scholarly journals Influence of stroke infarct location on quality of life assessed in a multivariate lesion-symptom mapping study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alina Königsberg ◽  
Andrew T. DeMarco ◽  
Carola Mayer ◽  
Anke Wouters ◽  
Eckhard Schlemm ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Learning Algorithm ◽  
Brain Regions ◽  
Support Vector ◽  
Lesion Volume ◽  
Patients At Risk ◽  
Lesion Symptom Mapping ◽  
The Right ◽  
Small Stroke

AbstractStroke has a deleterious impact on quality of life. However, it is less well known if stroke lesions in different brain regions are associated with reduced quality of life (QoL). We therefore investigated this association by multivariate lesion-symptom mapping. We analyzed magnetic resonance imaging and clinical data from the WAKE-UP trial. European Quality of Life 5 Dimensions (EQ-5D) 3 level questionnaires were completed 90 days after stroke. Lesion symptom mapping was performed using a multivariate machine learning algorithm (support vector regression) based on stroke lesions 22–36 h after stroke. Brain regions with significant associations were explored in reference to white matter tracts. Of 503 randomized patients, 329 were included in the analysis (mean age 65.4 years, SD 11.5; median NIHSS = 6, IQR 4–9; median EQ-5D score 90 days after stroke 1, IQR 0–4, median lesion volume 3.3 ml, IQR 1.1–16.9 ml). After controlling for lesion volume, significant associations between lesions and EQ-5D score were detected for the right putamen, and internal capsules of both hemispheres. Multivariate lesion inference analysis revealed an association between injuries of the cortico-spinal tracts with worse self-reported quality of life 90 days after stroke in comparably small stroke lesions, extending previous reports of the association of striato-capsular lesions with worse functional outcome. Our findings are of value to identify patients at risk of impaired QoL after stroke.

Aprosodia Secondary to Right Hemisphere Damage

2009 ◽  
Vol 19 (3) ◽  
pp. 71-76
Author(s):  
Amy D. Rodriguez
Keyword(s):  
Quality Of Life ◽  
Right Hemisphere ◽  
Large Body ◽  
Motor Impairment ◽  
Brain Regions ◽  
Human Communication ◽  
Right Hemisphere Damage ◽  
Informed Treatment ◽  
The Right

Abstract Purpose: This article introduces two types of prosody in human communication; describes right hemisphere contributions to prosody; describes prosodic deficits associated with right hemisphere damage; and discusses prevalence, quality of life, spontaneous recovery, and treatment of aprosodia. Method: Definitions of affective and linguistic prosody and aprosodia are provided. Results of lesion studies and neuroimaging studies are reviewed to inform the reader of the importance of the right hemisphere in prosody expression and comprehension, as well as to describe patterns of prosodic deficits in individuals with right hemisphere damage. Results and Conclusions: There is a large body of evidence supporting the role of the right hemisphere in affective prosody comprehension and production. Specifically, frontal brain regions and the basal ganglia are associated with aprosodia, suggesting there may be an underlying motor impairment. Because aprosodia is enduring and can impact quality of life, it is important to gain a better understanding of this disorder so that clinicians can accurately diagnose prosodic deficits and provide informed treatment.

scholarly journals P.104 Glioblastomas located in the right hemisphere are associated with worse quality of life

2016 ◽  
Vol 43 (S2) ◽  
pp. S44-S44
Author(s):  
C Iorio-Morin ◽  
P Goffaux ◽  
M Descoteau ◽  
K Whittingstall ◽  
D Fortin
Keyword(s):  
Quality Of Life ◽  
Large Scale ◽  
Right Hemisphere ◽  
Management Strategies ◽  
Brain Regions ◽  
Tumor Location ◽  
Posterior Cingulate Cortex ◽  
The Right ◽  
The Impact

Background: Because glioblastoma is currently incurable, the goal of therapy is the optimization of the patient’s quality of life (QOL). Tumor location is critical in screening surgical candidates, yet the impact of tumor location on QOL has never been demonstrated. By using a novel computer-driven algorithm, we set out to investigate the impact of tumor location on QOL. Methods: The tumors of fourty consecutive glioblastoma patients were segmented and the Euclidian distance between 90 brain regions and each tumor’s margin was calculated and correlated to the patients’ self-reported QOL as measured by the SNAS questionnaire. Results: QOL was statistically associated with proximity to three areas: the right para-hypocampal gyrus, the right posterior cingulate cortex and the right postcentral gyrus. We postulate that the adverse relation between proximity to these areas and QOL results from disruption in large-scale networks involved in high-order functions such as visuospatial memory. While harder to detect with a bedside clinical examination, such deficits are likely more impactful on QOL than those related to the motor cortex or Broca’s area. Conclusions: Tumor proximity to right parietooccipital region are associated with decreased QOL. This should be considered in the management strategies of glioma patients.

