Science topic

Stroke - Science topic

A group of pathological conditions characterized by sudden, non-convulsive loss of neurological function due to BRAIN ISCHEMIA or INTRACRANIAL HEMORRHAGES. Stroke is classified by the type of tissue NECROSIS, such as the anatomic location, vasculature involved, etiology, age of the affected individual, and hemorrhagic vs. non-hemorrhagic nature. (From Adams et al., Principles of Neurology, 6th ed, pp777-810)
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I was struggling with this situation. Common studies investigating the sEMG of post-stroke patients are focused on the muscles of the hand rather than the leg or the arm. Why?
I mean, I know that the hand muscles are more accessible, but how could we generalize that the processes happening in hand can be generalized to the rest of the body?
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One of the reason is may be: The Hand muscles have more precise contraction relaxation ability than the leg muscles.
But sEMG can be done in any limb muscles. Federico Roggio
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Need ECG image dataset for stroke prediction. Any public access database?
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Hello Sourav,
thank you for your response. I might then suggest to maybe first check this article: Deep Neural Networks Can Predict New-Onset Atrial Fibrillation From the 12-Lead ECG and Help Identify Those at Risk of Atrial Fibrillation–Related Stroke; as more than 25% of all strokes are deemed a result of AF, and ≈20% of strokes caused by AF occur in individuals not previously diagnosed with AF. That might be interesting article to read presenting comparison of patients at high risk for new-onset atrial fibrillation and no history of AF predicting future AF and stroke using deep learning model.
other useful article might be: Electrocardiographic abnormalities in acute cerebrovascular events in patients with/without cardiovascular disease.
this is review of 361 patients with results of the most common ECG abnormalities associated with stroke being T-wave abnormalities, prolonged QTc interval and arrhythmias.
You might need to read more and then separate patients with/without cardiovascular disease
Hope this would help
Filip
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Greetings!
I, Darshan Prakashbhai Parmar, MPT student, from Government Physiotherapy College Jamnagar, am conducting a survey on 'EFFICACY OF PELVIC PNF TO IMPROVE TRUNK CONTROL, BALANCE AND GAIT PATTERN IN NEUROLOGICAL CONDITIONS' as a part of my Evidence Based Study(EBS) under the supervision of my Guide, Dr. Karishma Jagad (MPT-NEURO), Sr. Lecturer at Government Physiotherapy College Jamnagar.
We therefore request physiotherapists practicing in India to kindly fill this questionnaire, which will hardly take around 10-15 minutes. The link for the survey is provided below. The responses will be kept anonymous.
I further request you to forward the link to your friends or colleagues.
*(In case the link does not open, please copy and paste the link in your web browser or you can whatsapp me on +917984377793, I will share the form link there.)*
Thank you for your time and participation.
Take care and stay safe
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answer submitted
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I have a stainless steel 2 mm thick raw material. A 3 diameter hole is to be punched into it. My punch is made of ASP2023 or HSS material. It is giving a life of only 3000 - 4000 strokes before chipping off.
Which is the best coating to be used to increase the life of my punch. The target punch life that I need is 70000.
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I am working on cortical stroke model. Prior to any experimentation, I need to group rats into right-handed and left-handed. I decided to apply the skilled reaching task (food reaching task) and I am following guidlines approved by previous published papers, yet I have not succeeded in training the rats and familiarization with the apparatus.
Has anyone worked with this test. Comments would be appreciated.
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Hi Fatemeh,
I do similar research for stroke rehabilitation purposes - are you trying the single pellet reaching task or the montoya staircase task? Usually both require several weeks of training to learn the task. Our standard protocol for training in the staircase task is 2 x 15 minute sessions/day, 5 days/week for 4 weeks. Over the last three days (6 sessions) we average how many pellets are successfully retrieved on left vs. right side and that's how we determine paw preference. For the single pellet task it is 1 session/day with 20 repetitions, 5 days/week for 4 weeks. Usually after a few days you start to see a trend for paw preference, and then you switch to training the preferred paw. You can shorten the training periods, but if you do that I would recommend continuous training (ex: 15 consecutive days). In both tasks rats are food controlled over the period of training (we maintain at ~90% of free feeding weight to ensure motivation for food retrieval). We use banana flavoured precision pellets in these tasks (45 mg from BioServ), the rats really seem to love them.
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How to manage anticoagulation in patient with hemorrhagic stroke and atrial fibrillation ?
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Actually It's very much rare association, commonly AF with Ischemic stroke,
but when hemorrhagic stroke with AF, we have to think about risk benefit ratio, considering HAS-BLED score & CHADVASc score. So far i know in that case anticoagulant must have STOP as because more chances of bleeding.
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I need one that has its validity, developers and year it was developed known.
Thank you
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Thank you @Sergiu Groppa
@Ndia Fatima
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Would you recommend starting iron supplement in a child with cyanotic congenital heart disease ( not corrected) as prophylaxis to decrease the risk of stroke even with normal blood indicies?
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I won't recommend iron supplements in cyanotic congenital heart disease
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According to your clinical experience, which approach you prefer in clinic and do you think that it is better than other one approach? (For Stroke patients only)
A top-down approach such as using task-specific interventions.
A bottom-up approach, using weight bearing, PNF, and NDT techniques
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about tennis stroke detection using wearable sensors data
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Hi Reza ,
if you mean this link:
the dataset consists of 27 different actions, and the number of tennis strokes are as follow:
(15) tennis right hand forehand (17) tennis serve
and for my research on 2019 , no , I did not find a dataset similar to what we generate.
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Some patient refer ocular pain pre stroke case
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Anyone with experience keeping MCAO mice with a small to medium infarct alive for more than a few days? Would like some insight into any pre or post-op care provided to the mice, especially immediately post-surgery.
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Look for any established pre/post-op monitoring guidelines from your university's animal care/welfare committees, those are really good for general monitoring. You could also reach out to the university vet
For immediate post-stroke care we ensure there is sufficient analgesic at wound sites so when they wake up they aren't scratching/irritating the wounds. We will often often give a subcutaneous injection of saline after surgery to ensure they're hydrated when they are recovering but disoriented and unable/unlikely to drink. Once back in their home cage we sprinkle rat chow in the bottom of the cage so that it's easily accessible, and make some wet mash - think crushed wet (softened) rat chow (easy to eat),often mixed with peanut butter or small seeds in a little plastic weigh boat. You can give additional subcutaneous saline injections if hydration is still an issue when monitoring.
For stroke animals we usually tag them with a risk level (low, moderate, high) which determines how frequently we are monitoring them (once/day vs. every few hours). This also lets the facility animal care team gauge how severe the expected impairments are and when the animals might require immediate attention.
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Hello !
We have one patient who presented pulmonary embolism and haemmorhagic stroke in same time.
So, anyone can help us for the management of anticoagulation ?
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This is a very challenging situation.
Can use sequential pneumatic compression for lower limbs. Also need to consider placement of an IVC filter if the patient has lower limb deep vein thrombosis.
Thereafter would discuss management of anticoagulation with a haematologist. Would then explain to the patient and their family the options for treatment and the potential risks and benefits.
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US health coverages exclude cognitive rehabilitation (CR) after stroke due to a lack of evidence of efficacy.
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I would like to measure the TTC stained mouse/Rat stroke brain infarct in a square millimeter area using ImageJ.
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This would be a great question to post in our new free medical imaging question and answer forum ( www.imagingQA.com ), there are number of histology and ImageJ experts in the community. If useful, please feel free to open a new topic at the link below :
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Where can I download the datasets used by ISLES challenges regarding stroke Lesion segmentation? It has not been possible for me to get it from its website. Or any other public dataset about this subject.
