Scale Score Research Articles

Determinants of Caregiver Burden in Stroke Survivors who Underwent Decompressive Craniectomy.

For stroke survivors (SS) who undergo decompressive craniectomy (DC), quality of life is intertwined with the care they receive. Burden on caregiver becomes an important determinant of recovery of SS. In this study, we aimed to analyze the determinants of burden on caregivers of SS who undergo DC. Caregivers of 198 SS who underwent DC formed the study population of this prospective observational study. The study was conducted in a tertiary referral unit between September 2019 and March 2021. Caregiver burden was quantified using Zarit Burden Interview. Analysis for association between the reported burden and modified Rankin Scale (mRS) score was done. Mean age of the participants was 47.00 ± 11.2 years. The mRS outcome was poor in SS aged >60 years, Glasgow coma scale (GCS) score at presentation of <8, and in SS with bilateral/dominant hemisphere involvement. Outcome was better when DC was done ≤48 h (74.2% vs. 47.2%, P < 0.001) and if SS were shifted to a rehabilitation unit. Among caregivers, 58% and 16% reported to be always and frequently burdened, respectively; 33.3% of caregivers considered a retrospective review of consent for DC. A higher mRS score was associated with more burden. Early DC and care at rehabilitation unit were associated with better functional outcomes in SS. Nearly 75% of caregivers of patients post-DC reported high burden of providing care to SS, and the burden increased linearly with mRS score.

Effect of continuous infusion in alleviating pain during male urethral catheterization

AimsThe aim of this study was to explore whether continuous infusion causing lubrication can effectively alleviate pain during male urethral catheterization.MethodsThis prospective, multicenter, double-blinded study included 190 male patients scheduled for urethral catheterization. Patients were randomly allocated into four groups: Group A: the catheter was lubricated with paraffin; Group B: the catheter was lubricated with compound lidocaine gel; Group C: the pump continuously infusing with sterilized water; Group D: the pump continuously infusing with 2% lidocaine. The primary outcome was the visual analogue scale (VAS) scores. Statistical analysis system (SAS) (version 9.4) was used to perform all the statistical analyses. Significance for all results was set at P < 0.05.ResultsThe VAS of Group D was the lowest (18.90 ± 11.44), followed by the Group C (33.00 ± 11.07), and the VAS of Group A was the highest (53.98 ± 14.76). There were significant differences in VAS in Group D compared to Group A(P < 0.0001), Group B(P < 0.0001) and Group C (P < 0.0001), Group C compared to Group A (P < 0.0001) and Group B(P < 0.0001), Group B compared to Group A (P < 0.0001), indicating that patients treated with lidocaine infusion (Group D) experienced significantly less pain than did those in the other three groups.ConclusionsContinuous infusion with sterilized water during catheterization is an efficient method for lubricating the urethral mucosa; furthermore, infusion with 2% lidocaine provides better analgesia as well as lubrication.Trial registrationThe study protocol was registered in the Chinese Clinical Trial Registry (ChiCTR2300070866) (https://www.chictr.org.cn/showproj.html?proj=194591) on Apr. 25th, 2023.

Infarct Growth in Patients with Emergent Large Vessel Occlusion Stroke Transferred for Endovascular Thrombectomy.

Patients with a large vessel occlusion (LVO) stroke who are transferred to a comprehensive stroke center (CSC) for endovascular thrombectomy (EVT) often experience infarct growth. We aimed to investigate the clinical predictors of fast infarct growth and its effect on clinical outcomes. We retrospectively collected EVT data of patients with LVO transferred to our center between March 14, 2019, and June 28, 2022. The absolute rate of Alberta Stroke Program Early Computed Tomography Score (ASPECTS) decay was defined as (ASPECTS primary CT - ASPECTS repeat CT)/elapsed hours. The ratio of relative ASPECTS deterioration was defined as (ASPECTS primary CT - ASPECTS repeat CT)/ASPECTS primary CT. In the primary analysis, the study population was dichotomized into absolute slow progressors and absolute fast progressors using the median absolute rate of ASPECTS decay. Secondary analysis was also conducted using the median relative ASPECTS deterioration ratio, and the study population was categorized into relative fast progressors and relative slow progressors. Favorable outcome was defined as a 90-day modified Rankin Scale (mRS) score ≤ 2. We included 309 patients: median age 72years (IQR 65-77); median National Institutes of Health Stroke Scale (NIHSS) 14 (IQR 11-18). The median absolute rate of ASPECTS decay was 0.42 points/hour and the median relative ASPECTS deterioration ratio was 11.1%. Overall, fast infarct growth was independently associated with worse 90-day outcome (absolute rate of ASPECTS decay: OR = 3.395; 95% CI 1.844-6.250; P < 0.001; relative ASPECTS deterioration ratio: OR = 3.754; 95% CI 2.050-6.873; P < 0.001). In multivariable analysis, fast infarct growth was independently associated with high admission NIHSS, proximal occlusions, and poor collateral status, while intravenous thrombolysis before transfer was negative with fast inter-hospital infarct growth. For patients with LVO stroke who are transferred from a PSC to CSC for EVT, the infarct growth rate is highly variable and is strongly associated with 90-day outcomes. Initiation of intravenous bridging therapy before transfer may limit the infarct growth during inter-hospital transfer.

