Comprehensive analysis of publication of physical medicine and rehabilitation theses in Türkiye between years 2010 and 2020: Academic productivity and related factors.

Objectives: This study aimed to investigate the publication rates of physical medicine and rehabilitation specialty training theses, which are required to complete a residency in Türkiye, and determine the factors that affect publication. Materials and methods: Residency theses involved in this descriptive study were detected from the database of Higher Education Council Thesis Center (tez.yok.gov.tr) between January 2010 and December 2020. Publication of theses and date of publication were investigated by the writer's and supervisor's names on PubMed and Google Scholar. Results: Three hundred eighty-eight of 1,130 theses were turned into publications. Two hundred seventy-seven (24.5%) were published in SCI (Science Citation Index)/SCI Expanded indexed journals. The publication rates of residents were 47.1% in private universities, 34.2% in public universities, and 32.3% in training and research hospitals. The trainees who published their theses were more likely to become associate and assistant professors. Conclusion: Although approximately one-third of the theses defended were published, this rate is insufficient for sharing the knowledge. Considering that publishing their theses affected the residents' current academic careers positively, supervisors should provide the residents supportive facilitation to give the knowledge in research and publish their theses.

Assessment of the reliability and usability of ChatGPT in response to spinal cord injury questions.

OBJECTIVE: The use of artificial intelligence chatbots to obtain information about patients' diseases is increasing. This study aimed to determine the reliability and usability of ChatGPT for spinal cord injury-related questions. METHODS: Three raters simultaneously evaluated a total of 47 questions on a 7-point Likert scale for reliability and usability, based on the three most frequently searched keywords in Google Trends ('general information', 'complications' and 'treatment'). RESULTS: Inter-rater Cronbach α scores indicated substantial agreement for both reliability and usability scores (α between 0.558 and 0.839, and α between 0.373 and 0.772, respectively). The highest mean reliability score was for 'complications' (mean 5.38). The lowest average was for the 'general information' section (mean 4.20). The 'treatment' had the highest mean scores for the usability (mean 5.87) and the lowest mean value was recorded in the 'general information' section (mean 4.80). CONCLUSION: The answers given by ChatGPT to questions related to spinal cord injury were reliable and useful. Nevertheless, it should be kept in mind that ChatGPT may provide incorrect or incomplete information, especially in the 'general information' section, which may mislead patients and their relatives.

The use of standing powered wheelchairs from the perspective of individuals with spinal cord injury.

PURPOSE: The aim of this study was to investigate the experiences of standing powered wheelchair (SPWC) users with spinal cord injury (SCI). MATERIALS AND METHODS: This cross-sectional study included 20 participants with SCI. SPWC daily usage time (total, in sitting position and standing position) and the frequency of using the SPWC's standing feature were recorded. Participants' level of satisfaction and comfort associated with the SPWC were assessed on a five-point Likert scale. If there was a dissatisfaction reason with the SPWC, the issues related to it were recorded. Participants were asked about their positive and adverse experiences with the use of SPWC. RESULTS: Mean age of the participants was 41.65 (± 9.35) years. Eighty percent were tetraplegic. Ninety percent of the participants stood for at least 30 minutes at least one day a week, and 55% stood for at least 30 minutes at least four days a week. The most commonly reported perceived benefits were improvement in activities of daily living, bowel movements, and blood pressure regulation, better perception of body image, and feeling better. The most frequently identified reasons for dissatisfaction with the SPWC were its big dimensions, heavy weight, and difficulty of use in indoor environment and on uneven surfaces. CONCLUSIONS: The findings show positive perceived experiences for SPWC users with SCI in terms of physical, social, and psychological aspects. Prospective controlled studies are needed to explore the benefits of SPWC use regarding secondary complications of SCI.

This paper shows that participants with spinal cord injury (SCI) report numerous perceived physical, social, and psychological benefits of using standing powered wheelchair (SPWC).Individual adjustments must be made for SPWCs. Before prescribing SPWC, the physician and physical or occupational therapist who specialises in wheelchairs should make the necessary evaluations based on the individual's abilities and needs. The necessity for special SPWC equipment and orthoses during standing should be evaluated.In SPWC users with SCI, neck discomfort may occur due to the contraction of non-postural innervated muscles such as the neck due to inadequate trunk control. In addition to the adjustable chest support in SPWC, equipment that provides additional chest support can be used for better control of the trunk. Better control of the trunk can contribute to improved neck comfort.

