Background
The Migraine Disability Assessment Scale (MIDAS) is one of the tools for measuring and understanding disability caused by migraine. The purpose of this study was to validate a Kiswahili ...translation of the MIDAS (MIDAS‐K) among patients suffering from migraines in Dar es Salaam, Tanzania.
Methods
A psychometric validation study of MIDAS was conducted after translation to Kiswahili. A total of 70 people with migraine were recruited by systematic random sampling and they completed the MIDAS‐K questionnaire twice, 10–14 days apart. Internal consistency, split‐half reliability, and test‐retest reliability, convergent and divergent validity were examined.
Results
70 patients (F:M; 59:11) with median (25th, 75th) headache days of 4.0 (2.0, 7.0) were recruited. Twenty‐eight out of 70 (40%) of the population had severe disability on MIDAS‐K. The overall test‐retest reliability of MIDAS‐K was high (ICC = 0.86; 95% CI = 0.78–0.92 p < 0.001). Factor analysis showed a two‐factor structure; the number of days missed and reduced efficiency. MIDAS‐K had a good internal consistency of 0.78, good split‐half reliability of 0.80 and acceptable test‐retest reliability for all items as well as total MIDAS‐K scores.
Conclusion
The Kiswahili version of the MIDAS questionnaire (MIDAS‐K) is a valid, responsive, and reliable tool to measure migraine‐related disability among Tanzanians and other Swahili‐speaking populations. Quantification of migraine disability in the region will guide policies directed at care allotment, improvement in the provision of interventions for migraine, as well as enhancement of health‐related quality of life for patients with migraine in our region.
•Applying a magnetic field can decrease the rate of melting and increase fusion duration.•Nanoparticles increase the thermal conductivity of PCM and the Lorentz force.•The enclosure aspect ratio ...affects the susceptibility of PCM to magnetism.
In phase-change materials (PCMs) application for cooling, melting happens at nearly constant temperature preventing an increase in temperature until full melting occurs. So, controlling the fusion duration can be helpful to maintain the thermal comfort at lower energy demand. This study investigates the impact of using a uniform magnetic field on the rate of melting of Octadecane PCM, with and without the addition of high-conductivity nanoparticles, and when considering enclosures of various aspect ratios. We note that about 43% decrease in liquid fraction, and consequently melting rate, can be obtained for a Hartmann number of 100 and when Lorentz force direction is opposite to the buoyant force. We also show that the aspect ratio of the enclosure has an impact on the magnetic susceptibility of the PCM. Also, with the addition of nanoparticles, the effect of Lorentz force becomes more intense but the overall decrease in melting rate is not evident because of the increase in conductive heat transfer. So, their use might be promising in scenarios where increasing the rate of melting is needed. Consequently, for a substantial impact on the fusion rate of a phase-change material, the strength of the magnetic field, the enclosure shape, and the conductivity of the material should be carefully considered.
Background
Primary generalized dystonia due to the DYT1 gene is an autosomal dominant disorder caused by a GAG deletion on chromosome 9q34. It is a well‐defined, genetically proven, isolated dystonia ...syndrome. However, its pathophysiology remains unclear.
Objectives
This study was aimed at profiling the functional neuroimaging findings in DYT1 dystonia and harmonizing the pathophysiological implications for DYT1 dystonia from the standpoint of different neuroimaging techniques.
Methods
A systematic review was conducted using identified studies published in English from Medline, PsycINFO, Embase, CINAHL, and the Cochrane Database of Systematic Reviews (CDSR), between 1985 and December 2019 (PROSPERO protocol CRD42018111211).
Results
All DYT1 gene carriers irrespective of clinical penetrance have reduced striatal GABA, dopamine receptors and increased metabolic activity in the lentiform nucleus, supplementary motor area, and cerebellum in addition to an abnormal cerebellothalamocortical pathway. Nonmanifesting carriers on the other hand have a disruption of the distal (thalamocortical) segment and have larger putaminal volumes than manifesting carriers and healthy controls. Activation of the midbrain, thalamus, and sensorimotor cortex was only found in the manifesting carriers.
Conclusions
Therefore, we propose that DYT1 dystonia is a cerebellostriatothalamocortical network disorder affecting either the structure or function of the different structures or nodes in the network.
Entrapment neuropathy is the result of pressure on a peripheral nerve as it passes through a narrow canal that is bounded by stiff tissues. In spite of their ubiquitous nature, they are ...underdiagnosed, underreported, and sometimes not properly managed, especially in developing countries. Entrapment neuropathies are of various types, but the most common type is carpal tunnel syndrome. Mechanisms involved in the pathophysiology of entrapment neuropathies include mechanical compression and nerve ischemia. A clear understanding of the various types and the underlying mechanisms of entrapment neuropathies are invaluable in the decision-making process involved in the management of every patient with the condition.
Background
Severe carpal tunnel syndrome (CTS) readily lends itself to both clinical and electrophysiological recognition. The uncertainty sometimes is in identifying and quantifying motor ...involvement in mild and, perhaps, in moderate CTS. Our study aimed to evaluate F responses in mild and moderate CTS and determine the contribution of BMI to the F‐wave parameters.
Methods
A retrospective review of the clinical and electrophysiological data of patients with CTS seen at the clinical neurophysiology laboratory of Aga Khan Hospital, Dar es Salaam, between 1 August 2017 and 31 July 2019 was retrieved. Carpal tunnel syndrome was graded according to the electrophysiological criteria of Padua. The F‐wave parameters of patients with mild‐to‐moderate CTS were analyzed and compared with asymptomatic controls.
