Conectar
by Nipaporn Butsing, Nalinrat Thongniran, Jesada Keandoungchun
BackgroundStrokes are the major cause of disability. Functional recovery following an acute stroke is time-dependent and varies depending on several factors. This study aimed to investigate changes in functional outcomes after stroke from discharge to six months post-discharge and to identify factors associated with changes in functional outcomes during this six-month period.
MethodsThe study included 155 consecutive patients with a first stroke and were hospitalized in an acute stroke unit at an advanced tertiary hospital in Bangkok between April 2020 and August 2021. The patients’ functional outcomes were evaluated using the modified Rankin Scale (mRS) and the Barthel Index (BI) before hospital discharge and at one-, three-, and six-month post-discharge. Friedman tests were used to assess changes in mRS scores over six months. Linear mixed effect regression was applied to identify the change in BI scores during the six months post-discharge.
ResultsOf the participants, 62.6% were men, and the mean age was 64.0 (SD = 12.5). The median mRS scores ranged from 3.0 at discharge to 0.0 at six months post-discharge. Significant changes in mRS scores were identified within three months post-discharge, and differences by stroke subtype and severity (P Conclusion
The time after discharge, gender, stroke subtype, and stroke severity are significant factors affecting functional outcomes after a stroke. The most significant improvement in functional outcomes occurred within one month post-discharge.
by Kanyanee Promsawan, Chalurmpon Srichomthong, Monnat Pongpanich, Vorasuk Shotelersuk
DNA methylation, a key epigenetic modification, regulates gene expression and diverse cellular functions. Bisulfite sequencing (BS) remains the gold standard for methylation detection, while PacBio HiFi sequencing enables direct detection without chemical conversion. Although both technologies are increasingly used, few studies have directly compared their concordance, particularly in clinically relevant settings such as Down syndrome (DS). We performed a comparative analysis of DNA methylation profiles using whole-genome bisulfite sequencing (WGBS) and PacBio high-fidelity (HiFi) whole-genome sequencing (WGS) in a pair of monozygotic twins with DS. WGBS data were processed with two pipelines, wg-blimp and Bismark, while HiFi WGS data were analyzed using pb-CpG-tools. Our analysis focused on four key aspects: CpG site detection, genomic distribution of methylated CpGs (mCs), average methylation levels, and inter-platform concordance. HiFi WGS detected a greater number of mCs—particularly in repetitive elements and regions with low WGBS coverage—while WGBS reported higher average methylation levels than HiFi WGS. Both platforms exhibited methylation patterns consistent with known biological principles, such as low methylation in CpG islands, and the relative methylation patterns across genomic features were largely concordant. Pearson correlation coefficients indicated strong agreement between platforms (r ≈ 0.8), with higher concordance in GC-rich regions and at increased sequencing depths. Depth-matched comparisons and site-level down-sampling revealed that methylation concordance improves with increasing coverage, with stronger agreement observed beyond 20 × . Our findings support the reliability of HiFi WGS for methylation detection and highlight its advantages in regions that are challenging for bisulfite-based methods. This study demonstrates that HiFi WGS can serve as a robust alternative for genome-wide methylation profiling.
by Thamonwan Kirdthongkham, Maria Justine, Akkradate Siriphorn
Gait prediction is critical in optimizing rehabilitation strategies for stroke survivors. This study evaluates the prognostic utility of the Stroke Rehabilitation Assessment of Movement (STREAM) scores, recorded at admission, for predicting walking ability at discharge and one-month follow-up. We assessed 47 stroke patients using STREAM at admission; walking independence was defined using two criteria: a Functional Ambulation Category (FAC) score > 3 and a 10-Meter Walk Test (10-MWT) speed ≥ 0.4 m/s. The predictive validity of STREAM scores was analyzed using the area under the receiver operating characteristic curve (AUC). Sensitivity, specificity, and cut-off values were computed. The analysis revealed that a STREAM score above 38 at admission significantly predicted independent gait by discharge, evidenced by a high AUC of 0.897. At the one-month follow-up, a cut-off score of 29 continued to predict walking independence, with an AUC of 0.987. The subscores further enhanced predictive accuracy and highlighted the effectiveness of the STREAM assessment as a robust predictor of independent walking in stroke patients. These findings suggest the practicality of using STREAM scores to predict walking independence, which can guide the planning of more effective rehabilitation interventions. Trial registration TCTR20240323004 at www.thaiclinicaltrials.org.
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