Temperature and salinity regimes in a shallow, mesotidal lagoon, the Ria Formosa, Portugal

In a recent study of the mesotidal Ria Formosa, a coastal lagoon in southern Portugal, water temperature in the channels ranged from 12 C in winter to 27 C in summer and salinity from 13 to 36.5, although much higher values were observed in saltpans. Conditions in the Ria Formosa were not homogeneous despite a large tidal exchange of water; the inner channels of the Ria Formosa were brackish in winter but hypersaline in summer. Water in inner areas of lagoon had significantly different temperature and salinity characteristics compared to the inflowing coastal water, both in winter and in summer. Areas with these differences in temperature and salinity were detectable both at low water and at high water neaps. Deterioration of water quality is therefore more probable in these areas. The waters went through a complex heating and cooling cycle in summer with diurnal difference of 6 C and 2 in temperature and salinity, respectively. The lack of freshwater input and high insolation meant the outflowing water of the lagoon was more saline that the inflowing coastal waters. In summer, the temperature controlled density with the least dense waters also being the most saline, whereas in winter salinity was the major density controlling parameter. The effects of these freshwater inputs were localised to the vicinity of the Gila˜o River. No evidence was found of persistent or widespread temperature or salinity stratification in the Ria Formosa and so this shallow lagoon appears to be vertically well mixed. Vertical mixing does not allow a dense, stagnant, bottom layer of water to form that would aggravate a deterioration of water quality. The net effect of these processes is a parcel of water that moves through the lagoon with minimal dilution and potentially receiving waste discharges

Timed walking tests correlate with daily step activity in individuals with stroke

Objectives To examine the relationship among 4 clinical measures of walking ability and the outputs of the StepWatch Activity Monitor in participants with stroke. Design Correlational study. Setting Clinic and participants' usual environments. Participants Fifty participants more than 6 months after stroke were recruited. All participants were able to walk independently, but with some residual difficulty. Interventions Not applicable. Main Outcome Measures Rivermead Mobility Index (RMI), Rivermead Motor Assessment (RMA), six-minute walk test (6MWT), ten-meter walk test (10MWT), StepWatch outputs (based on daily step counts and stepping rates). Results The correlations between the RMA and all StepWatch outputs were low (ρ=0.36–0.48; P<.05), as were most for the RMI (ρ=0.31–0.52; P<.05). The 10MWT and 6MWT had moderate to high correlations (ρ=0.51–0.73; P<.01) with most StepWatch outputs. Multiple regression showed that the 6MWT was the only significant predictor for most StepWatch outputs, accounting for between 38% and 54% of the variance. Age and the RMI were further significant predictors of 1 and 2 outputs, respectively. Conclusions The 6MWT has the strongest relationship with the StepWatch outputs and may be a better test than the 10MWT to predict usual walking performance. However, it should be remembered that the 6MWT explains only half the variability in usual walking performance. Thus, activity monitoring captures aspects of walking performance not captured by other clinical tests and should be considered as an additional outcome measure in stroke rehabilitation

Circuit-based rehabilitation improves gait endurance but not usual walking activity in chronic stroke: a randomised clinical trial

Objective To determine whether circuit-based rehabilitation would increase the amount and rate that individuals with stroke walk in their usual environments. Design Single-blind randomized controlled trial. Setting Rehabilitation clinic. Participants Sixty participants with a residual gait deficit at least 6 months after stroke originally enrolled in the study. Two withdrew in the initial phase, leaving 58 participants (median age, 71.5y; range, 39.0–89.0y) who were randomized to the 2 intervention groups. Interventions The exercise group had 12 sessions of clinic-based rehabilitation delivered in a circuit class designed to improve walking. The control group received a comparable duration of group social and educational classes. Main Outcome Measures Usual walking performance was assessed using the StepWatch Activity Monitor. Clinical tests were gait speed (timed 10-meter walk) and endurance (six-minute walk test [6MWT]), confidence (Activities-Based Confidence Scale), self-reported mobility (Rivermead Mobility Index [RMI]), and self-reported physical activity (Physical Activity and Disability Scale). Results Intention-to-treat analysis revealed that the exercise group showed a significantly greater distance for the 6MWT than the control group immediately after the intervention (P=.030) but that this effect was not retained 3 months later. There were no changes in the StepWatch measures of usual walking performance for either group. The exercise and control groups had significantly different gait speed (P=.038) and scores on the RMI (P=.025) at the 3-month follow-up. These differences represented a greater decline in the control group compared with the exercise group for both outcome measures. Conclusions Circuit-based rehabilitation leads to improvements in gait endurance but does not change the amount or rate of walking performance in usual environments. Clinical gains made by the exercise group were lost 3 months later. Future studies should consider whether rehabilitation needs to occur in usual environments to improve walking performance

Who is in control? Clinicians' view on their role in self-management approaches: a qualitative metasynthesis

