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Objective: To show the effectiveness of goal-oriented proprioceptive training in subacute stroke for balance, autonomy, and fall risk., Methods: Out a total of 35 patients, consistent in age (75.31±8.65 years), type of stroke (ischemic, 3 to 11 weeks before), and motor impairment, 18 patients underwent solely proprioceptive rehabilitation, the other 17 dual task exercises. The study assessed autonomy using Barthel Index, fall risk with Timed Up and Go Test (TUG), balance through Berg Balance Scale (BBS) and Tinetti test., Results: After two months, significant improvements were recorded in Barthel Index, BBS (p<0.0001), Tinetti test (p<0.0001 in dual task group, p=0.0029 in single task group), and TUG (p=0.0052 in dual task group, p=0.0020 in single task group) in both groups. Comparing the two groups, dual task group showed a significant difference in Tinetti balance assessment (p=0.0052), between the total score of Tinetti test and TUG in single (p=0.0271), and dual task (p=0.0235). Likewise, Tinetti gait test was significantly related to TUG in single (p=0.0536), and dual task (p=0.0466), while Tinetti balance test to Barthel Index (p=0.0394), BBS (p<0.0001), and TUG in single (p=0.0219), and dual task (p=0.0196). Lastly, there is a positive correlation of the use of aids with BBS (p=0.0074), and total score of Tinetti test (p=0.0160)., Conclusion: In subacute stroke, goal-oriented proprioceptive training improved balance, but only partially autonomy. Furthermore, the use of aids after dual-task exercises improved recovery of balance, but did not reduced falls.

This study compares pandemic experiences of Missouri's 115 counties based on rurality and sociodemographic characteristics during the 1918-20 influenza and 2020-21 COVID-19 pandemics. The state's counties and overall population distribution have remained relatively stable over the last century, which enables identification of long-lasting pandemic attributes. Sociodemographic data available at the county level for both time periods were taken from U.S. census data and used to create clusters of similar counties. Counties were also grouped by rural status (RSU), including fully (100%) rural, semirural (1-49% living in urban areas), and urban (>50% of the population living in urban areas). Deaths from 1918 through 1920 were collated from the Missouri Digital Heritage database and COVID-19 cases and deaths were downloaded from the Missouri COVID-19 dashboard. Results from sociodemographic analyses indicate that, during both time periods, average farm value, proportion White, and literacy were the most important determinants of sociodemographic clusters. Furthermore, the Urban/Central and Southeastern regions experienced higher mortality during both pandemics than did the North and South. Analyses comparing county groups by rurality indicated that throughout the 1918-20 influenza pandemic, urban counties had the highest and rural had the lowest mortality rates. Early in the 2020-21 COVID-19 pandemic, urban counties saw the most extensive epidemic spread and highest mortality, but as the epidemic progressed, cumulative mortality became highest in semirural counties. Additional results highlight the greater effects both pandemics had on county groups with lower rates of education and a lower proportion of Whites in the population. This was especially true for the far southeastern counties of Missouri ("the Bootheel") during the COVID-19 pandemic. These results indicate that rural-urban and socioeconomic differences in health outcomes are long-standing problems that continue to be of significant importance, even though the overall quality of health care is substantially better in the 21st century., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Sattenspiel et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: We evaluated the role of scuba diving on cardiovascular risk in a small group of divers., Methods: We have enrolled 14 subjects (12 males and 1 female, mean age 49±12.2 years) undergone to scuba diving (one patient did not complete the period of observation due to the b-blocker treatment). We evaluated electrocardiographyc trace and we have measured QT and RR interval to calculate the QTc index (Bazzet, Fridericia, Hodges and Framingam index) and the Tpeak to Tend index and heart rate variability index before and after scuba diving activity., Results: The results of our study confirm that there is a statistically significant improvement of the RR and QT index but there is not a statistically significant increase of the QTc index (QT interval normalized by heart rate) evaluated before and after scuba diving. In the same cohort of subjects, we have noted a not statistically significant improvement of Tpeak to Tend index. Our study has underlined a statistically significant modification of the SD1 and SD2 indices representative of parasympathetic and orthosympathic activity. Scuba diving activity seems to not be associated with a statistically significant variation of the cardiovascular risk., Conclusions: Our data confirm that non-linear analysis is characterized by a statistically significant variation of the neurovegetative tone mainly linked to an increased parasympathetic activity. However, further studies are necessary to elucidate these preliminary findings.