Musical Anhedonia

2020 ◽  
Vol 31 (2) ◽  
pp. 62-68
Author(s):  
Sara E. Holm ◽  
Alexander Schmidt ◽  
Christoph J. Ploner
Keyword(s):  
Quality Of Life ◽  
Nucleus Accumbens ◽  
Brain Damage ◽  
Parietal Cortex ◽  
Neurological Disorders ◽  
Brain Regions ◽  
Precise Information ◽  
Exact Localization ◽  
High Prevalence

Abstract. Some people, although they are perfectly healthy and happy, cannot enjoy music. These individuals have musical anhedonia, a condition which can be congenital or may occur after focal brain damage. To date, only a few cases of acquired musical anhedonia have been reported in the literature with lesions of the temporo-parietal cortex being particularly important. Even less literature exists on congenital musical anhedonia, in which impaired connectivity of temporal brain regions with the Nucleus accumbens is implicated. Nonetheless, there is no precise information on the prevalence, causes or exact localization of both congenital and acquired musical anhedonia. However, the frequent involvement of temporo-parietal brain regions in neurological disorders such as stroke suggest the possibility of a high prevalence of this disorder, which leads to a considerable reduction in the quality of life.

Advantages of a mini right axillary thoracotomy for congenital heart defect repair in children

2021 ◽  
pp. 1-6
Author(s):  
Jannika Dodge-Khatami ◽  
Ali Dodge-Khatami
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Global Health ◽  
Congenital Heart ◽  
Surgical Repair ◽  
Median Sternotomy ◽  
Axillary Approach ◽  
Post Operative Pain ◽  
The Right

Abstract Objectives: The mini right axillary thoracotomy is an alternative surgical approach to repair certain congenital heart defects. Quality-of-life metrics and clinical outcomes in children undergoing either the right axillary approach or median sternotomy were compared. Methods: Patients undergoing either approach for the same defects between 2018 and 2020 were included. Demographic details, operative data, and outcomes were compared between both groups. An abbreviated quality of life questionnaire based on the Infant/Toddler/Child Health Questionnaires focused on the patient’s global health, physical activity, and pain/discomfort was administered to all parents/guardians within two post-operative years. Results: Eighty-seven infants and children underwent surgical repair (right axillary thoracotomy, n = 54; sternotomy, n = 33) during the study period. There were no mortalities in either group. The right axillary thoracotomy group experienced significantly decreased red blood cell transfusion, intubation, intensive care, and hospital durations, and earlier chest tube removal. Up to 1 month, parents’ perception of their child’s degree and frequency of post-operative pain was significantly less after the right axillary thoracotomy approach. No difference was found in the patient’s global health or physical activity limitations beyond a month between the two groups. Conclusions: With the mini right axillary approach, surrogates of faster clinical recovery and hospital discharge were noted, with a significantly less perceived degree and frequency of post-operative pain initially, but without the quality of life differences at last follow-up. While providing obvious cosmetic advantages, the minimally invasive right axillary thoracotomy approach for the surgical repair of certain congenital heart lesions is a safe alternative to median sternotomy.

scholarly journals Convergence of heteromodal lexical retrieval in the lateral prefrontal cortex

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alexander A. Aabedi ◽  
Sofia Kakaizada ◽  
Jacob S. Young ◽  
Jasleen Kaur ◽  
Olivia Wiese ◽  
...  
Keyword(s):  
Prefrontal Cortex ◽  
Picture Naming ◽  
Cognitive Rehabilitation ◽  
Tumor Model ◽  
Brain Regions ◽  
Support Vector ◽  
Lexical Retrieval ◽  
Lateral Prefrontal Cortex ◽  
Lesion Symptom Mapping ◽  
Single Construct