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Service Unavailable Reza Amini Gougeh
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Hi
I'm working in Diagnosis Location  of aphasia lesion of  Stroke patients and I need to  database of MRI images for aphasia Patients.
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Hi Driss,
You could check out the free datasets listed on www.imagingQA.com at the following link :
If you don't find what your looking for, its free to join so please open a new discussion topic (there are lots of data scientists and imaging specialists in the community) :
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Hello everyone..
I am master student on neurophysiotherapy and I am interesting on motor relearning program on stroke patients.. Can anyone kindly advice me about the best books about this subject?
It will really help me with my thesis...
Thanks on advance
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you can refer these two books
1) Steps to Follow: A Guide to the Treatment of Adult Hemiplegia: Based on the Concept of K. and B. Bobath
2) Starting Again: Early Rehabilitation After Traumatic Brain Injury Or Other Severe Brain Lesion: by Patricia M. Davies
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I know that an infant's brain can repair itself when damaged but why doesn't the same happen in adults after stroke or brain injuries?
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With Regenerative Medicine, using stem cells, the ongoing Programs are doing it, with good results and promising expectations.
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Do colleagues have any experience of patients who have lost colour vision after a traumatic brain injury or after a stroke
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Peter Gray Yes! Injury to occipital cortex often present with complete vision loss (achromatopsia) to classic red-green or blue-yellow defects (dyschromatopsia).
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I search researcher that evaluate the physical activity with wearable tracker ( possibly armband of bodymedia) during the first year post stroke. I have 40 patients actually and I wanted to make comparison with different environnement
Best.
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Please follow this link
Physical Activity and Exercise After Stroke | Stroke
https://www.ahajournals.org › STROKEAHA.114.004311
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I am studying MSc Public health . Related to my academic work I have to conduct a research.
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Please, target each of the objectives and think what are the questions can be asked to get information regarding the specific objective. Relate your objectives with the existing literatures. A draft questionnaire should pretest to make it final. Pretesting is much effective.
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There are a large number of articles using EEG and fMRI to study the evaluation and prediction of upper limb function of subjects after stroke, and there is a lack of research on lower limb function. Is it because EEG and fMRI are not suitable for studying lower limb function or are there any technical difficulties?(For example, it may be difficult for EEG to collect signals from brain regions that are in charge of lower limb functions?)
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In terms of recovery from brain injury such as stroke, recovery of upper limb function is more important than lower limb in terms of one's ability to successfully carry out activities of daily living. Partly as a result of this, most investigators studying recovery have focused on the upper limb.
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I would like to carry out this research in Mulago hospital-Uganda, however, I have not been able to find a standardised tool.
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Thank you!
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My friend is looking for coauthors in Psychology & Cognitive Neuroscience field. Basically you will be responsible for paraphrazing, creating figures, and collecting references for a variety of publications. Please leave your email address if you are interested. 10 hours a week is required as there is a lot of projects to be done!
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Dear all,
When I tried to run the ‘MR segment-normalize’ module of the Clinical Toolbox for SPM12, I got the following error:
###
12-May-2021 16:29:03 - Running ‘MR segment-normalize’
12-May-2021 16:29:03 - Failed ‘MR segment-normalize’
Undefined function ‘clinical_mrnormseg_job’ for input arguments of type ‘struct’.
In file “C:\Users\Neuroimager\Desktop\spm12\toolbox\Clinical-master\tbx_cfg_clinical.m” (???), function “clinical_local_mrnormseg” at line 319.
The following modules did not run: Failed: MR segment-normalize
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For more details of the information entered:
I would appreciate it very much if anyone could help me on this issue.
Thanks so much,
Luan.
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I will keep this question here because someone can search in that community in the future.
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Hello,
I am planning to treat in vitro cultured glial cells with the stroked brain lysate. Do anyone has such experience of treating culture cells with fresh tissue lysates? If yes, could you please let me know the procedure.
Thanks in advance!
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Look into Vleggeert-Lankamp CLAM, Pego AP, Lakke EAJF, Deenen M, Marani E, Thomeer RTWM (2004) Adhesion and proliferation of human Schwann cells on adhesive coatings. Biomaterials 25:2741-2751. Also try to find the articles of Anna Pego's thesis. Look into Biomaterials and like journals. Should be at hand, but somebody lent it. Sorry. However, using chemically defined medium you know what happens if you add extra substances. Succes. Marani
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I am looking at sex differences in acute stroke symptoms through meta analysis.
One of the symptoms I am looking at is "vision symptoms" but some studies report multiple vision symptoms in their population.
For example:
One study has reported that 28/268 women experienced vision loss, and 5/268 women experienced hemianopia. There is no way to know whether any of these women experienced both vision loss AND hemianopia.
Is there a way I can combine these two symptoms into one value to represent "vision symptoms" in this study to include in my meta analysis? Or will I need to meta-analyse each sub-symptom on their own, so a separate analysis for "vision loss" and "hemianopia"?
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If the articles do not say that women have vision loss and hemianopia, I believe that it is not possible to estimate women with vision loss AND hemianopia using a meta-analysis.
You can use a subgroup analysis to assess women who have had vision loss and women who have hemianopia. After that, evaluate the results using the odds ratio or relative risk.
subgroup 1. healthy women vs. women with vision loss
subgroup 2. healthy women vs. women with hemianopia
If there are more visual symptoms, you can add more subgroups.
I use the "meta" package from the R program to do meta-analysis.
The following link may be useful
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Patient with neurological problems have different problems. This will impaired their physical, cognitive and even social interaction and so forth.
So, which approach and why that approach is used?
Look into more discussion and information.
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Task-based interventions are highly effective for gait and ambulation among patients with chronic CVA and TBI provided that a sufficient intensity is maintained.
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A large majority of intracerebral hemorrhages, especially in younger patients, are due to hypertensive emergency. Often, these patients will get started on a titratable continuous IV drip medication like Nicardipine in the emergency room. However, there was a recent paper in Neurocritical Care journal that suggests that starting oral antihypertensives in conjunction during this very acute stage can lower morbidity, costs, and hospital/ICU stays. The rebuttal is of course that blood pressures on oral antihypertensives are subject to peaks and troughs with medication administration until steady state is reached. During this time, overshooting the target and causing hypotension can cause significant ischemia to surrounding cellular tissue that may be amenable to rehab, and hence worsening long-term outcomes [though this has not yet been systematically analyzed]. What is your opinion on this?
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ESSENTIAL!!
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Hello everyone,
I have some brain slides that I CV stained, and I need to learn how to assess infarct volume and quantify it comparing it to the other hemisphere or my controls. I looked online for a protocol or a description of the steps but couldn't find any.
I have both ImageJ and Sigma Scan Pro software, I still can't use them both well so I can learn on either of them.
I need to produce data similar to this:
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Maybe Carolina Giorgetto can help you.
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If we have a biochemical parameter we wish to compare between ischemic vs haemorrhagic stroke, (idea being this parameter is responsible for ischemic stroke), what is the adequate number we should study?
with the same background, is it necessary that we compare this with healthy individuals?
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You can look for previous studies that have evaluated the biomedical parameter of interest. Based on previous results, you can either use a sample size calculator (i.e. https://sample-size.net/) or request advice from a statistician (best option). Regarding the comparison with a healthy control group, it depends on the parameter. If there is information that the parameter is affected also in hemorrhagic stroke, then it would be better to use a healthy control group.