Investigation of the efficacy of epidermal growth factor, boric acid and their combination in cartilage injury in rats: An experimental study.

OBJECTIVES: In this study, we aimed to determine the bioefficacy of epidermal growth factor (EGF), boric acid (BA), and their combination on cartilage injury in rats. MATERIALS AND METHODS: In in vitro setting, the cytotoxic effects of BA, EGF, and their combinations using mouse fibroblast cell (L929), human bone osteosarcoma cell (Saos-2), and human adipose derived mesenchymal stem cells (hAD-MSCs) were determined by applying MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide] test. In in vivo setting, 72 rats were randomly divided into four groups. A standard chondral defect was created and microfracture was performed in all groups. Group A was determined as the control group. In addition to the standard procedure, Group B received 100 ng/mL of EGF, Group C received a combination of 100 ng/mL of EGF and 10 µg/mL of BA combination, and Group D 20 µg/mL of BA. RESULTS: The cytotoxic effect of the combinations of EGF dilutions (1, 5, 10, 25, 50, 100, 200 ng/mL) with BA (100, 300, 500 µg/mL) was observed only in the 72-h application period and in Saos-2. The cytotoxic effect of BA was reduced when combined with EGF. There was no significant difference in the histopathological scores among the groups (p=0.13). CONCLUSION: Our study showed that EGF and low-dose BA application had a positive effect on cartilage healing in rats. Significant decreases in recovery scores were observed in the other groups. The combination of EGF and BA promoted osteoblast growth. Detection of lytic lesions in the group treated with 20 µg/mL of BA indicates that BA may have a cytotoxic effect.

Comparison of the Therapeutic Efficacy of Antibiotic-Loaded Polymeric Tissue Scaffold and Bone Cement in the Regeneration of Infected Bone Tissue.

Background Local antibiotic applications have been used in chronic osteomyelitis and have been defined as an adjunctive treatment method. Biodegradable materials are also used for the same purpose by adding antibiotics. The fact that it does not require additional surgery to be removed is an important advantage. In this study, we intended to develop a new biodegradable drug-loaded polymeric scaffold with good antibiotic release and compare the microbiological results with antibiotic-impregnated bone cement. Methodology A tissue scaffold containing poly(2-hydroxyethyl methacrylate) (PHEMA) was prepared in our laboratory and loaded with ertapenem and daptomycin antibiotics. The surface morphology and pore geometries of drug-loaded and unloaded scaffolds were analyzed by a scanning electron microscope under vacuum. The dose-dependent antiproliferative effects of PHEMA scaffold, drug-loaded scaffold, cement, and drug-loaded cement on osteoblast cells were investigated. To evaluate drug release kinetics, the absorbance values of the scaffold loaded with ertapenem and daptomycin were measured with the spectrometer. For microbiological tests, ertapenem and daptomycin-impregnated cement and scaffold, as well as the control scaffold and cement samples, were investigated for their antibacterial activities on Staphylococcus aureus and Klebsiella pneumoniae strains using the disc diffusion method. These microorganisms are one of the most common microorganisms in osteomyelitis. Results The efficacy of antibiotic-impregnated scaffold and cement on both gram-negative and gram-positive microorganisms was investigated. The daptomycin zone diameter in S. aureus ATCC 29233 strain was 17 mm, whereas it was 24 mm for scaffold and 22 mm for cement. Scaffold was found to be more effective than cement against S. aureus strain. The K. pneumoniae ATCC BAA-2814 strain was found to be resistant to ertapenem, but the zone diameter was 21 mm for scaffold and 20 mm for cement. Ertapenem-loaded scaffold was found to be more effective than cement. It was found that the antimicrobial activity of the scaffold was higher than cement. When we evaluated the release profiles, for the daptomycin-loaded cement group, 98% of daptomycin was cumulatively released within 30 minutes, and for the daptomycin-loaded scaffold group, 100% of daptomycin was cumulatively released in six days. To compare ertapenem-loaded cement and scaffold, 98% of ertapenem was cumulatively released within 10 minutes in the cement group. For the scaffold group, 100% of ertapenem was cumulatively released in 17 days. We found that the scaffold released the antibiotic more slowly and for a longer duration. Therefore, it was thought that the scaffold would be more effective on biofilm and the treatment of osteomyelitis would be more successful. Conclusions The produced scaffold was compared with cement, and it was concluded that the scaffold had better release and antimicrobial efficacy. Scaffold is more advantageous than cement because it is bioeliminable. Thus, there is no need for a second surgical intervention with the likely prevention of mortality and morbidity. Because of all these features, the scaffold seems promising in the local treatment of osteomyelitis.

