Concordance between the international standards for neurological classification of spinal cord injury motor examination and needle electromyography findings in muscles with a motor power grade of zero or trace.

Context/Objective: To evaluate the accuracy of the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) motor examination in individuals with spinal cord injury (SCI) with motor grade 0 or 1 and analyze its degree of concordance with needle electromyography (EMG) findings for each key muscle.Design: Retrospective study.Setting: University hospital in Goyang, Korea.Participants: Individuals with SCI admitted to the Department of Rehabilitation from January 2013 to June 2019.Interventions: In the enrolled persons, needle EMG was performed on muscles with motor grade 0 or 1 on ISNCSCI examination, and muscle contraction was confirmed through the detection of motor unit action potential.Outcome measures: The agreement between motor examination and needle EMG findings was analyzed.Results: In 175 key muscles, needle EMG findings in 115 and 60 muscles evaluated as grades 0 and 1 on ISNCSCI examination showed 80% and 50% agreements, respectively. We found a fair agreement between motor examination and needle EMG findings (κ = 0.309, P < 0.0001). Moreover, statistically significant agreement was seen only in T1, L2, and S1 key muscles (κ = 1, P < 0.0001; κ = 0.359, P = 0.019; and κ = 0.521, P = 0.004, respectively).Conclusions: It is important to accurately distinguish between grade 0 and 1 motor power to maximize the positive outcomes from rehabilitation treatment and predict the possibility of recovery in individuals with SCI. Therefore, to improve the accuracy of motor examination and the American Spinal Injury Association Impairment Scale, needle EMG confirmation could be considered for muscles with motor grade 0 or 1 in individuals with SCI.

Epidemiology of Spinal Cord Injury: Changes to Its Cause Amid Aging Population, a Single Center Study.

OBJECTIVE: To investigate the epidemiologic and demographic characteristics of patients with spinal cord injury (SCI) who were admitted to a department of rehabilitation of a university hospital. METHODS: This was a descriptive cross-sectional study. Medical records including sex, age at injury, type of disability, traumatic or non-traumatic etiology and presence of ossification of posterior longitudinal ligament (OPLL) of patients with SCI who were admitted to the department of rehabilitation between 2012 and 2018 were reviewed. RESULTS: Of the 221 cases of SCI, 161 were traumatic and 60 were non-traumatic. The mean age at injury was 52.8 years. People aged 40-49 years showed highest proportion among overall SCI patients (19.0%). The proportion of male patients was higher in traumatic SCI at 4.96:1 than in non-traumatic SCI at 1.30:1. The most common cause of traumatic SCI was falling off (37.3%), followed by motor vehicle crash (35.4%) and tripping over (19.3%). Meanwhile, the most common cause of non-traumatic SCI was neoplasm (35.0%). Tripping over was the leading cause of traumatic SCI in patients aged ≥60 years (42.6%). A high proportion of traumatic SCI patients were found to have underlying OPLL (26.1%), particularly those who were injured by tripping over (64.5%). CONCLUSION: The mean age of SCI patients was higher than that of previous studies. Falls was the single most common cause of traumatic SCI, and tripping over was the most common cause of injury in the elderly patients. OPLL was prevalent in patients who were injured from tripping over.

The efficacy of computerized cognitive rehabilitation in improving attention and executive functions in acquired brain injury patients, in acute and postacute phase.

BACKGROUND: Cognitive deficits, particularly executive dysfunction is common following acquired brain injury (ABI) and has detrimental effect on functional status and autonomy in daily life. Among various cognitive training methods, computerized cognitive rehabilitation (CCR) has been investigated as an alternative method to therapist-driven cognitive rehabilitation (TCR). However, previous studies have shown conflicting results on the superiority or inferiority of CCR and TCR. AIM: To investigate the efficacy of TCR and CCR in improving executive function in patients with acute-to-subacute ABI. DESIGN: A prospective, assessor-blinded randomized controlled trial. SETTING: Hospitalized care setting in the department of rehabilitation in a university hospital. POPULATION: Thirty-two acute-to-subacute (less than 3 months after onset) ABI patients with executive dysfunctions were included in this study. The mean time after injury was 25.1±18.1 days. METHODS: Participants were assigned to the TCR group (N.=14) or the CCR group (N.=18). Each group performed TCR or CCR for 30 minutes each day for two weeks in addition to routine rehabilitation. Neurocognitive function tests to assess complex attention, executive function, general cognitive function (mini-mental status examination [MMSE] and Montreal Cognitive Assessment [MoCA]), and functional evaluations [modified Barthel Index, MBI]) were performed at baseline (T0) and at the end of treatment (T1). RESULTS: The TCR and CCR groups showed significant improvements in the MMSE (P=0.004, 0.000), MoCA (P=0.003, 0.006), and MBI (P=0.000, 0.000) scores. TCR and CCR groups both showed significant improvements in some of the complex attention tests (trail-making test A, P=0.002, 0.005) and executive function tests (trail-making test B, P=0.016, 0.016). The TCR group showed significant improvements in the additional executive function tests (phonemic fluency test, P=0.004, semantic fluency test, P=0.001), while the CCR group showed significant improvements in the additional complex attention tests (symbol search, P=0.02, digit symbol coding, P=0.002). In the intergroup comparison of the changes from pre- to postintervention, only the TCR group showed a significant improvement in the phonemic fluency test (P=0.013). CONCLUSIONS: TCR might be more effective than CCR in improving frontal lobe-related executive function in ABI patients. CCR might be beneficial for improving psychomotor speed and working memory. CLINICAL REHABILITATION IMPACT: TCR or CCR should be chosen according to the targeted domain of cognitive dysfunction in acute-to-subacute ABI patients.