Sinus laser therapy versus Karydakis flap procedure in the management of pilonidal sinus disease: a comparative analysis of intraoperative parameters and postoperative outcome.

This study aimed to investigate the utility of minimally invasive sinus laser therapy (SiLaT) versus flap surgery (Karydakis flap procedure) in terms of intraoperative parameters and postoperative outcome in patients with pilonidal sinus disease (PSD). A total of 106 patients with PSD (mean ± SD age: 26.4 ± 7.0years, 86.8% male) treated with Karydakis flap procedure (KF group; n = 63) or sinus laser therapy (SiLaT group; n = 43) were included in this retrospective study. Data on patient demographics, operative characteristics (number of openings, length of sinus tract, and operative time), and postoperative outcome including postoperative (day 1) pain intensity-visual analog scale (VAS) scores, time to return to work after surgery (days), complication rate, and recurrence rate were recorded in each patient and compared between KF and SiLaT groups. The SiLaT versus KF procedure was associated with significantly shorter operative time [median (min-max) 17 (12-28) versus 27 (20-44) min, p = 0.001], lower pain scores [3 (1-4) versus 5 (3-7), p = 0.001], and earlier return to work [1 (1-3) versus 10 (5-20) days, p = 0.001]. Although no significant difference was noted in complication and recurrence rates between the KF and SiLaT groups, 6.3% (wound infection only) and 3.2% of patients in the KF group but none of the patients in the SiLaT group developed complication and recurrence, respectively. SiLaT seems to be a promising minimally invasive technique for the management of PSD, being comparable to the KF procedure in terms of complications and recurrence, along with added advantages of shorter operative time, reduced postoperative pain, and earlier return to work.

Clinical Study of Limosilactobacillus reuteri for the Treatment of Children with Chronic Tic Disorders/Tourette Syndrome: A Mid-Term Efficacy Evaluation.

Gut microbiota plays an important role in tic disorders (TDs); however, clinical research on probiotics for chronic TDs treatment is lacking. We aimed to investigate the effectiveness of probiotics, hypothesizing that their clinical efficacy is comparable to that of clonidine in treating chronic TDs. Patients were randomly assigned to receive either Limosilactobacillus reuteri or clonidine transdermal patch treatment for 8weeks while maintaining their existing treatment. The Yale Global Tic Severity Scale (YGTSS); Swanson, Nolan, and Pelham-IV Scale (SNAP-IV); and Child Behavior Check List (CBCL) scores were assessed before and after treatment. We matched the patients in both groups for age, sex, age at onset, and tic type. A significant improvement in YGTSS scores was observed in both groups (p = 0.024). The improvement in attention deficits on the SNAP-IV scale was similar between the two groups, with no significant difference (p = 0.465). For hyperactivity disorder, after matching patients in both groups for age, sex, age at onset, tic type, and Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) scores, a significant difference in improvement was observed between the groups (p = 0.010), with the probiotics group showing greater improvement (0.3 ± 0.58 vs. 0.1 ± 0.50). At 9weeks, social ability on the CBCL scale increased by 3.2 ± 6.26 from baseline in the probiotics group and by 0.6 ± 4.07 in the clonidine group, with a significant difference between the two (p = 0.049). Although there was no significant difference in behavioral problems between the two groups (p = 0.347), the trend of improvement was more pronounced in the probiotics group than in the clonidine group (12.7 ± 25.86 vs. 8.4 ± 13.15). The mid-term efficacy evaluation demonstrated that L.reuteri, when added to the treatment of children with chronic TDs, was more effective in improving tic symptoms than clonidine transdermal patch treatment. Additionally, it provided moderate improvement in hyperactivity symptoms. chictr.org.cn (registration numbers ChiCTR2200056708, ChiCTR2200056578).

Intracranial complications in adult patients with severe pneumococcal meningitis: a retrospective multicenter cohort study.

