Lower Extremity Exoskeleton

Develop a lower extremity device that provides assistance, support, and gait correction for children with cerebral palsy who display crouch gait as a symptom. The device will be designed for children ages 7-12. The device will be adjustable to accommodate varying levels of gait irregularity, weakness and human growth. The device would assist walking and stair climbing by providing bilateral support at hips, knees and ankle joints. The device will be designed for ease of donning and doffing. Battery, drive and control electronics will be designed to reside in a minimalistic backpack (outside the scope of this project)

Validation of the Kinyarwanda-Version Short-Form Leeds Dyspepsia Questionnaire and Short-Form Nepean Dyspepsia Index to Assess Dyspepsia Prevalence and Quality-of-Life Impact in Rwanda

We aimed to develop and validate Kinyarwanda versions of Short-Form Leeds Dyspepsia Questionnaire (SF-LDQ) and Short-Form Nepean Dyspepsia Index (SF-NDI) to measure the frequency and severity of dyspepsia and associated quality-of-life impact in Rwanda

WEATHERING, RADIOGENIC ISOTOPES, AND MARINE RECORDS OF GLACIAL DYNAMICS

Glacial advance and retreat is related to numerous climate system feedbacks; yet, this dynamic glacial activity tends to erase its own terrestrial record. As a result, deep-sea sediments may be the best archives for studying past glacial processes. Interpretations of these archives depend on understanding terrestrial sources to the marine sediments. Systematic spatial variations in dissolved riverine and soil leachate Sr, Nd and Pb isotopes across an ~175 km transect from the Greenland Ice Sheet to the coast present an analog for temporal changes during glacial retreat. Specifically, the offset between dissolved (riverine or soil leachates) and bulk sediment (bedload or leached soil) isotopes is highest in young glacial sediments close to the ice sheet and approaches zero in 10 ky old glacial sediments at the coast. This difference is attributed to a transition from preferential chemical weathering of trace minerals and/or radiation damaged sites in freshly comminuted, ice-proximal sediments to predominant weathering of less radiogenic (Sr and Pb) and more radiogenic (Nd) isotopes from bulk major minerals in more extensively weathered coastal material. These isotopes are transported to the ocean where the residence time of Sr is too long to be an effective tracer of local or regional glacial processes; however, the short residence time of Pb makes it an excellent tracer of local chemical weathering processes and the intermediate residence time of Nd allows application to region studies. Data from IODP Sites 1302/3 (3550 m water depth) in the NW Atlantic illustrate that seawater Pb and Nd isotopes preserved in authigenic FeMn-oxide coatings respond dramatically to retreat of the Laurentide Ice Sheet during the penultimate glacial termination (T2; 135-129 ka) and to rapid variations during Dansgaard-Oeschger cycles. These data suggest deep-sea radiogenic isotopes preserve a more detailed record of the long term history of ice sheet dynamics than terrestrial proxies. The systematic variation in chemical weathering linked to ice sheet retreat and reflected in deep-sea isotope records may also help refine estimates of past and future carbon cycling and fluxes of nutrients and isotopes to the ocean associated with high latitude climate change

Individual and Triadic and group? Supervisors’ and supervisees’ perceptions of each modality.

In this consensual qualitative research study, the authors explored supervisors' (n= 11) and their supervisees' (n= 31) perceptions of individual, triadic, and group supervision sessions during practicum. Data from supervisor individual interviews and supervisee focus-group interviews revealed several themes regarding the advantages and disadvantages of each supervision modality. Findings suggest the relative place of each modality in terms of goals and impact

The burden of selected digestive diseases in the United States

AbstractBackground & Aims: Gastrointestinal (GI) and liver diseases inflict a heavy economic burden. Although the burden is considerable, current and accessible information on the prevalence, morbidity, and cost is sparse. This study was undertaken to estimate the economic burden of GI and liver disease in the United States for use by policy makers, health care providers, and the public. Methods: Data were extracted from a number of publicly available and proprietary national databases to determine the prevalence, direct costs, and indirect costs for 17 selected GI and liver diseases. Indirect cost calculations were purposefully very conservative. These costs were compared with National Institutes of Health (NIH) research expenditures for selected GI and liver diseases. Results: The most prevalent diseases were non–food-borne gastroenteritis (135 million cases/year), food-borne illness (76 million), gastroesophageal reflux disease (GERD; 19 million), and irritable bowel syndrome (IBS; 15 million). The disease with the highest annual direct costs in the United States was GERD ($9.3 billion), followed by gallbladder disease ($5.8 billion), colorectal cancer ($4.8 billion), and peptic ulcer disease ($3.1 billion). The estimated direct costs for these 17 diseases in 1998 dollars were $36.0 billion, with estimated indirect costs of$22.8 billion. The estimated direct costs for all digestive diseases were $85.5 billion. Total NIH research expenditures were$676 million in 2000. Conclusions: GI and liver diseases exact heavy economic and social costs in the United States. Understanding the prevalence and costs of these diseases is important to help set priorities to reduce the burden of illness.GASTROENTEROLOGY 2002;122:1500-151

Validation of the Kinyarwanda-version Short-Form Leeds Dyspepsia Questionnaire and Short-Form Nepean Dyspepsia Index to assess dyspepsia prevalence and quality-of-life impact in Rwanda

OBJECTIVES: We aimed to develop and validate Kinyarwanda versions of Short-Form Leeds Dyspepsia Questionnaire (SF-LDQ) and Short-Form Nepean Dyspepsia Index (SF-NDI) to measure the frequency and severity of dyspepsia and associated quality-of-life impact in Rwanda. SETTING: A single, tertiary care centre in Rwanda. PARTICIPANTS: 200 consecutive Kinyarwanda-speaking patients referred to endoscopy (100 patients) or medical outpatients (100 patients). INTERVENTIONS: Kinyarwanda versions of the SF-LDQ and SF-NDI were developed from English versions by translation, with back translation, crosschecking and pilot testing. Study participants completed these questionnaires at enrolment (time 1), and then completed the surveys again with blinded phone interviewers 3 days later (time 2). 20 randomly selected participants, diagnosed with a peptic ulcer on index endoscopy, completed a third survey by phone at day 30 (time 3), after therapy. PRIMARY OUTCOME MEASURES: Internal consistency at time 1 (by Cronbach's α) and test–retest reliability between time 1 and time 2 (Spearman's correlation coefficient) for translated SF-LDQ and SF-NDI; validity versus clinical diagnosis (by receiver operating characteristic (ROC) curve) and responsiveness to treatment for SF-LDQ (by change in mean score). All outcomes were measured as per protocol. RESULTS: Cronbach's α of the translated SF-LDQ was 0.93, showing high internal consistency. Spearman's correlation coefficient comparing time 1 and time 2 was 0.978 (p<0.001), demonstrating high reliability. Cronbach's α for the translated SF-NDI was 0.92. A cut-off score of 16 on the SF-LDQ showed a sensitivity of 97% and a specificity of 71% for the diagnosis of dyspepsia, correctly classifying 89% of patients. In the responsiveness analysis, the mean SF-LDQ score was reduced from 20.1 prior to treatment to 13.9 after 30 days of treatment (p=0.003). CONCLUSIONS: The Kinyarwanda versions of the SF-LDQ and SF-NDI were valid, reliable and responsive to treatment