Randomized Trial of Two Exercise Programs to Increase Physical Activity and Health-Related Quality of Life for Persons With Spinal Cord Injury.

Objectives: To compare the effectiveness of two different interventions that promote physical activity in individuals with traumatic spinal cord injury (SCI) and determine the effect of relapse prevention.

Methods: A sequential, multiple assignment, randomized trial was conducted at a universally designed community-based exercise facility. Participants were individuals with traumatic SCI, >3 months post injury, levels C5 to T12, age ≥18 years ( = 79).

Exploratory examination of the scale structure of the Moorong Self-Efficacy Scale: Application of Rasch Measurement Theory.

Objective: Exploratory application of the Rasch Measurement (RM) Model for evidence for reproducibility, conceptual/content validity, and structural validity of the Moorong Self-Efficacy Scale (MSES).

Study Design: Secondary RM analysis of data collected in a randomized controlled trial comparing two exercise interventions for persons living with spinal cord injury (SCI).

Setting: Community-dwelling persons living with SCI enrolled in an exercise study.

High ionic strength dissociation assay reduces dimeric target interference in immunogenicity testing.

The presence of di-/multi-meric forms of soluble target in biological samples can interfere in anti-drug antibody (ADA) assays, leading to increased background values and potentially false positivity. The authors investigated the use of the high ionic strength dissociation assay (HISDA) to reduce target interference in two different ADA assays. Interference caused by homodimeric FAP was successfully eliminated to enable cut point determination after applying HISDA.

Prognosis of Individual-Level Mobility and Self-Care Stroke Recovery During Inpatient Rehabilitation, Part 1: A Proof-of-Concept Single Group Retrospective Cohort Study.

Objective: To demonstrate feasibility of generating predictive short-term individual trajectory recovery models after acute stroke by extracting clinical data from an electronic medical record (EMR) system.

Design: Single-group retrospective patient cohort design.

Setting: Stroke rehabilitation unit at an independent inpatient rehabilitation facility (IRF).

Prognosis of Individual-Level Mobility and Daily Activities Recovery From Acute Care to Community, Part 2: A Proof-of-Concept Single Group Prospective Cohort Study.

Objective: To demonstrate a proof-of-concept for prognostic models of post-stroke recovery on activity level outcomes.

Design: Longitudinal cohort with repeated measures from acute care, inpatient rehabilitation, and post-discharge follow-up to 6 months post-stroke.

Setting: Enrollment from a single Midwest USA inpatient rehabilitation facility with community follow-up.

Gait and Balance Outcome Measures Are Responsive in Severely Impaired Individuals Undergoing Inpatient Stroke Rehabilitation.

Objective: To investigate whether gait and balance outcome measures in patients with severe gait and balance impairments at admission to inpatient rehabilitation provided additional and meaningful information beyond customary measures. Specifically, this study investigated whether individuals who obtained low scores at admission exhibited improvements that exceeded the established minimal detectable change during inpatient rehabilitation. We also investigated whether gait outcomes would capture changes in function not identified by customary measures.

Exploiting the metabolic dependencies of the broad amino acid transporter SLC6A14.

Tumor cells typically enhance their metabolic capacity to sustain their higher rate of growth and proliferation. One way to elevate the nutrient intake into cancer cells is to increase the expression of genes encoding amino acid transporters, which may represent targetable vulnerabilities. Here, we study the regulation and function of the broad amino acid transporter SLC6A14 in combination with metabolic stress, providing insights into an uncharacterized aspect of the transporter activity.

Applying the Knowledge-to-Action Framework to Implement Gait and Balance Assessments in Inpatient Stroke Rehabilitation.

Objectives: The overall objectives of this project were to implement and sustain use of a gait assessment battery (GAB) that included the Berg Balance Scale, 10-meter walk test, and 6-minute walk test during inpatient stroke rehabilitation. The study objective was to assess the effect of the study intervention on clinician adherence to the recommendations and its effect on clinician perceptions and the organization.

Design: Pre- and post-training intervention study.

Commentary on the Challenges and Benefits of Implementing Standardized Outcome Measures.

