Citations

Background: There are multiple stroke guidelines globally. To synthesize these and summarize what existing stroke guidelines recommend about the management of people with stroke, the World Stroke Organization (WSO) Guideline committee, under the auspices of the WSO, reviewed available guidelines. Aims: To systematically review the literature to identify stroke guidelines (excluding primary stroke prevention and subarachnoid hemorrhage) since 1 January 2011, evaluate quality (The international Appraisal of Guidelines, Research and Evaluation (AGREE II)), tabulate strong recommendations, and judge applicability according to stroke care available (minimal, essential, advanced). Summary of review: Searches identified 15,400 titles; 911 texts were retrieved, 200 publications scrutinized by the three subgroups (acute, secondary prevention, rehabilitation), and recommendations extracted from most recent version of relevant guidelines. For acute treatment, there were more guidelines about ischemic stroke than intracerebral hemorrhage; recommendations addressed pre-hospital, emergency, and acute hospital care. Strong recommendations were made for reperfusion therapies for acute ischemic stroke. For secondary prevention, strong recommendations included establishing etiological diagnosis; management of hypertension, weight, diabetes, lipids, and lifestyle modification; and for ischemic stroke, management of atrial fibrillation, valvular heart disease, left ventricular and atrial thrombi, patent foramen ovale, atherosclerotic extracranial large vessel disease, intracranial atherosclerotic disease, and antithrombotics in non-cardioembolic stroke. For rehabilitation, there were strong recommendations for organized stroke unit care, multidisciplinary rehabilitation, task-specific training, fitness training, and specific interventions for post-stroke impairments. Most recommendations were from high-income countries, and most did not consider comorbidity, resource implications, and implementation. Patient and public involvement was limited. Conclusion: The review identified a number of areas of stroke care where there was strong consensus. However, there was extensive repetition and redundancy in guideline recommendations. Future guideline groups should consider closer collaboration to improve efficiency, include more people with lived experience in the development process, consider comorbidity, and advise on implementation.

Abstract Background Engineering self‐efficacy, or the belief in one's own capabilities to complete engineering tasks, has been shown to predict greater motivation, academic performance, and retention of engineering students. Investigating the types of experiences that influence engineering students' self‐efficacy can reveal ways to support students in their undergraduate engineering programs. Purpose/Hypothesis(es) The purpose of this study was to qualitatively examine how undergraduate engineering students describe the sources of their engineering self‐efficacy and whether patterns in students' responses differed by gender. Design/Method Participants ( N = 654) were undergraduate engineering students attending two public, land‐grant universities in the U.S. Open‐ended survey questions were used to identify the events, social experiences, and emotions that students described as relevant to their engineering self‐efficacy. Chi‐square analyses were used to investigate whether response patterns varied by gender. Results Students described enactive performances as their most salient source of self‐efficacy, but interesting insights also emerged about how engineering students draw from social and emotional experiences when developing their self‐efficacy. Women more often referred to social sources of self‐efficacy and reported fewer positive emotions than did men. Conclusion Findings suggest ways that educators can provide more targeted opportunities for students to develop their self‐efficacy in engineering.

Abstract Background Self‐efficacy, or the beliefs learners hold about what they can do, develops largely from how learners perceive and interpret four main sources of information: mastery experiences, vicarious experiences, social persuasions and physiological and affective states. Although the relationship between these sources and self‐efficacy is well‐established, less is known about the factors that may influence how early adolescent learners perceive and interpret information from these sources. Aims The purpose of this study was to investigate how the predisposition of perfectionism might predict how learners perceive efficacy‐relevant information in the domain of math. Methods Using a correlational design, this study considered whether perfectionism was associated with how middle school students ( N = 1683) perceive information from the four hypothesized sources of self‐efficacy. Participants completed a paper‐based survey at two time points. Perfectionism was measured at Time 1. Self‐efficacy and its sources were measured at Time 2. Structural equation modelling techniques were used to examine the relationship between factors. Results and Conclusions Students who held themselves to high standards (i.e., greater self‐oriented perfectionism) reported higher levels of mastery experiences, vicarious experiences, social messages and self‐efficacy. Conversely, students who felt external pressure to be perfect (i.e., socially prescribed perfectionism) reported lower levels of mastery experiences, vicarious experiences and self‐efficacy, as well as higher levels of negative physiological and affective states. The relationship between perfectionism and self‐efficacy was partially mediated by students' perceptions of mastery. This study extends the current literature on the sources of math self‐efficacy in early adolescence by showing how a predisposition like perfectionism is associated with how adolescent learners perceive and interpret efficacy‐relevant information.

ABSTRACT The mariner (myo7aa−/−) mutant is a zebrafish model for Usher syndrome type 1 (USH1). To further characterize hair cell synaptic elements in myo7aa−/− mutants, we focused on the ribbon synapse and evaluated ultrastructure, number and distribution of immunolabeled ribbons, and postsynaptic densities. By transmission electron microscopy, we determined that myo7aa−/− zebrafish have fewer glutamatergic vesicles tethered to ribbon synapses, yet maintain a comparable ribbon area. In myo7aa−/− hair cells, immunolocalization of Ctbp2 showed fewer ribbon-containing cells in total and an altered distribution of Ctbp2 puncta compared to wild-type hair cells. myo7aa−/− mutants have fewer postsynaptic densities – as assessed by MAGUK immunolabeling – compared to wild-type zebrafish. We quantified the circular swimming behavior of myo7aa−/− mutant fish and measured a greater turning angle (absolute smooth orientation). It has previously been shown that L-type voltage-gated calcium channels are necessary for ribbon localization and occurrence of postsynaptic density; thus, we hypothesized and observed that L-type voltage-gated calcium channel agonists change behavioral and synaptic phenotypes in myo7aa−/− mutants in a drug-specific manner. Our results indicate that treatment with L-type voltage-gated calcium channel agonists alter hair cell synaptic elements and improve behavioral phenotypes of myo7aa−/− mutants. Our data support that L-type voltage-gated calcium channel agonists induce morphological changes at the ribbon synapse – in both the number of tethered vesicles and regarding the distribution of Ctbp2 puncta – shift swimming behavior and improve acoustic startle response.

PurposeMore than 460 million people suffer from disabling hearing loss worldwide, and about 50%–60% of hearing loss in infants are due to genetics. Usher syndrome is a genetic condition in which children are born deaf or hard of hearing and subsequently develop retinitis pigmentosa. It is the most common cause of deafness and blindness in pediatric populations, and pathogenic variants in 10 different genes are shown to be causative. The purpose of this review article is to advance the understanding of the clinical symptoms of an individual with Usher syndrome and highlight the latest research in the development of new treatments including gene therapy. The care and management of individuals with Usher syndrome require a team of multidisciplinary health care professionals, including an audiologist, a speech-language pathologist, an ophthalmologist, and a medical geneticist. We highlight the importance of early identification for better speech and developmental outcomes, specifically in pediatric individuals.ConclusionThis review empowers audiologists to be aware of early signs of Usher syndrome as they are typically the first point of contact and provides important information for audiologists and other health care professionals involved in the care of individuals with hearing loss and vision loss.