The effect of high-frequency repetitive transcranial magnetic stimulation on motor recovery and gait parameters in chronic incomplete spinal cord injury: A randomized-controlled study.

Objectives: This study aims to examine the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) on gait parameters and lower extremity motor recovery in a more specific sample of individuals with chronic and traumatic incomplete spinal cord injury (iSCI). Patients and methods: This double-blind, sham-controlled, randomized study included a total of 28 individuals (20 males, 8 females; mean age: 35.7±12.1 years; range, 18 to 45 years) with chronic (>1 year) traumatic iSCI. The participants were randomly allocated to either sham rTMS group (n=14) or real rTMS group (n=14). We compared the groups based on the lower extremity motor scores (LEMS), the temporal-spatial gait measurements using three-dimensional gait analysis, the Walking Index for SCI-II (WISCI-II), and 10-m walking test at baseline, three weeks (post-treatment) and five weeks (follow-up) after the treatment. Results: The real rTMS group revealed a significant improvement in walking speed, LEMS score, and 10-m walking test after the treatment compared to baseline (p=0.001, p=0.002, and p=0.023, respectively). Changes in the LEMS score were significantly increased in the real rTMS group compared to the sham group at both three and five weeks (p=0.001 and p=0.001, respectively). No significant difference was observed in the other variables between the groups (p>0.05). Conclusion: Our study findings support the therapeutic effectiveness of rTMS on motor recovery in chronic iSCI. The rTMS can be used as an adjuvant therapy to conventional physiotherapy in the rehabilitation of patients with iSCI.

Atypical compartment syndrome of the forearm due to mixed infection with Proteus mirabilis and Morganella morganii after a penetrating injury: A limb-saving approach.

Compartment syndrome is a well-described clinical condition and is considered an orthopedic emergency affecting individuals of all ages. A typical scenario for acute compartment syndrome involves lower limb fractures or crush injuries. However, physicians may occasionally encounter atypical presentations, defined as atypical compartment syndrome (ACS). A 38-year-old, left-handed male patient without any comorbidities developed ACS of the forearm and clinical presentation of sepsis after a small penetrating injury to his right forearm. He developed ACS secondary to infected hematoma and subsequent soft tissue infection caused by Proteus mirabilis and Morganella morganii. Both bacteria infected the patient by direct contamination after injury with a knife, resulting in multifloral contamination. The patient was successfully treated with reconstructive surgery. In conclusion, ACS secondary to this type of penetrating injury shows a subtle clinical course at the time of hospital admission and can insidiously progress from an infected hematoma, posing a serious threat to the limb or even cause mortality. Good extremity function without any disability can be achieved with an accurate diagnosis during the initial evaluation of the patient in the emergency department and prompt surgical intervention followed by appropriate reconstructive methods.

The effect of brace on apical vertebral derotation in adolescent idiopathic scoliosis.

PURPOSE: The current study aims to evaluate the effect of Boston brace treatment on apical vertebral derotation in adolescent idiopathic scoliosis (AIS) patients receiving conservative treatment. METHODS: The study included 51 AIS patients, consisting of 8 males and 43 females, with Cobb angles between 25° and 45° and Risser's findings ranging from 0 to 4. The mean age of the participants was 12.20 ± 1.34 years. All patients were treated with the Boston brace for a minimum of 2 years and evaluated before the brace, during early brace use, and at the last follow-up. Radiographs were assessed to measure apical vertebral rotation (AVR) and vertebral translation (AVT). The SRS-22 questionnaire was used to evaluate patient outcomes. RESULTS: The radiographs of patients were evaluated over a mean follow-up period of 32.42 ± 8.65 months. Before the brace, the mean AVR was 2.1 ± 0.6, while it was 1.1 ± 0.5 with the brace. At the last follow-up, the mean AVR was 1.3 ± 0.5 (p < 0.001). Before the brace, the mean AVT was 36.4 ± 9.6 mm, which decreased to 16.7 ± 7.3 mm with the brace (p < 0.001). At the last follow-up, the mean AVT was 19.8 ± 8.1 mm (p < 0.001). The use of the brace had a significant corrective effect on thoracolumbar and lumbar curvatures compared to before the brace (p < 0.001). CONCLUSION: The findings of the current study suggest that the use of a Boston brace in the conservative treatment of AIS is effective in correcting the coronal and sagittal plane deformities, including thoracic, thoracolumbar, and lumbar curvatures, and in reducing apical vertebral rotation and translation.