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I am having some difficulties trying to discern whether the following studies are cross-sectional or cohort (they do not state in their methodology)
I believe they might be cross-sectional, with the last one perhaps being cross-sectional cohort, but if anyone could help I would greatly appreciate it!
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The three studies are cross-sectional. A cohort study is when you follow-up the population over time, either in a retrospective or prospective way. In the studies you share, the authors did not follow up the participants but described only the characteristics of the admitted/evaluated patients.
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Research shows how stress can lead to heart attacks and stroke . your valuable comments are highly appreciated. Thanks
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Physical fitness is essential to allow people to carry out everyday activities. It is often particularly low in stroke survivors. It may limit their ability to perform everyday activities and also worsen any stroke-related disability. So, it is recommended that seniors do exercises in order to improve cognitive function, quality of life, and the ability to maintain physical activity. On the other hand, other researchers say that training programs increase the risk of having another stroke.
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Have a look at the following RG links.
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I'd like to use it in a classification task.
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A lot of variations in spatiotemporal parameters during gait performance among stroke survivors have been recorded. Studies have slso shown that such variations in gait paramets during gait performance have strong (confounding) influence on the outcome/results of gait analysis conducted among these individuals.  A number of factors have been pointed out as contributing factors to the observed variations in gait performance. Such include fear of falling, fatigability/post stroke fatigue and environmental factors.  It is therefore of serious concern to me to find out how these variables could be assessed objectively as this would help me immensely in my current study.
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Good Afternoon Dr. Ezenwankwo---
If the individual is at a higher functional level, I would utilize the Falls Efficacy Scale - International to measure fear of falling. I might employ the Activities-specific Balance Confidence Scale (ABC) to measure balance confidence. Both are easy to administer in gait studies and demonstrate sufficient validity and reliability properties.
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Hello,
I am planing an experiment to figure out the effect of an compound for recovery after stroke.
I am wondering whether sham mice group is necessary for this study.
Some reference didn't use sham or others did it.
In my opinion, only two groups (compound-treated mice and compound-non treated mice after stroke) are enough to demonstrate the effect of the compound. 
Will reviewer ask the sham result during paper submission process?
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Certainly, A Sham group is very helpful to rule out the actual effect of any drug in the current experiment. Must include.
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Dear researcher,
I am looking for actuators with an area of 1x1 mm² or smaller. The actuators should have a stroke of 0.5 mm or similar/bigger. The actuators have to be capable of being mounted as an array.
Thank you for your input.
Best regards,
Michael
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The only thing that I can think of is PL022 PICMA Miniature Piezo Actuator from PI, but that is double size (2x2x2)
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Hello Everyone,
I've been writing review articles on the following topics:
1. Stroke and MMP-9 research
2. CRISPER cas-9 and MMP-9
3. Heterogeneity of Monocytes among stroke patient
3. COVID-19 Pathophysiology
4. Brain on a chip
Is anyone interested in collaborative writing and publication? Please let me know. We can share our ideas on extending the content of the paper and get it published mutually.
Professionals with an interest in stroke and neurology research are most welcome.
Thanks,
Rozan
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Hello, I am last year medical student. I am interested in neurology research and pathophysiology of neurological diseases. I will be glad to join)
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I am working on school reform. The work is not having the full desired effect. I am trying to do my analysis of this subject under the concept of “organizational stroke.”
In your opinion, why we have not obtained the results we want, in the general and specific terms of reform and studies for the school. ?
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Most people do not realize how hard this is. For a comparison, look at the efforts of Ignacz Semmelweis to get doctors to wash their hands. It took him over 30 years...
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Dear all,
My question is about a study with tennis players. I have two categorical independent variables: skill level (3 levels) and type of stroke (three different strokes). I have one continuous dependent variable (ball speed). I want to compare if there exist differences between strokes and between levels in this variable (ball speed). I have think about Two-Way Mixed ANOVA or simply perform two One-Way's ANOVA, one including the skill level as the independent variable and another including the type of stroke... You think in this case it is interesting studying the interaction between level and type of stroke. I think so but I would like to listen the opinion of an expert... Two-Way Mixed ANOVA is adequate? I have forgotten to say that each player has performed the three different type of strokes.
Thanks very much,
Gabriel
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Hola Juan,
Muchas gracias por tu respuesta- Finalmente hicimos un MANOVA pero no incluimos las dimensiones antropométricas del jugador como covariables. En los próximos estudios lo haremos (parece una buena idea).
Gracias de nuevo y a ver si nos encontramos en algún congreso.
Saludos,
Gabriel
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I'm doing a retrospective case-control study on the outcome of stroke patients were either A) Community Onset or B) In-hospital onset
We have an n of ~1400 patients over several years. We wanted to do a multivariate analysis comparing patient outcome of whether their outcome by discharge from hospital was either A) Functionally Independent or B)Death/Dependency (no longer able to care for themselves)
We wanted to look a the following variables which we've tracked to see if there is a difference between community and hospital-onset stroke
1) Pre-hospital independence (YES/NO) *Defined as an OHS of <3
2) Patient Age
3) If they had atrial fibrillation (YES/NO)
4) If they received Thrombolytic Therapy (YES/NO)
5) If they received endovascular thrombectomy (YES/NO)
6) Sex (MALE/FEMALE)
For the inpatients, we're curious to know if there is a difference between those who had a procedure and those who did not but I think that has to go in a within-group analysis later on.
Most of my stats background comes from behavioural sciences where I worked with continuous data, not discrete data. I don't know/think a multiple-ANOVA would be the right approach here.
I thought about doing a Logistic-regression or a binomial - regression but I'm not if that fits especially with the patient age being a factor.
I thought of taking OUT patient age and doing a 2x7 Chi-square but then the sample size may contribute to a type 1 error.
Could anyone offer advice on the best to analyse this data or is the question setup flawed?
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I think you have two possibility:
1) I think that you have to do a "survival analysis" with kaplan-meyer curves. I made a similar analysis last year (https://www.nature.com/articles/s41598-020-60180-6) comparing stroke patients with and without a diagnosis of atrial fibrillation during a period of about 2 years. You may do a similar analysis calculating a kaplan curve for each factor (A) Functionally Independent or (B)Death/Dependency while caring about. You will have an Odd ratio for each "risk factor" (1-6);
2) you may simply calculate Mann-Whitney U test and Chi Square depending on the type of variables comparing the two population with (A) Functionally Independent or B)Death/Dependency (if the two population share similar demographics).
I hope you will find useful my answer. Good lack!
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  1. With an improvised document, a plagiarism issue was reversely raised. And several plagiarism issues were raised intentionally afterward.
  2. Slander with ungrounded information has been made to you in front of people despite your commitment to the lab’s work and projects even though they were out of your task and interest for more than 2 years.
  3. Incorrect information has been continuously produced to avoid academic discussion, concealing the fact. Even last week, wrong information was given out to people again.
Are you willing to publicize this matter, although the advisor is being investigated by school?
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Thank you for your good comment.
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Memory is an exciting and still mysterious function, and if we can easily find places of memory, do we know where in the brain our memory is stored?
We have seen it, it is plural. We cannot therefore associate it with a single place. There is, however, a place of "passage": the seahorse, involved through the circuit known as Papez. And cerebral imaging techniques make it possible to identify some structures particularly involved in memory processes, including the hippocampus, but also the amygdala and the prefrontal cortex. They operate in systems that are constantly interacting, and are linked to our emotions: there is no memory that is not linked to the emotional context in which it was recorded.
