Scale Values Research Articles

Does Combined Reconstruction of the Medial Collateral and Anterior Cruciate Ligaments Provide Better Knee Function? A Systematic Review and Meta-Analysis.

Objective: This study aimed to determine if medial collateral ligament reconstruction (MCLR) alongside anterior cruciate ligament reconstruction (ACLR) preserves knee functionality better than isolated ACLR in combined ACL and MCL tears. Methods: MEDLINE, EMBASE, Scopus, CENTRAL, and Web of Science were searched systematically on 31 March 2023. Studies reporting post-operative function after ACLR and ACLR + MCLR in combined injuries were included. Outcomes included International Knee Documentation Committee (IKDC) score, side-to-side difference (SSD), Lysholm, and Tegner scale values. Results: Out of 2362 papers, 8 studies met the criteria. The analysis found no significant difference in outcomes (MD = 3.63, 95% CI: [-5.05, 12.3] for IKDC; MD = -0.64, 95% CI: [-3.24, 1.96] for SSD at 0° extension; MD = -1.79, 95% CI: [-4.61, 1.04] for SSD at 30° extension; MD = -1.48, 95% CI: [-16.35, 13.39] for Lysholm scale; MD = -0.21, 95% CI: [-4.29, 3.87] for Tegner scale) between treatments. Conclusions: This meta-analysis found no significant difference in outcomes between ACLR and ACLR + MCLR, suggesting that adding MCLR does not provide additional benefits. Due to the heterogeneity and quality of the included studies, further high-quality randomized controlled trials are needed to determine the optimal treatment for combined severe MCL-ACL injuries.

Comparison of Work Relative Value Units Assigned to Urological and Gynecological Surgical Procedures.

We sought to determine if work relative value unit differences exist between analogous, sex-specific procedures. Representatives from the AUA and the American College of Obstetricians and Gynecologists independently reviewed the entire procedural code set and identified sex-specific procedures that had an analogous procedure in the opposite sex. These pairs were then evaluated and compared using current American Medical Association Relative Value Scale Update Committee methodology. Comparable code pair values were then examined to determine any systemic bias in the work relative value units assigned between the procedures. Mean differences and 95% confidence intervals were used to determine any differences in procedure or physician time values. The methodology used considered global period, intraservice time, total time, hospital days, postoperative office visits, and the date of the committee review. Of the 10 directly analogous code pairs reviewed, 7 of the female procedures had higher work relative value unit differences (range 0.29-6.47), and 3 of the male procedures had higher work relative value unit differences (range 1.23-2.34). There was no statistical difference between the code pair work relative value units. The work relative value unit per minute of intraservice time and total time were not statistically different. In this study, we compared operative procedures performed in women with clinically comparable operative procedures performed in men that had similar surgical approaches, global periods, and valuation methodologies. Overall, no statistical differences in work relative value units were demonstrated.

Development of Curriculum Practices Proficiency Scale for School Principals: A Study of Validity and Reliability

The main aim of this study is to test the construct validity of the scale of school principals' self-efficacy perceptions in managing curriculum implementation through confirmatory factor analysis (CFA). The study group consisted of 297 school principals working in primary, secondary and high schools affiliated to Trabzon Provincial Directorate of National Education. The data of the study were obtained by using the Self-Efficacy Perceptions of Managing Curriculum Implementation Scale. In the CFA analysis conducted to test the scale structure, χ2/sd ratio was calculated as 1.68; RMSEA: 0.05; SRMR: 0.04; IFI: 0.95; TLI: 0.94; CFI: 0.95; GFI: 0.88; AGFI: 0.86; RMR: 0.02. These values indicate an acceptable fit. Cronbach Alpha value for the entire scale was measured as 0.94. Alpha value indicates that the reliability level of the scale is high. The Confirmatory Factor Analyses suggest that the scale assessing school principals' perceptions of self-efficacy in managing curriculum implementation, comprising 28 items across 4 factors, demonstrates construct validity.

Comparison between Classical- and Rotational-Mechanical-Chair-Assisted Maneuvers in a Population of Patients with Benign Paroxysmal Positional Vertigo.

