Shoulder pain after stroke: prevalence, contributing factors and consequences in daily life

Post stroke shoulder pain, PSSP, is a common type of pain after stroke, but still further knowledge of this condition is needed. An increased knowledge of prevalence, contributing factors and impact on the individual’s life could enhance the possibility to find more effective treatments and therefore more studies are needed. The overall aim of this thesis was to evaluate PSSP with a special focus on prevalence, contributing factors and consequences in daily life. In an unselected stroke population of 327 individuals, the prevalence of PSSP was 22% four months post stroke. Predictors of PSSP (paper I) were shown to be severely affected arm motor function and severe impairments according to the National Institutes of Health Stroke Scale, (NIHSS). About 70% of the individuals with impaired sensorimotor function at stroke onset and PSSP at four months had still pain one year later. Predictors for long-lasting PSSP were left-sided hemiparesis, pain frequency and decreased passive shoulder abduction (paper II). In a group of 49 individuals with mild to moderate sensorimotor impairments post stroke (24 with and 25 without PSSP) and 11 healthy controls, somatosensory abnormalities were assessed with thermal and mechanical thresholds using the Quantitative Sensory Testing (QST) method. No significant difference in QST measurements were found between the groups with and without PSSP, but both stroke groups had generally higher thermal thresholds and more extreme low or high mechanical thresholds than the healthy controls (paper III). The association between PSSP, sensorimotor function, ability to perform daily hand activities, perceived participation and life satisfaction were evaluated in 24 individuals with and 25 individuals without PSSP, all with mild to moderate sensorimotor impairments. PSSP was associated with reduced motor function, but the PSSP had a weak association with daily hand activities, perceived participation and life satisfaction (paper IV). In conclusion, this thesis has shown that PSSP is common in individuals with decreased upper extremity motor function. Left-sided hemiparesis, pain frequency and decreased passive shoulder abduction seem to predict long-lasting PSSP. In individuals with mild to moderate upper extremity paresis, somatosensory impairments seem to have only a small impact on the pain and the PSSP appears to have a small impact on their life situation

Measurement variability of quantitative sensory testing in persons with post-stroke shoulder pain.

OBJECTIVE: To evaluate the measurement variability of quantitative sensory testing (QST) in persons with post-stroke shoulder pain. DESIGN: A test-retest design. PARTICIPANTS: Twenty-three persons with post-stroke shoulder pain (median age 65 years).METHODS: Thermal detection thresholds (cold and warm), pain thresholds (cold and heat) and mechanical pain thresholds (pressure and pin prick) were assessed twice in both arms, 2–3 weeks apart. Measurement variability was analysed with the intraclass correlation coefficient (ICC2.1), the change in mean (đ) with 95% confidence interval (logarithmic scales), and the relative standard error of measurement (SEM%; re-transformed scales). RESULTS: The ICCs for thermal thresholds ranged from 0.48 to 0.89 in the affected (painful) arm and from 0.50 to 0.63 in the unaffected arm, and for mechanical pain thresholds from 0.66 to 0.90 in both arms. No systematic changes in the mean (đ) were found. The SEM% ranged from 4% to 10% for thermal detection and heat pain thresholds, and from 17% to 42% for cold pain and mechanical pain thresholds in both arms.CONCLUSION: QST measurements, especially cold pain thresholds and mechanical pain thresholds, vary in persons with post-stroke shoulder pain. Before QST can be used routinely to evaluate post-stroke shoulder pain, a test protocol with decreased variability needs to be develope

Increased prevalence of seropositivity for non-gastric Helicobacter species in patients with autoimmune liver disease

