Validating the Balance of Semi-Professional Dancers by Use of the Jenaer-Standing-Stability-Score (JESS-Score)

Introduction Postural control plays a central role in dance performance. The most dance styles contain manifold balance requirements. However, the data available on balance performance in dance is meagre. The dancers’ balancing ability depends on different components, which are still not totally understood. It can be assumed that standing stability as well as balance and therefore the test results of dancers are better than those of the recently published norm values. The aim of the study is to compare and verify the published standard values of the Jenaer-Standing-Stability-Score (JESS-Score). Material and Methods 24 dancers were included and measured with the first version of the recently published JESS-Score. 11 items include the assessment of mobility, sensorimotor skills, posture control and strength endurance. The dancers average test results are compared to the norm population. Results The dancers reached the norm or were even better concerning the tested items of the JESS-Score. Conclusion Standing stability and balance are basic requirements for dancing. The components measured by the JESS-Score are clearly involved in the equilibrium performance. Moreover, it shows the applicability of the JESS-Score norm values to a healthy, but untrained control population.

Evaluation of Rotavirus Surveillance System, Yemen 2018: Surveillance Evaluation (Preprint)

BACKGROUND Rotavirus kills over 185,000 children under 5 every year and responsible for over one-third of all child diarrheal deaths worldwide. The Rotavirus Surveillance System (RVSS) in Yemen was launched in 2007 in five sentinel sites to monitor the impact of vaccine on rotavirus morbidity and mortality. OBJECTIVE This study aimed to determine the level of usefulness of the RVSS, assess its performance, and identify the strengths and weaknesses of the surveillance system implementation. METHODS The Centers for Disease Control and Prevention (CDC) updated guidelines on evaluation of a public health surveillance system was used to evaluate RVSS. In this assessment, qualitative indicators of usefulness and other attributes of the system including flexibility, stability, simplicity and acceptability were assessed through in-depth interviews with the stakeholders at central level and semi-structured questionnaires with sentinel sites coordinators. Furthermore, indicators for quantitative attributes including sensitivity, Positive Predictive Value (PPV), completeness and timeliness were assessed through reviewing results of laboratory samples and a random sample of case report forms. Scores for the indicators were expressed as following: poor: <60%, average: 60 - <80%, and good: ≥ 80%. RESULTS The overall usefulness score percent of the RVSS was 73%, which indicates an average rank. The RVSS was rated as good on flexibility (score percent = 91%) and stability (score percent = 81%) attributes and was rated as an average on simplicity (score percent = 77%) and acceptability (score percent = 76%) attributes. Regarding the quantitative attributes, the system was rated as poor for sensitivity (score percent = 91%), average for PPV (score percent = 73%) and good for completeness and timeliness (score percent = 100%). CONCLUSIONS The overall RVSS performance was an average. Although the system attributes demonstrated a good flexibility, stability, data quality and timeliness, some attributes still need enhancements. The system was rated “average” on the usefulness, simplicity, and acceptability and poor for the sensitivity. To ensure sustainability, there is a need for planning gradual replacement of donor’s fund with government’s funds. Gradual scaling up of the RVSS through increasing the number of sites and governorates, and enhancement of the sensitivity of the RVSS are strongly recommended.

Fatigue and brain arousal in patients with major depressive disorder

Fatigue is considered a key symptom of major depressive disorder (MDD), yet the term lacks specificity. It can denote a state of increased sleepiness and lack of drive (i.e., downregulated arousal) as well as a state of high inner tension and inhibition of drive with long sleep onset latencies (i.e., upregulated arousal), the latter typically found in depression. It has been proposed to differentiate fatigue along the dimension of brain arousal. We investigated whether such stratification within a group of MDD patients would reveal a subgroup with distinct clinical features. Using an automatic classification of EEG vigilance stages, an arousal stability score was calculated for 15-min resting EEGs of 102 MDD patients with fatigue. 23.5% of the patients showed signs of hypoarousal with EEG patterns indicating drowsiness or sleep; this hypoaroused subgroup was compared with remaining patients (non-hypoaroused subgroup) concerning self-rated measures of depressive symptoms, sleepiness, and sleep. The hypoaroused subgroup scored higher on the Beck Depression Inventory items “loss of energy” (Z = − 2.13, p = 0.033; ɳ2 = 0.044, 90% CI 0.003–0.128) and “concentration difficulty” (Z = − 2.40, p = 0.017; ɳ2 = 0.056, 90% CI 0.009–0.139), and reported higher trait and state sleepiness (p < 0.05) as compared to the non-hypoaroused group. The non-hypoaroused subgroup, in contrast, reported more frequently the presence of suicidal ideation (Chi2 = 3.81, p = 0.051; ɳ2 = 0.037, 90% CI 0.0008–0.126). In this study, we found some evidence that stratifying fatigued MDD patients by arousal may lead to subgroups that are pathophysiologically and clinically more homogeneous. Brain arousal may be a worth while target in clinical research for better understanding the mechanisms underlying suicidal tendencies and to improve treatment response.

