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Search Results: 1 - 10 of 191285 matches for " D. Kleindorfer "
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The Adverse Effect of Spasticity on 3-Month Poststroke Outcome Using a Population-Based Model
S. R. Belagaje,C. Lindsell,C. J. Moomaw,K. Alwell,M. L. Flaherty,D. Woo,K. Dunning,P. Khatri,O. Adeoye,D. Kleindorfer,J. Broderick,B. Kissela
Stroke Research and Treatment , 2014, DOI: 10.1155/2014/696089
Abstract: Several devices and medications have been used to address poststroke spasticity. Yet, spasticity’s impact on outcomes remains controversial. Using data from a cohort of 460 ischemic stroke patients, we previously published a validated multivariable regression model for predicting 3-month modified Rankin Score (mRS) as an indicator of functional outcome. Here, we tested whether including spasticity improved model fit and estimated the effect spasticity had on the outcome. Spasticity was defined by a positive response to the question “Did you have spasticity following your stroke?” on direct interview at 3 months from stroke onset. Patients who had expired by 90 days or did not have spasticity data available were excluded. Spasticity affected the 3-month functional status ( , to 0.645) after accounting for age, diabetes, leukoaraiosis, and retrospective NIHSS. Using spasticity as a covariable, the model’s changed from 0.599 to 0.622. In our model, the presence of spasticity in the cohort was associated with a worsened 3-month mRS by an average of 0.4 after adjusting for known covariables. This significant adverse effect on functional outcomes adds predictive value beyond previously established factors. 1. Introduction Spasticity is defined as a motor disorder characterized by a velocity-dependent increase in tonic stretch reflexes with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex. The definition, however, fails to describe the complex etiologies of spasticity, especially after a stroke. It can be due to a loss of upper motor neuron function, changes in the properties of the muscle membranes, augmentation of prior reflexes, or a combination of the above. Equally unclear is spasticity’s effect on poststroke recovery. There are some reports which suggest adverse effects on recovery. In a longitudinal study of 95 subjects, Sommerfeld et al. found that, at 3-month poststroke, patients without spasticity had statistically significant better motor and activity scores than patients with spasticity [1]. However, there are others who argue that spasticity’s effects are being overstated, specifically by mentioning the absence of evidence to suggest that treatment of spasticity improves stroke recovery [2]. In fact multiple medications and treatments of spasticity have been developed and are used routinely in the clinical setting for poststroke spasticity. The literature describes improvements in passive function only and reduction in disability after botulinum toxin administration to spastic muscles [3–5]. In their approval of
Bill Morphology Does Not Influence Vocal Performance in Darwin''s Small Tree Finch on Floreana Island
澳大利亚Floreana岛达尔文小树雀喙型与其鸣唱的不相关性

Rebekah Christensen,Sonia Kleindorfer,Sonia Klcindorfer,
Rebekah Christensen
,Sonia Kleindorfer

动物学研究 , 2009,
Abstract: Bird song is used for mate attraction and is important for establishing reproductive isolation. Current research highlights performance constraints on song production that may be influenced by variation in bill morphology. Darwin's finches are a model system for studying the relationship between morphology and song performance, with previous studies suggesting that lower vocal performance is correlated with larger bill size. Here, we tested for a relationship between bill morphology and vocal performance in Darwin's Small Tree Finch (Camarhynchus parvulus) on Floreana Island. We found no evidence of a correlation between bill morphology and vocal performance. This finding is in agreement with prior study of the Small Tree Finch, but contrasts a greater body of work addressing song in Darwin's Finches. We discussed our findings in the context of ecological divergence, and ecological variation across species.