The fleeting memory of the sensory organs:
Our brain is the strategic center of memory circuits. Our five senses are constantly called upon to send their information to the hippocampus. These pass through the filter of the emotional brain, or limbic system, to be projected to the areas of the cerebral cortex that are dedicated to them. However, in the very short term, various sensory memories (visual, olfactory, tactile, taste, auditory) are managed by the sensory organs.
Thus, the back of the retina is involved in the phenomenon of retinal persistence, retaining information for a few hundred milliseconds, when the auditory nerve and the cells at the back of the ear retain over this same period of time the memory of a sound. . The same goes for the other three senses, always with this principle: withhold information for the time necessary to select the important elements. Knowing that this filtering takes place upstream of the short-term memory, to capture and encode a “good” message, it is therefore important to correct any sensory deficit. As for short and long term memories, they are fully taken care of by the brain.
There are several arguments in favor of an important role of a region located at the front of the brain - the prefrontal cortex - in short-term memory. In particular, when it comes to keeping the data necessary for reasoning available. As for the encoding of information in long-term memory, it involves the hippocampus, the temporal lobes and the structures of the limbic system which are connected to them.
The seahorse: an obligatory crossroads:
Made up of different structures buried deep in the center of the brain, the limbic system plays an important role in fear, pleasure, pain, aggression, and other emotional behaviors. But several of its components also participate in the memorization of certain memories. This is particularly the case with two structures: the hippocampus, and the amygdala.
The hippocampus is made up of several layers of neurons. It is greatly involved in the consolidation of long-term memory, in particular in a type of memory that can be brought out through language (it is said to be declarative), and more precisely that of facts and places (called episodic, because keeping traces of episodes of life). Its role is such that it is carefully examined on MRI scans in Alzheimer's disease. Because a radiological sign of atrophy of the hippocampi, linked to Alzheimer's disease, is visible on MRI and thus allows us to grade the course of the disease.
Memories of various and varied events are however not stored in the hippocampus: the information only passes through this structure, as in a crossroads where they are associated before reaching other areas of the cerebral cortex (occipital region for visual memories, temporal for auditory memories, etc.) where they will be kept. Conversely, our spatial memory is partly archived in the hippocampus.
At the heart of the emotional brain:
Another structure of the limbic system involved in memorization, the amygdala is shaped like a blackberry and is located in front of the hippocampus. Neuroimaging studies have shown that its activity increases when the individual visualizes an emotionally charged scene, and even more so in cases of post-traumatic stress, or fears. But like the hippocampus, it is not affected by any other type of long-term memory, called implicit or procedural.
Unconscious, that is to say automatic, this emotional memory is mobilized the longest. Moreover, this implicit memory is that of know-how - tying a shoe, tying a tie, driving a car, etc. And it is rather associated with changes in the cerebellum (cerebral structure closely related to motor control) or in the basal ganglia (also called basal ganglia) and the motor cortex.
The two hemispheres of the brain:
The cortex, also known as gray matter, is the outermost layer of the brain and includes all other structures. It is made up of two cerebral hemispheres. Separated by a groove, however, they are not isolated and communicate with each other through nerve fibers called the corpus callosum. We know that they are always helping each other and exchanging information. But since the work of the American Roger Sperry (Nobel Prize for physiology or medicine in 1981), it is classic to consider that they each have their specialties - each hemisphere also receives sensory information and controls the motor responses of half opposite of the body.
So when there is a stroke of the left hemisphere, the right side of the body is paralyzed (hemiplegia) and there may be aphasia, which is difficulty speaking or understanding language. The left hemisphere would in fact mainly take care of what is analytical: numbers, calculations and all the processes related to numbering. But he would also be responsible for most of the language processing, both oral and written. Knowledge allows us to stimulate and re-educate speech and memory through speech therapy, for example when a patient suffers from particular forms of Alzheimer's, or when he presents vascular signs in addition to neurodegeneration.
The right hemisphere, on the other hand, would be more involved in the management of novelty, learning, visuospatial skills, the perception of faces or the understanding of common expressions, metaphors or innuendo. This can make it difficult to organize your bedroom, write essays or analyze an abstract art painting in the event of an injury in the right hemisphere. Ultimately, if locating memory remains a matter of research, knowing the circuits involved helps us better understand and deal with its failures.
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Are memories stored in just one part of the brain, or are they stored in many different parts of the brain? The brain is key to our existence, but there’s a long way to go before neuroscience can truly capture its staggering capacity. For now though, our Brain Control series explores what we do know about the brain’s command of six central functions: language, mood, memory, vision, personality and motor skills – and what happens when things go wrong.
One of the critical functions of the brain is to encode and store information, which becomes our memories. Our memories provide us with insight into events and knowledge of the world around us and influence our actions and behaviors – forming important aspects of our personality.
There are multiple aspects and types of memories. What we usually think of as “memory” in daily usage is actually long-term memory. But there are also important short-term and sensory memory processes, which are required before a long-term memory can be established.
Memory is generally divided into two broad categories: explicit (declarative) and implicit (non-declarative) memory.
Implicit, or non-declarative, memories are behaviors that we have learned, but cannot verbalise. These memories typically operate without conscious awareness, encompassing skills, habits and behaviors.
These behaviors run on auto-pilot – for example, tying your shoelaces. It’s easy to do once learned, but it is very difficult to tell someone how you perform this task. Being able to tie your shoelaces is an implicit memory.
Multiple areas of the brain form implicit memories as they involve a variety of responses to be coordinated. A key region of the brain called the basal ganglia is involved in the formation of these “motor” programs. Additionally, the cerebellum at the back of the skull plays a vital role in the timing and execution of learned, skilled motor movement.
Explicit, or declarative, memories can verbally expressed. These include memories of facts and events, and spatial memories of locations. These memories can be consciously recalled and can be autobiographical – for instance, what you did for your last birthday – or conceptual, such as learning information for an exam.
These memories are easy to acquire. However, they are also easy to forget as they are susceptible to disruption during the process of forming and storing the information.
The prefrontal cortex and working memory. The prefrontal cortex is important in the formation of short-term or working memory. Although these short-term memories are lost due to interference with new incoming information, they are essential for planning behaviors and deciding what actions to perform based on the current situation.
A short-term memory can consolidated into an enduring long-term memory. This involves a system of brain structures within the medial temporal lobe that are essential for forming declarative memories. The hippocampus is a key region in the medial temporal lobe, and processing information through the hippocampus is necessary for the short-term memory to be encoded into a long-term memory.
The long-term memory does not remain stored permanently in the hippocampus. These long-term memories are important and having them stored in only one brain location is risky – damage to that area would result in the loss of all of our memories.
Instead, it is proposed that long-term memories become integrated into the cerebral cortex. This process is referred to as cortical integration; it protects the information stored in the brain.
However, damage to areas of the brain, particularly the hippocampus, results in loss of declarative memories, which is known as amnesia.
Are memories stored in just one part of the brain, or are they stored in many different parts of the brain? Karl Lashley began exploring this problem, about 100 years ago, by making lesions in the brains of animals such as rats and monkeys. He was searching for evidence of the engram: the group of neurons that serve as the “physical representation of memory” (Josselyn, 2010). First, Lashley (1950) trained rats to find their way through a maze. Then, he used the tools available at the time—in this case a soldering iron—to create lesions in the rats’ brains, specifically in the cerebral cortex. He did this because he was trying to erase the engram, or the original memory trace that the rats had of the maze.