Introduction: Benign paroxysmal positional vertigo (BPPV) stands as the most common cause of peripheral vertigo. Its treatment with repositioning maneuvers on an examination table is highly effective. However, patients with back or neck problems, paraplegia, or other conditions face challenges with these maneuvers, potentially experiencing longer healing times and creating additional difficulties for physicians diagnosing and treating BPPV in everyday practice. The emergence of mechanical rotational chairs (MRCs) offers a more convenient alternative for performing these maneuvers. Objectives: The primary objective was to compare the effectiveness of maneuvers on the examination table with those on MRCs in BPPV patients diagnosed in the emergency room and randomly classified into one of the treatment options. The secondary objectives included a comparison of patient quality of life during BPPV episodes and after their resolution and an analysis of recurrences and associated risk factors. Methods: This was a cohort study on sixty-three patients diagnosed with BPPV in the emergency department. Patients were classified into two cohorts depending on diagnostic and treatment maneuvers (MRC or conventional repositioning maneuvers (CRMs)) and received weekly follow-ups until positioning maneuvers became negative. Subsequent follow-ups were conducted at 1 month, 3 months, and 6 months after the resolution of vertigo. Patients were classified into two groups based on their assigned treatment method. Results: Thirty-one patients were treated with CRMs and 32 with TRV. Mean age was 62.29 ± 17.67 years and the most affected canal was the PSC (96.8%). The mean number of required maneuvers was two, while 55.56% only required one maneuver until resolution. Recurrence was present in 26.98% of the patients during the 6-month follow-up. Comparing both cohorts, there were no statistically significant differences between treatments (TRV vs. CRM) regarding the number of maneuvers, number of recurrences, and days until remission of BPPV. Dizziness Handicap Inventory and Visual Analogue Scale values decreased considerably after BPPV resolution, with no statistically significant differences between the groups. Age was identified as a covariable in the number of maneuvers and days until BPPV resolution, showing that an increase in age implies a greater need of maneuvers. Conclusions: There was no difference between the means of treatment for BPPV in our population ot There was no difference between the groups of treatments for BPPV in our population. The quality of life of patients improved six months after the resolution of BPPV, regardless of the treatment applied.

Diagnostic Accuracy of the Recognizing Acute Delirium as Part of Your Routine (RADAR) Scale for Delirium Assessment in Hospitalized Older Adults: A Cross-Sectional Study.

Delirium is highly prevalent among hospitalized older adults and is associated with unfavorable outcomes. However, delirium often remains undiagnosed in the hospital context. Having a valid, simple, and fast screening tool could help in limiting the additional workload for healthcare professionals, without leaving delirium undetected. The aim of this study was to estimate the sensitivity and specificity of the Recognizing Acute Delirium As part of your Routine (RADAR) scale in an Italian hospital. An observational cross-sectional study was conducted. A total of 150 patients aged ≥70 years were enrolled. Receiver operating characteristic (ROC) curves using the Confusion Assessment Method (CAM) criterion-defined delirium as the gold standard were plotted to evaluate the performance of the RADAR scale. The cut-off suggested by previous research was used to estimate the sensitivity, specificity, and positive and negative predictive values of the RADAR scale. The involved patients were mostly females (60%; n = 90), with a median age of 84 years (I-III quartiles: 80-88). According to the CAM and the RADAR scale, 37 (25%) and 58 (39%) patients were classified as experiencing delirium, respectively. The area under the ROC curve of the RADAR scale was 0.916. Furthermore, the RADAR scale showed robust sensitivity (95%), specificity (80%), and positive (60%) and negative predictive values (98%). The RADAR scale is thus suggested to be a valid tool for screening assessment of delirium in hospitalized older adults.