AbstractLexical retrieval requires selecting and retrieving the most appropriate word from the lexicon to express a desired concept. Few studies have probed lexical retrieval with tasks other than picture naming, and when non-picture naming lexical retrieval tasks have been applied, both convergent and divergent results emerged. The presence of a single construct for auditory and visual processes of lexical retrieval would influence cognitive rehabilitation strategies for patients with aphasia. In this study, we perform support vector regression lesion-symptom mapping using a brain tumor model to test the hypothesis that brain regions specifically involved in lexical retrieval from visual and auditory stimuli represent overlapping neural systems. We find that principal components analysis of language tasks revealed multicollinearity between picture naming, auditory naming, and a validated measure of word finding, implying the existence of redundant cognitive constructs. Nonparametric, multivariate lesion-symptom mapping across participants was used to model accuracies on each of the four language tasks. Lesions within overlapping clusters of 8,333 voxels and 21,512 voxels in the left lateral prefrontal cortex (PFC) were predictive of impaired picture naming and auditory naming, respectively. These data indicate a convergence of heteromodal lexical retrieval within the PFC.

Nordic retirement contracts and the economic situation of widows

2006 ◽  
Vol 21 (3) ◽  
pp. 383-418 ◽  
Author(s):  
BEATRICE MORING
Keyword(s):  
Quality Of Life ◽  
Eighteenth Century ◽  
Economic Status ◽  
Economic Situation ◽  
Standard Of Living ◽  
The Family ◽  
Early Eighteenth Century ◽  
The Right

The aim of this article is to explore the economic status and the quality of life of widows in the Nordic past, based on the evidence contained in retirement contracts. Analysis of these contracts also shows the ways in which, and when, land and the authority invested in the headship of the household were transferred between generations in the Nordic countryside. After the early eighteenth century, retirement contracts became more detailed but these should be viewed not as a sign of tension between the retirees and their successors but as a family insurance strategy designed to protect the interests of younger siblings of the heir and his or her old parents, particularly if there was a danger of the property being acquired by a non-relative. Both the retirement contracts made by couples and those made by a widow alone generally guaranteed them an adequate standard of living in retirement. Widows were assured of an adequately heated room of their own, more generous provision of food than was available to many families, clothing and the right to continue to work, for example at spinning and milking, but to be excused heavy labour. However, when the land was to be retained by the family, in many cases there was no intention of establishing a separate household.

scholarly journals Ambient Air Quality Classification by Grey Wolf Optimizer Based Support Vector Machine

2017 ◽  
Vol 2017 ◽  
pp. 1-12 ◽  
Author(s):  
Akash Saxena ◽  
Shalini Shekhawat
Keyword(s):  
Support Vector Machine ◽  
Air Quality ◽  
Industrial Development ◽  
Learning Algorithm ◽  
Ambient Air ◽  
Support Vector ◽  
Grey Wolf Optimizer ◽  
Mathematical Framework ◽  
Primary Concern

With the development of society along with an escalating population, the concerns regarding public health have cropped up. The quality of air becomes primary concern regarding constant increase in the number of vehicles and industrial development. With this concern, several indices have been proposed to indicate the pollutant concentrations. In this paper, we present a mathematical framework to formulate a Cumulative Index (CI) on the basis of an individual concentration of four major pollutants (SO2, NO2, PM2.5, and PM10). Further, a supervised learning algorithm based classifier is proposed. This classifier employs support vector machine (SVM) to classify air quality into two types, that is, good or harmful. The potential inputs for this classifier are the calculated values of CIs. The efficacy of the classifier is tested on the real data of three locations: Kolkata, Delhi, and Bhopal. It is observed that the classifier performs well to classify the quality of air.

