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Efficacy and safety of venous angioplasty of the extracranial veins for multiple sclerosis. Brave dreams study (brain venous drainage exploited against multiple sclerosis): study protocol for a randomized controlled trial.

BackgroundMultiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system with a disabling progressive course. Chronic cerebrospinal venous insufficiency (CCSVI) has recently been described as a vascular condition characterized by restricted venous outflow from the brain, mainly due to blockages of the internal jugular and azygos veins. Despite a wide variability among studies, it has been found to be associated with MS. Data from a few small case series suggest possible improvement of the clinical course and quality of life by performing percutaneous ball

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… All pharmacological or rehabilitative treatments (motor reeducation and balance, walking and cognitive training), carried out during the study and in the six months previous randomization will be recorded in the e-CRF. …

Root causes of errors in a simulated prehospital pediatric emergency.

OBJECTIVES: Systematic evaluation of prehospital provider performance during actual resuscitations is difficult. Although prior studies reported pediatric drug-dosing mistakes and other types of management errors, the underlying causes of those errors were not investigated. The objective of this study was to identify causes of errors during a simulated, prehospital pediatric emergency. METHODS: Two-person emergency medical services (EMS) crews from five geographically diverse agencies participated in a validated simulation of an infant with altered mental status, seizures, and respiratory arr

Association of the Resident Assessment Instrument (RAI) with changes in function, cognition, and psychosocial status.

OBJECTIVE: To evaluate the impact of the Resident Assessment Instrument (RAI) on changes in nursing home residents' functional status, cognitive status, and psychosocial well-being. DESIGN: A quasi-experiment involving the collection of longitudinal data on two cohorts of nursing home residents. One cohort was assessed before the implementation of the RAI, and the other was assessed after the implementation of the new assessment process. SETTING AND PARTICIPANTS: Over 2000 nursing home residents in 267 nursing homes located in 10 geographic areas were assessed during the pre-RAI period. In t

Paediatric Audiology: An analysis of stakeholder perspectives on advancement in Early Hearing Detection and Intervention for deaf infants in Nigeria.

BACKGROUND: Early Hearing Detection and Intervention (EHDI) plays a critical role in improving language, cognitive, and socio-emotional outcomes for infants with hearing loss. In Nigeria, however, EHDI implementation remains limited by fragmented service delivery, uneven technological capacity, and sociocultural factors that delay timely diagnosis. This study explored the perspectives of paediatric audiologists and parents to provide a comprehensive understanding of the opportunities and challenges influencing early hearing care across diverse Nigerian settings. METHODS: A mixed-methods desig

Predictive Value of Machine Learning and Nomogram Models Based on Brain Amyloid SUVR in Alzheimer's Disease.

RATIONALE AND OBJECTIVES: This study aimed to develop machine learning and nomogram models based on brain amyloid standardized uptake value ratio (SUVR) for the prediction of Alzheimer's disease (AD). Least absolute shrinkage and selection operator (LASSO) regression was employed to identify key brain regions associated with amyloid SUVR, which were then integrated into a composite SUVR_Score. A nomogram model was subsequently constructed to support clinical decision-making. METHODS: A total of 751 subjects diagnosed with either cognitively normal (CN; n=550) or Alzheimer's disease (AD; n=201

Functional near-infrared spectroscopy (fNIRS) in patients with major depressive disorder, generalized anxiety disorder and their comorbidity: Comparison with healthy controls.

BACKGROUND: This study aimed to investigate prefrontal function in patients with generalized anxiety disorder (GAD), major depressive disorder (MDD), and the comorbidity of MDD and GAD (CMG), using the fNIRS-VFT task. And to assess the reliability of functional near-infrared spectroscopy (fNIRS) devices as a clinical aid for diagnostic tools when performing cognitive tasks by building a deep neural network. METHODS: Including 75 patients with GAD, 75 patients with MDD, 71 patients with CMG, and 75 healthy controls (HC). In the verbal fluency test, hemodynamic responses in the prefrontal corte

Comparing the effects of augmented virtual reality treadmill training versus conventional treadmill training in patients with stage II-III Parkinson's disease: the VIRTREAD-PD randomized controlled trial protocol.