We aimed to investigate the association of intracranial complications diagnosed on neuroimaging with neurological outcomes of adults with severe pneumococcal meningitis. We performed a retrospective multicenter study on consecutive adults diagnosed with pneumococcal meningitis requiring at least 48h of stay in the intensive care unit (ICU) and undergoing neuroimaging, between 2005 and 2021. All neuroimaging were reanalyzed to look for intracranial complications which were categorized as (1) ischemic lesion, (2) intracranial hemorrhage (3) abscess/empyema, (4) ventriculitis, (5) cerebral venous thrombosis, (6) hydrocephalus, (7) diffuse cerebral oedema. The primary outcome was unfavorable outcome at 90 days after ICU admission, defined by a modified Rankin Scale (mRS) score > 2. Among the 237 patients included, intracranial complications were diagnosed in 68/220 patients (31%, 95%CI 0.25-0.37)who underwent neuroimaging at ICU admission and in 75/110 patients (68%, 95%CI 0.59-0.77) who underwent neuroimaging during ICU stay. At 90 days, 103 patients (44%, 95%CI 37-50) had unfavorable outcome, including 71 (30%) deaths. The most frequent intracranial complications were ischemic lesion (69/237 patients, 29%), diffuse cerebral oedema (43/237, 18%) and ventriculitis (36/237, 15%). Through multivariable analysis, we found that intracranial complications (adjusted odds ratio (aOR) 2.88, 95%CI 1.37-6.21) were associated with unfavorable outcome, along with chronic alcohol consumption (aOR 3.10, 95%CI 1.27-7.90), chronic vascular disease (aOR 4.41, 95%CI 1.58-13.63), focal neurological sign(s) (aOR 2.38, 95%CI 1.11-5.23), and cerebrospinal fluid leukocyte count < 1000 cell/microL (aOR 4.24, 95%CI 2.11-8.83). Competing risk analysis, with persistent disability (mRS score 3-5) as the primary risk and ICU-death as the competing risk, revealed that chronic alcohol consumption was the sole significant variable associated with persistent disability at 90 days (cause-specific hazard ratio 4.26, 95%CI 1.83-9.91), whereas the remaining variables were associated with mortality. In adults with severe pneumococcal meninigitis, intracranial complications were independently associated with a higher risk of poor functional outcome, in the form of persistent disability or death. This study highlights the value of neuroimaging studies in this population,and provides relevant information for prognostication.

Should Femoral Nerve Blocks and Adductor Canal Blocks Be Used in Pediatric or Adolescent Anterior Cruciate Ligament Reconstruction?: A Systematic Review.

Achieving adequate pain control is vital for proper rehabilitation, satisfaction, and earlier discharge after anterior cruciate ligament reconstruction. Opioids have traditionally been used for this purpose, however, can be associated with various negative outcomes. As such, multimodal analgesia was introduced to reduce postoperative opioid use. Regional nerve blocks constitute one modality of multimodal analgesia, with femoral nerve blocks (FNBs) and adductor canal blocks (ACBs) being standard. This review sought to evaluate the utility and adverse effects of FNBs and ACBs relative to controls, alternative regional anesthesia options, and each other in pediatric or adolescent anterior cruciate ligament reconstruction (ACLR). Three databases were searched on January 31, 2024. The authors adhered to the PRISMA and R-AMSTAR guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. The definition of pediatric was considered to be a mean age of 18 years or younger. Data on demographics, operative and anesthetic details, strength and functional outcomes, postoperative opioid consumption, revision rates and return to sport (RTS) rates, and Visual Analogue Scale (VAS) scores were extracted. Eleven studies (1 level I, 10 level III) comprising 5453 patients were included in this review (54.1% female), with a mean age of 16.3 (range of means: 15.0 to 16.9) years. Two studies compared FNB with and without a sciatic-nerve block (SNB), finding lower opioid consumption (P=0.007) and VAS scores (P<0.0001) in the postanesthesia care unit (PACU) in the FNB + SNB group. Three studies compared FNB or ACB with controls, with no studies reporting a benefit in rates of RTS, isokinetic quadriceps or hamstrings strength, or functional test performance. There were minimal differences when comparing continuous and single nerve blocks and FNB with ACB. There is inconclusive evidence investigating the role of FNB and ACB in pediatric or adolescent ACLR. The addition of a SNB to FNB may result in improvements in opioid consumption and VAS scores in the early postoperative period. There was minimal evidence in support of continuous blocks over single-shot blocks. Future studies should compare the use of ACB, FNB, and no blocks for pediatric or adolescent ACLR, with primary endpoints of acute pain control, postoperative opioid use, and the presence of longer-term motor deficits. Level III.

The Respiratory-Swallow Coordination may be Related to Aspiration in Infratentorial Stroke Patients.

