Method: A total of 170 adult participants participated in the study after the translation phase. The data were analyzed using confirmatory factor analysis and Rasch analysis. Results: Among the 12 items, 11 on the competence scale and all 12 on the value scale were unidimensional and demonstrated local independence. The 11 competence items and 12 value items were fitted to the Rasch model, demonstrating good validity and reliability. Conclusion: The 11-item BOSA-SF demonstrates to be a valid and reliable tool for use in client-centered goal setting and intervention planning for Bengali adults. Nonetheless, further research is warranted to conduct more comprehensive analyses that thoroughly assess the functions of the BOSA-SF in various contexts.

Spatial normalization for voxel-based lesion symptom mapping: impact of registration approaches.

Voxel-based lesion symptom mapping (VLSM) assesses the relation of lesion location at a voxel level with a specific clinical or functional outcome measure at a population level. Spatial normalization, that is, mapping the patient images into an atlas coordinate system, is an essential pre-processing step of VLSM. However, no consensus exists on the optimal registration approach to compute the transformation nor are downstream effects on VLSM statistics explored. In this work, we evaluate four registration approaches commonly used in VLSM pipelines: affine (AR), nonlinear (NLR), nonlinear with cost function masking (CFM), and enantiomorphic registration (ENR). The evaluation is based on a standard VLSM scenario: the analysis of statistical relations of brain voxels and regions in imaging data acquired early after stroke onset with follow-up modified Rankin Scale (mRS) values. Fluid-attenuated inversion recovery (FLAIR) MRI data from 122 acute ischemic stroke patients acquired between 2 and 3 days after stroke onset and corresponding lesion segmentations, and 30 days mRS values from a European multicenter stroke imaging study (I-KNOW) were available and used in this study. The relation of the voxel location with follow-up mRS was assessed by uni- as well as multi-variate statistical testing based on the lesion segmentations registered using the four different methods (AR, NLR, CFM, ENR; implementation based on the ANTs toolkit). The brain areas evaluated as important for follow-up mRS were largely consistent across the registration approaches. However, NLR, CFM, and ENR led to distortions in the patient images after the corresponding nonlinear transformations were applied. In addition, local structures (for instance the lateral ventricles) and adjacent brain areas remained insufficiently aligned with corresponding atlas structures even after nonlinear registration. For VLSM study designs and imaging data similar to the present work, an additional benefit of nonlinear registration variants for spatial normalization seems questionable. Related distortions in the normalized images lead to uncertainties in the VLSM analyses and may offset the theoretical benefits of nonlinear registration.

Implementasi Metode Waterfall Pada Rancang Bangun Sistem Informasi Manajemen Aset Di SMK Muhammadiyah 3 Karanganyar

Asset management is an important aspect in an organization in the form of a series of activities related to identifying required assets, identifying funding needs, acquiring assets, providing logistical support, asset maintenance systems, and deleting or renewing assets. Problems that occur with conventional management include inefficient management processes, limited access to information, and difficulties in tracking borrowed assets and repairing and maintaining assets. Information systems are technology-based solutions that can be used to support asset processing performance to make it more effective and efficient. This research explains the steps in developing an asset management system at SMK Muhammadiyah 3 Karanganyar. System development involves the waterfall method, including requirements analysis, system design, implementation, testing, and maintenance. Its features include asset recording, tracking asset loan and return transactions, maintenance tracking, as well as providing reports and analyses that support informed decision making by organizations. The implementation of this system is expected to improve transparent and accurate asset management, reduce losses due to unrecorded inventory and minimize human error in recording transactions. The system was built using PHP programming language with Code Igniter framework and MySQL as the database. Based on the results of system testing using the black box method, it shows that the system works according to its function. Meanwhile, the test results using SUS method obtained an assessment of 80.3 which was stated in Acceptable Range with a Scale Value of A, which means good. Thus, the system is suitable for use by users. This shows that the system has the potential to increase efficiency and better asset management.

Automated Prediction of Photographic Wound Assessment Tool in Chronic Wound Images

Many automated approaches have been proposed in literature to quantify clinically relevant wound features based on image processing analysis, aiming at removing human subjectivity and accelerate clinical practice. In this work we present a fully automated image processing pipeline leveraging deep learning and a large wound segmentation dataset to perform wound detection and following prediction of the Photographic Wound Assessment Tool (PWAT), automatizing the clinical judgement of the adequate wound healing. Starting from images acquired by smartphone cameras, a series of textural and morphological features are extracted from the wound areas, aiming to mimic the typical clinical considerations for wound assessment. The resulting extracted features can be easily interpreted by the clinician and allow a quantitative estimation of the PWAT scores. The features extracted from the region-of-interests detected by our pre-trained neural network model correctly predict the PWAT scale values with a Spearman's correlation coefficient of 0.85 on a set of unseen images. The obtained results agree with the current state-of-the-art and provide a benchmark for future artificial intelligence applications in this research field.

