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https://www.readbyqxmd.com/read/29040110/racial-differences-in-palliative-care-use-after-stroke-in-majority-white-minority-serving-and-racially-integrated-u-s-hospitals
#1
Roland Faigle, Wendy C Ziai, Victor C Urrutia, Lisa A Cooper, Rebecca F Gottesman
OBJECTIVES: Racial/ethnic differences in palliative care resource use after stroke have been recognized, but it is unclear whether patient or hospital characteristics drive this disparity. We sought to determine whether palliative care use after intracerebral hemorrhage and ischemic stroke differs between hospitals serving varying proportions of minority patients. DESIGN: Population-based cross-sectional study. SETTING: Inpatient hospital admissions from the Nationwide Inpatient Sample between 2007 and 2011...
October 14, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29034265/coupled-bimanual-training-using-a-non-powered-device-for-individuals-with-severe-hemiparesis-a-pilot-study
#2
Preeti Raghavan, Viswanath Aluru, Sina Milani, Peter Thai, Daniel Geller, Seda Bilaloglu, Ying Lu, Donald J Weisz
BACKGROUND: Few options exist for training arm movements in participants with severe post-stroke hemiparesis who have little active range of motion. The purpose of this study was to test the safety and feasibility of training with a non-powered device, the Bimanual Arm Trainer (BAT), to facilitate motor recovery in individuals with severe hemiparesis. The BAT enabled coupled bimanual training of shoulder external rotation, which is reduced in individuals with severe post-stroke hemiplegia...
June 2017: International Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29022422/investigating-cognitive-ability-and-self-reported-driving-performance-of-post-stroke-adults-in-a-driving-simulator
#3
Alison Blane, Torbjörn Falkmer, Hoe C Lee, Tania Dukic Willstrand
Background Safe driving is a complex activity that requires calibration. This means the driver can accurately assess the level of task demand required for task completion and can accurately evaluate their driving capability. There is much debate on the calibration ability of post-stroke drivers. Objectives The aim of this study was to assess the cognition, self-rated performance, and estimation of task demand in a driving simulator with post-stroke drivers and controls. Methods A between-groups study design was employed, which included a post-stroke driver group and a group of similarly aged older control drivers...
October 12, 2017: Topics in Stroke Rehabilitation
https://www.readbyqxmd.com/read/28994667/relative-contribution-of-different-altered-motor-unit-control-to-muscle-weakness-in-stroke-a-simulation-study
#4
Henry Shin, Nina Suresh, William Zev Rymer, Xiaogang Hu
Chronic muscle weakness impacts the majority of individuals after a stroke. The origins of this hemiparesis is multifaceted, and an altered spinal control of the motor unit (MU) pool can lead to muscle weakness. However, the relative contribution of different MU recruitment and discharge organization is not well understood. In this study, we sought to examine these different effects by utilizing a MU simulation with variations set to mimic the changes of MU control in stroke. Approach: Using a well-established model of the MU pool, this study quantified the changes in force output caused by changes in MU recruitment range and recruitment order, as well as MU firing rate organization at the population level...
October 10, 2017: Journal of Neural Engineering
https://www.readbyqxmd.com/read/28987764/comparing-the-effects-of-adapting-to-a-weight-on-one-leg-during-treadmill-and-overground-walking-a-pilot-study
#5
Gabriela Lopes Gama, Douglas N Savin, Taylor Keenan, Sandy McCombe Waller, Jill Whitall
BACKGROUND: Locomotor adaptation has been suggested as a way to improve gait symmetry in individuals post-stroke. Most perturbation methods utilize costly, specialized equipment. The use of a unilateral leg weight may provide a low cost, clinically translatable alternative. Furthermore, previous studies have suggested that adaptation context may affect movement outcomes. The purpose of this study was to assess the ability of a unilaterally applied ankle weight to drive locomotor adaptation and determine the effect of context (treadmill versus overground) in young, non-disabled participants...