To investigate the characteristics of respiratory-swallow coordination (RSC) in poststroke dysphagia (PSD) patients following infratentorial stroke (IS) and further explore their association with aspiration. PSD patients after IS and age-matched healthy controls were recruited. Nasal airflow and sound signals were recorded using a nasal cannula-type flow sensor and contact microphone, which were synchronized with videofluoroscopic swallowing studies (VFSS). For healthy controls, only nasal airflow and sound signals recordings were conducted. A 5ml thickened liquid was utilized during these assessments. The penetration-aspiration scale (PAS) score was determined through VFSS. Various parameters, including swallowing apnoea duration (SAD), swallowing duration (SD), swallowing latency duration (SLD), number of swallows (NS), and RSC patterns, were analysed to assess RSC. A total of 37 patients with PSD following IS-comprising 25 non-aspirators and 12 aspirators-and 31 age-matched healthy controls were included. The PSD patient group exhibited a shorter SAD (p = 0.016), a longer SD (p = 0.000), and fewer NS (p = 0.000) compared to the healthy control group. Among the PSD patients, those who aspirated exhibited a notably shorter SAD (p = 0.018) and longer SD (p = 0.028) compared to non-aspirators. The prevalence of the swallow-inspiration pattern was higher in PSD patients (p = 0.006), particularly among those who aspirated (p = 0.010). Logistic regression analysis and the area under the receiver operating characteristic curve (AUC) indicated that both SAD (AUC = 0.825, p = 0.002) and SD (AUC = 0.757, p = 0.020) were significant predictors of aspiration. The optimal cut-off values for SAD and SD were determined to be 0.19s and 1.93s, respectively. The RSC characteristics in patients with PSD following IS differed from those observed in healthy controls, particularly among patients who experienced aspiration. In these patients, a shorter SAD and longer SD may contribute to an increased risk of aspiration.

Analysis of anxiety and depression status and their influencing factors in patients with diabetic retinopathy

BACKGROUND Diabetic retinopathy (DR) is a common complication of diabetes and the leading cause of visual impairment and blindness. It has a serious impact on the mental and physical health of patients. AIM To evaluate the anxiety and depression status of patients with DR, we examined their influencing factors. METHODS Two hundred patients with DR admitted to the outpatient and inpatient departments of ophthalmology and endocrinology at our hospital were selected. A questionnaire was conducted to collect general patient information. Depression and anxiety were assessed using the Patient Health Questionnaire-9 and Seven-item Generalized Anxiety Disorder scale, respectively. The diabetes specific quality of life scale and Social Support Rating Scale were used to assess the quality of life of patients with DR and their social support, respectively. Logistic regression analysis was used to assess the correlations. RESULTS The prevalence of depression and anxiety were 26% (52/200) and 14% (28/200), respectively. Regression analysis revealed that social support was associated with depression [odds ratio (OR) = 0.912, 95% confidence interval (CI): 0.893-0.985] and anxiety (OR = 0.863, 95%CI: 0.672-0.994). Good quality of life (diabetes specific quality of life scale score &lt; 40) was a protective factor against anxiety (OR = 0.738, 95%CI: 0.567-0.936) and depression (OR = 0.573, 95%CI: 0.4566-0.784). Visual impairment significantly increased the likelihood of depression (OR = 1.198, 95%CI: 1.143-1.324) and anxiety (OR = 1.746, 95%CI: 1.282-2.359). Additionally, prolonged diabetes duration and history of hypertension were significant risk factors for both conditions, along with a family history of diabetes. CONCLUSION Key factors influencing anxiety and depression in patients with DR include social support, quality of life, visual impairment, duration of diabetes, family history of diabetes, and history of hypertension.

The radiohumeral synovial plica: anatomy, histology, and implications in chronic lateral epicondylitis.

Our study aimed to elucidate synovial plica (SP) of the elbow histological characteristics and the anatomical relationship with adjacent structures. Subsequently, we sought to assess the relationship between SP and clinical symptoms as well as magnetic resonance imaging (MRI) features in patients with chronic lateral epicondylitis. MRI was performed on eight cadaveric elbows specimens. The MRI findings were compared with those in anatomic sections and histologic preparations. In addition, ninety-nine patients with chronic lateral epicondylitis who underwent preoperative elbow MRI and arthroscopic surgery were included. The patients were divided into SP and without SP groups. The differences in clinical symptoms and MRI features between the two groups were compared. SP is located proximal to the annular ligament that extends into the joint cavity, then moves to the lateral collateral ligament (LCL) complex, and finally attaches to the lateral epicondyle of the elbow along with the common extensor tendon (CET). The SP, ligament, and tendon blend imperceptibly without distinct boundaries. Furthermore, in a study of patients with chronic lateral epicondylitis, we found that compared to the without SP group, patients in the SP group had higher preoperative and 3-week postoperative VAS scores and more severe abnormalities in LCL complex and CET. The SP is distinct from the annular ligament and closely correlates with the LCL complex and CET enthesis at the lateral epicondyle. Chronic lateral epicondylitis patients with SP have more severe abnormalities of the LCL complex and CET, more severe pain, and longer postoperative recovery times. Question Synovial plica (SP) cause lateral elbow pain, but few studies regarding histological and imaging features of SP and its relationship to chronic lateral epicondylitis exist. Findings The presence of SP leads to more severe common extensor tendon abnormalities and higher visual analog scale scores in patients with chronic lateral epicondylitis. Clinical relevance The combination of magnetic resonance imaging and clinical symptoms to further understand the effect of SP on the clinical symptoms and postoperative recovery in chronic lateral epicondylitis can help refine treatment strategies and improve the prognosis of patients.