Lashley did not find evidence of the engram, and the rats were still able to find their way through the maze, regardless of the size or location of the lesion. Based on his creation of lesions and the animals’ reaction, he formulated the equipotentiality hypothesis: if part of one area of the brain involved in memory is damaged, another part of the same area can take over that memory function (Lashley, 1950). Although Lashley’s early work did not confirm the existence of the engram, modern psychologists are making progress locating it. Eric Kandel, for example, spent decades working on the synapse, the basic structure of the brain, and its role in controlling the flow of information through neural circuits needed to store memories (Mayford, Siegelbaum, & Kandel, 2012).
Many scientists believe that the entire brain is involved with memory. However, since Lashley’s research, other scientists have been able to look more closely at the brain and memory. They have argued that memory is located in specific parts of the brain, and specific neurons can be recognized for their involvement in forming memories. The main parts of the brain involved with memory are the amygdala, the hippocampus, the cerebellum, and the prefrontal cortex.
The amygdala is involved in fear and fear memories. The hippocampus is associated with declarative and episodic memory as well as recognition memory. The cerebellum plays a role in processing procedural memories, such as how to play the piano. The prefrontal cortex appears to be involved in remembering semantic tasks.
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I've heard garlic and high nitrate foods like arugula or beets typically occupy high ranking here. What others do you know of or recommend? What's your top 10 list, based on what research? Thanks.
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When I eat lemon, lower my blood pressure
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Why, when I did the modeling, the result of the analysis give an increase in the value of impact force in the subsequent strokes while it was supposed to decrease.
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thank you Muhammad Ali
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I am doing a systematic review looking at factors that could predict the level of burden in stroke carers. I have narrowed down to the final studies I want to use and I have their data. Unfortunatley the only data I have are the Means and SDs of the factors and burden levels. I am trying to work out how I can look at if there is a correlation or not, but I can't work out how to do it. Everything I try (except for SPSS summary independent samples t-test) doesn't seem to work, I think because it takes each result from a study as one participant and I cant find anyway of me saying for this study there were x participants and this as the mean result. Can anyone help?
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Hello Julia,
The ideal way is to have either: (a) reported inter-variable correlation values for each individual study; or (b) access to the raw data from the individual studies. It might be that you could contact authors of the respective studies and request either (a) or (b). Barring that, your task will be quite difficult.
A proxy method, which could yield somewhat misleading results, would be to use the study as the individual case/unit/replication, and record the respective means as if they were raw data points. Given a sufficient number of studies, you could report on whether average IV values did or did not relate systematically to average DV values across studies. You could optionally weight the studies by their sample sizes so as to give more impact to the larger-N studies.
However, the potential danger is that, the behavior of inter-variable relationships is often different for individual cases than for batches of cases (which is why multi-level designs have become so important in the past 20-30 years).
Good luck with your work.
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Dear Clinical Rehabilitation colleagues, I have just finished Malcolm Gladwell's excellent book 'Outliers' (2011) for probably the 4th time and would like to recommend such a tremendous and inspiring book to any clinical therapist or anyone working in the neuroplasticity field. I have read all Malcolm's books and in fact his most recent'Talking To Strangers' was also excellent because of the important issues it raises (I can assure everyone I am not related to Malcolm or have no vested interest in promoting his work but it introduces some really interesting psychological concepts, although as far as I'm aware Malcolm never mentions how these could possibly be applied in the clinical setting). I am interesting in getting a discussion started because I believe that there needs to be a fundamental shift in our approach to rehabilitating patients (especially neurology) towards achieving greater successful outcomes. I believe that the same psychological principles mentioned in outliers can apply to clinical rehabilitation and I would be very interested to develop this over the coming years. I have already started writing focus and editorials for journals based on his work.
As a Physical Therapist (Physiotherapist in Ireland) and now researcher who is very interested in developing and improving clinical rehabilitation post stroke etc, I would like to consider outliers in this context and would be interested if you agree. I firmly believe that a new approach to rehabilitation is required and the current 'passiveness' that takes place needs to be replaced with 'psychological education' to equip patients with the confidence for success. For me all physiotherapy is 70% psychology (partly placebo effect) and 30% physical interventions.
I believe that a lot of the psychological approaches mentioned in Malcolm's book could be applied to clinical rehabilitation and would indeed improve current outcomes. Regarding 'Outliers' can I make some observations please;
Introduction: I believe that patients rehabilitating from home rather than in a rehabilitation setting can benefit from a similar 'Rosetto Effect'.
Chapter 1 & 2: We can apply the principle of the 10,000 hour rule to rehabilitation. Success in rehabilitation is also the result of 'Cumulative Advantage' (availability of home-based rehab equipment, access to professional supervision, means of receiving real-time feedback) but in order to achieve this we need to find a way to motivate patients to do the '10,000 hours of meaningful rehabilitation'. After 30 years of experience I truly believe that almost all patients can get a successful recovery if they are willing to work really really really hard.
Chapters 3 & 4: In a similar fashion to practical intelligence that is gained from rich parents, stroke patients need to take control of their therapy and if they start to steer their therapy then they will create a neuroplasticity in their brains that will result in improved success. I believe there is an element of stereotyping that exists in elderly patients who accept 'their lot' and don't have the confidence to fight hard enough to make a full recovery.
Chapters 5 & 6: Again, emphasises the concept that hard work or 'grit' will make us successful. Same principle can be applied to rehabilitation. The ability of a patient to question their therapist/consultant and to guide treatment is probably a result of their cultural background and again this type of disadvantage can lead to poor results.
Chapters 7 & 8: The concept of Power Distance Index again fits with patient potential in rehabilitation. Medicine is general is a passive process, where the patient waits to be told what to take/do. I believe that patients need to be educated to improve confidence and realise that rehab techniques will be more successful if initiated by the patient themselves. Lets give them a menu of therapies and let the patient decide which is best suited to them. We need more of a personal approach. Again, hard work and effort important for good results.
Chapters 9 & 10: Could a new form of KIPP School be created for rehabilitation excellence where the emphasis is 70% education/psychological approach and 30% physical interventions. I believe the reverse is happening unsuccessfully at present.
Its recommended to stand on the shoulders of giants and none are greater than Malcolm Gladwells. I would be very interested in your opinion to these comments (whether you agree or disagree) and this book has inspired me so much, brought great enjoyment to my life and has been inspirational to hundreds of people like me. I think a change is needed!!
Thanks Ken
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I think both of them important
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Hi everyone,
I was wondering if there was an optimal time for performing the follow up assessment when evaluating the long term effect of a rehabilitation technology (such as VR, robot assisted therapy,...) in a stroke population. Especially for upper limb function, activity and participation. Is there any paper supporting the fact that stroke patients’ long term retention should be assessed a certain time after the intervention ?
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Dear Dr Monaghan,
I read with interest your answer and I have to admit that your analogy between post-stroke/neuro-rehabilitation and Malcolm Gladwells issues is quite relevant. Indeed, you make here very interesting comments about improving physiotherapy through a psychological approach.
Stroke rehabilitation is a patient-centered approach and should therefore be adapted to each patient regarding his needs. Education about pathology and rehabilitation process is certainly one of the most important things to do when meeting the patient for the first time. I do agree that adding a psychological education would help patients to better recover. Indeed, teaching them to think positive and to develop the habits of working hard would probably lead to improved results.
I would also like to add that patient's motivation could be easily enhanced by giving him the opportunity to self-rehabilitate. In fact, with the development of new technologies such as robot-assisted therapy and virtual reality, self-rehabilitation becomes very interesting. More importantly, thanks to serious games, these technologies offer a good opportunity to enhance patient's adherence to rehabilitation. Indeed, a serious game is an interactive game specifically designed for rehabilitation whose difficulty is constantly adapted to the patient. These games help to make rehabilitation more playful.
