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Summary: Background & Aims: Intermittent nasogastric (ING)/intermittent orogastric (IOG) tube feeding is an intermittent tube feeding (ITF) method in which a catheter is sporadically placed through the mouth or nose into the stomach to administer nutrients with syringes. This method proves advantageous in rehabilitation wards, as it allows for bed release and training. However, detailed reports on this method are limited, and its safety remains controversial. This study aimed to investigate the incidence of complications and risk factors associated with ING/IOG tube feeding. Methods: This longitudinal cohort study included 135 patients who received ING/IOG tube feeding for all meals and were discharged from our hospital between October 2018 and September 2022. The incidence and prevalence of complications (diarrhea, vomiting, and pneumonia) during the first 28 days after admission were retrospectively investigated. Multiple logistic regression analysis was performed to analyze factors associated with complications. The explanatory variables selected were age, functional independence measure (FIM) motor scores, low body mass index (BMI) (

Background Tracheostomy procedures inhibit swallowing, although details of subsequent recovery of oral intake remain unknown. This retrospective cohort study aimed to investigate factors influencing dysphagia improvement in patients with subacute stroke after tracheostomy. Methods and Results The study included 117 patients who underwent tracheostomy after subacute stroke, cerebral hemorrhage, or endogenous subarachnoid hemorrhage and received care at 2 convalescent rehabilitation wards in urban and suburban Japan between 2015 and 2022. The primary outcome measure was the achievement of complete oral intake. Patient demographics, Functional Independence Measure scores, body mass index, food intake level scale scores, and the presence of severe white matter hyperintensities on imaging were retrospectively collected from medical records. Statistical analysis involved univariate logistic regression to identify potential predictors and multivariate logistic regression to refine the model while accounting for multicollinearity. In total, 47% of patients achieved complete oral intake on discharge. Sex, days from onset to admission, Functional Independence Measure motor and cognitive scores, body mass index, food intake level scale scores, and severe white matter hyperintensities were identified as potential predictors in the univariate analysis. However, multivariate logistic regression identified only food intake level scale scores (odds ratio [OR], 3.687 [95% CI, 1.519–8.949]; P=0.004) and severe white matter hyperintensities (OR, 0.302 [95% CI, 0.096–0.956]; P=0.042) as significant predictors of complete oral intake. Conclusions In patients with subacute stroke undergoing tracheostomy, the level of oral intake on admission and severe white matter hyperintensities on imaging may be better predictors of complete oral intake. However, prospective studies with larger sample sizes and more comprehensive data are warranted to confirm these findings.

Background: Various neurorehabilitation programs have been developed to promote recovery from motor impairment of upper extremities. However, the response of patients with chronic-phase stroke varies greatly. Prediction of the treatment response is important to provide appropriate and efficient rehabilitation. This study aimed to clarify whether clinical assessments, such as motor impairments and somatosensory deficits, before treatment could predict the treatment response in neurorehabilitation. Methods: The data from patients who underwent neurorehabilitation using closed-loop electromyography (EMG)-controlled neuromuscular electrical stimulation were retrospectively analyzed. A total of 66 patients with chronic-phase stroke with moderate to severe paralysis were included. The changes from baseline in the Fugl-Meyer Assessment–Upper Extremity (FMA-UE) and the Motor Activity Log-14 (MAL-14) of amount of use (AOU) and quality of movement (QOM) were used to assess treatment response, and multivariate logistic regression analysis was performed using the extracted candidate predictors, such as baseline clinical assessments, to identify predictors of FMA-UE and MAL-14 improvement. Results: FMA-UE and MAL-14 scores improved significantly after the intervention (FMA-UE p