The Institute of Medicine (now the National Academy of Medicine) has proposed a Learning Heath system (LHS) as a model to improve health care. A LHS focuses on capturing data from the clinical encounter and applying those data to improve practice. The process can be described as an iterative learning cycle composed of 3 areas: performance to data, data to knowledge, and knowledge to performance or often knowledge translation.

Participation by design: Integrating a social ecological approach with universal design to increase participation and add value for consumers.

Background: Physical activity is an essential component of a healthy lifestyle. Health clubs encourage sustained healthy lifestyles but are still largely not accessible to people with disabilities. Cost is a barrier for accessibility enhancements.

Measuring Value in Postacute Care.

The value of postacute care (PAC) is unclear. While experienced clinicians understand the appropriateness of each specific site of PAC, clear evidence-based guidelines are not available, and many referrals to PAC today are made based on bed availability rather than patient need. Measuring value (value=outcomes/cost) for the entire episode of care has been proposed as an effective method to both evaluate and enable faster innovation in care.

Imaging properties of small-pixel spectroscopic x-ray detectors based on cadmium telluride sensors.

Spectroscopic x-ray imaging by means of photon counting detectors has received growing interest during the past years. Critical to the image quality of such devices is their pixel pitch and the sensor material employed. This paper describes the imaging properties of Medipix2 MXR multi-chip assemblies bump bonded to 1 mm thick CdTe sensors.

Spectroscopic (multi-energy) CT distinguishes iodine and barium contrast material in MICE.

Objective: Spectral CT differs from dual-energy CT by using a conventional X-ray tube and a photon-counting detector. We wished to produce 3D spectroscopic images of mice that distinguished calcium, iodine and barium.

Methods: We developed a desktop spectral CT, dubbed MARS, based around the Medipix2 photon-counting energy-discriminating detector.

Susac's syndrome: neuropsychological characteristics in a young man.

A 29-year-old man developed vertigo, diplopia, confusion and spasticity. Brain biopsy revealed multifocal microinfarcts. Bilateral hearing loss and retinal microangiopathy were also noted.

Acoustic neurinoma presenting as subarachnoid hemorrhage. Case report.

A case of an acoustic neurinoma presenting as a subarachnoid hemorrhage is described. This is the second such case in the literature.

Computerized axial tomography of intracerebral hematoma. A clinical and neuropathological study.

Excellent correlation between computerized axial tomographic (CT) scans and the location and extent of pathologically verified intracerebral hematomas was demonstrated in eight patients. Superficial and intraventricular extension, hydrocephalus, and mass effect were easily identified; CT scanning was superior to angiography and radionuclide brain scanning in diagnosing hematoma and in determining its extent and associated ventricular size. Angiography was superior to CT scanning in demonstrating aneurysms and arteriovenous malformations as a cause of intracerebral hematoma.

Transient ischemic attacks.

The treatment of TIA must be individualized. TIA is one of several manifestations of generalized atherosclerosis. While one-third of patients with TIA will suffer a stroke in five years, one-half of the same group will die of myocardial infarction.

F-wave conduction velocity in Guillain-Barré syndrome. Assessment of nerve segment between axilla and spinal cord.

The F-wave conduction velocity (FWCV) in the central segment (axilla to spinal cord) of the median and ulnar nerves was compared to the motor nerve conduction velocity (MNCV) in the more distal segments in nine patients with mild cases of the Guillain-Barré syndrome. In four patients, FWCV was slow despite normal or borderline MNCV. In four others, both FWCV and MNCV were abnormal.

Amantadine in Parkinson's disease. A double-blind, placebo-controlled, crossover study with long-term follow-up.

A double-blind, placebo-controlled, crossover study with long-term follow-up of amantadien i- Parkinson's disease was performed on 26 patients. Other antiparkinsonian medications were discontinued in all but three patients. Amantadine resulted in a statistically significant 12 percent overall improvement over placebo.

Infantile neuroaxonal dystrophy. An electron microscopic study of a case clinically resembling neuronal ceroid-lipofuscinosis.

An unusual case of infantile neuroaxonal dystrophy (INAD) in which seizures were the presenting and predominant clinical feature is described. Although the clinical manifestations were indistinguishable from neuronal ceroid-lipofuscinosis, the diagnosis was readily established by electron microscopic examination of the brain biopsy specimen. Even after the ultrastructural features were known, the dystrophic axons were not evident by light microscopy.