Empathy and Self-Empathy in the Anthropological Dimension of Modernity

Purpose. In the article, the author questions rethinking the phenomena of empathy and self-empathy as modes of self-understanding of humanity and the inner intention to self-exploration of human spirituality. Theoretical basis. The research is based on the phenomenological dimension of modern anthropology and axiology. Originality. The change of the traditional intersubjective approach in the understanding of empathy to an introsubjective one and the affirmation of self-empathy as one of the defining existences in human beings, which is adjusted by the altruism-egoism value scale and forms the skills of unconditional empathic action towards the Other as a mode of self-exploration in the spiritual essence of a person are argued. Conclusions. The commonplace in a wide palette of research views on empathy is the construct for the Self – Other disposition and the intersubjective approach emphasizing the object of empathy. Transformation of the intention vector of empathic consciousness from the object to the subject of empathic action opens up deep possibilities of spiritual improvement as a way of self-awareness in the human essence. The transformation of the intention vector of empathic consciousness from intersubjective (I in the Other) to introsubjective (I through the Other) has the potential for spiritual development according to the altruism-egoism value scale. Empathy as an introsubjective position of self-exploration is inseparably connected with self-empathy, which in the mutual integration of its three main components – benevolence towards oneself, reflexivity towards one’s own experience and a tendency to understand one’s fate as common to all mankind – forms an important regulator of self-understanding of a person’s spiritual potential and the possibility of the practical extrapolation for these skills to an empathic way of communication at all levels of anthropo-being. Anthropological accentuation on the inner essence and meanings of human existence is carried out through intuition and self-altruism as the fading of pragmatic interest in the socially conditioned Self (Ego) and immersion in the essential Self – the bearer of the universal spiritual in a person. Self-empathy is considered in the context of the ideas of Stoicism as a deep self-immersion in the human essence and sensitivity to immediate emotional internal states, as a construct of emotional intelligence and a way of realizing individual uniqueness in the context of the metamodern concept of atopy. Self-empathy is defined as one of the key existences in human beings, which forms the skill of altruistic (unconditional) implementation of empathy.

Development of a Versatile Nanostructured Lipid Carrier (NLC) Using Design of Experiments (DoE)-Part II: Incorporation and Stability of Butamben with Different Surfactants.

Nanostructured lipid carriers (NLCs) are typically composed of liquid lipids, solid lipids, and surfactants, enabling the encapsulation of lipophilic drugs. Butamben is a Class II anesthetic drug, according to the Biopharmaceutical Classification System (BCS); it has a log P of 2.87 and is considered a 'brick dust' (poorly water-soluble and poorly lipid-soluble) drug. This characteristic poses a challenge for the development of NLCs, as they are not soluble in the liquid lipid present in the NLC core. In a previous study, we developed an NLC core consisting of a solid lipid (CrodamolTM CP), a lipophilic liquid with medium polarity (SRTM Lauryl lactate), and a hydrophilic excipient (SRTM DMI) that allowed the solubilization of 'brick dust' types of drugs, including butamben. In this study, starting from the NLC core formulation previously developed we carried out an optimization of the surfactant system and evaluated their performance in aqueous medium. Three different surfactants (CrodasolTM HS HP, SynperonicTM PE/F68, and CroduretTM 40) were studied and, for each of them, a 23 factorial design was stablished, with total lipids, % surfactant, and sonication time (min) as the input variables and particle size (nm), polydispersity index (PDI), and zeta potential (mV) as the response variables. Stable NLCs were obtained using CrodasolTM HS HP and SynperonicTM PE/F68 as surfactants. Through a comparison between NLCs developed with and without SRTM DMI, it was observed that besides helping the solubilization of butamben in the NLC core, this excipient helped in stabilizing the system and decreasing particle size. NLCs containing CrodasolTM HS HP and SynperonicTM PE/F68 presented particle size values in the nanometric scale, PDI values lower than 0.3, and zeta potentials above |10|mV. Concerning NLCs' stability, SBTB-NLC with SynperonicTM PE/F68 and butamben demonstrated stability over a 3-month period in aqueous medium. The remaining NLCs showed phase separation or precipitation during the 3-month analysis. Nevertheless, these formulations could be freeze-dried after preparation, which would avoid precipitation in an aqueous medium.

