Spearsbullard1814

To establish the reliability and construct validity of two French-Canadian versions of assessment tools for manual (MWC) and powered wheelchair (PWC) users with autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) the Wheelchair Skills Test Questionnaire (WST-Q-F) version 5.0 and the Wheelchair Use Confidence Scale (WheelCon-F) Short Form.

We recruited 32 MWC and PWC users with ARSACS aged between 34 and 64 years. Participants completed measures twice within 2 weeks for test-retest reliability and to determine the standard error of measurement. Construct validity was established by verifying hypothesized relationships between wheelchair use scores and other variables regarding personal factors, body functions, and activities. Participants' scores were also compared with those of MWC and PWC users with other diagnoses to explore known-groups validity.

Adequate to excellent test-retest reliability values were found for all questionnaires (intraclass correlation coefficients between 0.506 andlinical practice and are recommended for future research in adults with ARSACS. These outcome tools may be especially useful to measure the effects of a wheelchair training program.Background Providing effective education to students with autism spectrum disorder (ASD) poses a significant challenge to educators. Although several evidence-based practices (EBPs) have been developed, few have been systematically implemented in educational settings. Pivotal response treatment (PRT) is a naturalistic behavioral intervention that has been adapted for implementation in the school context. Methods This pilot study used a concurrent multiple baseline design across seven teachers and students with ASD to examine the effectiveness of teacher training in classroom pivotal response teaching (CPRT) on teacher fidelity of implementation during small-group instruction and students' communication skills and maladaptive behaviors in schools for special education in the Netherlands. Results Results indicated no replicated effect of CPRT training on teachers' fidelity of implementation or children's communications skills and maladaptive behavior, although teachers reported high satisfaction with the CPRT training. Discussion Implications for clinical practice and directions for future research are discussed.The Kinect video game (KVG) has received attention as an intervention method for cerebral palsy (CP). However, evidence remains limited.

To investigate the effects of training using Xbox Kinect on lower extremity motor function, balance, and gait in adolescents with spastic diplegia CP.

This study was a pilot randomized controlled trial. selleck chemical Ten participants were randomly allocated to either the KVG training group (n=5) or the conventional training (CT) group (n=5). The Selective Control Assessment of the Lower Extremity (SCALE) tool, Pediatric Balance Scale (PBS), and GAITRite were used for the outcome measurements.

In the comparison between the groups, the KVG group showed significant improvements in all the items in the SCALE (except for right hip abduction) and PBS score as compared with the CT group.

KVG training might be an effective intervention for the rehabilitation of adolescents with spastic diplegia CP.

KVG training might be an effective intervention for the rehabilitation of adolescents with spastic diplegia CP.Juvenile xanthogranuloma (JXG) is the most common non-Langerhans cell histiocytic disorder in children. This report describes the case of a 28-day-old boy that presented with multiple subcutaneous nodular lesions on the trunk and extremities, and multiple red nodular lesions on the scrotum. Magnetic resonance imaging (MRI) of the brain showed a well-demarcated extra-axial dura-based mass that appeared isointense or slightly hyperintense on T1-weighted images, hypointense on T2-weighted images and had intense enhancement on gadolinium-enhanced T1-weighted images. Computed tomography (CT) or MRI scans of the chest and abdomen revealed multiple scattered nodular or patchy lesions of varying sizes in the lungs, liver and left kidney. Histological analysis of a subcutaneous mass suggested JXG. The patient was diagnosed with neonatal systemic JXG with involvement of the central nervous system, lungs, liver, kidneys, subcutaneous soft tissue and skin. CT and MRI after 3 months of treatment with methylprednisolone sodium succinate demonstrated that the lesions were obviously diminished. This report discusses the imaging findings in this current case of multi-organ JXG and reviews the imaging literature on this condition to improve awareness of the lesions in order to help radiologists establish an accurate differential diagnosis when confronted with similar cases.The outbreak of coronavirus disease 2019 (COVID-19) has posed a serious threat to public health. There is an urgent need for discovery methods for the prevention and treatment of COVID-19 infection. Understanding immunogenicity together with immune responses are expected to provide further information about this virus. We hope that this narrative review article may create new insights for researchers to take great strides toward designing vaccines and novel therapies in the near future. The functional properties of the immune system in COVID-19 infection is not exactly clarified yet. This is compounded by the many gaps in our understanding of the SARS-CoV-2 immunogenicity properties. Possible immune responses according to current literature are discussed as the first line of defense and acquired immunity. Here, we focus on proposed modern preventive immunotherapy methods in COVID-19 infection.An organized and dynamic cytoskeleton is required for platelet formation and function. Formins are a large family of actin regulatory proteins which are also able to regulate microtubule dynamics. There are four formin family members expressed in human and mouse megakaryocytes and platelets. We have previously shown that the actin polymerization activity of formin proteins is required for cytoskeletal dynamics and platelet spreading using a small molecule inhibitor. In the current study, we analyze transgenic mouse models deficient in two of these proteins, mDia1 and Fhod1, along with a model lacking both proteins. We demonstrate that double knockout mice display macrothrombocytopenia which is due to aberrant megakaryocyte function and a small decrease in platelet lifespan. Platelet function is unaffected by the loss of these proteins. This data indicates a critical role for formins in platelet and megakaryocyte function.Macular tears rarely occur without trauma. Here, we describe a patient with vitreous haemorrhage, which was caused by an unusual giant macular tear secondary to existing branch retinal vein occlusion. A 60-year-old woman presented with vision loss in the right eye because of vitreous haemorrhage. She had a history of branch retinal vein occlusion and had been treated with retinal photocoagulation 3 years prior. As treatment for vitreous haemorrhage, the patient underwent 23-gauge pars plana vitrectomy combined with silicone oil tamponade. During the operation, a large jagged tear was observed in the macula. We presumed that stretching of the fibrous proliferating membrane secondary to branch retinal vein occlusion was responsible for the macular tear and vitreous haemorrhage. Eventually, the results of pars plana vitrectomy led to anatomical closure of the macular tear and partial restoration of visual acuity.Displacement and embolization of the stent is one of the major complications of right ventricular outflow tract (RVOT) stenting. Since embolized stents cannot be retrieved percutaneously as they cannot be crimped into pre-stenting state (unlike duct occluders and septal devices, which can be pulled back into the sheath), surgery remains the gold standard treatment. We describe a hybrid approach for the retrieval of the embolized RVOT stent, which will decrease morbidity when compared to the standard surgical approach that is otherwise required.

