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Effects of lesion guided transcranial electric stimulation to the visual cortex on cognition and self reported symptoms in psychosisMolho, Willa 05 March 2024 (has links)
Dysfunction of the visual cortex is implicated in psychosis and recently, the extrastriate visual cortex (V5/MT) has been causally linked to visual hallucinations through lesion network mapping. Transcranial electric stimulation (tES) has been shown to improve psychotic symptoms and cognition in psychosis spectrum disorders. However, few investigations have used novel approaches, such as high definition tES (HD-tES) to target specific brain circuits. Previously, we showed that stimulation delivered to V5/MT using HD-tDCS (direct current) reduced Positive and Negative Syndrome Scale (PANSS) general symptoms in the short-term (5 days), while HD-tACS (alternating current) improved general symptoms and functioning in the long-term (30 days). Here, we aim to determine if HD-tES to V5/MT has altering effects on cognition and self-reported symptoms of psychosis, and to investigate the differences between self-reported and clinician-reported symptoms. A pilot open label study with a within-subjects, single blind, crossover design was conducted in order to characterize the efficacy of cathodal HD-tDCS and 2Hz delta HD-tACS for psychosis treatment. Enrolled patients received 20 mins of HD-tES twice daily for 5 consecutive days applied bilaterally to V5/MT with a washout between conditions. Assessments were performed at baseline, day 5, and day 30. HD-tACS treatment was found to improve cognition on Digit Sequencing, Tower of London, Semantic Fluency, and “S” Letter Fluency tasks as measured by brief assessment of cognition in schizophrenia (BACS) as well as symptoms of paranoid ideation and anger/hostility as measured by the symptom checklist 90 (SC-90) 1 month after treatment. HD-tDCS treatment yielded significant improvement on “F” Letter Fluency as measured by BACS and did not yield any significant improvement on SC-90 symptoms. Lastly, correlations between SC-90 and PANSS described a distinct relationship between the two scales and their measures of psychiatric morbidity. Ultimately, delta wave tACS may be able to improve cognition and certain symptoms of psychosis by altering cortico-cortico communication between relevant brain structures. Future large-scale investigations are needed to further solidify these results. / 2026-03-04T00:00:00Z
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An assessment of heart failure screening tools for an outpatient arrhythmia devices clinicPaul, Lucy Joanne 01 January 2017 (has links)
People living with heart failure (PLHF) should be screened for symptoms at every
healthcare visit since they are 3 times more likely to experience ventricular arrhythmias. This quality improvement project (QIP) compared 3 self-administered HF symptoms questionnaires to determine the best screening tool for a tertiary hospital arrhythmia devices clinic. The instruments included the Minnesota Living with Heart Failure Questionnaire (MLHFQ), the Kansas City Cardiomyopathy Questionnaire (KCCQ), and the Self-Reported Heart Failure Symptoms (SHEFS) questionnaire. For a 30-day period, 76 people were eligible to participate in the QIP, with 55 participants included in the final analysis (72.5% participation). The questionnaires were compared and assessed with the gold standard laboratory test for HF (NT-proBNP) for sensitivity and specificity. For HF, the SHEFS was the most sensitive (83%) compared to the NT-proBNP, but the MLHFQ was most specific (89%). When compared to the MLHFQ as the standard, SHEFS was 71% sensitive, and 73% specific for HF. Similarly, when compared to the KCCQ, the SHEFS was both, 75% specific and sensitive in identifying HF. However, the rate of correlation to a positive or negative NT-proBNP test results was the highest for the SHEFS (87%). All 3 questionnaires were statistically significant in predicting admission to hospital for HF in the past 6 months (p = 0.02 to 0.03). Finally, given the shortest length and simplicity of use, the SHEFS was selected by the stakeholders to be the standard screening tool for the clinic. This project contributes to positive social change by providing the first reported comparison in the literature to implement questionnaires in a clinic to assess symptoms for PLHF attending an arrhythmia devices clinic.