Compromised T-cell immunity in patients with spinal cord injury and its relationship with injury characteristics.

Objectives: The aim of this study was to investigate in vivo and in vitro cellular immune responses in patients with chronic (spinal cord injury; SCI), determine the effects of autonomic dysfunction on cellular immune response, and determine the effect of completeness of the injury at different levels on cellular immune response. Patients and methods: Forty-nine patients (42 males, 7 females; mean age: 35.5±13.4 years; range, 18 to 68 years) with chronic (time since injury >6 months) traumatic SCI were included in this cross sectional study between March 2013 and December 2013. Patients were allocated into two groups: Group 1, patients with an injury at T7 or below, and Group 2, patients with an injury at T6 or above. All patients in Group 2 had a history of autonomic dysreflexia and orthostatic hypotension. Intradermal skin tests were applied to the participants to reveal delayed T-cell responses. The percentages of cluster of differentiation (CD)3+ T cells and CD3+ T cells expressing CD69 and CD25 were analyzed by flow cytometry for the detection of activated T cells including all T-cell subsets. Results: When patients with complete injuries were compared, the CD45+ cell percentage was found to be significantly higher in patients in Group 2. Patients with an incomplete SCI had increased skin response to candida antigens compared to complete SCI patients. Incomplete SCI patients also had higher percentages of lymphocytes and CD3+CD25+ and CD3+CD69+ T cells compared to patients with complete SCI. Conclusion: T-cell activity is impaired in chronic SCI patients with higher levels of injury, and the completeness of injury and autonomic dysfunction gain prominence as compromising factors in T-cell immunity.

Processing renewable and waste-based feedstocks with fluid catalytic cracking: Impact on catalytic performance and considerations for improved catalyst design.

Refiners around the globe are either considering or are actively replacing a portion of their crude oil inputs originating from fossil sources with alternative sources, including recycled materials (plastics, urban waste, mixed solid waste) and renewable materials (bio-mass waste, vegetable oils). In this paper, we explore such replacement, specifically focusing on the fluid catalytic cracking (FCC) operation. Five pyrolysis oils, obtained from municipal solid waste (MSW) and biogenic material (olive stones/pits), were fully characterized and tested at 10% loading against a standard fluid catalytic cracking (FCC) vacuum gasoil (VGO) feed in a bench scale reactor using an industrially available fluid catalytic cracking catalyst based on ultrastable Y zeolite to simulate fluid catalytic cracking co-processing. Despite having unique feed properties, including high Conradson carbon (e.g., up to 19.41 wt%), water (e.g., up to 5.7 wt%), and contaminants (e.g., up to 227 ppm Cl) in some cases, the five pyrolysis oils gave similar yield patterns as vacuum gasoil. Gasoline was slightly (ca. 1 wt%) higher in all cases and LPG slightly (ca. 1 wt%) lower. Olefinicity in the LPG streams were unchanged, bottoms and light cycle oil (LCO) showed no significant changes, while dry gas was slightly (up to -0.2 wt%) lower. Coke selectivity was also unchanged (maximum -7.7 wt%, relatively), suggesting minimal to no heat balance concerns when co-processing in an industrial fluid catalytic cracking unit. The results demonstrate the applicability of municipal solid waste and biogenic originating pyrolysis oils into a refinery. A catalyst design concept is explored, based on higher rare Earth oxide exchange and/or utilization of ZSM-5 zeolite, that would further minimize the impacts of replacing fossil oils with pyrolysis oils, namely one that shifts the 1% higher gasoline into LPG.