Safety and efficiency of Wharton’s Jelly-derived mesenchymal stem cell administration in patients with traumatic brain injury: First results of a phase I study

BACKGROUND Traumatic brain injury (TBI) is characterized by a disruption in the normal function of the brain due to an injury following a trauma, which can potentially cause severe physical, cognitive, and emotional impairment. Stem cell transplantation has evolved as a novel treatment modality in the management of TBI, as it has the potential to arrest the degeneration and promote regeneration of new cells in the brain. Wharton’s Jelly-derived mesenchymal stem cells (WJ-MSCs) have recently shown beneficial effects in the functional recovery of neurological deficits. AIM To evaluate the safety and efficiency of MSC therapy in TBI. METHODS We present 6 patients, 4 male and 2 female aged between 21 and 27 years who suffered a TBI. These 6 patients underwent 6 doses of intrathecal, intramuscular (i.m.) and intravenous transplantation of WJ-MSCs at a target dose of 1 × 106/kg for each application route. Spasticity was assessed using the Modified Ashworth scale (MAS), motor function according to the Medical Research Council Muscle Strength Scale, quality of life was assessed by the Functional Independence Measure (FIM) scale and Karnofsky Performance Status scale. RESULTS Our patients showed only early, transient complications, such as subfebrile fever, mild headache, and muscle pain due to i.m. injection, which resolved within 24 h. During the one year follow-up, no other safety issues or adverse events were reported. These 6 patients showed improvements in their cognitive abilities, muscle spasticity, muscle strength, performance scores and fine motor skills when compared before and after the intervention. MAS values, which we used to assess spasticity, were observed to statistically significantly decrease for both left and right sides (P < 0.001). The FIM scale includes both motor scores (P < 0.05) and cognitive scores (P < 0.001) and showed a significant increase in pretest posttest analyses. The difference observed in the participants’ Karnofsky Performance Scale values pre and post the intervention was statistically significant (P < 0.001). CONCLUSION This study showed that cell transplantation has a safe, effective and promising future in the management of TBI.

Land Green Utilization Efficiency and Its Driving Mechanisms in the Zhengzhou Metropolitan Area

Improving land green use efficiency is of great significance for promoting high-quality economic development and promoting the modernization of harmonious coexistence between humans and nature. In this study, the super-efficiency SBM model with non-expected output was used to measure the level of land green use efficiency at county scale in the Zhengzhou metropolitan area from 2005 to 2020. Based on this, the spatio-temporal evolution and spatial agglomeration characteristics were analyzed. Finally, the driving mechanisms were revealed by using the geographical detector model. The results were as follows: (1) From 2005 to 2020, the land green use efficiency of the Zhengzhou metropolitan area fluctuated from 0.5329 to 0.5164, with an average annual decline rate of 0.21%, exhibiting three stages: decline, rise, then another slight decline. At the city level, Luohe City had the highest land green use efficiency, while Zhengzhou City had the lowest. (2) The land green use efficiency of the Zhengzhou metropolitan area showed a significant spatial positive correlation, Moran’s I index increased from 0.1472 to 0.2991, and the spatial agglomeration effect was continuously enhanced. On the local scale, high-high (H-H) aggregation and low-low (L-L) aggregation were dominant, high-high (H-H) aggregation areas were mainly distributed in the southwest and southeast of the Zhengzhou metropolitan area, and low-low (L-L) aggregation areas were mainly distributed in the central and western parts of the Zhengzhou metropolitan area. (3) There is heterogeneity in the degree of influence of different driving factors on land green use efficiency in the Zhengzhou metropolitan area, which is ranked as topographic relief (X7) > forest coverage rate (X8) > social consumption (X6) > industrial structure (X3) > urbanization rate (X2) > economic development (X1) > industrial added value scale (X5) > financial expenditure (X4). q values were 0.1856, 0.1119, 0.1082, 0.0741, 0.0673, 0.0589, 0.0492 and 0.0430, respectively. The interaction of two factors can enhance the explanatory power of land green use efficiency in the Zhengzhou metropolitan area. Except for the interaction of topographic relief and forest coverage rate, the other factors all show double factor enhancement. The explanatory power of the interaction between topographic relief and urbanization rate is the strongest, at 0.3513. In the future, policy regulation should be carried out from the perspectives of the interaction of social and economic conditions such as improving forest coverage rate, improving consumption power, optimizing industrial structure and improving land green use mechanisms to promote the improvement of land green use efficiency.

