Translating Modified Ashworth Scale into Functional Measures and Quantitative Kinematic Values: A Pilot Study

TRANSLATING MODIFIED ASHWORTH SCALE INTO FUNCTIONAL MEASURES AND QUANTITATIVE KINEMATIC VALUES: A PILOT STUDY by Patrick D. Frigge The University of Wisconsin-Milwaukee, 2016 Under the Supervision of Professor Ying-Chih Wang, PhD Introduction: Spasticity is a motor disorder characterized by a velocity-dependent increase in tonic stretch reflexes. The gold standard for assessing spasticity in stroke patients is the Modified Ashworth Scale (MAS), but the scale is highly subjective to the clinician’s opinion and previous experience and lacks psychometric fidelity. Numerous studies have criticized the scale’s subjectivity and lack of rater reliability. Development of a quantitative spasticity device in routine clinical care is warranted. Before doing so, however, it is important to examine how MAS scores translate into functional measures and quantitative kinematic and/or kinetic values. Methods: Data from 20 subjects (6 female, 14 male; mean age 57 ± 10) with chronic hemiparesis secondary to a cerebrovascular accident (stroke) were used to examine the relationships between the MAS and residual impairments (active range of motion of shoulder flexion, elbow, and wrist, and muscle strength of the elbow flexion and extension), the MAS and functional limitations as measured by the Fugl-Meyer upper extremity assessment, finger to nose movement, the MAS and overall health status following stroke as measured by the Stroke Impact Scale, and to inspect whether there are potential kinematic values or physiological responses that can be used to identify the characteristics of the passive stretch (passive stretch duration, catch angle, electromyography response). The data were collected at both the Rehabilitation Institute of Chicago and the University of Wisconsin-Milwaukee. Results: Overall, results showed that stroke subjects who had more severe spasticity tended to have reduced range of motion at the shoulder (flexion) (Pearson correlation coefficient rp = -.601; Spearman correlation coefficient rs = -.607), elbow (rp = -.436; rs = -.495) and wrist (rp = -.206; rs = -.305) joints, as well as reduced muscle strength for elbow flexion (rp = -.547; rs = -.618). The relationship between the MAS scores and the muscle strength for elbow extension was weak (rp = -.160; rs = -.191). Analysis between the FM-UE subscale and MAS revealed a significant negative correlation. The strongest correlation occurred between the FM-UE total score (rp = -0.817; rs = -0.806), while the weakest correlation amongst all subscales occurred between coordination subscale (rp = -0.696; rs = -0.684). A one-way, between-subjects design ANOVA showed significant mean differences between MAS scores and all FM-UE subscales: the FM-Arm subscale (F4,15 = 17.4, p \u3c .001), the FM-Wrist subscale (F4,15 = 4.3, p \u3c 0.016), the FM-Hand subscale (F4,15 = 4.8, p \u3c 0.011), the FM-Corr subscale (F4,15 = 4.4, p \u3c 0.015) as well as FM-Total Score subscale (F4,15 = 12.6, p \u3c 0.001). Overall, there was a tendency for increased levels of spasticity per scoring of the MAS to result in decreased motor performance as measured by the FM-UE subscale. There was a moderate negative correlation between MAS score and the Stroke Index Scale hand subscale (rp = -0.543; rs = -0.576), indicating that a higher MAS score may be indicative of the magnitude of impairment in the hand. No significant relationships were demonstrated between the remaining subscales of the Stroke Impact Scale, suggesting that there is little to no relationship between MAS scores and overall health status. In comparing EMG activity and motion capture analysis, there was a marked increase in the EMG response when the subjects affected limb is stretched into full elbow extension, such phenomenon was not observed when stretching the unaffected limb. Conclusion: The strong correlation between MAS scores and the residual impairments as well as the FM-UE subscale suggests that a higher MAS score may be indicative of the general stage of motor recovery following incurrence of a stroke. Additionally, there was a marked increase in EMG activity through passive stretching of the affected limb into full elbow extension; conversely, such a phenomenon was not observed in the unaffected limb

