Pharyngeal electrical stimulation for treatment of dysphagia in subacute stroke

Background and Purpose: Dysphagia is common after stroke, associated with increased death and dependency, and treatment options are limited. Pharyngeal electric stimulation (PES) is a novel treatment for poststroke dysphagia that has shown promise in 3 pilot randomized controlled trials. Methods: We randomly assigned 162 patients with a recent ischemic or hemorrhagic stroke and dysphagia, defined as a penetration aspiration score (PAS) of ≥3 on video fluoroscopy, to PES or sham treatment given on 3 consecutive days. The primary outcome was swallowing safety, assessed using the PAS, at 2 weeks. Secondary outcomes included dysphagia severity, function, quality of life, and serious adverse events at 6 and 12 weeks. Results: In randomized patients, the mean age was 74 years, male 58%, ischemic stroke 89%, and PAS 4.8. The mean treatment current was 14.8 (7.9) mA and duration 9.9 (1.2) minutes per session. On the basis of previous data, 45 patients (58.4%) randomized to PES seemed to receive suboptimal stimulation. The PAS at 2 weeks, adjusted for baseline, did not differ between the randomized groups: PES 3.7 (2.0) versus sham 3.6 (1.9), P=0.60. Similarly, the secondary outcomes did not differ, including clinical swallowing and functional outcome. No serious adverse device-related events occurred. Conclusions: In patients with subacute stroke and dysphagia, PES was safe but did not improve dysphagia. Undertreatment of patients receiving PES may have contributed to the neutral result. Clinical Trial Registration: URL: http://www.controlled-trials.com. Unique identifier: ISRCTN25681641

Structuring for team success:The interactive effects of network structure and cultural diversity on team potency and performance

This longitudinal study used data from 91 self-managed teams (456 individuals, 60 nationalities) to examine the interactive effects of a team’s task (“workflow”) network structure and its cultural diversity (as indexed by nationality) on the team’s “potency” (i.e., the team’s confidence in its ability to perform) and its performance (as rated by expert judges). We found that whereas the emergence of dense task networks enhanced team potency it was the emergence of (moderately) centralized task networks that facilitated team performance. These varied structural effects, moreover, were themselves contingent on team composition: the more culturally diverse a team, the more pronounced were the positive effects of network density on team potency and the higher the level of network centralization required for optimal team performance. The success of a team appears to hinge on the interplay between network structure and team composition

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Reorientation transition of the magnetic proximity polarization in Fe/(Ga,Mn)As bilayers

Recently, it has been observed that thin ferromagnetic Fe films deposited on top of (Ga,Mn)As layers induce a significant proximity polarization in the (Ga,Mn)As film even at room temperature. Furthermore, it was found that a thin interfacial region of the (Ga,Mn)As film is coupled antiferromagnetically to the Fe layer. Here we report a series of combined x-ray magnetic dichroism and superconducting quantum interference device magnetometer measurements for Fe/(Ga,Mn)As bilayers where the (Ga,Mn)As layer thickness is varied between 5 and 50 nm. We find a reorientation transition of the magnetic proximity polarization as a function of the (Ga,Mn)As thickness. The data are compared to results obtained performing ab initio calculations. A varying concentration of Mn interstitials as a function of (Ga,Mn)As layer thickness is responsible for this reorientation. Furthermore, exchange bias is studied in the fully epitaxial bilayer system. We find a rather strong ferromagnetic exchange bias. The strength of the exchange bias can be estimated by using a simple partial domain wall model

AI-based methodologies for exoskeleton-assisted rehabilitation of the lower limb : a review

Over the past few years, there has been a noticeable surge in efforts to design novel tools and approaches that incorporate Artificial Intelligence (AI) into rehabilitation of persons with lower-limb impairments, using robotic exoskeletons. The potential benefits include the ability to implement personalized rehabilitation therapies by leveraging AI for robot control and data analysis, facilitating personalized feedback and guidance. Despite this, there is a current lack of literature review specifically focusing on AI applications in lower-limb rehabilitative robotics. To address this gap, our work aims at performing a review of 37 peer-reviewed papers. This review categorizes selected papers based on robotic application scenarios or AI methodologies. Additionally, it uniquely contributes by providing a detailed summary of input features, AI model performance, enrolled populations, exoskeletal systems used in the validation process, and specific tasks for each paper. The innovative aspect lies in offering a clear understanding of the suitability of different algorithms for specific tasks, intending to guide future developments and support informed decision-making in the realm of lower-limb exoskeleton and AI applications

Hot electron spin attenuation lengths of bcc Fe34Co66—Room temperature Magnetocurrent of 1200%

We investigate spin-dependent hot electron transport through metallic epitaxial spin valves by ballistic electron magnetic microscopy (BEMM). By variation of the thickness of one of the ferromagnetic layers we determine the spin dependent attenuation lengths which reflect hot electron transport along the vicinity of the [1 0 0]-axis of the bcc Fe34Co66 lattice. The majority spin attenuation length is more than 6 times larger than that of the minority spins within the measured energy interval of 1.3 up to 2 eV above the Fermi level. Consequently a Magnetocurrent effect exceeding 1200% accompanied by a monotonic bias voltage behavior is observed at room temperature

Multivisceral abdominal gunshot wounds: report of a case of complex surgery

Multivisceral abdominal gunshot wounds: report of a case of complex surger

12 years delayed postoperative spinal recurrence of craniopharyngioma. Case report and literature review

A case of delayed spinal adamantinomatous craniopharyngioma recurrence is presented. A 54-year-old male patient was admitted in our Emergency Department complaining of urinary disorders and leg pains. He underwent surgical removal of intraventricular craniopharyngioma 12 years previously. On MR imaging a well-circumscribed intradural cistyc mass at the T12 level was reavealed. A T11 and T12 laminotomy was performed and total removal of the tumour was achieved. Histology examination showed adamantinous craniopharyngioma. The authors believe that this represents the third case described of spinal craniofaryngioma recurrence and the first involving the dorsal spine