ATTITUDE OF AGRICULTURE STUDENTS TOWARDS AGRIPRENEURSHIP: DEVELOPMENT AND VALIDATION OF A SCALE

Agripreneurship is doing business in agriculture or taking entrepreneurship in agriculture. Attitude is defined as the degree of positive or negative affect associated with some psychological object. The main objective of the study was to develop a scale on Attitude of agricultural students towards agripreneurship. In present study 'Scale Product Method' was used which is combination of Thurston's technique of equal appearing interval scale for selection of the items and Likert's technique of summated rating for ascertaining the response on the scale as proposed by Eysenck and Crown (1949). The statements, thus selected were edited on the basis of the criteria suggested by Edward (1969) and finally, 60 statements were selected. A schedule of 60 items was sent through 'Google forms' via email and whatsapp as well as through direct personal contacts to 140 experts working in the discipline of Agricultural extension of SAUs of Gujarat and other states. The judges were requested to sort out 60 statements on 11 point continuum from 'most unfavorable' to 'most favorable'. Out of them, 75 judges were responded. Based on Thurstone and Chave (1928) criteria in addition to Q as a basis for rejecting the statements in scales constructed by equal appearing interval scale method. Accordingly, when two or more items had the same scale values, those items having lowest Q values were selected. Thus, 24 statements were finally selected to constitute the attitude scale. A split-half technique was used to measure the reliability of the scale and the reliability coefficient was 0.82. The validity of the scale was also proved as per experts' judgments.

Comparison of Changes in Rso2 in Midazolam and Propofol Sedation Post Craniotomy in the Icu of H. Adam Malik Hospital

Introduction: Cerebral oxygen saturation reflects tissue perfusion in the cerebrum. Decreases in cerebral oxygen saturation are linked to longer hospital stays and cognitive impairment. Midazolam and propofol can decrease cerebral blood flow through decreasing the cerebral oxygen metabolic rate. The purpose of this research is to analyze the comparison of changes in cerebral oxygen saturation after midazolam and propofol administration in post-craniotomy patients in the ICU of Haji Adam Malik General Hospital Medan. Subject and Method: This is a randomized control trial study. Patients were divided into, Midazolam group, that given an initial dose of 0.05 mg/kg followed by a maintenance dose of 0.02-0.10 mg/kg/hour and Propofol group that given sedation with a dose of 0.3-3mg/kg/hour, with the target of the 2 groups being a Richmond Agitation-Sedation Scale (RASS) value of 0 to -2. Data analysis using unpaired T test. Results: The results for cerebral regional oxygen saturation and RASS between groups showed significant differences in right and left value (p < 0.001), but there was no significant difference in RASS (p>0.05) between each group at each measurement time. The results of the analysis of cerebral regional oxygen saturation and RASS between times, there was no significant difference in right and left value (p>0.05), but there was a significant difference in RASS (p<0.001) at each measurement time. Based on the results of the analysis carried out, it is known that there is no statistically significant difference in changes in cerebral regional oxygen saturation both right and left in changes in RASS because it is found that all data have p>0.05. Conclusion: There is no change in right and left for cerebral regional oxygen saturation after administration of propofol and midazolam groups with RASS value 0 to -2 in post-craniotomy patients in the ICU of Haji Adam Malik General Hospital Medan

A SCALE TO MEASURE THE GROUP DYNAMICS EFFECTIVENESS OF THE MEMBERS OF SELF-HELP GROUPS

The present study was conducted to develop and standardize the reliable and valid scale to measure the group dynamics effectiveness of the members of self-help groups. For the development of the scale, Normalized Rank Order Method recommended by Guilford (1954) was used. A total of eight indicators out of fourteen indicators that determine the group dynamics effectiveness were selected based on the relevancy per cent, relevancy weightage and mean relevancy scores. Scale values of each selected indicator were obtained through the rank order method. 84 subitems for the selected indicators were obtained through the relevancy test. Validity (Internal consistency technique) and Reliability (test-retest) were used to know the developed scale is valid and reliable.