September 23, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28985200/cellular-therapy-for-traumatic-neurological-injury
#6
REVIEW
Charles S Cox
Neurological injury is the primary lethal mechanism of injury in children, and the primary etiology of long-term disability after trauma. Laboratories and clinical/translational teams have sought to develop stem/progenitor cell therapies to improve recovery in a clinical setting in which there is no significant reparative option. While none of these treatments are currently standard therapeutics, Phase 2b clinical trials are underway in both adults and children in severe traumatic brain injury and Phase 1/2a trials in spinal cord injury...
October 6, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28977856/improvement-of-mitochondrial-function-mediated-the-neuroprotective-effect-of-5-4-hydroxy-3-dimethoxybenzylidene-2-thioxo-4-thiazolidinone-in-rats-with-cerebral-ischemia-reperfusion-injuries
#7
Mingyang Wang, Lu Feng, Ji Zheng, Junya Liu, Shujie Fan, Jun Zhao, Nan Yang, Yanyong Liu, Zhanjun Yang, Caiying Ye, Pingping Zuo
Deficits in mitochondrial function is a critical inducement in the major pathways that drive neuronal cell death in ischemic process particularly. Drugs target to improve the mitochondrial function may be a feasible therapeutic choice in treatment with ischemic diseases. In the present study, we investigated whether 5-(4-hydroxy-3-dimethoxybenzylidene)-2-thioxo-4-thiazolidinone (RD-1), a compound derived from rhodanine, could protect against ischemic neuronal damage via improving mitochondrial function. We tested the neuroprotective effect of RD-1 both in rats modeled by middle cerebral artery occlusion reperfusion in vivo and in primary cortical neurons subjected to hypoxia/reperfusion injury in vitro...
September 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28956691/the-blood-brain-barrier-insights-from-development-and-ageing
#8
Conor Delaney, Matthew Campbell
The blood brain barrier is a necessity for cerebral homeostasis and response to environmental insult, thus loss in functionality with age creates opportunities for disease to arise in the aged brain. Understanding how the barrier is developed and maintained throughout the earlier years of adult life can identify key processes that may have beneficial applications in the restoration of the aged brain. With an unprecedented increasing global aged population, the prevention and treatment of age-associated disorders has become a rising healthcare priority demanding novel approaches for the development of therapeutic strategies...
September 6, 2017: Tissue Barriers
https://www.readbyqxmd.com/read/28915837/professional-groups-driving-change-toward-patient-centred-care-interprofessional-working-in-stroke-rehabilitation-in-denmark
#9
Viola Burau, Kathrine Carstensen, Stina Lou, Ellen Kuhlmann
BACKGROUND: Patient-centred care based on needs has been gaining momentum in health policy and the workforce. This creates new demand for interprofessional teams and redefining roles and tasks of professionals, yet little is known on how to implement new health policies more effectively. Our aim was to analyse the role and capacity of health professions in driving organisational change in interprofessional working and patient-centred care. METHODS: A case study of the introduction of interprofessional, early discharge teams in stroke rehabilitation in Denmark was conducted with focus on day-to-day coordination of care tasks and the professional groups' interests and strategies...
September 16, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28913708/emergency-neurological-life-support-intracerebral-hemorrhage
#10
J Claude Hemphill, Arthur Lam
Intracerebral hemorrhage (ICH) is a subset of stroke due to spontaneous bleeding within the parenchyma of the brain. It is potentially lethal, and survival depends on ensuring an adequate airway, proper diagnosis, and early management of several specific issues such as blood pressure, coagulopathy reversal, and surgical hematoma evacuation for appropriate patients. ICH was chosen as an Emergency Neurological Life Support (ENLS) protocol because intervention within the first hours may improve outcome, and it is critical to have site-specific protocols to drive care quickly and efficiently...
