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Long-term Results of Per-oral Endoscopic Myotomy Carried out within the Endoscopy System With Students.
Background. People with Parkinson's disease and freezing of gait (FOG+) have more falls, postural instability and cognitive impairment compared with FOG-. Objective. To conduct a secondary analysis of the V-TIME study, a randomized, controlled investigation showing a greater reduction of falls after virtual reality treadmill training (TT + VR) compared with usual treadmill walking (TT) in a mixed population of fallers. We addressed whether these treadmill interventions led to similar gains in FOG+ as in FOG-. Methods. A total of 77 FOG+ and 44 FOG- were assigned randomly to TT + VR or TT. Participants were assessed pre- and posttraining and at 6 months' follow-up. Main outcome was postural stability assessed by the Mini Balance Evaluation System Test (Mini-BEST) test. Falls were documented using diaries. Other outcomes included the New Freezing of Gait Questionnaire (NFOG-Q) and the Trail Making Test (TMT-B). Results. Mini-BEST scores and the TMT-B improved in both groups after training (P = .001), irrespective of study arm and FOG subgroup. However, gains were not retained at 6 months. Both FOG+ and FOG- had a greater reduction of falls after TT + VR compared with TT (P = .008). NFOG-Q scores did not change after both training modes in the FOG+ group. Conclusions. Treadmill walking (with or without VR) improved postural instability in both FOG+ and FOG-, while controlling for disease severity differences. As found previously, TT + VR reduced falls more than TT alone, even among those with FOG. Interestingly, FOG itself was not helped by training, suggesting that although postural instability, falls and FOG are related, they may be controlled by different mechanisms.Objective Previous studies analyzing the factor structure of the Rey Auditory Verbal Learning Test (RAVLT) have been limited in the number of scores included in the analysis. Often, they lacked inclusion of process scores that have been shown to add predictive value in identifying future cognitive decline. Therefore, the goal of the current study was to determine the factor structure of the RAVLT utilizing factor scores including serial position effects, repetitions, and intrusion errors, and to examine if the factor structure for older adults is similar to that found in the entire lifespan sample.Method Exploratory factor analysis (EFA) was conducted on 718 participants (age 16-85 years) from the Nathan Kline Institute (NKI)-Rockland project. Confirmatory factor analyses (CFA) of a reduced model of the EFA was conducted on the entire sample and an older (ages 55-85 years; n = 265) and a younger (less than 55 years of age; n = 453) subsample.Results EFA indicated three factors Memory, Attention/Learning, and Inaccurate Memory (i.e., repetitions and intrusions). CFA of a reduced model indicated adequate fit in the entire sample and older subsample, and good fit in the younger subsample.Conclusion The present study examined the factor structure of the RAVLT in a large lifespan sample utilizing a larger set of RAVLT scores than have been examined in prior studies, including total scores and process scores. The same factors were identified in the entire lifespan sample and the younger and older adult subsamples, although similar to previous studies, measures of model fit were less robust in the older adult subsample. These results provide additional support for the error scores (e.g., intrusions and repetitions) as separable from other aspects of learning and memory.Post-traumatic stress disorder (PTSD), anxiety, and depression are seen in parents and children following critical illness. Whether this exists in parents and children following pediatric stroke has not been thoroughly studied. We examined emotional outcomes in 54 mothers, 27 fathers, and 17 children with stroke. Parents of children 0-18 years and children 7-18 years who were within 2 years of stroke occurrence were asked to complete questionnaires to determine their emotional outcomes. Of participating mothers, 28% reported PTSD, 26% depression, and 4% anxiety; in fathers, 15% reported PTSD, 24% depression, and none reported anxiety. Further, children reported significant emotional difficulty, with 24% having depression, 14% anxiety, and 6% PTSD by self-report ratings. Maternal PTSD, anxiety and depression, and paternal anxiety were all negatively associated with the child's functional outcome. see more Clinically significant anxiety (based on clinical thresholds) was not found in fathers; however, continuous scores were still analyzed for association between subclinical anxiety and functional outcome, which revealed a statistically significant association between more reported symptoms and higher Recovery and Recurrence Questionnaire scores. Prevalence of PTSD and depression are greater in parents compared to the general population in this preliminary study.There is a gap in measured microbial diversity when comparing genomic sequencing techniques versus cultivation from environmental samples in a laboratory setting. Standardized methods in artificial environments may not recapitulate the environmental conditions that native microbes require for optimal growth. For example, the intestinal tract houses microbes at various pH values as well as minimal oxygen and light environments. These microbes are also exposed to an atypical source of carbon dietary fiber compacted in fecal matter. To investigate how the addition of insoluble fiber to isolation media could affect the cultivation of microbes from zebrafish intestines, an isolate library was built and analyzed using the bioinformatics pipeline IDBac. While all isolation media encouraged the growth of species from several phyla, the extent of growth was greater with the addition of fiber allowing for easier isolation. Furthermore, fiber addition altered the metabolism of the cultivated gut-derived microbes and induced the production of unique metabolites that were not produced when microbes were otherwise grown on standard isolation media. Addition of this inexpensive carbon source to the media supported the cultivation of a diverse community whose secondary metabolite production may more closely replicate their metabolite production in vivo.
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