Ultrasound-Guided PRP and SVF Therapy Shows Sustained Improvement in Severe Knee Osteoarthritis: A 12-Month Retrospective Study.

BACKGROUND Knee osteoarthritis (OA) is a chronic disease caused by cartilage degeneration in the joint accompanied by joint deformities, pain, and stiffness. This study assessed the changes over time in the Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) and Visual Analog Scale (VAS) values of patients after the combined application of stromal vascular fraction (SVF) and platelet-rich plasma (PRP). MATERIAL AND METHODS A retrospective clinical study was designed. Thirty-four patients (8 males, 26 females, mean age 65.21±10.71, range 30-83 years) with pain due to knee osteoarthritis received SVF and PRP between 2019 and 2020. During and after the procedure, ultrasound-guided intra-articular spread was checked. RESULTS PRP+SVF injection provided significant improvement in the clinical symptoms of the patients measured according to their VAS and WOMAC scores, and this improvement continued until the twelfth month. The change in VAS scores of the patients was 1.76±1.18 (P=0.000) in the first month, 1.50±1.46 (P=0.000) in the sixth month, and 1.53±1.41 (P=0.000) in the twelfth month. VAS scores decreased 6.6 to 1.6 point at the end of the twelfth month. The WOMAC scores of the patients were 23.20±12.12 (P=0.000) in the first month, 19.48±12.0 (P=0.000) in the sixth month, and 20.01±10.48 (P=0.000) in the twelfth month. WOMAC scores decreased 51.99 to 20.48 point at the end of the twelfth month. CONCLUSIONS Applying ultrasound-guided PRP+SVF injection into the knee joint once in OA patients improved VAS and WOMAC scores.

Early cognitive assessment in premature infants: the discriminatory value of eye-tracking vs. Bayley Scales.

The testing of visuocognitive development in preterm infants shows strong interactions between perinatal characteristics and cognition, learning and overall neurodevelopment evolution. The assessment of anticipatory gaze data of object-location bindings via eye-tracking can predict the neurodevelopment of preterm infants at the age of 3 years; little is known, however, about the early cognitive function and its assessment methods during the first year of life. The current study presents data from a novel assessment tool, a Delayed Match Retrieval (DMR) paradigm via eye-tracking was used to measure visual working memory (VWM) and attention skills. The eye-tracking task that was designed to measure infants' ability to actively localize objects and to make online predictions of object-location bindings. 63 infants participated in the study, 39 preterm infants and 24 healthy full term infants - at a corrected age of 8-9 months for premature infants and similar chronological age for full term infants. Infants were also administered the Bayley Scales of Infant and Toddler Development. The analysis of the Bayley scores showed no significant difference between the two groups while the eye-tracking data showed a significant group effect on all measurements. Moreover, preterm infants' VWM performance was significantly lower than full term's. Birth weight affected the gaze time on all Areas Of Interest (AOIs), overall VWM performance and the scores at the Cognitive Bayley subscale. Furthermore, preterm infants with fetal growth restriction (FGR) showed significant performance effects in the eye-tracking measurements but not on their Bayley scores verifying the high discriminatory value of the eye gaze data. Visual working memory and attention as measured via eye-tracking is a non-intrusive, painless, short duration procedure (approx. 4-min) was found to be a significant tool for identifying prematurity and FGR effects on the development of cognition during the first year of life. Bayley Scales alone may not pick up these deficits. Identifying tools for early neurodevelopmental assessments and cognitive function is important in order to enable earlier support and intervention in the vulnerable group of premature infants, given the associations between foundational executive functional skills and later cognitive and academic ability.