Other neurorehabilitation principles described in the review of Maier et al., in 2019
("Effect of Specific Over Nonspecific VR-Based Rehabilitation on Poststroke Motor Recovery: A Systematic Meta-analysis") are also a good way to enhance patient's motivation and outcomes. These principles are: “a massed practice (training with repetitive tasks), dosage (intensive training), a structured practice (training that includes resting times), a task-specific practice (functional training), a variable practice (training that includes different types of task), a multisensory stimulation (training that provides at least two sensorial feedbacks such as visual, auditive or haptic feedback), an increasing difficulty, an explicit feedback (training that provides information about the patient’s task results), an implicit feedback (training that delivers information about the performance such as real time visualization of movement properties), an avatar representation (embodied training), and promoting the use of the paretic limb.”
I also think that stroke rehabilitation could be improved by collaborating between technology developers and the various experts involved in stroke rehabilitation, including physical medicine, neuropsychology, speech and language therapy and occupational therapy. Indeed, neuropsychological disorders are common after stroke and should more often be considered during motor relearning. Cognitive processes are important for the motor function as they spearhead voluntary actions, such as selective attention to select the object for interaction, selection of the response limb effector, planning action to the object and execution, including the inhibition and avoidance of distractors.
Lastly, as described by Stinear et al., in 2020 ("Advances and challenges in stroke rehabilitation"), we also have to improve the way of conducting experimental researches in order to better understand what is efficient or not in stroke motor rehabilitation.
Best regards,
Gauthier
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If i intend to carry out a cross sectional comparative study (analytical study design) to assess the association of cardiac diseases among young stroke patients, where do I begin? Do I enroll stroke patients in a medical ward and then select old and younger stroke patients based on an age demarcation and then proceed with the analysis? In that case, how do I calculate my sample size? Do I use the formula:
n = P(1-P)Z2/(error)2 for descriptive, hospital-based cross-sectional study or,
do i need two proportions for two different groups (P1, P2) and use this one instead:
n=(Z1-a+Z1-b)2 (P1Q1+P2Q2)/ (P1-P2)2
[a=alpha=probability for type I error, b=beta=probability for type II error]
If the latter equation is to be used, then how do I find out P1 and P2 from previous studies to construct a sample for this study? What would P1 and P2 stand for this study? P1=young stroke patients? P2=old stroke patients??
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Sample Size Rule
Sekaran (2013) wrote:
"Roscoe (1975) proposes the following rules of thumb for determining sample size:
1. Sample sizes larger than 30 and less than 500 are appropriate for most research.
2. Where samples are to be broken into sub-samples;(male/females, juniors/seniors, etc.), a minimum sample size of 30 for each category is necessary.
3. In multivariate research (including multiple regression analyses),the sample size should be several times (preferably 10 times or more) as large as the number of variables in the study.
4. For simple experimental research with tight experimental controls (matched pairs, etc.), successful research is possible with samples as small as 10 to 20 in size."
Reference
Sekaran, U., 2003. Research methods for business: A skill building approach. John Wiley & Sons.
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hi, if we are doing a single centered study, can we estimate/calculate sample size based on patients in that hospital?
e.g i want to conduct a research on stroke patients. so my population will be stroke patients in the country or stroke patients in that hospital ?
offcourse if we want to generalize the results, we take whole countrys stroke patients available in literature.
but lets suppose due to lack of time, or economic factors, we want to do single centered study where stroke patients may not be that high ? then how to justify sample size ?
i have seen many papers where sample size in hospitals was 100, 150, 90 etc. but they never mention how did they calculate this. can anyone share some evidence based answer ?
thank you
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Sample Size Rule
Sekaran (2013) wrote:
"Roscoe (1975) proposes the following rules of thumb for determining sample size:
1. Sample sizes larger than 30 and less than 500 are appropriate for most research.
2. Where samples are to be broken into sub-samples;(male/females, juniors/seniors, etc.), a minimum sample size of 30 for each category is necessary.
3. In multivariate research (including multiple regression analyses),the sample size should be several times (preferably 10 times or more) as large as the number of variables in the study.
4. For simple experimental research with tight experimental controls (matched pairs, etc.), successful research is possible with samples as small as 10 to 20 in size."
Reference
Sekaran, U., 2003. Research methods for business: A skill building approach. John Wiley & Sons.
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Farm level implementable other than chemical control, trenches formation, fire strokes usage and making sounds.
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1. Adults can be beaten to death by thorny sticks, brooms or can be swept together and buried underground in heaps. These things are easy to do when the females are laying eggs.
2. Farmers should go to their cropped field and make loud sounds by beating empty tins/ metal plates, drums or radio or through other electronic sound systems to prevent locust swarm landing in the crop.
3. Spray neem-based formulation (0.15 % EC) @ 3 ml/ liter of water on standing crop as feeding deterrent (Locust not known to feed on Neem plant).
4. Dig a trench 2 feet deep and 2 feet wide in front of the marching hopper band and then apply Cypermethrin 50 EC @ 2 ml per liter of water or Carbosulfan 1 g/l per liter of water. Dusting with Cypermethrin 10 WP or Fenvelerate 0.4 D (25 kg/ ha) in the trenches also effective especially against nymphs.
5. Poison bait consisting of wheat or rice bran, an insecticide and attractant like molasses may be useful [Rice bran + Jaggery + Chlorpyriphos (Can be changed depending on availability, as it is banned in recent government order): 10kg + 1 kg + 1 liter] prepare in small balls, and spray/spread in the field. Poison baits are effective when used early in the morning or in the evening. During the day, the baits dry quickly so hoppers do not eat it.
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Hi everyone. How to calculate the AP, AP per 100,000 population and Attributable Cases, for Health Endpoint e.g. Mortality due to IHD in Adults by using Impact Evaluation function in AirQ+ 2.0 software for the whole population (for ages 25+/30+) where the PM2.5 level is below 40ug/m3? The current AirQ+ 2.0 interface already divided the calculation to different age groups. No calculation interface available for the whole population. Thank you - Iqbal
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Dear all,
I would like to conduct the systematic review of stroke studies. I found that the GRADE-CERQual tool is useful to evaluate the strength of qualitative evidence. It is possible if I use this approach for my review?
Thanks for your help
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It is not clear to me if you want to assess the evidence generated by qualitative research OR if want to assess the evidence generated by qualitative synthesis generated by clinical studies.
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Hello Fellows,
I am running in vitro experiments using 'healthy donor blood'. It appears that clots formed from some samples do not respond to treatment with Alteplase. Any ideas, please, friends and colleagues?
Thanks in advance :)
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Good work, colleague and I think it will have a great impact on guidelines of IV thrombolysis.
To my mind , many factors interfere with IVT response beyond the time window and length of the thrombus.
They also include the nature of the thrombus as not all of them are formed of fibrin e.g. the white thrombus may contain tough tissue which may be detached from mitral valves
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Given parameters:
Stroke:+/-25 mm
Excitation: 5.3V rms, 2000 hz
Bobbin: SS tube, 3.5 mm ID, 4.65 mm OD
Primary coil is wound over the entire length of bobbin
Two secondary coils are wound over primary -- one in each half section.
Sum of two secondary outputs: 3.72 V rms
Determine:
Length of bobbin, number of turns of primary and secondary coils
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Construction of Linear Variable Differential Transducer? - MATLAB ...
