Background Children with cerebral palsy (CP) have motor deficits caused by spasticity, weakness, contractures, diminished selective motor control (SMC), and poor balance. The purpose of the current study was to evaluate the influence of mirror feedback on lower extremity selective motor control and balance in children with hemiplegic cerebral palsy. Understanding the relationship between SMC and balance will help children with hemiplegic CP receive more appropriate therapies. Methods Forty-seven children of both sexes diagnosed with hemiplegic CP participated in the study. Group1 (Gr1 - control group) received conventional physical therapy training while group 2 (Gr2 - intervention group) received conventional physical therapy training in addition to bilateral lower extremity mirror therapy (MT). The primary outcome measure used was Selective Control Assessment of Lower Extremity scale (SCALE), while the secondary outcome measure was the Pediatric Balance Scale (PBS). Results There were significant differences in Selective Control Assessment of Lower Extremity Scale (SCALE) and Pediatric Balance Scale (PBS) between both groups in favor of Gr2. After treatment, both groups improved significantly, yet Gr2 outperformed Gr1 by a large margin. Conclusion Mirror therapy may be a useful addition to home-based motor interventions for children with hemiplegic CP due to its relative simplicity, low cost, and high patient adherence. Additionally, it may help children improve their selective motor skills and balance. Trial registration Current Controlled Trials using African Clinical Trials Registry website with ID number PACTR202105604636415 retrospectively registered on 21/01/202.

Background Pulmonary arterial hypertension (PAH) in the setting of end-stage renal disease (ESRD) has important prognostic and therapeutic consequences. We estimated the prevalence of PAH among patients with ESRD treated with automated peritoneal dialysis (APD), investigated the effect of different variables and compared pulmonary artery pressure and cardiac function at the beginning and end of the study. Methods This is a 5-year study in which 31 ESRD patients on APD were recruited after fulfilling inclusion criteria. Blood samples were collected from all patients for the biochemical and hematological data at the beginning of the study and every month and at the study termination. Total body water (TBW) and extracellular water (ECW) were calculated using Watson’s and Bird’s calculation methods. All patients were followed-up at 3-month interval for cardiac evaluation. Logistic regression analysis was used to assess the relation between different variables and PAH. Results The mean age of the study population (n = 31) was 51.23 ± 15.24 years. PAH was found in 24.2% of the patients. Mean systolic pulmonary artery pressure (sPAP) and mean pulmonary artery pressure (mPAP) were significantly higher in the APD patients at study initiation than at the end of the study (40.75 + 10.61 vs 23.55 + 9.20 and 29.66 + 11.35 vs 18.24 + 6.75 mmHg respectively, p = 0.001). The median ejection fraction was significantly lower in patients with PAH at zero point than at study termination [31% (27-34) vs 50% (46-52), p = 0.002]. Hypervolemia decreased significantly at the end of study (p <  0.001) and correlated positively with the PAP (r = 0.371 and r = 0.369), p = 0.002). sPAP correlated with left ventricular mass index, hemoglobin level, and duration on APD. Conclusions Long term APD (> 1 years) seemed to decrease pulmonary arterial pressure, right atrial pressure and improve left ventricular ejection fraction (LVEF). Risk factors for PAH in ESRD were hypervolemia, abnormal ECHO findings and low hemoglobin levels. Clinical and echocardiographic abnormalities and complications are not uncommon among ESRD patients with PAH. Identification of those patients on transthoracic echocardiography may warrant further attention to treatment with APD.

We consider the following model repair problem: given a finite Kripke structure M and a specification formula η in some modal or temporal logic, determine if M contains a substructure M ′ (with the same initial state) that satisfies η. Thus, M can be "repaired" to satisfy the specification η by deleting some transitions.We map an instance (M, η) of model repair to a boolean formula repair (M, η) such that (M, η) has a solution iff repair (M, η) is satisfiable. Furthermore, a satisfying assignment determines which transitions must be removed from M to generate a model M ′ of η. Thus, we can use any SAT solver to repair Kripke structures. Furthermore, using a complete SAT solver yields a complete algorithm: it always finds a repair if one exists.We extend our method to repair finite-state shared memory concurrent programs, to solve the discrete event supervisory control problem [18,19], to check for the existence of symmettric solutions [12], and to accomodate any boolean constraint on the existence of states and transitions in the repaired model.Finally, we show that model repair is NP-complete for CTL, and logics with polynomial model checking algorithms to which CTL can be reduced in polynomial time. A notable example of such a logic is Alternating-Time Temporal Logic (ATL).

Background: Carotid endarterectomy (CEA) has shown a valuable role in preventing stroke in symptomatic patients. However, it is limited by the presence of high-risk medical conditions. Alternatively, carotid artery stenting (CAS) has evolved as a less invasive therapeutic method.Objective: This study aimed to compare between outcomes of artery stenting and carotid endarterectomy in asymptomatic carotid artery stenosis patients.Methods: This retrospective cohort included 37 adult patients with symptomatic carotid artery stenosis. Patients were scheduled for either CAS (N=20) or CEA (N=17). The records were reviewed, and the patients' demographics, comorbidities, and clinical data were recorded. Carotid artery assessment via carotid duplex ultrasonography was also recorded. The primary endpoint of the study was the incidence of myocardial infarction or stroke within 30-days, and the incidence of death, stroke, or myocardial infarction at 1-year. The secondary endpoints included cranial nerve injury, restenosis, vessel maturation, intracranial haemorrhage, and any complications at the surgical site within one month after the procedures.Results: Within 30 days of the procedures, the incidence of stroke or transient ischemic attack was 20.0% in the CAS group compared with 17.6% in the CEA group with no significant difference (p>0.999). Myocardial infarction did not ensue in either group. No patients in the CAS group developed cranial nerve injury compared to two patients (11.8%) in the CEA group, with no significant difference (p=0.204). The occurrence of local hematoma was lower in the CAS group (5.0%) than in the CEA group (29.4%), but it did not reach a significant level (p=0.075). A 1-year follow-up, equal death, and stroke rates in the CAS and CEA groups were 10.0% versus 11.8% (p>0.999).Conclusions: Data from our present study indicate comparable death, stroke, or myocardial infarction rates within one month and at 1-year follow-up among patients who underwent CAS or CEA. Furthermore, there were no significant differences between CEA and CAS procedures regarding incidence rates of cranial nerve injury, local neck hematoma, or restenosis within one month of the procedures.