Ballistic impact wave and back bulge propagation mechanism and blunt trauma assessment of ceramic/UHMWPE composite body armor

With increasing local conflicts worldwide, studying the impact response of body armor is crucial for enhancing soldier survival rates. However, there is still insufficient understanding of the back bulge expansion patterns, the impact waves transmission features, and blunt injury assessing method of body armor. To investigate these problems deeply, the three-dimensional digital image correlation method and numerical models were employed to reveal the ballistic response mechanism of ceramic/ultra-high-molecular-weight polyethylene (UHMWPE) composite body armor impacted by 7.62 mm rifle bullet. This study built theoretical function for the bulge expansion, revealed the wave transmission mechanism and fractures in both materials and their interaction. Firstly, the experiment revealed that the back-face bulge transverse expansion velocity exhibits a double exponential decrease. Secondly, the contour of back-face bulges consistently demonstrated excellent hyperbolic characteristics at various moments. Thirdly, the average Viscous Criterion (VC) and Blunt Criterion (BC) values were 5.37 and 0.95, corresponding to Abbreviated Injury Scale (AIS) values of 6 and 4. Fourthly, the simulation revealed that the ceramics transverse and radial cracks seems primarily induced by shear stress xy; ceramics conical cracks occurring at the boundaries of equivalent stress seems primarily induced by stress in x and y directions. Fifthly, numerical results revealed that the velocity of compression waves within the laminate increases over time in the impact direction and consistent with ceramic velocity impacted on the laminate. These findings lead to experimental and theoretical advances in the impact response mechanism of composite body armor and provide index for improving the protective performance.

Characterization of Anti-GAD65-Associated Neurological Syndromes: Clinical Features and Antibody Titers

Introduction: Anti-GAD65 antibodies are associated with several neurological phenotypes. Antibody titers are increasingly recognized as useful in diagnosis and prognosis. Objective: To describe a Portuguese cohort of patients with anti-GAD65-associated neurological syndromes. Methods: Retrospective analysis of all patients with positive anti-GAD65 antibodies and associated neurological syndromes followed in a tertiary referral center. Results: Nineteen anti-GAD65 antibody-positive neurological patients were identified, 62.3% female, with a mean age of onset of 56.0 (SD = 13.3) years. Comorbid autoimmune disorders were present in seven patients. Six patients had limbic encephalitis (31.6%), four had epilepsy (21.1%), four had cerebellar ataxia (21.1%), and three had stiff-person syndrome (15.8%). Two patients presented with isolated cognitive dysfunction (executive and mnesic) in the absence of other neurological symptoms. The mean follow-up time was 24.0 (14.0–42.0) months, at the end of which the mean modified Rankin Scale (mRS) value was 2.0 (1.0–4.0). Screening for malignancies was negative in all patients. Serum quantitative analysis was carried out in 18 patients, 10 of whom showed titers above previously defined cut-off points (>10,000 IU/L for ELISA and >20 mmol/L for RIA). Quantitative CSF analysis was performed in nine patients, with four showing above-threshold titers. There was no association between anti-GAD65 levels and clinical phenotype or the final mRS values. High-dose intravenous methylprednisolone and oral prednisolone were the most common acute and chronic treatment regimens, respectively. Conclusion: Anti-GAD65 antibodies are associated with varied neurological syndromes, and antibody titers alone should not be used to exclude a disease.

Effect of Using Numerical Data Scaling on Supervised Machine Learning Performance

Before building machine learning models, the dataset should be prepared to be a high quality dataset, we should give the model the best possible representation of the data. Different attributes may have different scales which possibly will increase the difficulty of the problem that is modeled. A model with varying scale values may suffers from poor performance during learning. Our study explores the usage of Numerical Data Scaling as a data pre-processing step with the purpose of how effectively these methods can be used to improve the accuracy of learning algorithms. In particular, three numerical data Scaling methods with four machine learning classifiers to predict disease severity were compared. The experiments were built on Coronavirus 2 (SARS-CoV-2) datasets which included 1206 patients who were admitted during the period between June 2020 and April 2021. The diagnosis of all cases was confirmed with RT-PCR. Basic demographic data and medical characteristics of all participants was collected. The reported results indicate that all techniques are performing well with Numerical Data Scaling and there are significant improvement in the models for unseen data. lastly, we can conclude that there are increase in the classifier performance while using scaling techniques. However, these methods help the algorithms to better understand learn the patterns in the dataset which help making accurate models

Predictors of Hospital Readmission, Institutionalization, and Mortality in Geriatric Rehabilitation Following Hospitalization According to Admission Reason.