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Dear Researcher,
I would like to know, how can we categorize stroke patients as Acute, subacute, and chronic.
Please specify how many days coming under acute, subacute and chronic
Thank you
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Dear sir,
As per the Stroke Recovery and Rehabilitation Round-table consensus- 2017, time points for stroke recovery is defined as;
  • Hyper acute (0-24 hours)
  • Acute (1-7 days)
  • Early sub-acute (7 days- 3 month)
  • Late sub-acute ( 3-6 months)
  • Chronic ( > 6 months)
Please refer the attached article for further details.
Kind regards,
Sulfikar Ali
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I am doing some experiments regarding stem cell transplantation in an animal stroke model. Now I need to quantify phagocytic microglia in the brain after stroke. I want to quantify them by immunostaining-based method, not by flow cytometry. It will be very helpful if someone suggest me what will be the suitable marker for phagocytic microglia in stroke condition. Thank you in advance.
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The morphology of the microglia would also give some information. Phagocytic microglia tend to have larger cell soma and shorter but thicker branches, compared to ramified microglia. Apart from this, if you know what kind of debris will be uptook by microglia in your model (e.g. myelin debris), you could co-stain Iba1 and a debri-specific antibody, e.g. fluoromyelin.
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The association of free radicals in the pathophysiology of chronic diseases like degenerative brain disorders (AD, PD, HD, Stroke) has been evident by a substantial research.
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I'm wondering if there is any literature on prognostic pessimism (PP) within areas of aphasia, speech disorders, stroke treatment, or any other similar area. I've found literature on PP and psychological disorders and some physical diseases (COPD / asthma) but looking for presence of PP in speech disorders.
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Dear Helen,
I share here Dr Glize's work about aphasia. I hope you could find data your are looking for.
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There are relatively many and growing efforts to find pharmacological alternatives to neurodegenerative and mental disorders, in this effort, successful trials have been carried out with the application of erythropoietin (EPO) 1-3 and similar molecules that do not induce erythropoiesis such as NeuroEPO, in which we have been working for several decades 4-7.
Unlike the EPO produced in the kidneys, the one produced by the mammalian brain does not appear in the databases of its sequencing nor does it have results of its molecular characteristics.
If we consider our brain the target of many mental disorders, it seems logical to think that we should know more about the molecular characteristics of its main components such as cerebral erythropoietin.
References
1. Sosa Testé I, J.C García Rodríguez, García JD. New goal in ischemia stroke therapy:rHu-EPO nasal application. (2006) Rev. Acta Pharmacol. Sin,2 006; 27 (Suppl 1): 97.
2. J. C. García Rodríguez and Iliana Sosa Testé. The nasal Route as a Potential Pathway for Delivery of Erythropoietin in the treatment of Acute Ischemic Stroke in Humans. (2009) TheScientificWorldJOUNAL 9,970-981. Review.
3. Yamila Rodríguez Cruz, Yuneidys Mengana Támos, Adriana Muñoz Cernuda, Nelvis Subirós Martines, Alina González-Quevedo4, Iliana Sosa Testé, and Julio César García Rodríguez. Treatment with Nasal Neuro-EPO Improves the Neurological, Cognitive, and Histological State in a Gerbil Model of Focal Ischemia. (2010) TheScientificWorldJOURNAL 10, 2288–2300.
4. Julio César García-Rodríguez and Yamila Rodríguez-Cruz The Therapeutic Potential of Neuro-EPO Administered Nasally on Acute Cerebrovascular Disease. Current Psychopharmacology, 2012, 1, 3; 228-232. PubMed FI:2.5
5. Yamila Rodríguez Cruz, Manon Strehaiano, Teresita Rodríguez Obaya Julio César García Rodríguez and Tangui Maurice. An Intranasal Formulation of Erythropoietin (Neuro-EPO) Prevents Memory Deficits and Amyloid Toxicity in the APPSwe Transgenic Mouse Model of Alzheimer’s Disease. Journal of Alzheimer’s Disease 55(2017) 231–248 DOI 10.3233/JAD-160500 IOS
6. Garzón Fernando, Rodríguez Yamila, García Julio Cesar and Rama Ramón. Neuroprotective Effects of neuro-EPO Using an In Vitro Model of Stroke. Behav. Sci. 2018, 8, 26; doi:10.3390/bs8020026.
7. Ramón Rama, Fernando Garzón, Yamila Rodríguez, Tanguí Maurice, Julio César García Rodríguez. Neuroprotective effect of Neuro-erythropoietin in neurodegenerative diseases: “Alea jacta est”. Neural Regen Res (2019) 14(9):1519-1521 Doi:10.4103/1673-5374.255968.
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Thank you very much Dr. Hassan Izzeddin Sarsak
Indeed, this is really an excellent paper that I reviewed at the time and also years later.
However, this work does not answer all the questions that have arisen about the apparent functions of the EPO produced by different cells and their relationship with the onset and development of neurodegenerative processes.
Just to quote a question. Are all erythropoietin produced by neurons, astrocytes or pericytes, the same?
Always.
Julio Cesar.
Julio Cesar Garcia-Rodriguez, PhD
Emeritus academic, Cuban Academy of Sciences
Full professor and senior researcher
CENPALAB, National Center for Animal Breeding
BioCubaFarma
Havana, Cuba
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I intend to measure a muscle function on stroke patients and I read but with no supportive evidence that patients should stop having paracetamol or antibiotics month before the test because it may affect the outcome results.
Anybody has any idea or suggest evidence to support this notion
thanks
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Paracetamol is a dangerous drug, because is NOT an anti-inflammatory, and in a range normal usual doses, depleted more than 90% the Glutathione in liver, as you known, the more anti-oxidant system in the tissues. https://www.semanticscholar.org/paper/Paracetamol-and-Cardiac-Congenital-Malformations-in-Jara-Guerrero/68a3110cb81f625b9ce0cc3f3f9cfd0016aced88
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Dear network!
I have a question and hope that you will share with me your experience in this field.
We have conducted a study (review of patients medical records) to assess if abnormal hemoglobin (Hb) levels are associated with stroke severity in our settings. We are interested in both; high and low Hb levels. As for me, I though the right thing is to dichotomize Hb levels into normal and abnormal status in the Regression Analysis. Upon submitting the work to a journal, the reviewers mentioned that Hb levels should have been continuous variable. As both extreme can be a determinant of stroke severity, how the results would be interpreted in this way!
Thank you for your time, Majeda
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Majeda -
Not a subject matter field for me, but can you use polynomial regression for that? Regardless, don't forget heteroscedasticity. I have an example of that, borrowing a BMI regression example in here:
Is this multiple regression where Hb is just one regressor? That should work too.
Cheers - Jim
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Defects in the brain tissue of a rat model I am working with look like small ischemic (not hemorrhagic) strokes when I do H&E stains. I would like to confirm this suspicion by staining the (paraffin-embedded) tissue with some markers. So far I am thinking of a panel using the following: fibrinogen, fibronectin, GFAP for astrocytes. As I'm not familiar with stroke research I'm not sure if there's any common ones I've missed! I would be grateful for any advice.
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H&E is actually sufficient for a neuropathologist.
It shows you the state of the stroke, depending on the time after the insult.
You can see granulocytes coming into the stroke area latest 12-24 hours, later you see macrophages and finally the scar formation (from 1 week).
Macrophages you can stain with CD68, but they are easily detectable in H&E: white foamy cells.
Reactive astrocytes around the stroke region appear blown up and can show strange shapes (immuno-positive for GFAP).