The effects of functional electrical stimulation cycling on gait parameters in diplegic cerebral palsy: a single-blind randomized controlled trial.

PURPOSE: To investigate the effects of functional electrical stimulation cycling (FES-C) training in addition to conventional physical therapy on gait, muscle strength, gross motor function, and energy expenditure in ambulatory children with spastic diplegic cerebral palsy. MATERIALS AND METHODS: Twenty children with diplegic cerebral palsy were randomly assigned to FES-C group (n = 10) or control group (n = 10). Subjects trained 3 days/week for 8 weeks. Control group received conventional physical therapy. The FES-C group additionally received FES-C training. The functional muscle test was used for muscle strength assessment. Vicon-3D system was used for gait analysis. Gross Motor Function Measure (GMFM-88) was used for motor function assessment and calorimeter was used for energy expenditure. Measurements were performed at the baseline, at the eight week and at the sixteenth week. RESULTS: Functional muscle strength, gross motor function, and energy expenditure improved more in the FES-C group after training and follow up (p < 0.05). There was no significant difference found between the changes in gait parameters of the two groups after treatment and follow up (p > 0.05). Pelvic tilt while walking decreased after training in the FES-C group (p < 0.05). CONCLUSIONS: FES-C applied in addition to conventional physical therapy in children with diplegic cerebral palsy is more effective than conventional physical therapy for increasing functional muscle strength, improving gross motor function functions, and reducing energy expenditure.HighlightsFES-C improves lower extremity functional muscle strength, gross motor function, and energy expenditure in ambulatory children with spastic dCP.The use of FES-C in combination with conventional physiotherapy methods may be beneficial in outpatients with spastic dCP.

Evaluation of secondary complication awareness among individuals with spinal cord injury.

Secondary complications (SCs) are common and cause high morbidity and mortality in individuals with spinal cord injury (SCI). There is no information or a satisfactory scale of measurement for evaluating the opinions of individuals with SCI on whether they have sufficient knowledge about these complications. This study aimed to evaluate the opinions of individuals with SCI about whether they have sufficient information on SCI-related SCs. Demographic and clinical characteristics of 64 SCI individuals were recorded. A questionnaire was applied to evaluate the opinions of the participants and whether they have sufficient information about SCs before and after a multidisciplinary rehabilitation for SCI. A test was performed to measure the knowledge level at admission to the hospital and discharge. The mean value of the total questionnaire score, which was 6.2 at admission, increased to 7.91 at discharge ( P < 0.001). All subgroup scores of the questionnaire were higher at discharge than at admission (all P < 0.05). Total, neurogenic bladder, neurogenic bowel and spasticity test scores increased at discharge compared to admission (all P < 0.05). There is a relationship between the change in questionnaire scores and some demographic and injury characteristics. The opinions of the individuals with SCI on having sufficient information about SCs and their knowledge levels increased after a multidisciplinary rehabilitation program. Applying such a questionnaire and test at admission may have increased the awareness of the participants about SCs and contributed to a higher level of knowledge and opinion.

Clarification of acid site location in MSE-type zeolites by spectroscopic approaches combined with catalytic activity: comparison between UZM-35 and MCM-68.

MSE-type zeolites synthesized by different organic structure-directing agents (OSDAs), UZM-35 and MCM-68, were prepared. The location of Brønsted acid sites derived from the framework Al atoms and acidic properties were investigated based on 27Al MQMAS NMR and in situ IR techniques combined with the evaluation of the catalytic activity. We have successfully found a significant difference in the location of Brønsted acid sites in the MSE-type framework; 61 and 33% of acid sites were located at the 12-ring channel for MCM-68 and UZM-35, respectively. The differences in the location of the acid sites yielded their unique catalytic activities for the hydrocarbon cracking reactions, indicating that a well-chosen type of OSDAs for the synthesis is one of the possibilities for controlling the distribution of the framework Al atoms in the MSE-type framework.

Raman Spectroscopy Characterization of Amorphous Coke Generated in Industrial Processes.

Examples on the real-world field application of Raman spectroscopy with systematic analysis of the intensity variation of D and G bands corresponding to the change of excitation laser energy to characterize and compare coke species from various industrial processes are presented. The findings indicate the different degree of sp2 and sp3 hybridized bonding structures of amorphous carbon collected from different industrial processes as well as heavy carbonaceous deposits generated by industrial catalysts. This spectroscopic methodology is practical and highly beneficial in identifying coke formation mechanisms in industrial processes, as well as supporting design strategies to abate the undesired coke formation on industrial catalysts.

