Feasibility and effects of adapted cardiac rehabilitation after stroke: a prospective trial

Abstract Background Despite the cardiovascular etiology of stroke, exercise and risk factor modification programs akin to cardiac rehabilitation (CR) are not available. This study aimed to establish the feasibility of adapting a CR model for individuals with mild to moderate stroke disability. A secondary objective was to determine the program's effects on aerobic and walking capacity, and stroke risk factors. Methods A repeated measures design was used with a 3-month baseline period and 6-month adapted CR intervention (n = 43, mean ± SD age 65 ± 12 years, 30 ± 28 months post stroke). Feasibility was determined by the number of participants who completed the study, occurrence of adverse events and frequency, duration and intensity of exercise performed. To determine effectiveness of the program, outcomes measured included aerobic capacity (VO2peak, ventilatory threshold), 6-Minute Walk Test (6MWT) distance, and risk factors. Descriptive statistics characterized the classes attended and number and intensity of exercise sessions. Paired t-tests, one-factor repeated measures analyses of variance contrasts and chi-square analyses were used to compare changes over time. Results Two participants withdrew during the baseline period. Of the remaining 41 participants who commenced the program, 38 (93%) completed all aspects. No serious adverse effects occurred. Post-intervention, VO2peak improved relative to the stable baseline period (P = 0.046) and the increase in ventilatory threshold approached significance (P = 0.062). Conclusions CR is feasible after stroke and may be adapted to accommodate for those with a range of post-stroke disability. It is effective in increasing aerobic capacity. CR may be an untapped opportunity for stroke survivors to access programs of exercise and risk factor modification to lower future event risk. Trial registration ClinicalTrials.gov registration number: NCT0106749

Exploring Cell Tropism as a Possible Contributor to Influenza Infection Severity

Several mechanisms have been proposed to account for the marked increase in severity of human infections with avian compared to human influenza strains, including increased cytokine expression, poor immune response, and differences in target cell receptor affinity. Here, the potential effect of target cell tropism on disease severity is studied using a mathematical model for in-host influenza viral infection in a cell population consisting of two different cell types. The two cell types differ only in their susceptibility to infection and rate of virus production. We show the existence of a parameter regime which is characterized by high viral loads sustained long after the onset of infection. This finding suggests that differences in cell tropism between influenza strains could be sufficient to cause significant differences in viral titer profiles, similar to those observed in infections with certain strains of influenza A virus. The two target cell mathematical model offers good agreement with experimental data from severe influenza infections, as does the usual, single target cell model albeit with biologically unrealistic parameters. Both models predict that while neuraminidase inhibitors and adamantanes are only effective when administered early to treat an uncomplicated seasonal infection, they can be effective against more severe influenza infections even when administered late

Innovative approaches for the study of biodiversity and water quality assessment in the Alpine region: the Interreg Alpine Space project Eco-Alpswater

The adoption of innovative approaches for monitoring and safeguarding lake and river ecosystems is the object of a new project - Eco-AlpsWater - co-financed by the European Regional Development Fund through the Interreg Alpine Space programme. The project, which begun in April 2018, will last three years, involving 12 partners belonging to 6 countries in the Alpine region (Austria, France, Germany, Italy, Slovenia and Switzerland). One of the main objectives is to develop and apply state of the art methods for the monitoring of cyanobacteria and bacteria, microalgae and fish based on the use of High Throughput Sequencing (HTS) techniques, complementing traditional approaches and anticipating the route in the development of new generation water monitoring systems. Owing to the ability to produce a wide variety of toxins, a specific attention is given to the identification of potentially toxigenic cyanobacteria. Traditionally, their monitoring in aquatic ecosystems was based on microscopic examinations. Nevertheless, traditional approaches suffer many drawbacks due to limitations in the correct microscopic recognition of diacritical characters. The new HTS technologies are providing a comprehensive picture of taxonomic composition and biodiversity of cyanobacteria and other biological elements in the Alpine region based on the analysis of samples collected in over 50 lakes and rivers. In order to evaluate general patterns in cyanobacteria composition related to cyanotoxin production, the survey is completed by the concurrent examination of sample aliquots for the determination of a wide variety of cyanotoxins in water samples and biofilms in lakes and rivers