The incidence of gliomas is increasing in elderly patients. Clinical factors, such as age, performance status, and comorbidities contribute when choosing adequate treatment in older patients.

This review covers the main pathological and molecular features of gliomas in elderly patients, as well as the neurological and geriatric assessment to select patients for surgery and antineoplastic treatments. The results from the most relevant clinical trials in both lower-grade (LGGs) and high-grade gliomas (HGGs) are reviewed.

Different clinical and biological factors need to be integrated into prognostic scales in order to better stratify the elderly population. Both Stupp and Perry regimens can be proposed to fit patients with GBM aged < 70years. Conversely, for patients aged ≥ 70years, the Perry regimen should be preferred. For unfit and frail patients, temozolomide alone when MGMT is methylated or hypofractionated RT alone when MGMT is unmethylated, are the optimal choice. Few data are available regarding the optimal management of elderly patients with LGGs. The benefit of an extensive resection and presence of methylation of the MGMT promoter need to be further investigated to confirm their role in improving the OS.

Different clinical and biological factors need to be integrated into prognostic scales in order to better stratify the elderly population. Both Stupp and Perry regimens can be proposed to fit patients with GBM aged less then 70 years. Conversely, for patients aged ≥ 70 years, the Perry regimen should be preferred. For unfit and frail patients, temozolomide alone when MGMT is methylated or hypofractionated RT alone when MGMT is unmethylated, are the optimal choice. Few data are available regarding the optimal management of elderly patients with LGGs. The benefit of an extensive resection and presence of methylation of the MGMT promoter need to be further investigated to confirm their role in improving the OS.

Within the hyperthermia community, consensus exists that clinical outcome of the treatment radiotherapy and/or chemotherapy plus hyperthermia (i.e. elevating tumor temperature to 40 - 44 °C) is related to the applied thermal dose; hence, treatment quality is crucial for the success of prospective multi-institution clinical trials. Currently, applicator quality assurance (QA) measurements are implemented independently at each institution using basic cylindrical phantoms. A multi-institution comparison of heating quality using magnetic resonance thermometry (MRT) and anatomical representative anthropomorphic phantoms provides a unique opportunity to obtain novel QA insights to facilitate multi-institution trial evaluation.

Perform a systematic QA procedure to compare the performance of MR-compatible hyperthermia systems in five institutions.

Anthropomorphic phantoms, including pelvic and spinal bones, were produced. Clinically relevant power of 600 watts was applied for ∼12 min to allow for 8 sequential Mrands. Comparable heating profiles are shown for the five evaluated institutions. Subcentimeter differences in position substantially affected the results when evaluating the heating patterns. Integration of advanced phantoms and precise positioning in QA-guidelines should be evaluated to guarantee the best quality patient care.