Demographic and clinical characteristics of patients with transverse myelitis and traumatic spinal cord injury: A comparative retrospective study.

OBJECTIVES: To identify the demographic and clinical characteristics of patients with transverse myelitis (TM) and to compare functional status between those patients and a matched group with traumatic spinal cord injury (T-SCI). STUDY DESIGN: Retrospective study. SETTING: A tertiary rehabilitation hospital. PARTICIPANTS: The demographic and clinical characteristics of 484 T-SCI patients and 25 TM patients were compared. Functional status was further analyzed by matching the two groups. OUTCOME MEASUREMENTS: The matched patients were compared in terms of motor and sensory functions, bladder and bowel symptoms, ambulation level, the Rivermead Mobility Index, and SCI-related medical complications. RESULTS: The mean age of the TM patients was 35.6 years and was similar to that of the T-SCI patients. There were significantly more females in the TM group (P = 0.017). Individuals with TM had fewer cervical injuries (P = 0.032) and a higher rate of paraplegia (P = 0.047) and were more often incomplete (P = 0.009) than those with T-SCI. Sensory function was significantly better in the TM group compared to the matched T-SCI group (P = 0.05). Independent ambulation frequency was higher in the TM patients. The SCI-related complications seen in the TM group were as common as those in the T-SCI group. CONCLUSION: The TM and T-SCI groups differed in terms of the demographic and clinical characteristics recorded. Additionally, when matched for these differences, functional status was slightly better in the TM group. However, like T-SCI, TM was a significant cause of disability and SCI-related complications were common.

Temporospatial parameters, shoulder kinematics, and acute tendon changes in four different stroke patterns in male wheelchair users with spinal cord injury.

BACKGROUND: Manual wheelchair propulsion causes shoulder tendon pathologies in wheelchair users with spinal cord injury. Four different wheelchair stroke patterns can cause varying amounts of acute changes in the shoulder tendons. OBJECTIVE: To evaluate and compare acute changes in the supraspinatus and biceps tendons and acromiohumeral distance (AHD) after propulsion between different stroke patterns in individuals with spinal cord injury. In addition, to associate tendon changes with demographic and biomechanical characteristics. DESIGN: Prospective and comparative study between four groups. SETTING: Tertiary rehabilitation hospital. PATIENTS: Male wheelchair users with spinal cord injury. INTERVENTIONS: Participants were divided into four groups according to stroke pattern (arcing, semicircular [SC], single-loop [SL], and double-loop [DL]), in which they used their wheelchair on a motorized treadmill at a speed of 1 m/s. A sample of 40 people was created, 10 in each group. All participants performed a propulsion test. MAIN OUTCOME MEASURES: Temporospatial variables and shoulder kinematics were analyzed. Supraspinatus tendon thickness (SSTT), long head of biceps tendon thickness (LHBTT), and AHD were measured before and after the propulsion test. RESULTS: SC pattern had lower cadence and larger contact angle. A reduction in SSTT and LHBTT in arcing pattern, LHBTT and AHD in SC pattern, and LHBTT in DL pattern was observed (all p < .05). However, SL pattern did not differ significantly in all ultrasonographic measurements (all p > .05). Body mass index was associated with a decrease in SSTT. Age and number of daily push-ups were associated with a decrease in AHD. CONCLUSIONS: Fewer tendon changes after the propulsion in the SL pattern suggested that the supraspinatus and biceps tendons were preserved in this pattern. The SL pattern may be a better choice for male wheelchair users with supraspinatus and biceps tendon pathologies.

The Effect of Sham Controlled Continuous Theta Burst Stimulation and Low Frequency Repetitive Transcranial Magnetic Stimulation on Upper Extremity Spasticity and Functional Recovery in Chronic Ischemic Stroke Patients.