Self-motion and heterogeneous droplet dynamics in moderately attractive dense emulsions.

We show that diffusing wave spectroscopy (DWS) is sensitive to the presence of a moderate short-range attraction between droplets in uniform fractionated colloidal emulsions near and below the jamming point associated with monodisperse hard spheres. This moderate interdroplet attraction, induced by micellar depletion, has an energy of about ∼2.4kBT, only somewhat larger than thermal energy. Although changes in the mean free path of optical transport caused by this moderate depletion attraction are small, DWS clearly reveals an additional secondary decay-to-plateau in the intensity autocorrelation function at long times that is not present when droplet interactions are nearly hard. We hypothesize that this secondary decay-to-plateau does not reflect the average self-motion of individual droplets experiencing Brownian excitations, but instead results from heterogeneous dynamics involving a sub-population of droplets that still experience bound motion yet with significantly larger displacements than the average. By effectively removing the contribution of this secondary decay-to-plateau, which is linked to greater local heterogeneity in droplet structure caused by the moderate attraction, we obtain self-motion mean square displacements (MSDs) of droplets that reflect only the initial primary decay-to-plateau. Moreover, we show that droplet self-motion primary plateau MSDs can be interpreted using the generalized Stokes-Einstein relation of passive microrheology, yielding quantitative agreement with plateau elastic shear moduli measured mechanically.

Diffusing wave microrheology of highly scattering concentrated monodisperse emulsions.

Motivated by improvements in diffusing wave spectroscopy (DWS) for nonergodic, highly optically scattering soft matter and by cursory treatment of collective scattering effects in prior DWS microrheology experiments, we investigate the low-frequency plateau elastic shear moduli [Formula: see text] of concentrated, monodisperse, disordered oil-in-water emulsions as droplets jam. In such experiments, the droplets play dual roles both as optical probes and as the jammed objects that impart shear elasticity. Here, we demonstrate that collective scattering significantly affects DWS mean-square displacements (MSDs) in dense colloidal emulsions. By measuring and analyzing the scattering mean free path as a function of droplet volume fraction φ, we obtain a φ-dependent average structure factor. We use this to correct DWS MSDs by up to a factor of 4 and then calculate [Formula: see text] predicted by the generalized Stokes-Einstein relation. We show that DWS-microrheological [Formula: see text] agrees well with mechanically measured [Formula: see text] over about three orders of magnitude when droplets are jammed but only weakly deformed. Moreover, both of these measurements are consistent with predictions of an entropic-electrostatic-interfacial (EEI) model, based on quasi-equilibrium free-energy minimization of disordered, screened-charge-stabilized, deformable droplets, which accurately describes prior mechanical measurements of [Formula: see text] made on similar disordered monodisperse emulsions over a wide range of droplet radii and φ. This very good quantitative agreement between DWS microrheology, mechanical rheometry, and the EEI model provides a comprehensive and self-consistent view of weakly jammed emulsions. Extensions of this approach may improve DWS microrheology on other systems of dense, jammed colloids that are highly scattering.

COWAT Performance of Persons with Alzheimer Dementia, Vascular Dementia, and Parkinson Disease Dementia According to Stage of Cognitive Impairment.

BACKGROUND: The Controlled Oral Word Association Test (COWAT) evaluates frontal lobe and executive function. Therefore, it can be helpful in differentiating cognitive deficits. However, there are no studies comparing the COWAT performance according to the type and stage of cognitive impairment. OBJECTIVE: To compare performance among persons with Alzheimer dementia (AD), vascular dementia (VaD), and Parkinson disease dementia (PDD) on the COWAT according to stage of cognitive impairment. DESIGN: Retrospective chart review. SETTINGS: University hospital rehabilitation psychology center. PATIENTS: We reviewed the medical records of 246 persons diagnosed with mild cognitive impairment (MCI) or dementia using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the Korean-Instrumental Activities of Daily Living (K-IADL). Patients were divided into a control group, Alzheimer groups (amnestic mild cognitive impairment [aMCI] + AD), Vascular groups (vascular mild cognitive impairment [VaMCI] + VaD), and Parkinson groups (Parkinson disease-mild cognitive impairment [PD-MCI] + PDD). METHODS: Total scores (ie, total number of words produced in 60 seconds on the semantic and phonemic fluency tests of the COWAT) were analyzed. Secondary analysis included calculating percentage scores of words produced during each of the four, 15-second segments from the total number of words produced in each trial. RESULTS: All MCI groups scored significantly lower than the control group on both semantic and phonemic fluency tests. Among the dementia groups, the VaD (mean ± SD, 5.6 ± 5.1) and PDD (5.5 ± 5.5) groups' scores were significantly lower and worse than that of the AD (11.0 ± 8.8) group on the phonemic test (P < .001). The difference in percentage scores was most marked between the PD-MCI (17.0 ± 2.2) and PDD (1.2 ± 3.1) groups, followed by the VaMCI (13.3 ± 1.9) and VaD (5.6 ± 1.8) groups on the latter phonemic test (P = .007). CONCLUSIONS: The COWAT is a sensitive test of frontal-lobe and executive function impairment in persons with MCI. Decreased verbal output in the last 15 seconds of phonemic fluency test is significantly decreased and impaired in persons with VaMCI and PD-MCI compared to persons with aMCI as they progress to dementia. LEVEL OF EVIDENCE: III.