Minimal clinically important differenceof fatigue severity scale in patients with chronic stroke

BackgroundOne of the most prevalent symptoms of stroke is fatigue. Fatigue severity scale is the most often used tool for evaluating fatigue in stroke patients, its minimal clinically important difference threshold has not been determined. This study aimed to identify the minimal clinically important difference of fatigue severity scale in stroke patients. MethodsAll study participants were examined using fatigue severity scale and multidimensional fatigue symptom inventory-short form before and after the intervention. The 6-week intervention combined graded activity training and pacing therapy employed to reduce fatigue severity. Participants reported changes in their fatigue severity after the intervention with the global rating of change and visual analog scale. The minimal clinically important difference of the fatigue severity scale calculated using both anchor- and distribution-based methods. ResultsA total of 117 stroke patients were included in the study. Using multidimensional fatigue symptom inventory-short form, global rating of change, and visual analog scale as an anchor, the minimal clinically important difference of fatigue severity scale was obtained at 3.5, 4.5, and 4.5, respectively. The minimal clinically important difference for fatigue severity scale varied from 4.28 to 12.90 using the distribution-based method, with SEM = 4.28 displaying the best sensitivity and specificity for use as minimal clinically important difference. ConclusionsThe minimal clinically important difference value for the fatigue severity scale was estimated at 3.5_12.90 using anchor-based and distribution-based methods. The study's results can be utilized to understand the effectiveness of fatigue interventions in stroke patients in clinical and research settings

Early flexible endoscopic evaluation of swallowing after mechanical thrombectomy in stroke patients.

The aims of the study were to (1) characterize the findings of flexible endoscopic evaluation of swallowing (FEES) in stroke patients undergoing mechanical thrombectomy (MT); (2) analyse the screening performance of the Standardized Swallowing Assessment (SSA); and (3) study the impact of FEES-defined dysphagia on 3-month outcomes. This single-centre study was based on a local registry of consecutive acute ischaemic stroke patients undergoing MT during a 1-year period. Patients received FEES within 5 days of admission regardless of the result of dysphagia screening. We compared baseline demographic and clinical characteristics of patients with and without FEES-defined dysphagia. We collected 3-month modified Rankin Scale (mRS) and individual index values of the European Quality of Life 5 Dimensions (EQ-5D-iv). Using univariable and multivariable regression analyses we predicted 3-month outcomes for presence of dysphagia and for FEES-defined dysphagia severity. We included 137 patients with a median age of 74 years, 43.1% were female, median NIHSS was 12 and successful recanalization was achieved in 92.7%. Stroke-associated pneumonia occurred in 8% of patients. FEES-defined dysphagia occurred in 81% of patients. Sensitivity of the SSA as a dysphagia screening was 67%. Presence of dysphagia and increasing severity of dysphagia were independently associated with increasing 3-month mRS score. Increasing dysphagia severity dysphagia was independently associated with lower EQ-5D-iv. Early FEES-defined dysphagia occurs in four in every five patients undergoing MT. SSA has a suboptimal dysphagia screening performance. Presence of dysphagia and increasing dysphagia severity predict worse functional outcome and worse health-related quality-of-life.

A Review of Current Approaches to Evaluating and Reimbursing New Medicines in a Subset of OECD Countries.

The aim of this study was to review the current evaluation and funding processes for new drugs in different developed countries, to provide a comparative framework with detailed, homogeneous, and up-to-date information. Scientific publications, reports and websites were reviewed between July and December 2021 using PubMed, Google Scholar, and grey literature sources. The main items searched were actors and processes, including timelines, characteristics of clinical and economic evaluations, participation of stakeholders, elements of price and reimbursement decisions, cost-effectiveness thresholds and specific funds. The analysed 13 countries were Australia, Canada, England, France, Germany, Italy, Japan, the Netherlands, Portugal, Scotland, South Korea, Spain and Sweden. Eight countries perform the assessment process separated from the pricing decision. Countries measure each drug's added therapeutic value through multi-attribute value scales, algorithms, non-prescriptive lists of criteria, or quality-adjusted life years (QALYs). Health technology assessment (HTA) methodologies differ in their outcome measures, elicitation techniques, comparators, and perspectives. The criteria used for pricing and reimbursement include humanistic, clinical, and economic aspects. Only Scotland, England, the Netherlands, Canada and Portugal use explicit efficiency thresholds. Health care professionals participate in all assessment committees, and patients are becoming increasingly involved in most countries. The official time from marketing authorisation to the completion of the evaluation and pricing processes varied from 126 to 540 days. Most analysed countries show a trend towards value-based approaches that consider value for money to society, but also other economic, clinical, and humanistic criteria. Good practices included robustness, transparency, independence, and participation.

The Revised Second Victim Experience and Support Tool: Thai Translation and Psychometric Evaluation.

Background and Purpose: Nurses are vulnerable to being second victims, resulting in physio-psychological problems and leaving their profession. Exploring second victims requires reliable instruments. This study aimed to translate the Revised Second Victim Experience and Support Tool (SVEST-R) and evaluate its psychometric properties. Methods: The translation process applied the World Health Organization guidelines and validated the Thai version of the SVEST-R (Thai-SVEST-R) with 400 registered nurses. Results: Part A of the scale had a highly constructed validity with a significantly good model fit and was equivalent to the original SVEST-R. For Part B, the test-retest reliability value was satisfactory. Conclusions: Thai-SVEST-R demonstrates evidence of validity and reliability, indicating the scale's value for measuring Thai nurses' experiences as second victims.