Mindfulness-based stress reduction training and supplemented Jinshui Liujun decoction promote recovery in patients with non-small cell lung cancer

BACKGROUND Conventional chemotherapy (CC) administered to patients with non-small cell lung cancer (NSCLC) often causes adverse effects, such as cardiopulmonary dysfunction and immune system imbalance. Patients may experience anxiety and depression during the perioperative period due to various factors, such as treatment costs and cancer recurrence risks, thereby compromising the overall quality of life. Consequently, we hypothesized that integrating mindfulness-based stress reduction training (MSRT) with Jinshui Liujun decoction may mitigate negative emotions and promote recovery in patients with NSCLC. AIM To explore the effects of MSRT and Jinshui Liujun decoction on the immune function and emotional state of NSCLC patients. METHODS A retrospective clinical study was conducted involving 92 patients with stage IIIb-IV NSCLC; 35 patients in the control group (CG) received CC therapy (combination of pemetrexed and carboplatin), and 57 patients in the treatment group (TG) received MSRT-assisted flavored Jinshui Liujun decoction (FJLD) in addition to CC. We evaluated the survival time, Karnofsky performance status, treatment efficacy, traditional Chinese medicine syndrome score, immune function, negative emotional level, and adverse reactions of the CG and TG. RESULTS Median progression-free survival, Karnofsky performance status, and clinical efficacy of the TG were superior to those of the CG (P &lt; 0.05). Symptoms of cough, weakness, bloody sputum, shortness of breath, and chest pain significantly decreased in the TG compared to that in the CG (P &lt; 0.05). In the TG, MSRT + FJLD treatment increased the numbers of CD3+ and CD4+ immune cells, effectively reduced the number of CD8+ cells, and enhanced the CD4+/CD8+ ratio, thereby restoring the immune function of patients. In the TG, the self-rating anxiety scale and self-rating depression scale scores decreased significantly. There was no statistically significant difference in the incidence of adverse reactions between the CG and TG (P &gt; 0.05). CONCLUSION MSRT + FJLD proved to be an effective treatment for patients with NSCLC.

Lipid-Lowering Therapy Use When Indicated and Subsequent Ischemic Stroke Severity.

Elevated low-density lipoprotein cholesterol is a risk factor for atherosclerotic cardiovascular disease, including acute ischemic stroke (AIS), due to large- and small-vessel disease. Cholesterol management guidelines recommend lipid-lowering therapy (LLT) to prevent atherosclerotic cardiovascular disease events. This study assessed use of LLT at the time of AIS according to guideline recommendations and determined the association of prestroke LLT use with stroke severity. We conducted a retrospective study of patients hospitalized with AIS from 2015 to 2020 at a large academic comprehensive stroke center. Patients with AIS secondary to either small-vessel disease or large-artery atherosclerosis recorded in the institutional Get With The Guidelines-Stroke registry and with a prestroke indication for LLT were included. Using propensity score subclassification, adjusted logistic regression models were built to explore the associations between LLT use before AIS when indicated and presenting National Institutes of Health Stroke Scale score >4. There were 384 patients with AIS who met guideline-recommended criteria for prestroke LLT (median age 70 years, 57% men), of whom only 207 patients (54%) were prescribed LLT before AIS. Not being prescribed LLT when indicated was associated with a significantly higher likelihood of a presenting with National Institutes of Health Stroke Scale score >4, even when adjusted for specific stroke cause (odds ratio, 1.13 [95% CI, 1.03-1.20]; P=0.006). LLT is underused in patients who present with atherosclerosis-related AIS. Lack of prestroke LLT use was associated with more severe stroke symptoms upon presentation. These findings emphasize the need to prescribe LLT when indicated, because its use may mitigate poststroke disability.