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Clinical Symptoms and Signs Related to Voice Disorders among Collegiate-Level Singers: A Retrospective StudyMohr, Caitlin 12 1900 (has links)
The objectives of this research were to (1) characterize the demographics and vocal health history of collegiate-level singers, particularly those with a voice disorder and (2) describe and compare self-reported symptoms of singers across diagnostic categories of vocal fold disorders. Clinical reports of 56 collegiate-level singers (15 male and 41 female) who visited the Voice Diagnostic Clinic at the University of North Texas for voice evaluations between 2010 and 2015 were reviewed. Information was extracted from clinical records including demographic data, vocal health history, self-reported voice-related symptoms, and voice diagnosis confirmed by strobolaryngoscopic examinations and phonatory function testing. Diagnoses of voice disorders were grouped under three categories: normal (i.e., no perceptible pathology), benign lesions and irritation/inflammation. Seven singers were diagnosed as normal, 27 (51.8%) with benign lesions, and 22 (39.3%) with irritation/inflammation. All singers diagnosed as normal were females. Female singers have twice as many benign lesions as irritation/inflammation whereas males presented the opposite pattern. Nodules, polyps, cysts and irritation/inflammation were the most common voice disorders. Singers with allergies and a past history of voice problems demonstrated a higher incidence of voice disorders. The top five self-reported vocal symptoms were worse voice in the morning (50%), pain in throat (46.4%), voice worse with prolonged use (44.6%), vocal fatigue (42.9%), and breathiness (41.1%). Self-reported symptoms are not a reliable screening tool to determine presence or absence of vocal pathology. Voice teachers must be familiar with the singing and speaking voice of each student, so as to perceive early onset of vocal attrition symptoms and encourage the student in seeking medical attention.
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Förekomst av hjärnskakningar samt av hjärnskakningsliknande symtom hos damishockeyspelare jämfört med kontrollgruppUusitalo, Elin January 2017 (has links)
Bakgrund: Inom både dam- och herrishockey är hjärnskakningar vanligt förekommande. Definitionen av hjärnskakning är att hjärnan hamnar i rörelse av direkt eller indirekt våld mot huvudet. Riktlinjer finns framtagna över hur hjärnskakningar ska hanteras och rehabiliteras och bör tas på allvar då det finns risk för blödning eller kvarstående symtom. SCAT-3 är ett värderingsverktyg vid hjärnskakningar, där ingår en symtomskattning. En hög poängsumma innebär stora symtomatiska besvär. Inga studier har påträffats över förekomst av hjärnskakningar samt hjärnskakningslikande symtom för spelare i Svenska damhockeyligan (SDHL).Syfte: Att beskriva förekomst av hjärnskakningar samt hjärnskakningsliknade symtom hos ishockeyspelare i SDHL jämfört med en kontrollgrupp.Metod: Kvantitativ, deskriptiv samt komparativ tvärsnittsdesign. Ett internetbaserat testformulär byggt på SCAT-3. Totalt 92 deltagare, n=48 hockeyspelare, n=44 kontrollgrupp.Resultat: Förekomsten av hjärnskakningar var 64,6 % bland ishockeyspelare, och signifikant högre jämfört med kontrollgruppen 38,6 % (p=0,013). Totalsumma av hjärnskakningsliknande symtom bland hockeyspelarna (17,6 poäng) jämfört med kontrollgruppen (16,4 poäng) skiljde sig inte signifikant. Vanligaste symtomen bland hockeyspelarna var känsla av trötthet/brist på energi, nackont samt irritation. Vanligaste symtomen för kontrollgruppen var känsla av trötthet/brist på energi, mer känslosam än vanligt och koncentrationssvårigheter. Konklusion: 64,6 % av spelarna i SDHL har fått minst en hjärnskakning. Hjärnskakningar var vanligare bland spelare i SDHL än i kontrollgruppen. Ingen signifikant skillnad av hjärnskakningsliknade symtom sågs mellan grupperna. Symtomen var inte tillräckligt specifika för att jämföra grupper emellan, utan bör enbart jämföras individuellt. / Background: Concussions are frequently occurring in ice hockey, both women and men hockey. A concussion appears from direct or indirect violence against the head, that will cause brain movement, and in worse case a bleeding on the brain. There are guidelines for concussion management and rehabilitation that needs to take