Automated parameters for troubled-cell indicators using outlier detection

In Vuik and Ryan (2014) we studied the use of troubled-cell indicators for discontinuity detection in nonlinear hyperbolic partial differential equations and introduced a new multiwavelet technique to detect troubled cells. We found that these methods perform well as long as a suitable, problem-dependent parameter is chosen. This parameter is used in a threshold which decides whether or not to detect an element as a troubled cell. Until now, these parameters could not be chosen automatically. The choice of the parameter has impact on the approximation: it determines the strictness of the troubled-cell indicator. An inappropriate choice of the parameter will result in detection (and limiting) of too few or too many elements. The optimal parameter is chosen such that the minimal number of troubled cells is detected and the resulting approximation is free of spurious oscillations. In this paper we will see that for each troubled-cell indicator the sudden increase or decrease of the indicator value with respect to the neighboring values is important for detection. Indication basically reduces to detecting the outliers of a vector (one dimension) or matrix (two dimensions). This is done using Tukey's boxplot approach to detect which coefficients in a vector are straying far beyond others (Tukey, 1977). We provide an algorithm that can be applied to various troubled-cell indication variables. Using this technique the problem-dependent parameter that the original indicator requires is no longer necessary as the parameter will be chosen automatically

Ultrafast structural non-equilibium dynamics of the optical induced Si(111)(8x2)→(4x1)-In phase transition