Genetic variation in the invasive avian parasite, Philornis downsi (Diptera, Muscidae) on the Galápagos archipelago
Rachael Y Dudaniec, Michael G Gardner, Steve Donnellan, Sonia Kleindorfer
BMC Ecology , 2008, DOI: 10.1186/1472-6785-8-13
Abstract: Both the mitochondrial and microsatellite data were consistent with there being a single species across islands. We found low genetic differentiation between islands and strong evidence for inter-island gene flow, or shared recent ancestry among individuals. Landscape genetic analysis identified two genetic clusters: one encompassing Santa Cruz and Isabela, and one on Floreana Island. There was no evidence of genetic differentiation between habitats and molecular variance was mainly attributable to within individuals. The combined P. downsi population was found to have undergone a population bottleneck.Philornis downsi populations have high connectivity within and between islands, with low levels of genetic differentiation between Floreana and the other two islands examined. The genetic bottleneck found across islands suggests there was a small founding population or few introduction events of P. downsi. The high dispersal capacity and wide habitat use of P. downsi highlights the significant threat that this parasite poses to the Galápagos avifauna. Our findings are relevant for assessing the viability of methods to control P. downsi on Galápagos, such as the sterile insect technique.Biological invasions threaten biodiversity and ecosystem function, with pronounced negative effects on islands in particular [1-3]. Genetic studies of invasive species can identify the adaptive potential of invaders to deal with new environmental conditions [4] or help to predict evolutionary responses to management practices (e.g. pesticides, biological control agents) [5]. Population bottlenecks affect many invasive species because they frequently experience founding effects that reduce genetic variability, but paradoxically, invasive species still manage to successfully establish and adapt to new environments [6]. However, the effects of bottlenecks may be countered by the occurrence of multiple introductions, high reproductive rates, and subsequent migration between locally bottlene
Predicting Mortality and Functional Outcomes after Ischemic Stroke: External Validation of a Prognostic Model  [PDF]
Achala Vagal, Heidi Sucharewv, Christopher Lindsell, Dawn Kleindorfer, Kathleen Alwell, Charles J. Moomaw, Daniel Woo, Matthew Flaherty, Pooja Khatri, Opeolu Adeoye, Simona Ferioli, Jason Mackey, Sharyl Martini, Felipe De Los Rios La Rosa F., Brett Kissela
Journal of Behavioral and Brain Science (JBBS) , 2018, DOI: 10.4236/jbbs.2018.810036
Abstract: Background: We previously developed predictive models for 3-month mortality and modified Rankin Score (mRS) after ischemic stroke. Aim: The aim was to test model validity for 3-month mortality and mRS after ischemic stroke in two independent data sets. Methods: Our derivation models used data from 451 subjects with ischemic stroke in 1999 enrolled in the Greater Cincinnati/Northern Kentucky Stroke Study (GCKNSS). We utilized two separate cohorts of ischemic strokes through GCKNSS (460 in 2005 and 504 in 2010) to assess external validity by utilizing measures of agreement between predicted and observed values, calibration, and discrimination using Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis. Results: The 3-month mortality model performed well in the validation datasets with an average prediction error (Brier score) of 0.045 for 2005 and 0.053 for 2010 and excellent discrimination with an area under the curve of 0.86 (95% CI: 0.79, 0.93) for 2005 and 0.84 (0.76, 0.92) for 2010. Predicted 3-month mRS also performed well in the validation datasets with R2 of 0.57 for 2005 and 0.50 for 2010 and a root mean square error of 0.85 for 2005 and 1.05 for 2010. Predicted mRS tended to be higher than actual in both validation datasets. Re-estimation of the model parameters for age and severe white matter hyperintensity in both 2005 and 2010, and for diabetes in 2005, improved predictive accuracy. Conclusions: Our previously developed stroke models performed well in two study periods, suggesting validity of the model predictions.