Older adults following an inpatient geriatric rehabilitation (GR) program commonly experience adverse health outcomes such as hospital readmission, institutionalization, and mortality. Although several studies have explored factors related to these outcomes, the influence of admission reason on the predictive factors of adverse health outcomes in the rehabilitation process remains unclear. Therefore, this study aimed to identify predictive factors for adverse health outcomes in inpatients attending GR according to their admission reason. This retrospective study included patients with orthogeriatric (OG) conditions and patients with hospital-associated deconditioning (HAD) admitted to GR after an acute hospitalization between 2016 and 2020. Patients were evaluated by a comprehensive geriatric assessment at admission, including sociodemographic data, social resources, clinical data, cognitive, functional and nutritional status, and physical performance measurements. Adverse health outcomes were collected (hospital readmission, institutionalization, and mortality). Univariate analyses and multivariate backward binary logistic regressions were used to determine predictive factors. In this study, 290 patients were admitted for OG conditions, and 122 patients were admitted due to HAD. In patients with OG conditions, lower Mini-Mental State Examination (MMSE) predicted institutionalization and mortality. Lower Mini Nutritional Assessment-Short Form predicted institutionalization, whereas lower Barthel Index and lower Tinetti-Performance-Oriented Mobility Assessment scores were associated with higher mortality. In patients with HAD, higher age-adjusted comorbidity index predicted hospital readmission and mortality, and lower Short Physical Performance Battery scores predicted institutionalization and mortality. Finally, lower MMSE scores, worse values in Older Americans Resources and Services Scale and male gender were associated with a higher risk of institutionalization. Predictive factors for hospital readmission, institutionalization, and mortality in patients with OG conditions and HAD during GR were different. Some of those predictors, such as nutritional status and physical performance, are modifiable. Understanding predictive factors for adverse outcomes, and how these factors differ by admission diagnosis, improves our ability to identify patients most at risk. Early identification of these patients could assist with prevention efforts and lead to a reduction of negative outcomes.

Adaptation and Validation of the Turkish Version of the Brain Fog Scale.

Brain fog is a condition that is characterized by poor concentration, memory loss, decreased cognitive function, and mental fatigue. Although it is generally known as a long-term COVID-19 symptom, brain fog has also been reported to be caused by many other diseases. Thus, it is necessary to assess this condition in certain populations. This study aimed to evaluate the reliability and validity of the Brain Fog Scale in a Turkish population. We conducted the study in two phases. In a pilot study including 125 participants, we confirmed the suitability of the scale for validity analyses and then conducted exploratory (n = 230) and confirmatory factor analyses (n = 343). The Cronbach's alpha value of the 23-item Brain Fog Scale was 0.966. In addition, the 23-item and three-factor structure was confirmed as a result of the analyses. These three factors are mental fatigue, impaired cognitive acuity, and confusion. We also found that participants previously diagnosed with COVID-19 had higher brain fog scores. This finding indicates that brain fog is an important condition that can accompany COVID-19. Furthermore, this validated construct has an acceptable fit and is a valid and useful tool for the Turkish population.

A Study on the Use of the Rasch Model in the Analysis of Data Collected by Ranking Judgments

This research aimed to exemplify the use of the Rasch model in the analysis of data on ranking judgments. To this end, in the study, we delineated in detail all the processes related to the Rasch analysis, from the preparation of the data file to the interpretation of the analysis outputs. Besides, we compered the Rasch analysis results with the outputs obtained from traditional method. We conducted our study on 261 secondary school students. We collected the research data by employing an instrument containing five stimuli regarding the positive aspects and limitations of the mathematics homework. We asked students to rank the positive aspects of the homework by coding the most prominent advantage with 1 and the last advantage with 5. Similarly, we requested them to put in order the limitations of the homework by coding the foremost limitation with 1 and the last limitation with 5. We analyzed the research data according to both the Rasch model and traditional method. Research results revealed that the agreement between the stimuli’s scale values obtained from the Rasch analysis and from the traditional method was high. Considering this result and that the Rasch model is a more practical option in terms of the analysis process, we can suggested researchers to prefer Rasch model instead of the traditional method in the analysis of data based on ranking judgments.