Result
We studied 91 hands. Twenty‐two hands were asymptomatic controls, 30 hands had mild CTS, and 39 hands had moderate CTS. Patients with moderate CTS were more obese (p =.011), had more females (p =.044), and were older (p= <0.001). F‐wave parameters were not convincingly different between mild and moderate CTS. F‐wave chronodispersion (p =.035) and F‐wave persistence (0.019) were significantly different between nonobese control and mild and moderate CTS. Median–ulnar F‐wave latency difference (FWLD) was significant between obese patients with mild CTS and moderate CTS scores (p =.017).
Conclusion
Although a clear difference exists between F‐wave parameters in asymptomatic controls and those with CTS, the F‐wave study is inadequate in distinguishing mild and moderate CTS even in the context of BMI. Median–ulnar F‐wave latency difference (FWLD) appeared to be a promising discriminant parameter between obese patients with mild CTS and those with moderate CTS.
We compared F wave parameters between normal individuals, patients with mild carpal tunnel syndrome and those with moderate carpal tunnel syndrome while considering the effect of obesity. F‐wave parameters clearly differs between asymptomatic controls and those with CTS. However, F‐waves study is inadequate in distinguishing mild and moderate CTS even when BMI is considered.
Chronic subdural hematoma is a known neurosurgical entity often associated with a spectrum of neurological manifestations. While primarily recognized for its characteristic accumulation of blood ...between the dura mater and arachnoid membrane, emerging literature suggests a rare association between chronic subdural hematoma and Parkinsonian symptoms. This report aims to underscore this unique neurological relationship by presenting a case of a 70-year-old male who developed Parkinsonism following chronic subdural hematoma post-head trauma. This case underscores the rare association between chronic subdural hematoma and Parkinsonian symptoms, emphasizing the importance of timely diagnosis and intervention in managing such cases.
Renewable energies, such as solar and wind, traditionally suffer from temporal incongruity. Society’s energy demand peaks occur at different times of day than the electricity generation potential of ...a photovoltaic panel or, often, a wind turbine. Heat demand, in particular, is subject to a significant mismatch between the availability of heat (in the summer) and the need for heat (in the winter). Thus, a future energy system design should incorporate underground thermal energy storage (UTES) to avoid this temporal mismatch and emphasize thermal applications. Such a basis of design would introduce new methods of energy arbitrage, encourage the adoption of geothermal systems, and decrease the carbon intensity of society. UTES techniques are becoming increasingly sophisticated. These methods of storage can range from simple seasonal storage for residential structures in a grouted borehole array (BTES), to aquifer thermal energy storage (ATES), deep reservoir storage (RTES) in basins, among others. The method that each of these techniques shares is the use of the earth as a storage medium. UTES can also be characterized for electricity production, but this work largely explores applications in heating and cooling, further limited in scope to sensible heat storage (SHS). Heating and cooling processes—residential, commercial, and industrial—make up large fractions of energy demand in North America. This is also true of other locales. With the increasing concerns of climate change, exacerbated by anthropogenic greenhouse gas emissions, developers and municipal planners are strategizing to decarbonize building heating and cooling at district scales. This review covers the integration of UTES techniques with thermal energy network (TEN) technology across large districts. Though storage has long been in use for conventional district heating networks, designs are rapidly innovating, indicating broader applications of UTES integration with a TEN is advantageous from both an efficiency and economic perspective. This rapid innovation indicates the need for the integrated review offered in this paper.
This study aimed to develop a risk-scoring model for hypertension among Africans.
In this study, 4413 stroke-free controls were used to develop the risk-scoring model for hypertension. Logistic ...regression models were applied to 13 risk factors. We randomly split the dataset into training and testing data at a ratio of 80:20. Constant and standardized weights were assigned to factors significantly associated with hypertension in the regression model to develop a probability risk score on a scale of 0 to 1 using a logistic regression model. The model accuracy was assessed to estimate the cutoff score for discriminating hypertensives.
Mean age was 59.9±13.3 years, 56.0% were hypertensives, and 8 factors, including diabetes, age ≥65 years, higher waist circumference, (BMI) ≥30 kg/m
, lack of formal education, living in urban residence, family history of cardiovascular diseases, and dyslipidemia use were associated with hypertension. Cohen κ was maximal at ≥0.28, and a total probability risk score of ≥0.60 was adopted for both statistical weighting for risk quantification of hypertension in both datasets. The probability risk score presented a good performance-receiver operating characteristic: 64% (95% CI, 61.0-68.0), a sensitivity of 55.1%, specificity of 71.5%, positive predicted value of 70.9%, and negative predicted value of 55.8%, in the test dataset. Similarly, decision tree had a predictive accuracy of 67.7% (95% CI, 66.1-69.3) for the training set and 64.6% (95% CI, 61.0-68.0) for the testing dataset.
The novel risk-scoring model discriminated hypertensives with good accuracy and will be helpful in the early identification of community-based Africans vulnerable to hypertension for its primary prevention.
This review provides an outlook of orthostatic tremor (OT), a rare adult-onset tremor characterized by subjective unsteadiness during standing that is relieved by sitting or walking. Recent case ...series with a long-time follow-up have shown that the disease is slowly progressive, spatially spreads to the upper limbs, and other neurological disorders may develop in about one-third of the patients. The diagnosis of OT hinges on the typical history of unsteadiness during standing, which is confirmed by electromyographic findings of a 13-18 Hz tremor that is typically absent during tonic activation while the patient is sitting and lying. Although the tremor is generated by a central oscillator, cerebellar and/or basal ganglia dysfunction are needed for its manifestation (double lesion hypothesis). However, functional neuroimaging findings have not consistently implicated the dopaminergic system in its pathogenesis. Drug treatments have been largely disappointing with no sustained benefits, although thalamic deep brain stimulation has helped some patients. Large-scale follow-up studies, more drug trials, and novel therapies are urgently needed.
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