The presence of visual dependence as an influential factor on the development of functional stability in ambulatory individuals with cerebral palsy (CP) was studied in 22 adults with spastic ...bilateral CP, 11 of whom were considered visually dependent, and 18 healthy adults. Participants stood upright during pitch plane disturbances of the visual field and support surface. Intersegmental coordination behaviors were assessed by fitting trajectories of adjacent body segments to an ellipse. Mixed-model repeated measures ANOVAs were performed on ellipse orientation angle and area. Dissimilar stabilizing strategies adopted by the two groups with CP imply that visual dependence impacts postural control. Postural reorganization in response to visual flow in all groups indicates that we cannot ignore perceptual aspects of postural control when designing therapeutic interventions.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, FSPLJ, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Purpose
We developed and validated a measure assessing quality of life (QOL) through importance, attainability, and discrepancy of life goals among adolescents and young adults (AYA) with and without ...cancer. A specific goal-based QOL measure for AYA fills a critical gap in knowledge for AYA who are at a unique life stage, which may include shifts in priorities and goals.
Methods
Through review of our existing AYA databases on goals, the literature, and cognitive interviews we developed the MAYA-GQOL. Items were administered to AYA with cancer (on/off treatment) (
n
= 124) and healthy AYA controls (
n
= 103) aged 15–29 years old. Psychometric analyses for comparison with existing QOL measures and discrepancies in perceived importance/attainability of goals were examined.
Results
An item pool of 700 goals, based on prior research, was refined to 173 goals across nine categories: academic, administrative, body, health, job, leisure, interpersonal, intrapersonal, and religion. Validation between the MAYA-GQOL and existing QOL measures was supported. AYA survivors reported fewer overall current goals and fewer administrative, interpersonal, leisure, and religious goals. AYA survivors rated body goal importance significantly higher than healthy controls and intrapersonal goal importance significantly lower. Little discrepancy in importance and attainability across AYA was found.
Conclusions
The MAYA-GQOL represents an innovative way of measuring QOL among AYA by focusing on the relative importance, attainability, and discrepancy of developmentally appropriate goals. The MAYA-GQOL can identify areas of resilience and competence via assessment of important and attainable goals and can further assess how AYA with chronic illness are functioning relative to peers on goal domains relevant to the AYA developmental period.
To demonstrate how to interpret Patient-Reported Outcomes Measurement Information System (PROMIS) pediatric patient-reported outcome measure (PROM) scores for patients with pediatric inflammatory ...bowel disease (IBD).
Using data from a prospective cohort study of patients ages 8 to 23 years with IBD (n = 1049), we established disease-specific percentiles and computed the minimal clinically important difference (MCID) change score for 6 pediatric PROMs. We applied these results, general population percentiles, and the reliable change index to interpret PROM scores in a clinical trial sample of patients ages 8 to 20 years with IBD (n = 294) in which PROMIS PROMs were obtained at baseline and 3 months later.
Application of general population percentiles showed that the clinical trial sample at baseline had moderately worse self-reported health than the general population (22% of patients at or above the 95th percentile on Fatigue; 21% on Pain Interference). IBD-specific percentiles showed that the sample was somewhat worse than the reference IBD sample (8% of patients at or above the 95th percentile on Fatigue; 11% on Pain Interference). Application of the MCID threshold indicated that among the subgroup of patients that improved by 15 or more on the short Pediatric Crohn's Disease Activity Index (n = 38), 45% also improved on IBD Symptoms, 47% for Fatigue, and 65% for Pain Interference.
This study established IBD-specific percentiles for 6 pediatric PROMIS measures and demonstrated the application of percentiles and other methods for interpreting PROM scores.
No reliable biometric measurement of vestibular involvement with migraine is currently available.
Measures of autonomic nervous system and postural responses could serve as quantifiable indicators of ...vestibular involvement with migraine.
A convenience sample of 22 young healthy adults (34±9 years old) and 23 young adults (34±8 years old) diagnosed with vestibular migraine (VM) participated. A rod and frame test and clinical outcome measures of dizziness and mobility were administered. Participants stood on foam while viewing two dynamic virtual environments. Trunk acceleration in three planes and electrodermal activity (EDA) were assessed with wearable sensors. Linear mixed models were used to examine magnitude and smoothness of trunk acceleration and tonic and phasic EDA. A Welch's t-test and associations between measures were assessed with a Pearson Correlation Coefficient. Effect sizes of group mean differences were calculated using Cohen's d.