Improvements in Cognition and Balance Following Neurological Rehabilitation for a 17-year-old female hockey player with Post Concussive Syndrome

ObjectiveObjective is to show improvements in cognition and balance following neurologic rehabilitation for patient with post-concussive syndrome (PCS).BackgroundA 17-year-old, female, patient presented to Plasticity Brain Centers for evaluation and treatment of persistent symptoms following 3 diagnosed concussions. Her first concussion occurred via a motor vehicle collision and the two latter concussions were obtained while playing hockey. Her primary symptoms included headaches and vision issues, which she has been experiencing for over 3 years. Upon intake, she reported on the graded symptom checklist (GSC) a symptom severity score of 32. During neurocognitive testing on the C3Logix program, her Trails A time was 14.1 seconds; Trails B time was 32.6 seconds; digit symbol matching score (DSMS) was 56; simple reaction time (SRT) was 299 milliseconds and her choice reaction time (CRT) was 381 milliseconds. A Comprehensive Assessment of Postural Systems (CAPS®) was performed assessing balance and stability, on both a solid and foamed surface, with eyes opened, eyes closed, and multiple head positions. An average stability score was calculated as 39.2%.Design/MethodsA 5-day intensive with multi-modal neurologic exercises was administered in ten one-hour treatment sessions. Each session consisted of repetitive peripheral somatosensory stimuli, cognitive exercises, neuromuscular reeducation exercises, balance exercises, vestibular rehabilitation exercises, orthoptic exercises, and off-vertical axis rotation utilizing a multi-axis rotational chair.ResultsUpon exit, the symptom severity score decreased to 5 (−80.0%); Trails A time decreased to 10.9 (−22.7%); Trails B time decreased to 25.3 seconds (−22.4%). DSMS representing processing speed increased to 59 (+5.4%). SRT improved with a time of 245 milliseconds (−18.1%); and CRT was 311 milliseconds (−18.4%). Stability scores improved, with the average stability score calculated as 83.2% (+112.4%).ConclusionsThe authors suggest further investigation into multi-modal, intensive approaches to improve cognition and balance in patients with PCS.

Improvements in Cognition, Graded Symptom Checklist Score, Balance and Memory Following Neurological Rehabilitation for a 58-year-old Male Patient with Post-Concussion Syndrome: Case Report

ObjectiveTo suggest the efficacy of multi-modal, intensive, neurologic rehabilitation approaches to improve cognition, balance, and cognitive impairment in patients with post-concussion syndrome.BackgroundA 58-year-old male patient presented to Plasticity Brain Centers for evaluation and treatment of persistent symptoms following a previously diagnosed concussion. His symptoms followed rapidly after injury and included headaches, neck pain, and difficulty with sleeping. Upon intake, he reported on the graded symptom checklist (GSC) a symptom severity score of 59. A Comprehensive Assessment of Postural Systems (CAPS ®) was performed assessing balance and stability on both a solid and foamed surface with eyes opened, eyes closed, and multiple head positions. An average stability score upon intake was calculated as 53.9% overall. Neurocognitive testing utilizing C3 Logix Neurocognitive Assessment Suite, Trails A time was 28.6 and standardized assessment of cognition (SAC) score was a 28/30 with specific difficulty in delayed memory.Design/MethodsA 5-day, intensive, multi-modal program of neurologic exercises was administered in 10 one-hour treatment sessions. Each session consisted of repetitive peripheral somatosensory stimuli, cognitive exercises, neuromuscular reeducation, vestibular rehabilitation, orthoptic exercises, and off-vertical axis rotation utilizing a multi-axis rotational chair.ResultsUpon exit, symptom severity score decreased to 35 (−40.6%); Trails A time decreased to 19.7 (−31.1%); balance improved from an average stability score of 75.5%–79.6% (+5.4%); and standardized assessment of cognition (SAC) score increased to an overall score of 30/10 (+7.1%) with an improvement in delayed memory.ConclusionsThe authors suggest further investigation into multi-modal, intensive approaches to improve cognition, balance, and cognitive impairment in patients with post-concussion syndrome.