Synthesis and Formation Mechanism of All-Organic Block Copolymer-Directed Templating of Laser-Induced Crystalline Silicon Nanostructures.

This report describes the generation of three-dimensional (3D) crystalline silicon continuous network nanostructures by coupling all-organic block copolymer self-assembly-directed resin templates with low-temperature silicon chemical vapor deposition and pulsed excimer laser annealing. Organic 3D mesoporous continuous-network resin templates were synthesized from the all-organic self-assembly of an ABC triblock terpolymer and resorcinol-formaldehyde resols. Nanosecond pulsed excimer laser irradiation induced the transient melt transformation of amorphous silicon precursors backfilled in the organic template into complementary 3D mesoporous crystalline silicon nanostructures with high pattern fidelity. Mechanistic studies on laser-induced crystalline silicon nanostructure formation revealed that the resin template was carbonized during transient laser-induced heating on the milli- to nanosecond timescales, thereby imparting enhanced thermal and structural stability to support the silicon melt-crystallization process at temperatures above 1250 °C. Photoablation of the resin material under pulsed excimer laser irradiation was mitigated by depositing an amorphous silicon overlayer on the resin template. This approach represents a potential pathway from organic block copolymer self-assembly to alternative functional hard materials with well-ordered 3D morphologies for potential hybrid photovoltaics, photonic, and energy storage applications.

The liquid-glass-jamming transition in disordered ionic nanoemulsions.

In quenched disordered out-of-equilibrium many-body colloidal systems, there are important distinctions between the glass transition, which is related to the onset of nonergodicity and loss of low-frequency relaxations caused by crowding, and the jamming transition, which is related to the dramatic increase in elasticity of the system caused by the deformation of constituent objects. For softer repulsive interaction potentials, these two transitions become increasingly smeared together, so measuring a clear distinction between where the glass ends and where jamming begins becomes very difficult or even impossible. Here, we investigate droplet dynamics in concentrated silicone oil-in-water nanoemulsions using light scattering. For zero or low NaCl electrolyte concentrations, interfacial repulsions are soft and longer in range, this transition sets in at lower concentrations, and the glass and the jamming regimes are smeared. However, at higher electrolyte concentrations the interactions are stiffer, and the characteristics of the glass-jamming transition resemble more closely the situation of disordered elastic spheres having sharp interfaces, so the glass and jamming regimes can be distinguished more clearly.

Advances and challenges in the rheology of concentrated emulsions and nanoemulsions.

We review advances that have been made in the rheology of concentrated emulsions and nanoemulsions, which can serve as model soft materials that have highly tunable viscoelastic properties at droplet volume fractions near and above the glass transition and jamming point. As revealed by experiments, simulations, and theoretical models, interfacial and positional structures of droplets can depend on the applied flow history and osmotic pressure that an emulsion has experienced, thereby influencing its key rheological properties such as viscoelastic moduli, yield stress and strain, and flow behavior. We emphasize studies of monodisperse droplets, since these have led to breakthroughs in the fundamental understanding of dispersed soft matter. This review also covers the rheological properties of attractive emulsions, which can exhibit a dominant elasticity even at droplet volume fractions far below maximal random jamming of hard spheres.

Template-Directed Directionally Solidified 3D Mesostructured AgCl-KCl Eutectic Photonic Crystals.

3D mesostructured AgCl-KCl photonic crystals emerge from colloidal templating of eutectic solidification. Solvent removal of the KCl phase results in a mesostructured AgCl inverse opal. The 3D-template-induced confinement leads to the emergence of a complex microstructure. The 3D mesostructured eutectic photonic crystals have a large stop band ranging from the near-infrared to the visible tuned by the processing.

Anisotropic colloidal templating of 3D ceramic, semiconducting, metallic, and polymeric architectures.

3D-porous anisotropic solids are fabricated by using horizontally and vertically aligned assemblies of silica rods with a length of ca. 2 µm and a diameter of 500 nm as templates. Templated materials include examples from metals, semiconductors, ceramics, and polymers, Ni, Si, HfO2, and PMMA, respectively. By varying the infilling conditions, the detailed mesoscale structure and degree of anisotropy can be controlled.