September 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28906387/a-nearly-full-recovery-from-avm-hemorrhagic-stroke-17-years-after-insult-using-a-new-integrated-neurodevelopmental-approach-a-case-report
#11
Alberto J Friedmann
RATIONAL: With the prevalence of stroke increasing in the USA and the world along with increased survival and longevity due to medical advancements, it has become increasingly necessary to look at the chronic phase of stroke recovery. Previous paradigms of stroke treatment have proven ineffective when looking at 10, 15, or 20 years of survival post insult. PATIENT CONCERNS: The patient, being a young man just out of high school, was concerned with his overall morbidity...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28883125/defining-optimal-brain-health-in-adults-a-presidential-advisory-from-the-american-heart-association-american-stroke-association
#12
REVIEW
Philip B Gorelick, Karen L Furie, Costantino Iadecola, Eric E Smith, Salina P Waddy, Donald M Lloyd-Jones, Hee-Joon Bae, Mary Ann Bauman, Martin Dichgans, Pamela W Duncan, Meighan Girgus, Virginia J Howard, Ronald M Lazar, Sudha Seshadri, Fernando D Testai, Stephen van Gaal, Kristine Yaffe, Hank Wasiak, Charlotte Zerna
Cognitive function is an important component of aging and predicts quality of life, functional independence, and risk of institutionalization. Advances in our understanding of the role of cardiovascular risks have shown them to be closely associated with cognitive impairment and dementia. Because many cardiovascular risks are modifiable, it may be possible to maintain brain health and to prevent dementia in later life. The purpose of this American Heart Association (AHA)/American Stroke Association presidential advisory is to provide an initial definition of optimal brain health in adults and guidance on how to maintain brain health...
October 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28882330/combining-muscle-synergies-and-biomechanical-analysis-to-assess-gait-in-stroke-patients
#13
Filipe O Barroso, Diego Torricelli, Francisco Molina-Rueda, Isabel M Alguacil-Diego, Roberto Cano-de-la-Cuerda, Cristina Santos, Juan C Moreno, Juan C Miangolarra-Page, José L Pons
The understanding of biomechanical deficits and impaired neural control of gait after stroke is crucial to prescribe effective customized treatments aimed at improving walking function. Instrumented gait analysis has been increasingly integrated into the clinical practice to enhance precision and inter-rater reliability for the assessment of pathological gait. On the other hand, the analysis of muscle synergies has gained relevance as a novel tool to describe the neural control of walking. Since muscle synergies and gait analysis capture different but equally important aspects of walking, we hypothesized that their combination can improve the current clinical tools for the assessment of walking performance...
August 20, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28878570/some-applications-of-mathematics-in-golf
#14
REVIEW
S R Otto
At its core, like many other sports, golf is a game of integers. The minimization of the number of strokes played is generally what determines the winner, whether each of these are associated with the shortest of putts or the longest of drives. The outcomes of these shots are influenced by very slight changes, but hopefully in a deterministic sense. Understanding the mechanics of golf necessitates the development of models and this is coupled more often than not to the use of statistics. In essence, the individual aspects of the sport can be modelled adequately via fairly simplistic models, but the presence of a human at one end of the kinematic chain has a significant impact on the variability of the entire process...
August 2017: Proceedings. Mathematical, Physical, and Engineering Sciences
https://www.readbyqxmd.com/read/28872819/a-facile-approach-to-prepare-tough-and-responsive-ultrathin-physical-hydrogel-films-as-artificial-muscles
#15
Ye Tian, Xiaoshuang Wei, Zhi Jian Wang, Pengju Pan, Fangyuan Li, Daishun Ling, Zi Liang Wu, Qiang Zheng
We report a facile approach to prepare ultrathin physical hydrogel films based on the Marangoni effect, which drives an ethanol solution of poly(stearyl acrylate-co-acrylic acid) (P(SA-co-AAc)) to rapidly spread on the water surface. The subsequent solvent exchange leads to sol-gel transition, where the long alkyl chains of SA units segregate to form physical cross-linking junctions. The resultant disk-shaped single-network (SN) gel films are uniform with tunable thickness (40-80 μm) and diameter (5-12 cm) and possess robust mechanical properties with tensile breaking stress, σb, and breaking strain, εb, being 0...