Development and validation of social issues advocacy scale 2-short form

ABSTRACT The Social Issues Advocacy Scale (SIAS) was published in 2011 as a tool to assess attitudes and behaviors associated with social justice advocacy. The scale was later revised to reflect updated theories and research, resulting in the 78-item scale, SIAS-2. Given the length of SIAS-2, this article reports on three studies with the aims to shorten the number of items and provide reliability and validity data. In Study 1, we developed SIAS-2 Short Form, consisting of 38 items and 8 subscales, measuring different aspects of social justice advocacy, replicating the scale structure of SAIS-2. In Study 2, we confirmed the scale structure, using confirmatory factor analysis, and examined construct validity. As expected, SIAS-2 SF was positively associated with political engagement, cultural openness, social justice self-efficacy, and engagement, and negatively associated with belief in a just world and cultural dominance. Total scale Cronbach’s alpha was .94 (subscale alphas: .74–.87). As in Study 3, we examined test–retest reliability, with a score of r = .84 for the total scale score. The results revealed a 38-item scale with 8 subscales that appears valid and presents with good to excellent internal reliability. Limitations and implications are addressed.

Attenuated afferent inhibition correlated with impaired gait performance in Parkinson’s disease patients with freezing of gait

BackgroundThe neural mechanisms underlying freezing of gait (FOG) in Parkinson’s disease (PD) have not been completely comprehended. Sensory-motor integration dysfunction was proposed as one of the contributing factors. Here, we investigated short-latency afferent inhibition (SAI) and long-latency afferent inhibition (LAI), and analyzed their association with gait performance in FOG PD patients, to further validate the role of sensorimotor integration in the occurrence of FOG in PD.MethodsTwenty-five levodopa responsive-FOG PD patients (LR-FOG), fifteen levodopa unresponsive-FOG PD patients (LUR-FOG), twenty-eight PD patients without FOG (NO-FOG PD) and twenty-two healthy controls (HC) were included in the study. Clinical features such as PD motor symptoms, FOG severity and cognitive abilities were evaluated using clinical scales in subjects with PD. All participants underwent paired associative stimulation (PAS) to evaluate SAI and LAI in addition to regular input-output curve by transcranial magnetic stimulation. The performances of gait were assessed using a portable gait analyzing system in 10-meter timed Up and Go task. The correlations between the gait spatiotemporal parameters or the scores of FOG scale and the magnitudes of SAI or LAI were analyzed.ResultsCompared to HC and NO-FOG PD patients, SAI was decreased in FOG PD subgroups. LAI was also reduced in both LR-FOG PD and LUR-FOG PD in relative to HC; however, only LUR-FOG PD showed significant reduction of LAI in comparison to NO-FOG PD group. FOG PD patients showed poorer gait performance compared to HC and NO-FOG PD group. The reduction of SAI and LAI were correlated with the impaired gait spatiotemporal parameters or scores of FOG scale in PD with FOG.ConclusionThe SAI and LAI were attenuated in PD patients with FOG, and the reduction of SAI or LAI were correlated to disturbed gait performance, indicating that sensory-motor integration dysfunction played a role in the development of FOG in PD.

Stigmatization and Psychosocial Burden in Acne Patients.

Acne vulgaris, a common dermatological condition, has physical manifestations and significant emotional and social implications for those affected. This study aims to assess the stigma experienced by acne vulgaris patients and identify relevant physical, social, and psychological factors. The research involved individuals aged 12-45 diagnosed with acne vulgaris. The authors recorded each patient's demographic information, global acne severity, and acne scar severity. Additionally, each patient completed the Dermatologic Life Quality Index, Beck Depression Inventory, Liebowitz Social Anxiety Scale, and 6-item stigmatization scale. Using the scale scores, the authors categorized the severity into subgroups and compared the results within these subgroups. The severity of acne was positively correlated with DLQI scores (r = 0.196, p = 0.004) and stigmatization scores (r = 0.156, p = 0.024). Higher stigmatization scores were associated with increased levels of depression (r = 0.461, p < 0.001) and anxiety (r = 0.336, p < 0.001), as well as a significant impact on quality of life (r = 0.472, p < 0.001). Upon stratification of patients into three age groups (adolescence, late adolescence, and adulthood), the comparisons between these groups did not reach statistical significance. The results of the current study reveal a clear connection between the severity of acne and psychosocial disturbances, irrespective of age. The authors advise incorporating psychosocial screening, especially for severe acne vulgaris patients of all ages.

