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81.
Home literacy environment (HLE) is one of most important modifiable risk factors to dyslexia. With the development in technology, we include the electronic devices usage at home, such as computers and televisions, to the definition of HLE and investigate its impact on dyslexia based on the on-going project of Tongji's Reading Environment and Dyslexia Study. The data include 5063 children, primary school students (grade 3–grade 6), from a middle-sized city in China. We apply the principal component analysis (PCA) to reduce the large dimension of variables in HLE, and find the first three components, denoted as PC1, PC2 and PC3, can explain 95.45% of HLE information. PC1 and PC2 demonstrate strong positive association with ‘total time spending on electronic devices’ and ‘literacy-related activity’, respectively. PC3 demonstrates strong negative association with ‘restrictions on using electronic devices’. From the generalized linear model, we find that PC1 significantly increases the risk of dyslexia (OR = 1.043, 95% CI: 1.018–1.070), while PC2 significantly decreases the risk of dyslexia (OR = 0.839, 95% CI: 0.795–0.886). Therefore, reducing the total time spending on electronic devices and increasing the literacy-related activity would be the potential protective factors for dyslexic children in China.  相似文献   
82.
83.
The objective of this study was to evaluate the effectiveness of two different closure devices in patients undergoing rescue percutaneous coronary intervention (PCI) using IIb/IIIa inhibitors and to compare it with patients undergoing elective PCI. One hundred sixty-two patients undergoing rescue PCI treated with IIb/IIIa inhibitors underwent vascular access site closure (6 Fr Perclose, n = 92, or 6 Fr Angioseal, n = 70). Vascular complications were compared with a sex- and age-matched group (n = 100) of patients undergoing manual compression after sheath removal and a similar group of patients undergoing elective PCI (n = 196). The incidence of access site complications was not significantly different between the three groups undergoing rescue PCI and was not higher than in patient receiving GP IIb/IIIa inhibitors without fibrinolysis (RR = 0.95; 95% CI = 0.88-1.01). In patients undergoing rescue PCI and receiving IIb/IIIa inhibitors, closure devices allow early sheath removal and are associated with similar outcomes compared with manual compression and elective PCI regardless of the type of closure device used.  相似文献   
84.
Purpose: To determine if older adult, novice wheelchair users who drive a power wheelchair with a JoyBar control complete maneuverability tasks in less time and with less error than those who drive a power wheelchair with a standard joystick control.

Materials and methods: A parallel randomized controlled trial design conducted at a medical rehabilitation and research centre with ambulatory older adults aged 60 and above (n?=?27). The intervention was the JoyBar alternative wheelchair control. The primary outcome measure was total time to complete each of the two maneuverability tasks. The secondary outcome measure was total number of errors during each of the maneuverability tasks.

Results: An independent, two sampled t-test was conducted and revealed that the JoyBar group took a greater amount of time to complete both maneuverability tasks than the control group (p?p?Conclusions: Maneuverability of a powered wheelchair by novice wheelchair users was not improved through the use of the JoyBar when compared to a standard wheelchair joystick, as measured by rates of error and time to complete maneuverability tasks.
  • Implications for rehabilitation
  • Clients who are new to powered wheelchair use may perform maneuverability tasks faster, with equivalent accuracy, using a standard joystick versus the JoyBar.

  • Clients who use a JoyBar may require adjustments to the programming of their wheelchair to ensure optimal performance.

  • Additional training may be required to achieve proficiency in maneuverability tasks with a JoyBar versus a standard joystick.

  相似文献   
85.
As the cases of heart failure continue to rise, more ventricular assist devices are likely to be implanted. Providers in a variety of care environments are more likely to see patients with ventricular assist devices because they are living longer; therefore, it is necessary for providers to understand the unique care and complications related to these devices, such as thrombosis, stroke, bleeding, right-sided heart failure, ventricular dysrhythmias, and infection. The current literature regarding the complications and management of patients with these devices was reviewed and summarized, with a focus on HeartWare (HeartWare International Inc, Framingham, MA) and HeartMate II (Thoratec Corp, Pleasanton, CA).  相似文献   
86.
87.

Objective

To quantify the effects of initial hip angle and angular hip velocity settings of a lower-limb wearable robotic exoskeleton (WRE) on the balance control and mechanical energy requirements in patients with paraplegic spinal cord injuries (SCIs) during WRE-assisted sit-to-stand (STS).

Design

Observational, cross-sectional study.

Setting

A university hospital gait laboratory with an 8-camera motion analysis system, 3 forceplates, a pair of instrumented crutches, and a WRE.

Participants

Patients (N=12) with paraplegic SCI.

Interventions

Not applicable.

Main Outcome Measures

The inclination angle (IA) of the body’s center of mass (COM) relative to the center of pressure (COP), and the rate of change of IA (RCIA) for balance control, and the mechanical energy and forward COM momentum before and after seat-off for energetics during WRE-assisted STS were compared between conditions with 2 initial hip angles (105° and 115°) and 3 initial hip angular velocities (800, 1000, 1200 rpm).

Results

No interactions between the main factors (ie, initial hip angle vs angular velocity) were found for any of the calculated variables. Greater initial hip angle helped the patients with SCI move the body forward with increased COM momentum but reduced RCIA (P<.05). With increasing initial angular hip velocity, the IA and RCIA after seat-off (P<.05) increased linearly while total mechanical energy reduced linearly (P<.05).