Subarachnoid hemorrhage: tests of association with apolipoprotein E and elastin genes
Ritesh Kaushal, Daniel Woo, Prodipto Pal, Mary Haverbusch, Huifeng Xi, Charles Moomaw, Padmini Sekar, Brett Kissela, Dawn Kleindorfer, Matthew Flaherty, Laura Sauerbeck, Ranajit Chakraborty, Joseph Broderick, Ranjan Deka
BMC Medical Genetics , 2007, DOI: 10.1186/1471-2350-8-49
Abstract: At the APOE locus, no individual SNP was associated with SAH after correction for multiple comparisons. Haplotype analysis revealed significant association of the major haplotype (Hap1) in APOE with SAH (p = 0.001). The association stemmed from both the 5' promoter and the 3' region of the APOE gene. APOE ε2 and ε 4 were not significantly associated with SAH. No association was observed for ELN at genotype, allele, or haplotype level and our study failed to confirm previous reports of ELN association with aneurysmal SAH.This study suggests a role of the APOE gene in the etiology of aneurysmal SAH.Non-traumatic, spontaneous subarachnoid hemorrhage (SAH) affects 16,000 to 17,000 individuals each year in the United States [1-3]. SAH has a 30-day mortality rate exceeding 40%, and surviving patients often demonstrate significant morbidity [2,4]. Over 80% of SAH can be attributed to intracranial aneurysm (IA) rupture. Familial aggregation studies of SAH have consistently identified an increased risk of a first-degree relative with SAH or family history of SAH independent of smoking and hypertension [5].Variants of the apolipoprotein E (APOE) gene have been associated with Alzheimer's disease, lipid disorders and cardiovascular disease [6-8]. Previous studies have demonstrated that APOE ε4 and/or APOE ε2 are associated with lobar intracerebral hemorrhage (ICH) [9,10]. We recently reported that haplotypes which include polymorphisms in the 5' untranslated region of the APOE gene are risk factors for lobar ICH [11]. Specific to SAH, Kokubo et al. [12] found significant association of APOE ε4 with SAH in a Japanese population. Niskakangas et al. [13] reported association of APOE ε4 with adverse outcome after aneurysmal SAH. No study on other polymorphisms of APOE with regard to risk of SAH has yet been reported.In addition to APOE, the elastin (ELN) gene emerged as a putative gene for IA after linkage was found on 7q11, where ELN is located [14]. However, prior association st
The use of standardized patients for mock oral board exams in neurology: a pilot study
Brett Kissela, Steven Harris, Dawn Kleindorfer, Christopher Lindsell, Robert Pascuzzi, Daniel Woo, Jerzy Szaflarski, Daniel Kanter, Alex Schneider, Michael Sostok, Joseph Broderick
BMC Medical Education , 2006, DOI: 10.1186/1472-6920-6-22
Abstract: Three cases were created and then used for this mock oral boards exercise utilizing trained standardized patients. Residents from the University of Cincinnati and Indiana University participated in the exam. Residents were scored by attending physician examiners who directly observed the encounter with the standardized patient. The standardized patient also assessed each resident. A post-test survey was administered to ascertain participant's satisfaction with the examination process.Resident scores were grouped within one standard deviation of the mean, with the exception of one resident who was also subjectively felt to "fail" the exam. In exams with two faculty "evaluators", scores were highly correlated. The survey showed satisfaction with the examination process in general.Standardized patients can be used for mock oral boards in the live patient format. Our initial experience with this examination process was positive. Further testing is needed to determine if this examination format is more reliable and valid than traditional methods of assessing resident competency.Currently, the American Board of Psychiatry and Neurology (ABPN) utilizes a live patient hour as one form of assessing candidates during the Step Two examination. This includes thirty minutes for the candidate to obtain a history and perform a physical examination on a patient with a neurologic disorder, and is followed by questioning in which candidates explain their thought process for evaluating the patient. Concerns have been raised about the reliability and validity of this exam, since the experience is not standardized. For example, some patients may openly reveal their diagnosis, or the diagnosis may be more readily evident than for other patients. For these reasons, the ABPN plans to replace the patient hour with other forms of assessment by 2008.[1]Residency programs commonly test their residents in "mock oral board exercises" that simulate the ABPN patient hour, using actual patients wit
Genome screen in familial intracranial aneurysm
Tatiana Foroud, Laura Sauerbeck, Robert Brown, Craig Anderson, Daniel Woo, Dawn Kleindorfer, Matthew L Flaherty, Ranjan Deka, Richard Hornung, Irene Meissner, Joan E Bailey-Wilson, Carl Langefeld, Guy Rouleau, E Sander Connolly, Dongbing Lai, Daniel L Koller, John Huston, Joseph P Broderick, the FIA Study Investigators [Familial Intracranial Aneurysm Study Investigators]
BMC Medical Genetics , 2009, DOI: 10.1186/1471-2350-10-3