BACKGROUND: Intensive treadmill training (TT) has been documented to improve gait parameters and functional independence in Parkinson's Disease (PD), but the optimal intervention protocol and the criteria for tailoring the intervention to patients' performances are lacking. TT may be integrated with augmented virtual reality (AVR), however, evidence of the effectiveness of this combined treatment is still limited. Moreover, prognostic biomarkers of rehabilitation, potentially useful to customize the treatment, are currently missing. The primary aim of this study is to compare the effects on ga

Orthogeriatric Assessment of the Elderly Patient with Fragility Hip Fracture: Preliminary Results of a Prospective Study.

Nowadays, more studies deal with "OrthoGeriatrics", for the co-management of elderly patients suffering fractures, from the admission to the discharge and beyond. For the first time at Cagliari University Hospital, we introduced an orthogeriatric service, in which trained geriatricians stay in orthopedic unit alongside trained orthopedics. The primary aim of the study was to analyze the rate of death and rehospitalization in elderly femur-fractured people of 65 or more years of age, identifying possible predictive factors. The secondary aim of the study was to analyze the recovery of daily liv

Monitoring at-home prosthesis control improvements through real-time data logging.

Objective.Validating the ability for advanced prostheses to improve function beyond the laboratory remains a critical step in enabling long-term benefits for prosthetic limb users.Approach.A nine week take-home case study was completed with a single participant with upper limb amputation and osseointegration to better understand how an advanced prosthesis is used during daily activities. The participant was already an expert prosthesis user and used the Modular Prosthetic Limb (MPL) at home during the study. The MPL was controlled using wireless electromyography (EMG) pattern recognition-based

Timing is everything: Clinical courses of Hunter syndrome associated with age at initiation of therapy in a sibling pair.

Hunter syndrome, or mucopolysaccharidosis (MPS) II, is a rare lysosomal disorder characterized by progressive, multi-system disease. As most symptoms cannot be reversed once established, early detection and treatment prior to the onset of clinical symptoms are critical. However, it is difficult to identify affected individuals early in disease, and therefore the long-term outcomes of initiating treatment during this optimal time period are incompletely described. We report long-term clinical outcomes of treatment when initiated prior to obvious clinical signs by comparing the courses of two si

The Effectiveness of Remote Exercise Rehabilitation Based on the "SCeiP" Model in Homebound Patients With Coronary Heart Disease: Randomized Controlled Trial.

BACKGROUND: While exercise rehabilitation is recognized as safe and effective, medium- to long-term compliance among patients with coronary heart disease (CHD) remains low. Therefore, promoting long-term adherence to exercise rehabilitation for these patients warrants significant attention. OBJECTIVE: This study aims to investigate the impact of remote exercise rehabilitation on time investment and related cognitive levels in homebound patients with CHD. This study utilizes the SCeiP (Self-Evaluation/Condition of Exercise-Effect Perception-Internal Drive-Persistence Behavior) model, alongside

Communication support in care homes for older adults: Views and reported practices of speech and language therapists and care home activities staff in the UK.

BACKGROUND: Speech and language therapists (SLTs) and care home activities staff play key roles in managing and supporting the communication needs of older residents in care homes. However, the current practice and perspectives of these two professions in the United Kingdom has not been examined. AIMS: To investigate the practice patterns and views of SLTs and activities staff working in UK care homes for older adults in relation to residents' communication needs. METHODS AND PROCEDURES: Two online surveys, with 63 questions (SLT survey) and 46 questions (activities staff survey) in total, w

Factors Influencing the Adoption of a Patient Decision Aid Development Platform: A Qualitative Study.

UNLABELLED: Background. Developing patient decision aids (PtDAs) requires considerable resources. We aimed to create a digital platform to streamline the process and investigate stakeholder perceptions of factors influencing the adoption of a mock-up of the platform. Methods. Using the Framework for Innovation, a design team developed an alpha version of the platform, with support from an advisory panel. A convenience sample of key stakeholders involved in the development of PtDAs, who were fluent in English, French, or Spanish, reviewed the mock-up in think-aloud sessions and answered open-en

Perceived Racism, Brain Development, and Internalizing and Externalizing Symptoms: Findings From the ABCD Study.