Improvements in Cognition and Balance Following Neurological Rehabilitation for a 23-year-old Male with Post Concussive Syndrome and Subsequent Minor Head Traumas

ObjectiveObjective is to show improvements in cognition and balance following neurological rehabilitation in patient with post-concussive syndrome (PCS) and subsequent minor head traumas.BackgroundA 23-year-old male presented to Plasticity Centers for evaluation and treatment of persistent symptoms following a sports-related concussion that occurred two years prior with subsequent minor head injuries. His symptoms included fatigue, concentration/focus difficulties, and issues when reading or looking at screens. Upon intake, he reported on the graded symptom checklist (GSC) a symptom severity score of 35. During neurocognitive testing on the C3Logix program, Trails A time was 28.8 seconds; Trails B time was 68.2 seconds; digit symbol matching score (DSMS) was 55 correctly matched digits/symbols; simple reaction time (SRT) was 303 milliseconds and choice reaction time (CRT) was 388 milliseconds. A Comprehensive Assessment of Postural Systems (CAPS®) was performed assessing balance and stability, on both a solid and foamed surface, with eyes opened, eyes closed, and multiple head positions. Average stability score upon intake was calculated as 75.8%.Design/MethodsThree separate intensives of 4 to 5 days, with multi-modal programs of neurological exercises were administered in multiple one-hour treatment sessions over the course of 19 weeks. Each session consisted of repetitive peripheral somatosensory stimuli, cognitive exercises, neuromuscular reeducation exercises, vestibular rehabilitation exercises, orthoptic exercises, and off-vertical axis rotation utilizing a multi-axis rotational chair.ResultsUpon exit, the symptom severity score decreased to 7 (−80.0%); Trails A time was 16.8 (−41.7%); Trails B time was 31.8 seconds (−53.4%). DSMS representing processing speed increased to 60 correctly matched digits/symbols (+9.1%). SRT was 253 milliseconds (−16.5%); and CRT was 319 milliseconds (−17.8%). Average stability score was calculated as 84.0% (+10.8%).ConclusionsThe authors suggest further investigation into multi-modal, intensive approaches to improve cognition, balance, and cognitive impairment in patients with PCS who have sustained subsequent minor head traumas.

COMPARING THE INTERTEMPORAL EFFICIENCY OF ISLAMIC BANKS IN INDONESIA AND MALAYSIA

This study aims to measure and compare the intertemporal efficiency of Islamicbanks in Indonesia and Malaysia using data envelopment analysis (DEA) togetherwith window (intertemporal) analysis for the period 2012–2018 and applying anintermediation approach. Window analysis is used to indicate the stability of efficiencyover the study period. The findings show that the intertemporal technical efficiency(TE) of Islamic banks in Indonesia was 77.4% with stability score of 0.034, which wassignificantly more efficient and more stable than Malaysian banks at 75.1% withstability score of 0.169. Moreover, the the intertemporal pure technical efficiency(PTE) of Islamic banks in Indonesia was 91.7% with stability score 0.020, which wasalso significantly more efficient and more stable than Malaysian banks at 88.0% PTEand stability score of 0.161. In contrast, the intertemporal scale efficiency (SE) ofIslamic banks in Indonesia was 84.5%, slightly lower than that of Malaysian banks at85.3% but not significantly different. PTE improvement has contributed to TEimprovement, while SE has not reached an optimal level. Comparison to previousresults also showed that since the global financial crisis the PTEs of Islamic banks inIndonesia and Malaysia have improved while SEs have worsened. Therefore, effortsto improve SE by expanding the size of Islamic banks to reach optimum economiesof scale are urgently needed.