Conclusions

The current results suggest that a greater initial hip angle with smaller initial angular velocity may provide a favorable compromise between momentum transfer and balance of the body for people with SCI during WRE-assisted STS. The current data will be helpful for improving the design and clinical use of the WRE.  相似文献   
88.
Purpose state: Orthotic wearing time may be an important confounder in efficacy studies of treatment in children with spastic cerebral palsy (SCP). Most studies measure parent-reported wearing time (WTparent) with questionnaires, but it is questionable whether this yields valid results. This study aims to compare WTparent with objectively measured wearing time (WTobj) in children with SCP receiving orthotic treatment.

Method: Eight children with SCP participated in this observational study. For one year, they received knee-ankle-foot orthosis (KAFO) treatment. WTparent was measured using questionnaires. WTobj was measured using temperature sensor-data-loggers that were attached to the KAFOs. The 2.5th and 97.5th percentiles and median of differences between methods (per participant) were used to calculate limits of agreement and systematic differences.

Results: There was no systematic difference between WTparent and WTobj (0.1?h per week), but high inter-individual variation of the difference was found, as reflected by large limits of agreement (lower limit/2.5th percentile: ?1.7?h/week; upper limit/97.5th percentile: 11.1?h/week).

Conclusions: Parent-reported wearing time (WTparent) of a KAFO differs largely from objectively measured wearing time (WTobj) using temperature sensors. Therefore, parent-reported wearing time (WTparent) of KAFOs should be interpreted with utmost care.
  • Implications for Rehabilitation
  • Low wearing time of orthoses may be a cause of inefficacy of orthotic treatment and incorrect reported wearing time may bias results of efficacy studies.

  • Results of this study show that parent-reported wearing time is not in agreement with objectively measured wearing time.

  • Parent-reported wearing time of KAFOs should be interpreted with utmost care.

  • Objective methods are recommended for measuring orthotic wearing time.

  相似文献   
89.
Excessive recreational noise exposure in young adults might result in noise-induced hearing loss (NIHL) and tinnitus. Inducing behavioral change in young adults is one of the aims of a hearing conservation program (HCP). The goal of the current study was to evaluate the effect of a hearing education program after 6 months in young adults in relation to knowledge regarding their individual hearing status. The results of a questionnaire regarding the weekly equivalent recreational noise exposure, attitudes and beliefs toward noise, and hearing loss and hearing protector devices (HPDs) were compared between both sessions. Seventy-eight young adults completed the questionnaire concerning recreational noise exposure, youth attitude to noise scale (YANS), and beliefs about hearing protection and hearing loss (BAHPHL). Their hearing status was evaluated based on admittance measures, audiometry, transient-evoked otoacoustic emissions (TEOAEs), and distortion-product otoacoustic emissions (DPOAEs). The main analysis consisted of a mixed model analysis of variance with dependent variables of either the noise exposure or the scores on (subscales of) YANS and BAHPHL. The independent variables were hearing status and session one versus session two. There was a significant decrease in recreational noise exposure and several (sub) scales of YANS and BAHPHL between both the sessions. This behavioral change resulted in a more frequent use of HPDs in 12% of the participants. However, the behavioral change was not completely related to the knowledge of young adults’ individual hearing status. To prevent hearing damage in young people, investing in HCPs is necessary, apart from regulating sound levels and its compliance at various leisure-time activities. Also, the long-term effect of HCPs and their most cost-efficient repetition rates should be further investigated.  相似文献   
90.
Magnetic resonance imaging (MRI) is currently considered an essential complementary method for diagnosis in many conditions. Exponential growth in its use is expected due to the aging population and a broader spectrum of clinical indications. Growth in its use, coupled with an increasing number of pacemaker implants, implantable cardioverter‐defibrillators and cardiac resynchronization therapy, has led to a frequent clinical need for this diagnostic modality in patients with cardiac implantable electronic devices (CIED). This clinical need has fueled the development of devices specifically designed and approved for use in a magnetic resonance (MR) environment under certain safety conditions (MR‐conditional devices). More than a decade after the introduction of the first MR‐conditional pacemaker, there are now several dozen MR‐conditional devices with different safety specifications. In recent years, increasing evidence has indicated there is a low risk to MRI use in conventional (so‐called non‐MR‐conditional) CIED patients in the right circumstances. The increasing number, as well as the greater diversity and complexity of implanted devices, justify the need to standardize procedures, by establishing institutional agreements that require close collaboration between cardiologists and radiologists. This consensus document, prepared jointly by the Portuguese Society of Cardiology and the Portuguese Society of Radiology and Nuclear Medicine, provides general guidelines for MRI in patients with CIED, ensuring the safety of patients, health professionals and equipment. In addition to briefly reviewing the potential risks of MRI in patients with CIED and major changes to MRI‐conditional devices, this article provides specific recommendations on risk‐benefit analysis, informed consent, scheduling, programming strategies, devices, monitoring and modification of MRI sequences. The main purpose of this document is to optimize patient safety and provide legal support to facilitate easy access by CIED patients to a potentially beneficial and irreplaceable diagnostic technique.  相似文献   
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