OBJECTIVE: Racial discrimination drives health disparities among racial/ethnic minority youth, creating chronic stress that affects brain development and contributes to mental and behavioral health issues. This study analyzed data from the Adolescent Brain Cognitive Development℠ (ABCD) Study to examine the neurobiological mechanisms linking discrimination to mental and behavioral health outcomes. METHOD: A sample of 3,321 racial/ethnic minority youth was split into training (80%, n = 2,674) and testing (20%, n = 647) groups. Propensity score-weighted machine learning was used to assess the ef

Efficacy of Digital Dance on Brain Imagery, Cognition, and Health: Randomized Controlled Trial.

BACKGROUND: Multidomain interventions have demonstrable benefits for promoting healthy aging, but self-empowerment strategies to sustain long-term gains remain elusive. OBJECTIVE: This study evaluated the effects of digital somatosensory dance game participation on brain imagery changes as primary outcomes and other physical and mental health measures as secondary outcomes related to healthy aging. METHODS: Between August 31, 2020, and June 27, 2021, this randomized controlled trial recruited 60 eligible participants older than 55 years with no recent engagement in digital dance games. A com

Examining Predictors of Depression and Anxiety Symptom Change in Cognitive Behavioral Immersion: Observational Study.

BACKGROUND: Depressive and anxiety disorders are the most common mental disorders, and there is a critical need for effective, affordable, and accessible interventions. Cognitive Behavioral Immersion (CBI) is a novel group-based cognitive behavioral skills training program delivered by lay coaches in the metaverse that can be accessed through various modalities including virtual reality (VR) head-mounted displays or flat-screen devices. Combining its ability to offer empirically supported therapy skills in a digital setting that can still facilitate interpersonal variables (eg, working allianc

Efficacy of Behavioural Intervention, Antipsychotics, and Alpha Agonists in the Treatment of Tics Disorder in Tourette's Syndrome.

Tourette's Syndrome (TS), in which patients have sudden, repeated, involuntary twitches and movements, called tics, is a condition of the nervous system. They can be motor, vocal, simple, or complex tics. It can be physically, emotionally, mentally, and socially distressing and challenging for those suffering from it. Usually, it is accompanied by various comorbidities like attention-deficit hyperactivity disorder, obsessive-compulsive disorder, and sleep disorders. A variety of environmental and genetic factors are also associated with tics in TS like the first-degree relatives are more at ri

The emerging contribution of speech and language therapists in awake craniotomy: a national survey of their roles, practices and perceptions.

BACKGROUND: Awake craniotomy with electrical stimulation has become the gold standard for tumour resection in eloquent areas of the brain. Patients' speech during the procedure can inform the intervention and evidence for language experts to support the procedure is building. Within the UK a burgeoning speech and language therapist awake craniotomy network has emerged to support this practice. Further evidence is needed to underpin the specific contribution of speech and language therapists working within the awake craniotomy service. AIMS: To investigate and analyse the current practices of

Hearing, self-motion perception, mobility, and aging.

Hearing helps us know where we are relative to important events and objects in our environment and it allows us to track our changing position dynamically over space and time. Auditory cues are used in combination with other sensory inputs (visual, vestibular, proprioceptive) to help us perceive our own movements through space, known as self-motion perception. Whether we are maintaining standing balance, walking, or driving, audition can provide unique and important information to help optimize self-motion perception, and consequently to support safe mobility. Recent epidemiological and experi

The impact of nUrsiNg DEliRium Preventive INnterventions in the Intensive Care Unit (UNDERPIN-ICU): A study protocol for a multi-centre, stepped wedge randomized controlled trial.

BACKGROUND: Delirium is a common disorder in Intensive Care Unit (ICU) patients and is associated with serious short- and long-term consequences, including re-intubations, ICU readmissions, prolonged ICU and hospital stay, persistent cognitive problems, and higher mortality rates. Considering the high incidence of delirium and its consequences, prevention of delirium is imperative. This study focuses on a program of standardized nursing and physical therapy interventions to prevent delirium in the ICU, called UNDERPIN-ICU (nUrsiNg DEliRium Preventive INterventions in the ICU). OBJECTIVE: To d