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Background and Aims The length of stay (LOS) in inpatient rehabilitation varies significantly and remains ambiguous. Therefore, we sought to determine the optimal length of inpatient rehabilitation. Methods This retrospective cohort study was conducted at a specialized inpatient rehabilitation hospital. Clinical data from 258 patients with neurological disorders, including stroke, spinal cord injury, and multiple sclerosis, were collected and analyzed. The primary outcome measure was the change in patients' functional status as assessed by the Functional Independence Measure (FIM). FIM scores were recorded at 21‐day intervals throughout the hospitalization period. To evaluate the effectiveness of inpatient rehabilitation over time, trends in FIM score changes were examined using effect size calculations. Additionally, Generalized Estimating Equations (GEE) were employed to analyze repeated measures and account for intra‐subject correlations across the different time points. Result In spinal cord injury (SCI) survivors, the trend of improvement continued with significant effectiveness:1.847 (95% CI: 1.445, 2.249), 3.320 (95% CI: 2.495, 4.144) and 3.036 (95% CI: 1.426, 4.645) during the first, second and discharge assessments, respectively, compared to Admission time. Patients with multiple sclerosis (MS) shown significant effectiveness only during the first 21‐day period: 1.276 (95% CI: 0.723, 1.830). Stroke survivors also showed significantly improved their FIM over the three 21‐day periods: first period:1.637 (95% CI: 1.284, 1.990), second period: 2.952 (95% CI: 2.106, 3.802), and discharge:3.804 (95% CI: 2.944, 4.668). Conclusions LOS exceeding 42 days resulted in a significant increase in the FIM scores of stroke patients. However, an extended stay of 21 days in the MS group and 42 days in the SCI group did not demonstrate significant improvement.

Background Static stretching is a treatment that reduces spasticity by elongating the muscle fibers. Dry needling is also a novel intervention that reduces spasticity by destroying dysfunctional endplates. Plantar flexor spasticity can cause gait disturbances and impaired balance in patients who have had a stroke. Therefore, reducing the spasticity of these muscles can improve the patient’s independence and overall function. This study reported the additional effects of dry needling on static stretching in reducing spasticity and function in a chronic stroke patient. Case presentation The patient was a 47-year-old Iranian woman with a past-7-month history of stroke and plantar flexor muscle spasticity. In this study, interventions were conducted for 5 days. In the treatment session, first dry needling (60 seconds × 3 days/week for 1 week total) was applied on the gastrocnemius, and then, an orthosis was used for static stretching (20 minutes × 5 days/week for 1 week total). The outcome measures were the Modified Modified Ashworth Scale, active and passive range of motion, the timed up and go test, and the European Quality of Life questionnaire . The patient was assessed at baseline (T0), immediately following treatment (T1), and at 1-week follow-up (T2). The results were reported as follows: The Modified Modified Ashworth Scale score decreased from 2 at T0 to 1 at T1 and remained 1 at T2. Active range of motion increased from 10° at T0 to 25° at T1 and decreased again to 15° at T2. Passive range of motion increased from 40° at T0 to 50° at T1 and decreased again to 45° at T2. The timed up and go test decreased from 50 seconds at T0 to 40 seconds at T1 and increased again to 42 seconds at T2. Her European Quality of Life questionnaire score increased from 0.25 at T0 to 0.39 at T1 and remained unchanged at 0.39 at T2. Conclusion This case study reported a patient with post-stroke spasticity. After dry needling in combination with static stretching, spasticity and overall function improved. It would be beneficial to conduct a randomized clinical trial study with a control group to comprehend the additional impact of dry needling on static stretching. Trial registration IRCT20230719058844N1, Registered 7 August 2023, https://irct.behdasht.gov.ir/trial/71395 .