Proliferation markers (BrdU, ki67 etc.) are not used in routine pathology and are actually not really helpful. NeuN labels neurons ..... lack means that the neurons are gone, but this you see in H&E already, or use a Nissl stain. White matter distruction you can stain with Luxol or MBP-immuno. Most of the old stains (LuxolFastBlue+Eosin, Nissl) are cheap and really suffcient.
Paraffin sections 4µm and you are done with best morphology.
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Is the origin level of right vertebral artery branch from the right subclavian artery the risk for vertebral artery stenosis?
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In an angiographic study of 4748 patients with ischaemic stroke, some degree of proximal extracranial vertebral artery stenosis was seen in 18% of cases on the right and 22.3% on the left. This was the second most common site of stenosis after internal carotid artery stenosis at the carotid bifurcation. Such stenotic lesions are now potentially treatable by endovascular techniques.
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i am a graduate student, i want to do a research about slow stroke back massage. I want to know is there any right order of the massage movement (as it is in original) because most of the research that I found used modification of SSBM, and i wonder how much pressure should I apply while doing the massage. I find it difficult to find book about it too... If you have an info about this please share, thank you.
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thank you Mr.Moreland for your replay
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I am doing reserch that prospectively follow pt with atrial fibrillation on warfarin for incidence of stroke hemorrhagic due to SIde effect of warfarin or ischemic due to cardioembolism I WONDER if NONcontrast CT beside history and exam and coagulation profile is sufficient to diffrentiate ischemic from hemorrhagic
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This is tricky mainly because individuals are going to have 1) asymptomatic (Issue 1) or non-stroke like 'chameleonic' manifestations of focal ICH or cardioembolism (Issue 2). Moreover, if all participants are seen hyperacutely after symptoms, CT is less sensitive for hyperacute infarcts (Issue 3). This becomes a little bit more complicated that CTs can potentially miss focal infarcts in the brainstem(Issue 4) both in hyperacute or acute setting( Issues 4a and 4b)
If patients are likely to be seen less acutely ( or imaged only at follow up) a CT loses its ability to discriminate ischemic vs hemorrhagic lesions as days pass since event or symptoms (Issue 5)
Of course there is also a problem of hemorrhagic infarcts which can pose problems ascertaining the exact underlying problem
Hemorrhage smaller than infarct - easy (grade 1 and 2 HTI )
Hemorrhage as big as the infarct or bigger than the infarct often masquerades as a hematoma rather than a hemorrhagic infarct, thus misleading as to the exact mechanism (Issue 6). These limitations should be borne in mind. An MRI will resolve
Issues 1 and 2 ( if routine follow up MRIs are done at intervals)
Issues 3 and 4 (if MRI study triggered by presentation)
Issue 5 if GRE/SW sequences are undertaken
Issue 6 (I don't think even an MR can help here)
The reason history and examination are not being mentioned with emphasis(though very useful) is because of the difficulties they pose due to interpersonal variability in ascertaining or interpreting, individuals with pre-existing neurological signs (making new vs old virtually impossible to ascertain unless the clinician continuity is there - though that cant fix the problem entirely). There is then an argument of whether asymptomatic infarcts and bleeds classify as a stroke (but may classify as an adverse event happening whilst on anticoagulation)
Having MRI will help giving more clarity to the study you do but a CT could help in
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The FRAX® tool has been developed to evaluate fracture risk of patients. But it does not include falls which are a well established clinical risk factor for fracture. Also, previous studies have suggested an up to 4-fold increase in the risk of fractures in those with stroke compared to healthy controls.
So, is FRAX tool really useful & necessary for "Stroke survivors" to computes the 10-year probability of fractures ?
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I believe Bone Scan is more useful than this method.
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Post Tpa for stroke- how soon after the administration of tpa -can the patient get out of bed and resume activity with assistance ?
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Well @ Sharma I suppose it is not related to half life of tpa which is as you mentioned not that long rather than following the NINDS part 1 study which waited for 24 hours then measuring NIHSS and comparing it to baseline NIHSS.
Another point is that all related monitoring guidelines are along first 24 hours either Bl/Pr, cardiac for AF and so on, and early mobilization may disturb these readings.
Also it is a matter of agreement between physicians in a study of fifty-four clinicians found that perceived risk of neurological decline, especially due to sICH; infection of unknown cause; severe chest infection; severe stroke (NIHSS >20); drowsiness and confusion were factors that significantly influenced the decision to mobilize early.
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It seems that we're heading industrial revolution 4.0, what are other steps that we can invent, create and execute?
Stroke or Brain attack is the 2nd killer of human around the world according to WHO.
Any brilliant idea or solution?
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Try to get rid of the ectopic fats in blood vessels and other organs in the body by daily regular restrictive eating. Stop eating 5 hours before going to bed, so that our body is forced to make full use of the possible ectopic fats in our blood vessels and rest of our body as energy source and clean them away.
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I have stress-stroke profile of a deformed rebar from the company. Moreover, the gauge length of the test specimen is known (G.L. = 100 mm). The estimated strain using equation (i.e., strain = stroke/gauge length) seems wrong. I am seeking some useful suggestion. Thanks in advance.
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Hi
I do not know your question.
Best regard
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Other than differences caused by stroke, would cognitive function (and other symptoms) differ in a group that includes all types of VCI compared to those that have a very specific type subcortical ischaemic vascular cognitive impairment
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Jordi Serra-Mestres Thank you for putting this in a clear way that helps me understand this. You have been very helpful, thank you.
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Looking for a free self-report or proxy-report assessment to administer to patients with brain injury with good psycometric properties. I am an oppucational therapist, so I need it to capture a person's ability to reintegrate back into their daily life (activities of daily living, work, community reintegration, etc). Something similar to the Stroke Impact Scale, but for brain injury, would be great! Any suggestions or links would be great! Currently digging around through the NeuroPT EDGE documents for inspiration
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Hello Amy,
I suggest you review https://www.sralab.org/rehabilitation-measures, to understand the content of the available measures first, and then select a measure most suited your need based on its content and properties described, when applied to population of your interest. best to choose a measure that was developed in the population you intend it to applied to.
In my research of daily functioning of patients with traumatic brain injury, I used two self-report measurements, and they complimented each other very well- the Community integration questionnaire and the Sheenah Disability scale. Both showed good Content validity with regards to daytime functioning.
the Community integration questionnaire assesses family, work, and social integration; the Sheenah Disability Scale, a visual analogue scale, assesses perceived disability in these same three domains- work, family, social, and it supported me greatly by providing a global understanding of perception of disability in these domains in each individual person, based on his or her activities described in the Community integration questionnaire.
Hope this helps. If you need more information please let me know.
Tatyana
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Once their medical issues have stabilised, physiotherapy, speech and language therapy and occupational therapy are the three main types of rehabilitation sought by stroke victims. Given the scope of the project, it would seem an omission to not consider speech and language therapy.
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Hi Sonia,
Yes. I would agree with that. Since the SLP focuses more on socialization and all social action -- especially since it is so dependent on language and communication -- this group is a natural source of information, assistance, and rehabilitation. Progressively over the last 20 years or so, SLPs have demonstrated significant importance of Individuals with Aphasia creating various kinds of compensations to increase their socialization and communication despite the language and symbolic processing problems (see Nina Simmons-Mackie, Ray Wilkinson, Suzanne Beeke, Madeline Cruice, and my work to mention a few). Additionally, quality of life issues revolve significantly around communicative ability and socialization. PTs and OTs do excellent work but far less in the social and communicative relam than SLPs. I hope this helps.
Jack