Background and Purpose: Limited research has been conducted with the aim of understanding which upper extremity movements are difficult for persons with severe chronic stroke. The purpose of this study was to test the structure of the Fugl-Meyer Assessment for Upper Extremity (FMA-UE) using Rasch analysis in persons with chronic stroke with moderate to severe deficits and to determine the item difficulty hierarchy.Methods: This was a secondary analysis of data from previous randomized, controlled trials, or clinical trials. The participants were 101 persons with chronic stroke with moderate to severe hemiparesis (time after onset of stroke, 1375.3 ± 1157.9 days; the 33-item FMA-UE, 31.1 ± 12.8). Principal component analysis and infit statistics were used to evaluate dimensionality. Rasch analysis using a rating scale model was performed, and item difficulty was determined.Results: Six misfit items were removed. The results showed that the 27-item FMA-UE was unidimensional. Rasch analysis showed that the movements performed within synergies were among the easiest items. Shoulder and elbow movements were among the easiest items, whereas forearm and wrist movements were among the moderately to most difficult items. Hand items spanned various difficulty levels.Discussion and Conclusions: The FMA-UE is a valid assessment tool of upper extremity motor function in persons with chronic stroke with moderate to severe deficits. The results showed that item difficulty was consistent with the stepwise recovery course proposed by Fugl-Meyer. The movements that are difficult for patients with moderate to severe chronic paresis were determined, which would enable comparison of each movement using a measure of motion difficulty in future studies.

In this study, we focused on temperature and current distributions in voltage-state large-size intrinsic Josephson junction (IJJ) mesas with a self-heating effect. Because it is difficult to experimentally obtain temperature and current distributions in IJJ mesas, we numerically computed these distributions by solving non-linear diffusion and temperature dependence circuit equations. The local temperature in the mesa exceeded the critical temperature, and a normal-state appeared in the high bias region. Non-uniform temperature and current density distributions were obtained for each bias point of the current–voltage (I–V) characteristics. Normalized c-axis current distributions decreased with an increase in the bias current in the high bias regions. These results were explained using temperature dependent c-axis resistivity.

We aimed to investigate whether a newly defined distance in the lower limb can capture the characteristics of hemiplegic gait compared to healthy controls. Three-dimensional gait analyses were performed on 42 patients with chronic stroke and 10 age-matched controls. Pelvis-toe distance (PTD) was calculated as the absolute distance between an anterior superior iliac spine marker and a toe marker during gait normalized by PTD in the bipedal stance. The shortening peak during the swing phase was then quantified as PTDmin. The sagittal clearance angle, the frontal compensatory angle, gait speed, and the observational gait scale were also collected. PTDmin in the stroke group showed less shortening on the affected side and excessive shortening on the non-affected side compared to controls. PTDmin on the affected side correlated negatively with the sagittal clearance peak angle and positively with the frontal compensatory peak angle in the stroke group. PTDmin in stroke patients showed moderate to high correlations with gait speed and observational gait scale. PTDmin adequately reflected gait quality without being affected by apparent improvements due to frontal compensatory patterns. Our results showed that various impairments and compensations were included in the inability to shorten PTD, which can provide new perspectives on gait rehabilitation in stroke patients.

Pinning stability and the introduction of pinning centers are essential problems in the application of high temperature superconductors. A study of the role of the addition of a variety of oxides into Gd-123 bulk superconductors was pursued with respect to the effect of magnetic pinning centers on enhancement of critical current density. We have found the addition of magnetic alloy particles into Gd-123 bulk contributes to the enhancement of the critical current density under a magnetic field. The magnetic particles of Fe-B alloy with small amounts of Cu-Nb-Si-Cr were added into the Gd123 matrix and grown into single-domain bulk in air. The effects of Fe-B alloy magnetic particles on the superconducting pinning properties of Gd123 bulk are reported. The experimental results showed that the Tc of the bulk was suppressed significantly and the transition width became larger with an increase in the doping content of the magnetic particles. This was consistent with magnetic impurities suppressing superconductivity. The critical current density deduced from the magnetization as a function of applied external magnetic field was enhanced under low magnetic field and high magnetic field, which is different from the bulk doped with paramagnetic particles. Possible mechanisms and the role of magnetic materials from the viewpoint of increased flux pinning inside the bulk are discussed. [ABSTRACT FROM AUTHOR]