October 4, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28857693/stroke-while-driving-frequency-and-association-with-automobile-accidents
#16
Joji Inamasu, Masashi Nakatsukasa, Kazuhiro Tomiyasu, Keita Mayanagi, Masaaki Nishimoto, Takeo Oshima, Masami Yoshii, Satoru Miyatake, Akira Imai
Background Cardiovascular events while driving have occasionally been reported. In contrast, there have been few studies on stroke while driving. Aim The objectives of this study were to (1) report the frequency of stroke while driving and (2) evaluate its association with automobile accidents. Methods Clinical data prospectively acquired between January 2011 and December 2016 on 2145 stroke patients (1301 with ischemic stroke, 585 with intracerebral hemorrhage, and 259 with subarachnoid hemorrhage) were reviewed to identify patients who sustained a stroke while driving...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28856834/disparities-in-hypertension-and-cardiovascular-disease-in-blacks-the-critical-role-of-medication-adherence
#17
REVIEW
Keith C Ferdinand, Kapil Yadav, Samar A Nasser, Helene D Clayton-Jeter, John Lewin, Dennis R Cryer, Fortunato Fred Senatore
Blacks are two to three times as likely as whites to die of preventable heart disease and stroke. Declines in mortality from heart disease have not eliminated racial disparities. Control and effective treatment of hypertension, a leading cause of cardiovascular disease, among blacks is less than in whites and remains a challenge. One of the driving forces behind this racial/ethnic disparity is medication nonadherence whose cause is embedded in social determinants. Eight practical approaches to addressing medication adherence with the potential to attenuate disparities were identified and include: (1) patient engagement strategies, (2) consumer-directed health care, (3) patient portals, (4) smart apps and text messages, (5) digital pillboxes, (6) pharmacist-led engagement, (7) cardiac rehabilitation, and (8) cognitive-based behavior...
October 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28832532/the-potential-of-targeting-brain-pathology-with-ascl1-mash1
#18
REVIEW
Bor Luen Tang
The proneural factor Achaete-scute complex-like 1 (Ascl1/Mash1) acts as a pioneering transcription factor that initializes neuronal reprogramming. It drives neural progenitors and non-neuronal cells to exit the cell cycle, and promotes neuronal differentiation by activating neuronal target genes, even those that are normally repressed. Importantly, force-expression of Ascl1 was shown to drive proliferative reactive astroglia formed during stroke and glioblastoma stem cells towards neuronal differentiation, and this could potentially diminish CNS damage resulting from their proliferation...
August 23, 2017: Cells
https://www.readbyqxmd.com/read/28818257/high-risk-carotid-plaque-lessons-learned-from-histopathology
#19
REVIEW
Frank D Kolodgie, Kazuyuki Yahagi, Hiroyoshi Mori, Maria E Romero, Hugh H Trout, Aloke V Finn, Renu Virmani
The pathophysiology and natural history of atherosclerotic carotid disease is predicated on a more extensive knowledge of lesion progression gained in the studies conducted in the coronary arteries, and these will be reviewed. While the precise sequence of lesion progression leading to carotid plaque vulnerability and cerebrovascular events remain less well understood, specific early and more advanced progressive lesion morphologies associated with stroke risk have been characterized. Of late, there has been a conscious effort for stroke prevention in symptomatic and asymptomatic patients to move beyond luminal stenosis as the only guidance to predict future cerebrovascular events...
March 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28814040/training-wrist-extensor-function-and-detecting-unwanted-movement-strategies-in-an-emg-controlled-visuomotor-task
#20
Mingxing Lyu, Charles Lambelet, Daniel Woolley, Xue Zhang, Weihai Chen, Xilun Ding, Roger Gassert, Nicole Wenderoth
Stroke patients often suffer from severe upper limb paresis. Rehabilitation treatment typically targets motor impairments as early as possible, however, muscular contractions, particularly in the wrist and fingers, are often too weak to produce overt movements, making the initial phase of rehabilitation training difficult. Here we propose a new training tool whereby electromyographic (EMG) activity is measured in the wrist extensors and serves as a proxy of voluntary corticomotor drive. We used the Myo armband to develop a proportional EMG controller which allowed volunteers to perform a simple visuomotor task by modulating wrist extensor activity...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
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