Various Helicobacter species have been isolated from the stomach, intestinal tract and liver of a variety of mammalian and some avian species, and Helicobacter DNA has been detected in human bile and liver samples. An immunoblot assay was established to analyse serum antibody responses to non-gastric Helicobacter species in patients with autoimmune liver diseases, in comparison with healthy individuals. Sera from 36 patients with primary sclerosing cholangitis (PSC), 21 with primary biliary cirrhosis, 19 with autoimmune chronic hepatitis and 80 blood donors were analysed by immunoblot, using cell-surface proteins from Helicobacter pullorum, Helicobacter bilis and Helicobacter hepaticus as antigens. Prior to testing, sera were cross-absorbed with a whole-cell lysate of Helicobacter pylori. Antibody reactivity to various proteins of these three Helicobacter species was measured by densitometric scanning and results were processed by computer software to estimate antigenic specificity. Results were also compared with antibody response to H. pylori. For H. pullorum, reactivity to at least two of the proteins with molecular masses of 48, 45, 37, 20 and 16 kDa, for H. hepaticus, reactivity to the 76, 30 and 21 kDa proteins and for H. bilis, reactivity to the 22 and 20 kDa proteins, seemed to have high specificity. Positive immunoblot results with sera from patients with PSC to antigens of H. pullorum, H. bilis and H. hepaticus were found in 38, 22 and 25 of cases, respectively, and from patients with other autoimmune liver diseases, in 30, 22 and 22 of cases, respectively. Prevalence of serum antibodies to non-gastric Helicobacter species was significantly higher in patients with autoimmune chronic liver diseases than in healthy blood donors (P < 0.001). Increased antibody levels to enterohepatic Helicobacter species raise questions concerning an infectious role of these emerging bacterial pathogens in human autoimmune liver diseases

Poststroke Shoulder Pain and Its Association With Upper Extremity Sensorimotor Function, Daily Hand Activities, Perceived Participation, and Life Satisfaction.

To assess the differences in upper extremity sensorimotor function, daily hand activities, and perceived participation and life satisfaction between individuals with and without poststroke shoulder pain (PSSP), and to determine how PSSP is associated with these variables

Towards Deep Cellular Phenotyping in Placental Histology

The placenta is a complex organ, playing multiple roles during fetal development. Very little is known about the association between placental morphological abnormalities and fetal physiology. In this work, we present an open sourced, computationally tractable deep learning pipeline to analyse placenta histology at the level of the cell. By utilising two deep Convolutional Neural Network architectures and transfer learning, we can robustly localise and classify placental cells within five classes with an accuracy of 89%. Furthermore, we learn deep embeddings encoding phenotypic knowledge that is capable of both stratifying five distinct cell populations and learn intraclass phenotypic variance. We envisage that the automation of this pipeline to population scale studies of placenta histology has the potential to improve our understanding of basic cellular placental biology and its variations, particularly its role in predicting adverse birth outcomes.Comment: Updated MRC funding material. Corrected typo that suggested ensembling and Inception accuracy were the same (updated to reflect the fact the ensemble model is 1% better than previously reported

Genome-wide association study of adipocyte lipolysis in the GENetics of Adipocyte Lipolysis (GENiAL) cohort

Objectives: Lipolysis, hydrolysis of triglycerides to fatty acids in adipocytes, is tightly regulated, poorly understood, and, if perturbed, can lead to metabolic diseases including obesity and type 2 diabetes. The goal of this study was to identify the genetic regulators of lipolysis and elucidate their molecular mechanisms. Methods: Adipocytes from abdominal subcutaneous adipose tissue biopsies were isolated and were incubated without (spontaneous lipolysis) or with a catecholamine (stimulated lipolysis) to analyze lipolysis. DNA was extracted and genome-wide genotyping and imputation conducted. After quality control, 939 samples with genetic and lipolysis data were available. Genome-wide association studies of spontaneous and stimulated lipolysis were conducted. Subsequent in vitro gene expression analyses were used to identify candidate genes and explore their regulation of adipose tissue biology. Results: One locus on chromosome 19 demonstrated genome-wide significance with spontaneous lipolysis. 60 loci showed suggestive associations with spontaneous or stimulated lipolysis, of which many influenced both traits. In the chromosome 19 locus, only HIF3A was expressed in the adipocytes and displayed genotype-dependent gene expression. HIF3A knockdown in vitro increased lipolysis and the expression of key lipolysis-regulating genes. Conclusions: In conclusion, we identified a genetic regulator of spontaneous lipolysis and provided evidence of HIF3A as a novel key regulator of lipolysis in subcutaneous adipocytes as the mechanism through which the locus influences adipose tissue biology

Genome-wide association study of adipocyte lipolysis in the GENetics of adipocyte lipolysis (GENiAL) cohort.