Support for People with Dementia

2009 ◽  
Vol 2 (4) ◽  
pp. 245-249
Author(s):  
Neil Hunt
Keyword(s):  
Quality Of Life ◽  
Early Intervention ◽  
Support Services ◽  
Daily Life ◽  
Terminal Condition ◽  
People With Dementia ◽  
The Right

Dementia is a progressive and eventually terminal condition, but with early intervention and the right support, people with dementia can continue to enjoy a good quality of life for many years. Living with dementia can be challenging both for those affected and their families as it can affect all aspects of daily life. It is vital that people with dementia and their carers are signposted to the support services that can help them take control of their condition and help them remain active and independent.

scholarly journals Prediction of Diabetic Nephropathy from the Relationship between Fatigue, Sleep and Quality of Life

2020 ◽  
Vol 10 (9) ◽  
pp. 3282
Author(s):  
Angela Shin-Yu Lien ◽  
Yi-Der Jiang ◽  
Jia-Ling Tsai ◽  
Jawl-Shan Hwang ◽  
Wei-Chao Lin
Keyword(s):  
Quality Of Life ◽  
Feature Selection ◽  
Diabetic Nephropathy ◽  
Sleep Quality ◽  
Support Vector ◽  
Svm Classifier ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
The Relationship

Fatigue and poor sleep quality are the most common clinical complaints of people with diabetes mellitus (DM). These complaints are early signs of DM and are closely related to diabetic control and the presence of complications, which lead to a decline in the quality of life. Therefore, an accurate measurement of the relationship between fatigue, sleep status, and the complication of DM nephropathy could lead to a specific definition of fatigue and an appropriate medical treatment. This study recruited 307 people with Type 2 diabetes from two medical centers in Northern Taiwan through a questionnaire survey and a retrospective investigation of medical records. In an attempt to identify the related factors and accurately predict diabetic nephropathy, we applied hybrid research methods, integrated biostatistics, and feature selection methods in data mining and machine learning to compare and verify the results. Consequently, the results demonstrated that patients with diabetic nephropathy have a higher fatigue level and Charlson comorbidity index (CCI) score than without neuropathy, the presence of neuropathy leads to poor sleep quality, lower quality of life, and poor metabolism. Furthermore, by considering feature selection in selecting representative features or variables, we achieved consistence results with a support vector machine (SVM) classifier and merely ten representative factors and a prediction accuracy as high as 74% in predicting the presence of diabetic nephropathy.

scholarly journals Euthanasia and suicide: a medical and social discourse

2021 ◽  
Vol 25 (1) ◽  
pp. 107-112
Author(s):  
V. N. Ostapenko ◽  
I. V. Lantukh ◽  
A. P. Lantukh
Keyword(s):  
Quality Of Life ◽  
Assisted Suicide ◽  
Human Life ◽  
Modern Science ◽  
Physician Assisted Suicide ◽  
Adequate Quality ◽  
The Subject ◽  
Strong Explosion ◽  
The Right

Annotation. The problem of suicide and euthanasia has been particularly updated with the spread of the COVID-19 pandemic, which caused a strong explosion of suicide, because medicine was not ready for it, and the man was too weak in front of its pressure. The article considers the issue of euthanasia and suicide based on philosophical messages from the position of a doctor, which today goes beyond medicine and medical ethics and becomes one of the important aspects of society. Medicine has achieved success in the continuation of human life, but it is unable to ensure the quality of life of those who are forced to continue it. In these circumstances, the admission of suicide or euthanasia pursues the refusal of the subject to achieve an adequate quality of life; an end to suffering for those who find their lives unacceptable. The reasoning that banned suicide: no one should harm or destroy the basic virtues of human nature; deliberate suicide is an attempt to harm a person or destroy human life; no one should kill himself. The criterion may be that suicide should not take place when it is committed at the request of the subject when he devalues his own life. According to supporters of euthanasia, in the conditions of the progress of modern science, many come to the erroneous opinion that medicine can have total control over human life and death. But people have the right to determine the end of their lives while using the achievements of medicine, as well as the right to demand an extension of life with the help of the same medicine. They believe that in the era of a civilized state, the right to die with medical help should be as natural as the right to receive medical care. At the same time, the patient cannot demand death as a solution to the problem, even if all means of relieving him from suffering have been exhausted. In defense of his claims, he turns to the principle of beneficence. The task of medicine is to alleviate the suffering of the patient. But if physician-assisted suicide and active euthanasia become part of health care, theoretical and practical medicine will be deprived of advances in palliative and supportive therapies. Lack of adequate palliative care is a medical, ethical, psychological, and social problem that needs to be addressed before resorting to such radical methods as legalizing euthanasia.

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