Objective To explore clinician perceptions of involvement in delivery of self-management approaches. Setting All healthcare settings. Design EBSCO, Scopus and AMED databases were searched, in July 2013, for peer-reviewed studies in English reporting original qualitative data concerning perceptions of clinicians regarding their involvement in or integration of a self-management approach. Of 1930 studies identified, 1889 did not meet the inclusion criteria. Full text of 41 studies were reviewed by two independent reviewers; 14 papers were included for metasynthesis. Findings and discussion sections were imported into Nvivo-10 and coded line-by-line. Codes were organised into descriptive themes and cross-checked against original sources to check interpretation, and refined iteratively until findings represented an agreed understanding. Studies were appraised for quality. Results Delivering self-management in practice appeared to be a complex process for many clinicians. The issue of ‘control’ arose in all studies, both in the qualitative data and authors’ interpretations. The first theme: Who is in control?—represented ways clinicians talked of exercising control over patients and the control they expected patients to have over their condition. The second theme: Changing clinician views—reflected what appeared to be an essential transformation of practice experienced by some clinicians in the process of integrating self-management approaches into the practice. A range of challenges associated with shifting towards a self-management approach were reflected in the third theme, Overcoming challenges to change. Tensions appeared to exist around forming partnerships with patients. Strategies found helpful in the process of change included: dedicating time to practice reciprocity in communication style, peer support and self-reflection. Conclusions A consistent finding across studies is that ‘control’ is a key feature of how self-management is viewed by clinicians. They described challenges associated with the paradigm shift required to share or let go of control. Future research should identify whether strategies described by clinicians are key to successful self-management

Enabling self-directed computer use for individuals with cerebral palsy: a systematic review of available assistive devices and technologies

Aim  The purpose of this study was to systematically review published evidence on the development, use, and effectiveness of devices and technologies that enable or enhance self-directed computer access by individuals with cerebral palsy (CP). Methods  Nine electronic databases were searched using keywords ‘computer’, ‘software’, ‘spastic’, ‘athetoid’, and ‘cerebral palsy’; the reference lists of articles thus identified were also searched. Thirty articles were selected for review, with 23 reports of development and usability testing of devices and seven evaluations of algorithms to increase computer recognition of input and cursor movements. Results  Twenty-four studies had fewer than 10 participants with CP, with a wide age range of 5 to 77 years. Computer task performance was usually tested, but only three groups sought participant feedback on ease and comfort of use. International standards exist to evaluate effectiveness of non-keyboard devices, but only one group undertook this testing. None of the study designs were higher than American Academy for Cerebral Palsy and Developmental Medicine level IV. Interpretation  Access solutions for individuals with CP are in the early stages of development. Future work should include assessment of end-user comfort, effort, and performance as well as design features. Engaging users and therapists when designing and evaluating technologies to enhance computer access may increase acceptance and improve performance

Non-coding regulatory elements: potential roles in disease and the case of epilepsy

Non-coding DNA (ncDNA) refers to the portion of the genome that does not code for proteins and accounts for the greatest physical proportion of the human genome. ncDNA includes sequences that are transcribed into RNA molecules, such as ribosomal RNAs (rRNAs), microRNAs (miRNAs), long non-coding RNAs (lncRNAs), and un-transcribed sequences that have regulatory functions, including gene promoters and enhancers. Variation in non-coding regions of the genome have an established role in human disease, with growing evidence from many areas, including several cancers, Parkinson's disease and autism. Here, we review the features and functions of the regulatory elements that are present in the non-coding genome and the role that these regions have in human disease. We then review the existing research in epilepsy and emphasise the potential value of further exploring non-coding regulatory elements in epilepsy. In addition, we outline the most widely used techniques for recognising regulatory elements throughout the genome, current methodologies for investigating variation and the main challenges associated with research in the field of non-coding DNA

Echolocation detections and digital video surveys provide reliable estimates of the relative density of harbour porpoises

Acknowledgements We would like to thank Erik Rexstad and Rob Williams for useful reviews of this manuscript. The collection of visual and acoustic data was funded by the UK Department of Energy & Climate Change, the Scottish Government, Collaborative Offshore Wind Research into the Environment (COWRIE) and Oil & Gas UK. Digital aerial surveys were funded by Moray Offshore Renewables Ltd and additional funding for analysis of the combined datasets was provided by Marine Scotland. Collaboration between the University of Aberdeen and Marine Scotland was supported by MarCRF. We thank colleagues at the University of Aberdeen, Moray First Marine, NERI, Hi-Def Aerial Surveying Ltd and Ravenair for essential support in the field, particularly Tim Barton, Bill Ruck, Rasmus Nielson and Dave Rutter. Thanks also to Andy Webb, David Borchers, Len Thomas, Kelly McLeod, David L. Miller, Dinara Sadykova and Thomas Cornulier for advice on survey design and statistical approache. Data Accessibility Data are available from the Dryad Digital Repository: http://dx.doi.org/10.5061/dryad.cf04gPeer reviewedPublisher PD

Real-time, label-free, intraoperative visualization of peripheral nerves and microvasculatures using multimodal optical imaging techniques

Accurate, real-time identification and display of critical anatomic structures, such as the nerve and vasculature structures, are critical for reducing complications and improving surgical outcomes. Human vision is frequently limited in clearly distinguishing and contrasting these structures. We present a novel imaging system, which enables noninvasive visualization of critical anatomic structures during surgical dissection. Peripheral nerves are visualized by a snapshot polarimetry that calculates the anisotropic optical properties. Vascular structures, both venous and arterial, are identified and monitored in real-time using a near-infrared laser-speckle-contrast imaging. We evaluate the system by performing in vivo animal studies with qualitative comparison by contrast-agent-aided fluorescence imaging