Visual dependence was present in 83% of the VM population. Individuals with VM exhibited lower baseline EDA (t(4.17) = -7.2, p = 0.001) and greater normalized trunk accelerations in the vertical (t(42.5) = 2.861, p = 0.006) and medial (t(46.6) = 2.65, p = 0.01) planes than healthy participants. Tonic EDA activity increased significantly across the period of the trial (F (1,417) = 23.31, p = 0.001) in the VM group. Significant associations appeared between vertical trunk acceleration and EDA, Dizziness Handicap Inventory, and Activities of Balance Confidence tools.
Higher tonic EDA activity in healthy adults results in more accurate postural reactions. Results support the supposition that EDA activity and postural acceleration are significantly different between VM and healthy individuals when accommodating for postural instability and visual-vestibular conflict.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Abstract
Background
Functional outcomes with early rehabilitation in the acute care setting have improved; however, an improved understanding of muscle fatigue using surface electromyography (sEMG) ...is warranted to better guide patient-centered exercise prescription.
Objectives
The objectives of this study were to assess the safety and feasibility of collecting sEMG at the acute care bedside and to determine differences in muscle fatigue during isometric and dynamic submaximal contractions among patients in the hospital, healthy younger participants, and healthy older participants.
Design
The study used an observational cohort design.
Methods
There were 37 participants. Median frequency (Fmed) of the myoelectric signal of the quadriceps femoris muscles and time to task failure (TTTF) were measured using sEMG during an isometric and dynamic fatiguing contraction. Primary analysis compared TTTF between groups for both types of contractions. Secondary analysis compared Fmed at initiation and termination of fatiguing contraction.
Results
High-quality sEMG measures were safe and feasible to collect at the acute care bedside with no adverse events. There was a statistically significant difference in TTTF between groups after isometric and dynamic contractions; hospitalized patients fatigued faster than healthy younger and healthy older participants after both contractions. With the exception of the vastus lateralis during a dynamic contraction in healthy younger and hospitalized patients, there was a statistically significant difference between Fmed at initiation and termination of contraction, indicating that subjects’ muscles did truly fatigue.
Limitations
A limitation of the study was the small sample size of patients who were hospitalized without matched controls.
Conclusions
sEMG is a lab quantitative technique that was found to be safe and feasible to assess muscle fatigue in the acute care environment. The protocol yielded similar results to previously published literature for healthy younger and healthy older people. Further research is needed to better understand how to integrate sEMG findings into patient-centered exercise prescriptions.
Linear polarization maps of the Carina Nebula were obtained at 250, 350, and 500 m during the 2012 flight of the Balloon-borne Large Aperture Submillimeter Telescope for Polarimetry (BLASTPol). These ...measurements are combined with Planck 850 m data in order to produce a submillimeter spectrum of the polarization fraction of the dust emission, averaged over the cloud. This spectrum is flat to within 15% (relative to the 350 m polarization fraction). In particular, there is no evidence for a pronounced minimum of the spectrum near 350 m, as suggested by previous ground-based measurements of other molecular clouds. This result of a flat polarization spectrum in Carina is consistent with recently published BLASTPol measurements of the Vela C molecular cloud and also agrees with a published model for an externally illuminated, dense molecular cloud by Bethell and collaborators. The shape of the spectrum in Carina does not show any dependence on the radiative environment of the dust, as quantified by the Planck-derived dust temperature or dust optical depth at 353 GHz.
Polarized emission from aligned dust is a crucial tool for studies of magnetism in the ISM, but a troublesome contaminant for studies of cosmic microwave background polarization. In each case, an ...understanding of the significance of the polarization signal requires well-calibrated physical models of dust grains. Despite decades of progress in theory and observation, polarized dust models remain largely underconstrained. During its 2012 flight, the balloon-borne telescope BLASTPol obtained simultaneous broadband polarimetric maps of a translucent molecular cloud at 250, 350, and 500 m. Combining these data with polarimetry from the Planck 850 m band, we have produced a submillimeter polarization spectrum, the first for a cloud of this type. We find the polarization degree to be largely constant across the four bands. This result introduces a new observable with the potential to place strong empirical constraints on ISM dust polarization models in a previously inaccessible density regime. Compared to models by Draine & Fraisse, our result disfavors two of their models for which all polarization arises due only to aligned silicate grains. By creating simple models for polarized emission in a translucent cloud, we verify that extinction within the cloud should have only a small effect on the polarization spectrum shape, compared to the diffuse ISM. Thus, we expect the measured polarization spectrum to be a valid check on diffuse ISM dust models. The general flatness of the observed polarization spectrum suggests a challenge to models where temperature and alignment degree are strongly correlated across major dust components.
