Domiciliary occupational therapy for patients with stroke discharged from hospital: randomised controlled trial

OBJECTIVE: To establish if a brief programme of domiciliary occupational therapy could improve the recovery of patients with stroke discharged from hospital. DESIGN: Single blind randomised controlled trial. SETTING: Two hospital sites within a UK teaching hospital. SUBJECTS: 138 patients with stroke with a definite plan for discharge home from hospital. INTERVENTION: Six week domiciliary occupational therapy or routine follow up. MAIN OUTCOME MEASURES: Nottingham extended activities of daily living score and "global outcome" (deterioration according to the Barthel activities of daily living index, or death). RESULTS: By eight weeks the mean Nottingham extended activities of daily living score in the intervention group was 4.8 points (95% confidence interval -0.5 to 10.0, P=0.08) greater than that of the control group. Overall, 16 (24%) intervention patients had a poor global outcome compared with 30 (42%) control patients (odds ratio 0.43, 0.21 to 0.89, P=0.02). These patterns persisted at six months but were not statistically significant. Patients in the intervention group were more likely to report satisfaction with a range of aspects of services. CONCLUSION: The functional outcome and satisfaction of patients with stroke can be improved by a brief occupational therapy programme carried out in the patient's home immediately after discharge. Major benefits may not, however, be sustained

Correlations of decision weights and cognitive function for the masked discrimination of vowels by young and old adults

AbstractOlder adults are often reported in the literature to have greater difficulty than younger adults understanding speech in noise [Helfer and Wilber (1988). J. Acoust. Soc. Am, 859–893]. The poorer performance of older adults has been attributed to a general deterioration of cognitive processing, deterioration of cochlear anatomy, and/or greater difficulty segregating speech from noise. The current work used perturbation analysis [Berg (1990). J. Acoust. Soc. Am., 149–158] to provide a more specific assessment of the effect of cognitive factors on speech perception in noise. Sixteen older (age 56–79 years) and seventeen younger (age 19–30 years) adults discriminated a target vowel masked by randomly selected masker vowels immediately preceding and following the target. Relative decision weights on target and maskers resulting from the analysis revealed large individual differences across participants despite similar performance scores in many cases. On the most difficult vowel discriminations, the older adult decision weights were significantly correlated with inhibitory control (Color Word Interference test) and pure-tone threshold averages (PTA). Young adult decision weights were not correlated with any measures of peripheral (PTA) or central function (inhibition or working memory)

Bubble Distribution in Cylindrical Fluidized Beds: The Effects of Bed Depth and Gas Speed

The dynamic behaviour of a bubbling fluidised bed markedly changes when the bed is run close to Umf or when it is shallow. It is shown that these changes can be explained using the kinematic models of Clift and Grace (1,2) and Davidson (3) (the model implementation is described in detail by Croxford (11)). The use of this model and tomographic measurements allows the conclusions to be made for three-dimensional fluidised beds, which can be difficult to observe directly

Misdiagnosis of hereditary amyloidosis as AL (Primary) amyloidosis

Background: Hereditary, autosomal dominant amyloidosis, caused by mutations in the genes encoding transthyretin, fibrinogen A -chain, lysozyme, or apolipoprotein A-I, is thought to be extremely rare and is not routinely included in the differential diagnosis of systemic amyloidosis unless there is a family history. Methods: We studied 350 patients with systemic amyloidosis, in whom a diagnosis of the light-chain (AL) type of the disorder had been suggested by clinical and laboratory findings and by the absence of a family history, to assess whether they had amyloidogenic mutations. Results: Amyloidogenic mutations were present in 34 of the 350 patients (9.7 percent), most often in the genes encoding fibrinogen A -chain (18 patients) and transthyretin (13 patients). In all 34 of these patients, the diagnosis of hereditary amyloidosis was confirmed by additional investigations. A low-grade monoclonal gammopathy was detected in 8 of the 34 patients (24 percent). Conclusions: A genetic cause should be sought in all patients with amyloidosis that is not the reactive systemic amyloid A type and in whom confirmation of the AL type cannot be obtained

High field magneto-transport in high mobility gated InSb/InAlSb quantum well heterostructures