Gegenstand dieser Arbeit ist die Untersuchung der initialen strukturellen Dynamik des photoinduzierten Schmelzens der Ladungsdichtewelle in Indiumatomdrähten auf einer Silizium(111)-Oberfläche. Diese bilden sich nach Adsorption von weniger als einer Monolage Indium auf einer reinen Si(111)-Oberfläche bei erhöhten Temperaturen und anschließendem Kühlen unterhalb einer kritischen Temperatur von 130 K aus. Die strukturelle Dynamik wird dabei mithilfe zeitaufgelöster, oberflächensensitiver Elektronenbeugung in RHEED-Geometrie bestimmt. Hierbei wird die Oberfläche zunächst mit einem 120 fs kurzen Infrarot-Laserpuls angeregt. In variablen Zeitabständen zur optischen Anregung wird dann an der Oberfläche ein kurzer Elektronenpuls in streifenden Einfall gebeugt (Anrege-Abfrage-Prinzip). Das daraus resultierende Beugungsbild erlaubt Rückschlüsse über die Struktur der Oberfläche für die einzelnen Zeitpunkte relativ zur Anregung. Um die zu erwartenden Änderungen im sub-Pikosekunden Bereich beobachten zu können, wurde im Rahmen dieser Arbeit der experimentelle Aufbau für beste Zeitauflösungen hin optimiert. Der entscheidende Faktor hierbei besteht in der Schrägstellung der anregenden Laserpulsfronten um mehr als 70° bei einer Elektronenergie von 30 keV. Hierdurch wird sichergestellt, daß die Zeitdifferenz zwischen Anregung und Abfrage über die gesamte abgefragte Probenoberfläche konstant ist. Durch Optimierung der optischen Schrägstellung und die gleichzeitige Reduktion der Elektronenanzahl in einem Abfragepuls konnte in dieser Arbeit das theoretisch zu erwartende zeitliche Auflösungsvermögen von 330 fs für den gesamten experimentellen Aufbau erreicht werden. Die signifikante Verbesserung der Zeitauflösung ermöglichte dann die Untersuchung der ultraschnellen Nichtgleichgewichtsdynamik der optisch angeregten Ladungsdichtewelle in den (quasi-)eindimensionalen Indiumatomdrähten. Dabei zeigte sich, daß die Geschwindigkeit des optisch induzierten Schmelzens von der Fluenz des anregenden Lasers abhängt und zu hohen Fluenzen hin ein sättigendes Verhalten mit einer Zeitkonstante von etwa 350 fs aufweist. Mit abnehmender Fluenz erhöht sich diese Zeitkonstante exponentiell auf etwa 1.9 ps bei 0.9 mJ/cm². Ferner wird gezeigt, daß unterhalb dieser Anregungsschwelle die Ladungsdichtewelle nicht geschmolzen, sondern lediglich angeregt wird. Im Bereich zwischen 0.9 mJ/cm² und 2 mJ/cm² wird die Ladungsdichtewelle hingegen partiell über die Oberfläche geschmolzen. Die daraus resultierende strukturelle Transformation der Oberflächeneinheitszelle von (8 x 2) -> (4 x 1) erfolgt dabei nichtthermisch, da zum einen die Temperaturerhöhung durch die Anregung nicht ausreicht und zweitens die Zeitkonstante für das Aufheizen der Indiummonolage mit 2.2 ps um das Sechsfache höher ist, als die der beobachteten Phasenumwandlung für die höchste Laserfluenz.This thesis deals with the initial structural dynamics of the photoinduced melting of a charge density wave in atomic chains of Indium on a Silicon(111) surface. These chains were prepared by adsorbing less than one monolayer of Indium on a clean Si(111) surface at elevated temperatures and subsequent cooling below a critical temperature of 130 K. The structural dynamics were monitored with time-resolved surface sensitive electron diffraction in a RHEED-geometry. The experimental setup is a classical pump-probe scheme, where the surface is excited with infrared laser pulses at a temporal width of 120 fs and probed with ultrashort electron pulses under gracing incidence at variable time delays before, during and after optical excitation. Consequently, the corresponding diffraction patterns are subject to the atomic arrangement of the surface and therefore allow to monitor ultrafast structural changes in the time domain. However, because such photoinduced processes typically happen in the sub-picosecond region the overall temperal resolution of the experimental setup had to be improved prior to the measurements.For this purpose it is necessary to compensate the velocity mismatch of 30 keV electrons and light across the entire sample surface by tilting the pump pulse front by more than 70°. This ensures a constant time delay between excitation and probing. By adjusting the existing optical setup of the pulse front tilter and simultaneously reducing the number of electrons in the probe pulses the overall temporal resolution was finally improved to 330 fs, which is the maximum value for this setup. The significant enhancement of the temporal resolution allowed the study of the ultrafast non-equilibrium dynamics of the photoexcited charge density wave in the (quasi)-onedimensional Indiumchains. It was found that the speed of the optical induced melting crucially depends on the applied fluence of the pump laser and saturates at a timeconstant of about 350 fs at high fluences. With decreasing fluences the time constant increases exponentially to 1.9 ps at 0.9 mJ/cm². However, below this threshold the charge density wave does not melt but is merely excited. In the mid-fluence region from 0.9 mJ/cm² to 2.0 mJ/cm² the charge density wave melts partially across the surface. Hereby, the driving force for the resulting structural transformation of the surface unit cell from an (8 x 2) -> (4 x 1) reconstruction is purely non-thermal. This is due to two basic findings: first, the transient temperature increase of the Indium monolayer is not sufficient to overcome the phase transition temperature of 130 K and second, the time constant for thermal heating is 2.2 ps, making this process up to six times slower than the observed structural transformation for the highest fluences

Shallow water experiment utilizing the STD Model 9006 at a fixed point

An examination of the salinity sensing capabilities of the STD model 9006 was made in laboratory and in shallow water field conditions both in Monterey Bay and at the N.U.C. Tower off Mission Beach at San Diego, California. Laboratory studies showed it to be influenced by changes in water velocity from zero to non-zero. Field studies showed that the instrument was unsuitable for sensing instantaneous microstructure fluctuations of salinity in shallow water while being held at a single depth in a wave influenced regime. Averaged over a period of ten seconds or more, however, the output of the instrument was judged to be accurate to at least the first decimal place.http://archive.org/details/shallowwaterexpe1094516797Lieutenant, United States NavyApproved for public release; distribution is unlimited