The increasing reliance on nuclear energy as a significant low‐carbon power source necessitates effective solutions for managing radioactive emissions. This study introduces a novel application of MXene nanohybrids, specifically silver‐MXene (Ag‐Ti3C2Tx), as an effective sorbent for radioiodine off‐gas capture at an operating temperature of 150 °C. Through comprehensive material characterization, including X‐ray diffraction, scanning and transmission electron microscopies, energy‐dispersive X‐ray spectroscopy, Raman spectroscopy, thermogravimetric analysis, inductively coupled plasma optical emission spectroscopy, and gas sorption analyses, the successful loading of Ag nanoparticles onto Ti3C2Tx is confirmed and the subsequent formation of AgI upon iodine capture. The results demonstrate that Ag‐Ti3C2Tx exhibits superior iodine uptake compared to traditional silver‐based sorbents such as silver mordenite zeolite (AgZ) and silver‐functionalized silica aerogel (AgAero). The Ag‐Ti3C2Tx achieves an iodine loading of 946 mg g−1, significantly outperforming AgZ (131 mg g−1). These findings highlight the potential of Ag‐Ti3C2Tx as a highly efficient, thermally stable sorbent for radioiodine capture, and potentially addressing key limitations of existing materials. Silver‐MXene (Ag‐Ti3C2Tx) nanohybrids effectively captured iodine gas at 150 °C, with Ag nanoparticles loaded onto MXene via silver nitrate reduction. Upon exposure to iodine gas, silver iodide forms, confirming successful adsorption. Ag‐Ti3C2Tx shows superior iodine uptake (946 mg g−1) compared to conventional sorbents, demonstrating its potential as an efficient, thermally stable solution for radioiodine capture.

Importance Stroke is a leading cause of disability worldwide and is often accompanied by complications such as spasticity. Static stretching (SS) is a common physiotherapy intervention for reducing spasticity, whereas dry needling (DN) is a novel approach. However, the combined effects of DN and SS on spasticity have not been thoroughly investigated. Given the pivotal effect of spasticity on daily activities, mitigating spasticity can significantly contribute to restoring patient independence. Objective This study will explore the impact of DN plus SS on spasticity, alpha motor neuron excitability, overall function, and quality of life in patients with chronic stroke. Design, Setting, and Population A double-blind, randomized, sham-controlled trial will be conducted in patients with post-stroke spasticity in the plantar flexor muscles. Twenty-eight participants will be randomly assigned to either an intervention or control group. The intervention group will receive DN (60s × 3 days/week; 1 week) plus SS (20 min × 5 days/ week; 1 week). The control group will undergo sham DN (60s × 3 days/week; 1 week) and SS (20 min × 5 days/week; 1 week). Exposures DN plus SS or sham DN plus SS. Main Outcomes and Measures Both groups will be assessed at baseline, immediately post-treatment, and after 1 week of follow-up. Outcome measures will include the Modified Modified Ashworth Scale, H-reflex latency, H max /M max ratio, active and passive ankle dorsiflexion range of motion, timed up and go test, and the EuroQol questionnaire. Results Results from this randomized, sham-controlled study will provide evidence for the effectiveness of DN in combination with SS for spasticity. Conclusions and Relevance The additional impact of DN in conjunction with SS, a widely used method for reducing muscle tone, remains unclear and warrants investigation. This study, with a high level of evidence, aims to address this knowledge gap.

Background and Aims Falling is a serious threat for patient safety in hospitals. This study aimed to identify the risk factors of fall amongst rehabilitation patients and to use them for developing and validating the Persian version of Fall Risk Assessment Scale (FRAS). Methods The current methodological study was conducted in two phases. In the first phase, based on the review of the literature and investigation of the medical records of 251 patients selected via purposive sampling, the risk factors of fall were extracted and the FRAS was developed accordingly. In the second phase, the face and content validities of the designed scale were determined by cognitive interview and Content Validity Index (CVI) and to evaluate the construct validity, known‐groups comparison was performed. Its inter‐rater reliability was analyzed using the weighted Kappa Coefficient (κ*). The study adhered to COSMIN guidelines. Results Fall was significantly associated with disease diagnosis, used medications, history of fall, cognitive impairments, and three items of the Functional Independence Measure (toilet transfer, bed transfer, and shoer transfer). The CVI of the scale was 0.94. The risk for falls group had a significantly higher perceived fall risk than the no risk for falls group, thus establishing known‐group validity. Its weighted kappa coefficient was >0.85, its sensitivity was 73%, and its specificity was 82%. Conclusion The valid and reliable FRAS may accurately assess the level of Fall Risk patients in Rehabilitation wards, helping to predict fall during hospitalization. So, enabling the planning and implementation of effective caring interventions.