We present high field magneto-transport data from a range of 30nm wide InSb/InAlSb quantum wells. The low temperature carrier mobility of the samples studied ranged from 18.4 to 39.5 m2V-1s-1 with carrier densities between 1.5x1015 and 3.28x1015 m-2. Room temperature mobilities are reported in excess of 6 m2V-1s-1. It is found that the Landau level broadening decreases with carrier density and beating patterns are observed in the magnetoresistance with non-zero node amplitudes in samples with the narrowest broadening despite the presence of a large g-factor. The beating is attributed to Rashba splitting phenomenon and Rashba coupling parameters are extracted from the difference in spin populations for a range of samples and gate biases. The influence of Landau level broadening and spin-dependent scattering rates on the observation of beating in the Shubnikov-de Haas oscillations is investigated by simulations of the magnetoconductance. Data with non-zero beat node amplitudes are accompanied by asymmetric peaks in the Fourier transform, which are successfully reproduced by introducing a spin-dependent broadening in the simulations. It is found that the low-energy (majority) spin up state suffers more scattering than the high-energy (minority) spin down state and that the absence of beating patterns in the majority of (lower density) samples can be attributed to the same effect when the magnitude of the level broadening is large

Dual and opposing roles of primary cilia in medulloblastoma development.

Recent work has shown that primary cilia are essential for Hedgehog (Hh) signaling during mammalian development. It is also known that aberrant Hh signaling can lead to cancer, but the role of primary cilia in oncogenesis is not known. Cerebellar granule neuron precursors (GNPs) can give rise to medulloblastomas, the most common malignant brain tumor in children. The primary cilium and Hh signaling are required for GNP proliferation. We asked whether primary cilia in GNPs have a role in medulloblastoma growth in mice. Genetic ablation of primary cilia blocked medulloblastoma formation when this tumor was driven by a constitutively active Smoothened protein (Smo), an upstream activator of Hh signaling. In contrast, removal of cilia was required for medulloblastoma growth by a constitutively active glioma-associated oncogene family zinc finger-2 (GLI2), a downstream transcription factor. Thus, primary cilia are either required for or inhibit medulloblastoma formation, depending on the initiating oncogenic event. Remarkably, the presence or absence of cilia was associated with specific variants of human medulloblastomas; primary cilia were found in medulloblastomas with activation in HH or WNT signaling but not in most medulloblastomas in other distinct molecular subgroups. Primary cilia could serve as a diagnostic tool and provide new insights into the mechanism of tumorigenesis

A Process of Original Cataloging of Theses and Dissertations

The purpose of this paper is to describe the reasoning, methodology, and impact behind a semi-automated cataloging process for electronic theses and dissertations, including explanations of the importance of retention and addition of cataloger created metadata. The authors explain an automated process that is generated by ProQuest and student entered data, and also the addition of metadata including the subject headings, classification number, etc. The study includes a survey of the public service librarians’ perceived usefulness of the cataloger and ProQuest generated metadata to describe theses and dissertations

On the Motion of Fluidized Granular Currents: Motion Along Horizontal Surfaces

The motion of fuidised granular currents over horizontal surfaces is investigated experi- mentally and by mathematical modelling of solid and fluid phases. Analytical solutions for the bulk motion were tested by experiments involving material being introduced at a constant volume flux, and a reasonable agreement found between theoretical predictions and laboratory measurements

The relationship between Hippocampal asymmetry and working memory processing in combat-related PTSD: a monozygotic twin study

BACKGROUND: PTSD is associated with reduction in hippocampal volume and abnormalities in hippocampal function. Hippocampal asymmetry has received less attention, but potentially could indicate lateralised differences in vulnerability to trauma. The P300 event-related potential component reflects the immediate processing of significant environmental stimuli and has generators in several brain regions including the hippocampus. P300 amplitude is generally reduced in people with PTSD. METHODS: Our study examined hippocampal volume asymmetry and the relationship between hippocampal asymmetry and P300 amplitude in male monozygotic twins discordant for Vietnam combat exposure. Lateralised hippocampal volume and P300 data were obtained from 70 male participants, of whom 12 had PTSD. We were able to compare (1) combat veterans with current PTSD; (2) their non-combat-exposed co-twins; (3) combat veterans without current PTSD and (4) their non-combat-exposed co-twins. RESULTS: There were no significant differences between groups in hippocampal asymmetry. There were no group differences in performance of an auditory oddball target detection task or in P300 amplitude. There was a significant positive correlation between P300 amplitude and the magnitude of hippocampal asymmetry in participants with PTSD. CONCLUSIONS: These findings suggest that greater hippocampal asymmetry in PTSD is associated with a need to allocate more attentional resources when processing significant environmental stimuli.Timothy Hall, Cherrie Galletly, C.R. Clark, Melinda Veltmeyer, Linda J. Metzger, Mark W. Gilbertson, Scott P. Orr, Roger K. Pitman and Alexander McFarlan