40Ca+;{40,48}Ca,46Ti reactions at 25 MeV/nucleon have been studied using the 4pi CHIMERA detector. An isospin effect on the competition between fusionlike and binarylike reaction mechanisms has been observed. The probability of producing a heavy residue is lower in the case of N approximately Z colliding systems as compared to the case of reactions induced on the neutron rich 48Ca target. Predictions based on constrained molecular dynamics II calculations show that the competition between fusionlike and binary reactions in the selected centrality bins can constrain the parametrization of the symmetry energy and its density dependence in the nuclear equation of state.

A new reaction mechanism of violent reseparation of a heavy nucleus-nucleus system, 197Au + 197Au, into three or four massive fragments in collisions at 15 MeV/nucleon has been observed. After reseparation, the fragments are almost exactly aligned, thus showing a very short time scale of the reseparation process, of about 70-80 fm/c.

Background: The ability of immunometric methods to identify anti-topoisomerase I (Scl70) antibodies is controversial. We wished to quantify the performance of the currently available commercial systems for the assay of anti-topoisomerase I antibodies in a large multicenter study., Methods: Fifty Italian clinical laboratories analyzed 36 serum samples: 27 from individuals with scleroderma/systemic sclerosis, and 9 from a control group. The scleroderma/systemic sclerosis samples were positive in our laboratories by both ELISA and immunoblot (IB), and the control samples were negative. The laboratories used 42 immunoenzymatic (ELISA), 21 IB, 3 counterimmunoelectrophoresis, and 2 dot-blot methods, produced by 23 different manufacturers., Results: We obtained 2389 results. The ELISA methods showed 99.2% specificity and 97.2% sensitivity for detection of anti-Scl70 antibodies. For IB methods, specificity was 97.6% and sensitivity was 96.1%. The Western-blot method had poor analytical specificity (27% false positives for anti-extractable nuclear antigen antibodies other than anti-Scl70)., Conclusions: Excluding Western blots, commercial ELISA and IB reagents as used in clinical laboratories have a sensitivity and a specificity >95% for determination of anti-Scl70 antibodies.

An account of the main causes of low blood magnesium and the predominant rôle of this ion in the organism is followed by the description of a case of encephalopathy due to magnesium deficiency in a chronic alcoholic with cirrhosis of the liver. This neuropsychological condition, together with its concomitant low blood calcium and potassium, rapidly regressed when magnesium sulphate was administered. Stress is laid on the desirability of giving attention to and preventing the onset of this electrolytic alteration in clinical practive.

Using monoclonal antibodies of the OKT series we studied the blood T lymphocyte subsets of 12 patients with Primary Sjögren's Syndrome, 15 with Rheumatoid Arthritis associated Sjögren's Syndrome and 10 normal controls. We found a marked reduction of T lymphocytes both in Primary and Secondary Sjögren's Syndrome compared with normal controls (p less than 0.001). While no difference was noted in the number of helper-inducer T cells between Primary and Secondary Sjögren's Syndrome, a more important decrease of suppressor-cytotoxic cells was demonstrated in Secondary Sjögren's Syndrome (p less than 0.01). These data may contribute to a better understanding of the disease.

In an attempt to investigate an aspect of the immunoregulatory mechanisms operating in alcoholic hepatic cirrhosis with ascites we have enumerated T-cell subsets in the peripheral blood and ascitic fluid of 16 patients with this disease. The peripheral blood analysis revealed a reduction of OKT3+, OKT4+ and OKT8+ cells compared to those of the control group (p less than 0.001) and an increase of OKT4+/OKT8+ ratio. In the ascitic fluid the OKT4+/OKT8+ ratio, compared to that of the peripheral blood, was decreased (p less than 0.001) because of increase of OKT8+ cell proportion. We suggest that the sequestrated splanchnic OKT8+ subset might be represented by suppressor lymphocytes transuding from the liver.

A long term open study of the use of thiopronine in the treatment of 38 patients with ARA classified "classic" or "definite" rheumatoid arthritis is reported. Doses of the drug were increased from an initial 250 mg per diem by the addition of 250 mg every 15 days to 1 g per diem. After 6 months testing, results were satisfactory (good and fair) in 65% of the cases in both biological and clinical terms. In 15% of the cases, treatment was interrupted mainly due to mucous and cutaneous side effects. These preliminary results confirm reports in the literature and encourage further experiment.