Untangling the Formation of Methoxymethanol (CH\u3csub\u3e3\u3c/sub\u3eOCH\u3csub\u3e2\u3c/sub\u3eOH) and Dimethyl Peroxide (CH\u3csub\u3e3\u3c/sub\u3eOOCH\u3csub\u3e3\u3c/sub\u3e) in Star-forming Regions

© 2019. The American Astronomical Society. All rights reserved.. Methoxymethanol (CH3OCH2OH) was recently detected toward the MM1 core in the high-mass star-forming region NGC 6334I. However, the underlying formation mechanisms of this complex organic molecule (COM) as well as its structural isomers ethylene glycol (HOCH2CH2OH) and the hitherto unobserved dimethyl peroxide (CH3OOCH3) are still elusive. Here, we report the very first confirmed synthesis of dimethyl peroxide - at various deuteration levels within interstellar analogous ices of D3-methanol (CD3OH) exposed to ionizing radiation at ultralow temperatures of 5 K. The discrimination of specific isomers is achieved by exploiting reflectron time-of-flight mass spectrometry coupled with isomer-selective photoionization of the subliming molecules in the temperature programmed desorption phase of the experiment. Based on the distribution of the identified species at distinct mass-to-charge ratios, we reveal primary and secondary reaction pathways to methoxymethanol, ethylene glycol, and dimethyl peroxide involving radical-radical recombination of methoxy (CH3O) and hydroxymethyl (CH2OH). Our findings help to constrain the formation mechanism of COMs detected within star-forming regions (methoxymethanol, ethylene glycol) and propose that the hitherto elusive dimethyl peroxide isomer represents an excellent candidate for future astronomical searches

Free electron laser induced processes in thin molecular ice

Intermolecular reactions in and on icy films on silicate and carbonaceous grains constitute a major route for the formation of new molecular constituents in interstellar molecular clouds. In more diffuse regions and in protoplanetary discs, energetic radiation can trigger reaction routes far from thermal equilibrium. As an analog of interstellar icecovered dust grains, highly oriented pyrolytic graphite HOPG covered with D2O, NO, and H atoms is irradiated by ultrashort XUV pulses and the desorbing ionic and neutral products are analysed. The yields of several products show a nonlinear intensity dependence and thus enable the elucidation of reaction dynamics by two pulse correlated desorptio

Localization of a gene for migraine without aura to chromosome 4q21.

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldMigraine is a common form of headache and has a significant genetic component. Here, we report linkage results from a study in Iceland of migraine without aura (MO). The study group comprised patients with migraine recruited by neurologists and from the registry of the Icelandic Migraine Society, as well as through the use of a questionnaire sent to a random sample of 20,000 Icelanders. Migraine diagnoses were made and confirmed using diagnostic criteria established by the International Headache Society. A genome-wide scan with multipoint allele-sharing methods was performed on 289 patients suffering from MO. Linkage was observed to a locus on chromosome 4q21 (LOD=2.05; P=.001). The locus reported here overlaps a locus (MGR1) reported elsewhere for patients with migraine with aura (MA) in the Finnish population. This replication of the MGR1 locus in families with MO indicates that the gene we have mapped may contribute to both MA and MO. Further analysis indicates that the linkage evidence improves for affected females and, especially, with a slightly relaxed definition of MO (LOD=4.08; P=7.2 x 10(-6))

Support for involvement of the AHI1 locus in schizophrenia

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldRecently, markers in the Abelson Helper Integration Site 1 (AHI1) region were shown to be associated with schizophrenia in a family sample of Israeli-Arabs. Here, we report a study evaluating the relevance of the AHI1 region to schizophrenia in an Icelandic sample. Seven markers shown to confer risk in the previous report were typed in 608 patients diagnosed with broad schizophrenia and 1,504 controls. Odds ratios for the overtransmitted alleles in the Israeli-Arab families ranged from 1.15 to 1.29 in the Icelandic sample. After Bonferroni correction for the seven markers tested, two markers were significantly associated with schizophrenia. Thus, our results are in general agreement with the previous report, with the strongest association signal observed in a region upstream of the AHI1 gene