Ulnar neuropathy at elbow is the second-most common compression neuropathy. The main aim of this study was to assess the diagnostic value of ultrasonography (US) as an alternative method to electrodiagnosis (EDX), which had traditionally been used as the method of choice. This diagnostic study was conducted on 66 participants (32 patients` elbows and 34 normal elbows) referred for EDX. Both groups were reassessed by US to evaluate the consistency of the two tests. The quantitative parameters of US, such as cross-sectional area (CSA) of the ulnar nerve at three different levels around the medial epicondyle (ME) were compared between groups. Our findings demonstrated that CSA at the ME and 2 cm distal to the ME were significantly larger in the patient group than normal participants. This higher nerve size was more prominent among those who had predominant axonal loss rather than demyelinating lesions ( <0.01). Finally, we evaluated US diagnostic value with the best singular feature (2 cm distal to ME) at a cutoff of 9 mm , which revealed specificity of 80% and sensitivity 84%. Based on these results we can conclude that US is a sensitive and specific method in diagnosing ulnar neuropathy at the elbow and can be used as an acceptable complementary method, in particular when EDX is not available.

Lumbosacral radiculopathy is a challenging diagnosis, and Electrodiagnostic study (EDX) is a good complementary test for Magnetic Resonance Imaging (MRI). Physical examination, MRI and electrodiagnosis have different diagnostic values in this regard. MRI can provide anatomical evidence and is useful in choosing a treatment process, but it could also have false positive results. In this study, we assessed the correlation of clinical and electrodiagnostic findings in patients with positive MRI findings for S1 radiculopathy. EDX was performed for 87 patients referred with clinical and MRI diagnosis of S1 radiculopathy. The consistency between EDX results, MRI, and clinical findings were evaluated by Pearson chi 2 and odds ratio. Fifty-eight percent of patients had disc protrusion, and 42% had extrusion. Physical examination revealed absent Achilles reflex in 83% and decreased S1 dermatome sensation in 65%. In this study, EDX sensitivity was about 92%. The highest consistency among EDX parameters and physical examination findings was between absent H-reflex and decreased Achilles reflex (OR=6.20, P=0.014), but there was no significant consistency between H-reflex and neither muscular weakness nor SLR test result (P>0.05). There was also no relationship between type of disc herniation in MRI and H reflex. There was correlation between H-reflex abnormalities and absent ankle reflex in patients with unilateral L5-S1 disc herniation in MRI. Results of this study showed that in patients with positive MRI for L5-S1 disc protrusion and S1 nerve root compression, it is still beneficial to perform EDX for selected patients. © 2019 Tehran University of Medical Sciences. All rights reserved. Acta Med Iran 2019;57(4):229-234.

Silver‐MXene Nanohybrid for Iodine Gas Capture In article 2500011, Michael Naguib and co‐workers report the synthesis of silver‐MXene nanohybrids and demonstrate their use for iodine gas capture at 150 °C. The material achieves an iodine uptake of 946 mg·g−1, outperforming conventional silver‐based sorbents. The formation of thermally stable silver iodide is confirmed, underscoring the potential of MXene hybrids as effective sorbents for radioiodine and nuclear off‐gas capture applications.

Purpose: Ulnar neuropathy at elbow is the second-most common compression neuropathy. The main aim of this study was to assess the diagnostic value of ultrasonography (US) as an alternative method to electrodiagnosis (EDX), which had traditionally been used as the method of choice. Methods: This diagnostic study was conducted on 66 participants (32 patients' elbows and 34 normal elbows) referred for EDX. Both groups were reassessed by US to evaluate the consistency of the two tests. The quantitative parameters of US, such as cross-sectional area (CSA) of the ulnar nerve at three different levels around the medial epicondyle (ME) were compared between groups. Results: Our findings demonstrated that CSA at the ME and 2 cm distal to the ME were significantly larger in the patient group than normal participants. This higher nerve size was more prominent among those who had predominant axonal loss rather than demyelinating lesions (P<0.01). Finally, we evaluated US diagnostic value with the best singular feature (2 cm distal to ME) at a cutoff of 9 [mm.sup.2], which revealed specificity of 80% and sensitivity 84%. Conclusion: Based on these results we can conclude that US is a sensitive and specific method in diagnosing ulnar neuropathy at the elbow and can be used as an acceptable complementary method, in particular when EDX is not available. Keywords: Cubital Tunnel Syndrome, elbow, diagnostic tests, nerve compression syndromes, electromyography