The effectiveness of dry needling for plantar fasciitis: a systematic review and meta-analysis

ObjectiveTo evaluate the effectiveness of dry needling (DN) on pain and functional outcomes in patients with plantar fasciitis (PF).MethodsPubMed, Embase, the Cochrane Library, EBSCO, web of science, physiotherapy Evidence Database (PEDro) were searched for randomized control trials (RCTs) evaluating the effectiveness of dry needling on plantar fasciitis. Article screening, data extraction and risk-of-bias evaluation were independently performed by two reviewers. Meta-analysis was conducted based on different control methods and assessment time using RevMan 5.3 software.ResultsA total of 12 RCTs involving 781 patients were included in the systemic review and meta-analysis. The comparison of DN + routine treatments vs. routine treatments alone demonstrated that PF patients receiving DN have significantly lower scores in Visual Analog Scale / Numerical Pain Rating Scale (VAS/NPRS) [95%CI (−2.12, −1.76), p &amp;lt; 0.0001], and the scores of Foot Function Index (FFI) [95%CI (−12.57, −3.58), p = 0.004]. In the comparison of DN vs. other treatments, results showed that DN significantly lowered the scores of FFI [95%CI (−6.55, −1.09), p = 0.006]. However, there was no significant difference in pain improvement between DN and other treatments [95%CI (−0.66, 0.06), p = 0.10]. In the meta-analysis based on different assessment time, results showed that there was significant difference in the scores of VAS/NPRS within 1 month, at 1 month and at over 1 month. But there was no significant difference in the scores of FFI within 1 month, while at 1 month and at over 1 month, the scores of FFI were lowered in patients receiving DN, and the difference were statistically significant.ConclusionDry needling is effective in relieving pain and restoring function in patients with plantar fasciitis. Furthermore, dry needling may take at least 1 month to take effects in patients with plantar fasciitis. More multi-center RCTs with high-quality, large sample size are needed to further conform our conclusion.

Detecting and classifying eco-anxiety: development of clinical cut-off scores for the climate change anxiety scale

BackgroundClimate change anxiety, that is worry and fear in relation to the awareness of the impacts of climate change, is widely observed around the world. Some evidence suggests that while climate change anxiety can, at times, be adaptive, a growing body of research has reported that climate change anxiety is also related to a range of negative mental health outcomes and psychological distress. Currently, however, there is limited ability to assess for elevated levels of climate change anxiety and to identify those who may need support. The present study, therefore, aimed to develop clinical cut-off scores on a measure of climate change anxiety.MethodsA largely representative sample of Australian young adults (aged 16–25 years) completed measures of psychological distress (Depression, Anxiety and Stress Scale-21) and the Climate Change Anxiety Scale. Markers of clinically meaningful psychological distress – elevated depression, anxiety, and stress symptoms—were used to classify cases. Receiver Operating Characteristics analyses were performed to assess the predictive ability of the indicators of psychological distress (mild, moderate, severe, and extremely severe thresholds of anxiety, depression, and stress symptoms) for detecting climate change anxiety and to ascertain optimal cut-off scores.ResultsThe Area Under the Curve was acceptable to moderate for detecting climate change anxiety across all analyses. Across symptom severity thresholds and markers of psychological distress, based on consideration of balancing sensitivity and specificity, results consistently suggested that a cut-score of 21 was indicative of mild-moderate climate change anxiety, with a cut-off score of 23 indicating severe-extremely severe climate change anxiety.ConclusionsThe proposed cut-offs can feasibly be used to identify those with elevated climate change anxiety. Use of these cut-off scores can inform research as well as be used to guide screening, assessment, and inform clinical practice. Results also highlight a high rate of climate change anxiety in young adults.

Serial Examination of Platelet Function Tests Might Predict Prognosis of Patients with Acute Ischemic Stroke—A Cohort Study

Background: This study investigated whether point-of-care platelet function measurements could predict favorable outcomes in patients with acute ischemic stroke (AIS). Antiplatelet agents, such as aspirin, are known to reduce the risk of recurrent stroke by 20–30%. However, identifying nonresponders to therapy remains a clinical challenge. The study aimed to assess the prognostic value of serial Platelet Function Analyzer (PFA)-100 measurements and hematological ratios in AIS patients. Methods: A prospective cohort study was conducted on 212 AIS patients in Taiwan. Platelet function was assessed at baseline, week 2, and week 4 using PFA-100. The primary outcome was functional recovery, defined by a modified Rankin Scale (mRS) score of 0–3, at 1-month and 1-year. Subgroup analyses compared outcomes between pre- and post-aspirin administrations. Statistical analyses examined the association between changes in platelet function and clinical outcomes. Results: Difference in collagen and epinephrine (CEPI) measurements between baseline and week 2 was associated with favorable mRS scores (p &lt; 0.001). A difference in CEPI closure time greater than 99 seconds was most predictive of a favorable outcome with an adjusted odds ratio of 11.859 (95% CI 2.318–60.669) at 1-month follow-up. Subgroup analyses revealed predictive value in pre-aspirin measurements at 1-month follow-up (p = 0.007). Conclusions: Serial PFA-100 measurements and hematological biomarkers, specifically changes in on-treatment CEPI closure times, may help predict favorable clinical outcome in AIS patients. These findings suggest that dynamic platelet function assessment could play a role in optimizing antiplatelet therapy in AIS management.