seriously as there are risks of retaining symptoms. SCAT-3 is a concussion tool, with a symptom scale. A higher score means bigger issues of the symptoms. No studies have been done on the concussion frequency and concussion-similar symptoms for players in the Svenska damhockeyligan (SDHL).Purpose: Find out frequency of concussion and concussion-similar symptoms compared to a control group. Method: Quantitative descriptive and comparative cross-sectional design. An internet based test, based on SCAT-3, with total 92 participants, n=48 hockey players, n=44 control group.Results: Concussion frequency was 64.6 % for hockey players, and significant higher compared to the control group 38.6% (p=0.013). In total, concussion-similar symptom score for hockey players was 17.6 points and for control group 16.4 points. No significant difference between the groups. The most common symptoms among hockey players were fatigue or low energy, neck pain and irritation. In the control group, fatigue or low energy, more emotional and concentration difficulties was the most common.Conclusion: 64.6 % of the players in SDHL had received at least one concussion. Concussions are more common among players in SDHL than a control group. No significant difference of concussion-similar symptoms. The symptoms are not specific
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Aiding Remote Diagnosis with Text Mining / Underlätta fjärrdiagnostik genom textbaserad datautvinningHellström Karlsson, Rebecca January 2017 (has links)
The topic of this thesis is on how text mining could be used on patient-reported symptom descriptions, and how it could be used to aid doctors in their diagnostic process. Healthcare delivery today is struggling to provide care to remote settings, and costs are increasing together with the aging population. The aid provided to doctors from text mining on patient descriptions is unknown.Investigating if text mining can aid doctors by presenting additional information, based on what patients who write similar things to what their current patient is writing about, could be relevant to many settings in healthcare. It has the potential to improve the quality of care to remote settings and increase the number of patients treated on the limited resources available. In this work, patient texts were represented using the Bag-of-Words model and clustered using the k-means algorithm. The final clustering model used 41 clusters, and the ten most important words for the cluster centroids were used as representative words for the cluster. An experiment was then performed to gauge how the doctors were aided in their diagnostic process when patient texts were paired with these additional words. The results were that the words aided doctors in cases where the patient case was difficult and that the clustering algorithm can be used to provide the current patient with specific follow-up questions. / Ämnet för detta examensarbete är hur text mining kan användas på patientrapporterade symptombeskrivningar, och hur det kan användas för att hjälpa läkare att utföra den diagnostiska processen. Sjukvården har idag svårigheter med att leverera vård till avlägsna orter, och vårdkostnader ökar i och med en åldrande population. Idag är det okänt hur text mining skulle kunna hjälpa doktorer i sitt arbete. Att undersöka om läkare blir hjälpta av att presenteras med mer information, baserat på vad patienter som skriver liknande saker som deras nuvarande patient gör, kan vara relevant för flera olika områden av sjukvården. Text mining har potential att förbättra vårdkvaliten för patienter med låg tillgänglighet till vård, till exempel på grund av avstånd. I detta arbete representerades patienttexter med en Bag-of-Words modell, och klustrades med en k-means algoritm. Den slutgiltiga klustringsmodellen använde sig av 41 kluster, och de tio viktigaste orden för klustercentroider användes för att representera respektive kluster. Därefter genomfördes ett experiment för att se om och hur läkare blev behjälpta i sin diagnostiska process, om patienters texter presenterades med de tio orden från de kluster som texterna hörde till. Resultaten från experimentet var att orden hjälpte läkarna i de mer komplicerade patientfallen, och att klustringsalgoritmen skulle kunna användas för att ställa specifika följdfrågor till patienter.
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