Abstract: Families with multiple members having ruptured or unruptured IA were recruited and all available medical records and imaging data were reviewed to classify possible IA subjects as definite, probable or possible IA or not a case. A 6 K SNP genome screen was performed in 333 families, representing the largest linkage study of IA reported to date. A 'narrow' (n = 705 definite IA cases) and 'broad' (n = 866 definite or probable IA) disease definition were used in multipoint model-free linkage analysis and parametric linkage analysis, maximizing disease parameters. Ordered subset analysis (OSA) was used to detect gene × smoking interaction.Model-free linkage analyses detected modest evidence of possible linkage (all LOD < 1.5). Parametric analyses yielded an unadjusted LOD score of 2.6 on chromosome 4q (162 cM) and 3.1 on chromosome 12p (50 cM). Significant evidence for a gene × smoking interaction was detected using both disease models on chromosome 7p (60 cM; p ≤ 0.01). Our study provides modest evidence of possible linkage to several chromosomes.These data suggest it is unlikely that there is a single common variant with a strong effect in the majority of the IA families. Rather, it is likely that multiple genetic and environmental risk factors contribute to the susceptibility for intracranial aneurysms.Subarachnoid hemorrhage due to the rupture of an intracranial aneurysm (IA) occurs in 16,000 to 17,000 persons in the U.S. annually and nearly half of affected persons are dead within the first 30 days. There are several important factors which modulate the risk of SAH. The incidence of SAH increases moderately with advancing age and it is the only stroke subtype in which women have a higher age-adjusted risk of SAH as compared to men [1]. Cigarette smoking has consistently been identified as the most important modifiable risk factor for SAH [2] with an average odds ratio of 3.1 [2,3]. In population-based and cohort studies, 70–75% of persons with SAH have a prior hist
Electrical Conductivity of Collapsed Multilayer Graphene Tubes  [PDF]
D. Mendoza
World Journal of Nano Science and Engineering (WJNSE) , 2012, DOI: 10.4236/wjnse.2012.22009
Abstract: Synthesis of multilayer graphene on copper wires by a chemical vapor deposition method is reported. After copper etching, the multilayer tube collapses forming stripes of graphitic films, their electrical conductance as a function of temperature indicate a semiconductor-like behavior. Using the multilayer graphene stripes, a cross junction is built and owing to its electrical behavior we propose that a tunneling process exists in the device.
Porous Carbon Grown by Chemical Vapor Deposition on Copper Substrates  [PDF]
D. Mendoza
Journal of Materials Science and Chemical Engineering (MSCE) , 2015, DOI: 10.4236/msce.2015.38003
Abstract: Amorphous porous carbon was synthesized by chemical vapor deposition on copper substrates. The average size of the pores is around 1.2 microns with some small pores decorating the big ones. Lamellar samples of this carbonaceous material can be separated from the copper support and may be useful as electrode due to its low electrical resistivity of the order of 0.4 Ωcm.
Application of Enzyme Extracted from Aloe vera Plant in Chemical Pretreatment of Cotton Knitted Textile to Reduce Pollution Load  [PDF]
D. Jothi
World Journal of Engineering and Technology (WJET) , 2015, DOI: 10.4236/wjet.2015.33B007
Abstract:

Nowadays, highly alkaline chemicals like caustic soda, soda ash, silicate, acetic acid and soaping agents are used for scouring to remove the non-cellulosic impurities from the cotton. Using 30 - 40 gm/Kg on weight of the fabric results in destruction of cotton structure. Intensive rinsing and more acid is needed for reutilization of cotton, which enlarges the volume of effluent. Furthermore, these hazards chemicals result in increase in COD, BOD and TDS in waste water. These chemicals also attack the cellulose leading to heavy strength loss and weight loss in the fabric. The net result is low quality control and polluted environment with high usage of energy, time, chemical and water. Aloe vera presents the finest commercial opportunity in various industrial sectors among the various plants. Also, most of the countries are gifted with the unique geographical features that are essential for cultivation of Aloe vera. Yet, none of the country has realized and reaped the full potential of such plants in various industrial applications. The reason is simple: lack of the requisite expertise in extraction of various enzymes present in aloe plant. Fortunately, the technology is now accessible to make use of enzyme in textile application. In this research an attempt has been made to make use of lipase enzyme extracted from aloe plant in textile chemical pre- treatment process. In the present research work, an attempt was made to develop bio scouring of 100% cotton knitted fabric with lipase enzyme extracted from Aloe deberena plant at various concentration (1%, 2% and 3%) at various temperature (40?C, 60?C and 70?C) for a period of 30 minutes, 60 minutes and 90 minutes. The properties of bio scoured fabrics are compared with these of conventional scoured one. Encouraging results in terms of dye uptake, dye levelness, wash fastness, light fastness and rubbing fastness are obtained in case of bio scouring fabric dyed with dark reactive colors. Further, it reduces volume of effluent as well as COD, TDS and pH. It saves a substantial thermal energy 50% and electrical energy 40%. Bio scouring waste water has 40% - 50% less COD and 60% less TDS as compared to conventional scouring waste water.

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