OBJECTIVE: This randomized controlled study examined the effect of continuous theta burst stimulation (cTBS) and low frequency repetitive transcranial magnetic stimulation (rTMS) on upper extremity spasticity and functional recovery in chronic ischemic stroke patients. MATERIALS AND METHODS: Twenty chronic ischemic stroke patients were randomized into three groups as real rTMS group (n = 7), real cTBS group (n = 7) and sham cTBS group (n = 6), in which real rTMS with physical therapy (PT), real cTBS with PT and sham cTBS with PT were applied in 10 sessions, respectively. The evaluation parameters were assessed at pre-treatment, post-treatment and follow up at 4 weeks. RESULTS: Ten sessions of real rTMS or real cTBS combined with PT were found beneficial in motor functional recovery and daily living activities both at post-treatment and follow up at 4 weeks (p Ë‚ 0.05). In the sham cTBS group, functional improvement was not significant (p > 0.05). In addition, in the real rTMS group, elbow flexor, pronator, wrist flexor and finger flexor spasticity were significantly decreased; in the real cTBS group, significant decrease was observed in the elbow flexor and wrist flexor spasticity (p Ë‚ 0.05). In comparison with sham cTBS group, only in the real cTBS group, significant improvement was observed in the level of wrist flexor spasticity at follow up at 4 weeks (p Ë‚ 0.017). CONCLUSIONS: In this study, it was observed that real cTBS or real rTMS combined with PT provided improvement on upper extremity motor functions and daily living activities in chronic ischemic stroke patients, but improvement in spasticity was limited.

Development of a Risk Behavior Diagnosis Scale for E-cigarette Use.

Objectives: Adolescent use of electronic cigarettes has risen dramatically, prompting concerns about the health effects. There is need for brief measures to assess adolescents' perceived threat and efficacy related to e-cigarette use and cessation. A 12-item Likert-type scale was modeled after the Risk Behavior Diagnosis Scale and designed to assess threat (ie, severity and susceptibility of threat) and efficacy (ie, self-efficacy and response efficacy) as they relate to e-cigarette use. Methods: The scale was administered online to a developmental sample of 674 adolescents to examine internal consistency and factor structure. Participants (52.1% female, M age = 14.6) were representative of the surrounding community (60% non-Hispanic white; 27% non-Hispanic black; 8% Hispanic). Results: Factor analysis and Velicer's minimum average partial test revealed 2 factors (as expected), which explained 68% of the variance. Analyses revealed strong internal consistency, with Cronbach's alpha of .93 overall and alphas of .92 and .87 for threat and efficacy subscales, respectively. The measure also exhibited good convergent and discriminant validity with other constructs. Conclusions: The measure demonstrates strong preliminary reliability and validity for a developmental sample of adolescents.

Validation of the Turkish Parent Supervision Attributes Profile Questionnaire.

AIM: The most common cause of death in childhood is unintentional injury. Most childhood injuries occur when children are under the supervision of caregivers. There is no valid and reliable instrument for measuring the parents' supervision attributes in Turkey. The aim of this study was to adapt the Parent Supervision Attributes Profile Questionnaire to Turkish. MATERIAL AND METHODS: This research was methodological. The data were collected through a questionnaire that consisted of 11 questions about the demographic and socioeconomic characteristics of the family and the Turkish Parent Supervision Attributes Profile Questionnaire. The Questionnaire, developed by Morrongiello and House, is a 5-point Likert-type scale and consists of 29 items. High scores obtained from the scale, which has no cut-off, indicate a high supervisory behavior. The language adaptation and content validity of the scale were completed by experts. Confirmatory factor analysis was used for construct validity. Reliability was tested by internal consistency coefficients. RESULTS: Five hundred sixty people participated in the study, 81.9% of whom were mothers. The mean age of the mothers was 33.8±4.6 years and the mean age of the fathers was 37.2±5.1 years. The percentage of university graduates was 56.8% among mothers and 53.9% among fathers. According to the confirmatory factor analysis, the fit index values were as follows: Standardized Root Mean Square Residual =0.097, Goodness of Fit Index =0.80, Root Mean Square Error of Approximation =0.089, Comparative Fit Index =0.88, Non-Normed Fit Index =0.87. The fit index values were moderate and confirmed 4-factor structure. It was found that the internal consistency coefficient calculated for reliability was 0.75 for the whole scale and ranged between 0.57 and 0.79 for the subscales. CONCLUSION: The Turkish Parent Supervision Attributes Profile Questionnaire is a valid and reliable measurement tool. Further research is needed to determine the current situation regarding supervisory behaviors.