OBJECTIVES:Lipolysis, hydrolysis of triglycerides to fatty acids in adipocytes, is tightly regulated, poorly understood, and, if perturbed, can lead to metabolic diseases including obesity and type 2 diabetes. The goal of this study was to identify the genetic regulators of lipolysis and elucidate their molecular mechanisms. METHODS:Adipocytes from abdominal subcutaneous adipose tissue biopsies were isolated and were incubated without (spontaneous lipolysis) or with a catecholamine (stimulated lipolysis) to analyze lipolysis. DNA was extracted and genome-wide genotyping and imputation conducted. After quality control, 939 samples with genetic and lipolysis data were available. Genome-wide association studies of spontaneous and stimulated lipolysis were conducted. Subsequent in vitro gene expression analyses were used to identify candidate genes and explore their regulation of adipose tissue biology. RESULTS:One locus on chromosome 19 demonstrated genome-wide significance with spontaneous lipolysis. 60 loci showed suggestive associations with spontaneous or stimulated lipolysis, of which many influenced both traits. In the chromosome 19 locus, only HIF3A was expressed in the adipocytes and displayed genotype-dependent gene expression. HIF3A knockdown in vitro increased lipolysis and the expression of key lipolysis-regulating genes. CONCLUSIONS:In conclusion, we identified a genetic regulator of spontaneous lipolysis and provided evidence of HIF3A as a novel key regulator of lipolysis in subcutaneous adipocytes as the mechanism through which the locus influences adipose tissue biology

Творческий подход студентов в изучении гистологии

Denna rapport innehåller texter som presenterats vid en konferens arrangerad inom ramen för Nätverk för barnomsorgsforskningi . Syftet med konferensen var att lyfta upp begreppet omsorg, diskutera dess innebörd, rädda det från retorisk förflackning och samtidigt via dess koppling till verksamheter belysa ett vidare sammanhang. När bamforskning diskuteras har jag på senare tid funnit det väsentligt att peka på att den har en kapacitet att kasta ljus över centrala samhällsfrågor. Forskning om barn bör inte bara vara en forskning om en viss grupp i samhället. Den nyare bamdomsforskningen söker tillämpa ett bamperspektiv. Detta innebär att fenomen studeras såsom de framstår från barnens perspektiv och att inverkan av olika sociala reformer, politiska förändringar och produktion av varor på barns liv belyses. Det handlar alltså både om att söka efter barnens perspektiv och att söka efter konsekvenserna för barnen av olika samhälleliga förändringar. Nya fålt som t.ex. barndomshistoria, barndomssociologi och barndomsantropologi har uppstått och begreppet generation har införts för att markera vikten av att anlägga ett generationsperspektiv på frågor som vanligtvis grupperats på annat sätt

Prevalence of Anaplasma phagocytophilum infection and effect on lamb growth

Background: A major challenge in sheep farming during the grazing season along the coast of south-western Norway is tick-borne fever (TBF) caused by the bacteria Anaplasma phagocytophilum that is transmitted by the tick Ixodes ricinus. Methods: A study was carried out in 2007 and 2008 to examine the prevalence of A. phagocytophilum infection and effect on weaning weight in lambs. The study included 1208 lambs from farms in Sunndal Ram Circle in Møre and Romsdal County in Mid-Norway, where ticks are frequently observed. All lambs were blood sampled and serum was analyzed by an indirect fluorescent antibody assay (IFA) to determine an antibody status (positive or negative) to A. phagocytophilum infection. Weight and weight gain and possible effect of infection were analyzed using ANOVA and the MIXED procedure in SAS. Results: The overall prevalence of infection with A. phagocytophilum was 55%. A lower weaning weight of 3% (1.34 kg, p < 0.01) was estimated in lambs seropositive to an A. phagocytophilum infection compared to seronegative lambs at an average age of 137 days. Conclusions: The results show that A. phagocytophilum infection has an effect on lamb weight gain. The study also support previous findings that A. phagocytophilum infection is widespread in areas where ticks are prevalent, even in flocks treated prophylactic with acaricides

Large-scale meta-analysis highlights the hypothalamic–pituitary–gonadal axis in the genetic regulation of menstrual cycle length

The normal menstrual cycle requires a delicate interplay between the hypothalamus, pituitary and ovary. Therefore, its length is an important indicator of female reproductive health. Menstrual cycle length has been shown to be partially controlled by genetic factors, especially in the follicle-stimulating hormone beta-subunit (FSHB) locus. A genome-wide association study meta-analysis of menstrual cycle length in 44 871 women of European ancestry confirmed the previously observed association with the FSHB locus and identified four additional novel signals in, or near, the GNRH1, PGR, NR5A2 and INS-IGF2 genes. These findings not only confirm the role of the hypothalamic–pituitary–gonadal axis in the genetic regulation of menstrual cycle length but also highlight potential novel local regulatory mechanisms, such as those mediated by IGF2