The impact of white matter hyperintensities on short-term outcomes of reperfusion therapy in patients with acute ischemic stroke.

This study aimed to explore the impact of white matter hyperintensities (WMH) on the short-term outcomes of reperfusion therapy in acute ischemic stroke (AIS) patients. We prospectively collected data on AIS patients undergoing reperfusion therapies at Chengdu Second People's Hospital from January 2020 and January 2024. WMH severity was graded as 0-3 (none to moderate) or 4-6 (severe) by the Fazekas scale. We analyzed National Institutes of Health Stroke Scale (NIHSS) scores, good functional outcomes (modified Rankin Scale, mRS 0-2) at 7days and discharge, and safety outcomes like in-hospital mortality and intracranial hemorrhage. During the study period, 669 patients were included, with 345 having none to moderate WMH and 324 with severe WMH. Patients with severe WMH exhibited significantly higher NIHSS and mRS at 7days and discharge, with a decrease in good outcomes (mRS 0-2: 40.43% vs. 75.65%), and an increase in intracranial hemorrhage (16.4% vs. 5.8%) and in-hospital mortality (11.7% vs. 2.0%) compared with none to moderate WMH patients. After matching the baseline data, none to moderate WMH was associated with higher likelihood of good outcomes at discharge [adjusted odds ratio (aOR), 2.142; 95% confidence interval (CI), 1.380-3.304; P < 0.001] and a lower rate of any intracranial hemorrhage (aOR, 0.348; 95% CI 0.180-0.673; P < 0.001), with no significant difference in in-hospital mortality between the groups. Severe WMH could reduce the benefits of reperfusion therapy in AIS, with increased risk of hemorrhagic complications, warranting further research into treatment strategies for these patients.

Clinical and immunological features in patients with neuroimmune complications of COVID-19 during Omicron wave in China: a case series

PurposeThis study aimed to present clinical and immunological features in patients with neuroimmune complications of COVID-19 during Omicron wave in China.MethodsPatients with neuroimmune complications associated with COVID-19 were retrospectively analyzed in Huashan Hospital from December 2022 to April 2023, during the widespread prevalence of Omicron variants in China. Demographic information, symptoms, electrophysiological findings, cerebrospinal fluid(CSF) test results and immunological markers, Magnetic Resonance Imaging(MRI) characteristics, treatment strategies and outcomes of these patients were reviewed and analyzed.ResultsA total of 53 cases of neuroimmune complications were included, with 7 cases of non-immune complications taken as controls. Neuroimmune complications comprised: 7 cases of Guillain-Barre syndrome/chronic inflammatory demyelinating polyneuropathy, 11 cases of spinal meningitis/myelitis, 2 cases of neuromyelitis optica spectrum disorder, 2 cases of myelin oligodendrocyte glycoprotein antibody-associated disease, 1 case of acute disseminated encephalomyelitis, 10 cases of autoimmune encephalitis, 17 cases of other encephalopathy/encephalitis and 3 cases of cerebellitis. SARS-CoV-2 was only detected in the CSF sample of one neuroimmune complications patient. CSF-restricted oligoclonal bands were detected in 11.1% (5/45) of neuroimmune patients, but absent in non-immune cases (0.0%, 0/5). Autoantibody testing identified specific antibodies in 26.5%(13/49) of neuroimmune cases and 0.0% (0/5) of non-immune cases. Glucocorticoids or intravenous immunoglobulins were administered as first-line treatments for all neuroimmune cases (100%, 53/53), whereas only 42.8% (3/7) of non-immune cases received these therapies. A baseline modified Rankin scale (mRS) score of 3 or above was present in the majority of both neuroimmune cases (96.2%, 51/53) and non-immune cases (71.4%, 5/7). At the end of a follow-up period, independent functional outcomes at day-90 with an mRS score below two were observed in a significant proportion of both neuroimmune cases (77.4%, 41/53) and non-immune case(71.4%, 5/7).ConclusionThe manifestations of neuroimmune complications of COVID-19 are diverse and can manifest with severe neurological deficits early in the course of the disease. The detection of immunological markers (such as autoantibody and oligoclonal bands) and immunotherapies can help to improve the prognosis of COVID-19 related neuroimmune complications.