Older cancer survivors likely experience physical function limitations due to cancer and its treatments, leading to disability and early mortality. Existing studies have focused on factors associated ...with surgical complications and mortality risk rather than factors associated with the development of poor disability status (DS), a proxy measure of poor performance status, in cancer survivors. We aimed to identify factors associated with the development of poor DS among older survivors of colorectal cancer (CRC) and compare poor DS rates to an age-sex-matched, non-cancer cohort.
This retrospective cohort study utilized administrative data from the Texas Cancer Registry Medicare-linked database. The study cohort consisted of 13,229 survivors of CRC diagnosed between 2005 and 2013 and an age-sex-matched, non-cancer cohort of 13,225 beneficiaries. The primary outcome was poor DS, determined by Davidoff's method, using predictors from 12 months of Medicare claims after cancer diagnosis. Multivariable Cox proportional hazards regression was used to identify risk factors associated with the development of poor DS.
Among the survivors of CRC, 97% were 65 years or older. After a 9-year follow-up, 54% of survivors of CRC developed poor DS. Significant factors associated with future poor DS included: age at diagnosis (hazard ratio HR = 3.50 for >80 years old), female sex (HR = 1.50), race/ethnicity (HR = 1.34 for Hispanic and 1.21 for Black), stage at diagnosis (HR = 2.26 for distant metastasis), comorbidity index (HR = 2.18 for >1), and radiation therapy (HR = 1.21). Having cancer (HR = 1.07) was significantly associated with developing poor DS in the pooled cohorts; age and race/ethnicity were also significant factors.
Our findings suggest that a CRC diagnosis is independently associated with a small increase in the risk of developing poor DS after accounting for other known factors. The study identified risk factors for developing poor DS in CRC survivors, including Hispanic and Black race/ethnicity, age, sex, histologic stage, and comorbidities. These findings underscore the importance of consistent physical function assessments, particularly among subsets of older survivors of CRC who are at higher risk of disability, to prevent developing poor DS.
To determine the associations between trauma variables, acute phase-related variables, and patient-level characteristics with functional recovery during the first-year post-discharge from inpatient ...rehabilitation facilities (IRF) for individuals with spinal cord injury (SCI).
Retrospective cohort analysis.
Two SCI Model Centers in Pennsylvania, United States.
We were able to link 378 individuals with traumatic SCI between the Pennsylvania Trauma Systems Outcomes Study and the National SCI Model Systems databases. Nineteen individuals with SCI were excluded due to missing data. We estimated functional recovery based on changes in functional independence measure (FIM) total motor score during the first-year post-discharge from IRF in 359 individuals with SCI, who did not have any missing data, using ordinary least squares regression (OLS).
After discharge from IRF the majority of individuals with SCI improved over the first-year post-injury. Individuals with cervical A-C (injury severity group) who were older had a slight decrease in motor FIM at 1-year post-injury. Regression analysis indicated that lower functional recovery was associated with being of Black and Hispanic race and ethnicity, higher injury severity group, occurrence of non-pulmonary infection during acute care, and longer length of stay at IRF (R
2
= 0.36).
Patient-level characteristics, trauma variables, and acute phase-related variables were associated with functional recovery post-discharge from IRF. Further research is necessary to collect and assess post-rehabilitation and socio-economic factors that play a critical role in continued functional recovery in the community.
Abstract Sensitive wide-field observations of polarized thermal emission from interstellar dust grains will allow astronomers to address key outstanding questions about the life cycle of matter and ...energy driving the formation of stars and the evolution of galaxies. Stratospheric balloon-borne telescopes can map this polarized emission at far-infrared wavelengths near the peak of the dust thermal spectrum—wavelengths that are inaccessible from the ground. In this paper we address the sensitivity achievable by a Super Pressure Balloon polarimetry mission, using as an example the Balloon-borne Large Aperture Submillimeter Telescope (BLAST) Observatory. By launching from Wanaka, New Zealand, the BLAST Observatory can obtain a 30 days flight with excellent sky coverage—overcoming limitations of past experiments that suffered from short flight duration and/or launch sites with poor coverage of nearby star-forming regions. This proposed polarimetry mission will map large regions of the sky at sub-arcminute resolution, with simultaneous observations at 175, 250, and 350 μ m, using a total of 8274 microwave kinetic inductance detectors. Here, we describe the scientific motivation for the BLAST Observatory, the proposed implementation, and the forecasting methods used to predict its sensitivity. We also compare our forecasted experiment sensitivity with other facilities.
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