Determinants of Neurological Functional Recovery Potential after Stroke in Young Adults

BACKGROUND/OBJECTIVES: Despite recent progress in stroke prevention and acute treatment, neurorehabilitation remains one of the main methods of treatment in the management of stroke patients. The aim of this study is to point out some important predicting factors of in-hospital neurorehabilitation outcomes. METHODS: A rehabilitation registry including all patients who had undergone a standardized program of neurorehabilitation at the neurorehabilitation unit of the Lausanne University Hospital, Lausanne, Switzerland, was created. Patients aged <65 years and having experienced a first ever nontraumatic stroke from 2005 to 2010 were admitted. Using logistical regression models, predicting factors for each patient were compared to the exit Functional Independence Measure (FIM) score. RESULTS: Age >55 years, gender, aphasia, hemilateral spatial neglect, spasticity, complications, length of stay >70 days, entry FIM >100 and relative possible FIM gain/week of >10% were considered to be significant and independent predicting factors of the neurorehabilitation outcome. DISCUSSION/CONCLUSION: Some factors of the in-hospital rehabilitation period have been identified before (spasticity, complications, length of stay, relative possible FIM gain/week) and should be considered for a better management of the neurorehabilitation therapy. In addition, a personalized rehabilitation strategy based on the patient's individual needs should be aimed at. The question of resource allocation can also be addressed with regard to the present findings

Beyond immune escape:a variant surface glycoprotein causes suramin resistance in Trypanosoma brucei

Suramin is one of the first drugs developed in a medicinal chemistry program (Bayer, 1916), and it is still the treatment of choice for the hemolymphatic stage of African sleeping sickness caused by Trypanosoma brucei rhodesiense. Cellular uptake of suramin occurs by endocytosis, and reverse genetic studies with T. b. brucei have linked downregulation of the endocytic pathway to suramin resistance. Here we show that forward selection for suramin resistance in T. brucei spp. cultures is fast, highly reproducible and linked to antigenic variation. Bloodstream-form trypanosomes are covered by a dense coat of variant surface glycoprotein (VSG), which protects them from their mammalian hosts' immune defenses. Each T. brucei genome contains over 2000 different VSG genes, but only one is expressed at a time. An expression switch to one particular VSG, termed VSGSur , correlated with suramin resistance. Reintroduction of the originally expressed VSG gene in resistant T. brucei restored suramin susceptibility. This is the first report of a link between antigenic variation and drug resistance in African trypanosomes

Cyclones causing wind storms in the Mediterranean: characteristics, trends and links to large-scale patterns

A climatology of cyclones with a focus on their relation to wind storm tracks in the Mediterranean region (MR) is presented. Trends in the frequency of cyclones and wind storms, as well as variations associated with the North Atlantic Oscillation (NAO), the East Atlantic/West Russian (EAWR) and the Scandinavian variability pattern (SCAND) are discussed. The study is based on the ERA40 reanalysis dataset. Wind storm tracks are identified by tracking clusters of adjacent grid boxes characterised by extremely high local wind speeds. The wind track is assigned to a cyclone track independently identified with an objective scheme. Areas with high wind activity – quantified by extreme wind tracks – are typically located south of the Golf of Genoa, south of Cyprus, southeast of Sicily and west of the Iberian Peninsula. About 69% of the wind storms are caused by cyclones located in the Mediterranean region, while the remaining 31% can be attributed to North Atlantic or Northern European cyclones. The North Atlantic Oscillation, the East Atlantic/West Russian pattern and the Scandinavian pattern all influence the amount and spatial distribution of wind inducing cyclones and wind events in the MR. The strongest signals exist for the NAO and the EAWR pattern, which are both associated with an increase in the number of organised strong wind events in the eastern MR during their positive phase. On the other hand, the storm numbers decrease over the western MR for the positive phase of the NAO and over the central MR during the positive phase of the EAWR pattern. The positive phase of the Scandinavian pattern is associated with a decrease in the number of winter wind storms over most of the MR. A third of the trends in the number of wind storms and wind producing cyclones during the winter season of the ERA40 period may be attributed to the variability of the North Atlantic Oscillation

Magma mixing enhanced by bubble segregation

In order to explore the materials' complexity induced by bubbles rising through mixing magmas, bubble-advection experiments have been performed, employing natural silicate melts at magmatic temperatures. A cylinder of basaltic glass was placed below a cylinder of rhyolitic glass. Upon melting, bubbles formed from interstitial air. During the course of the experimental runs, those bubbles rose via buoyancy forces into the rhyolitic melt, thereby entraining tails of basaltic liquid. In the experimental run products, these plume-like filaments of advected basalt within rhyolite were clearly visible and were characterised by microCT and high-resolution EMP analyses. The entrained filaments of mafic material have been hybridised. Their post-experimental compositions range from the originally basaltic composition through andesitic to rhyolitic composition. Rheological modelling of the compositions of these hybridised filaments yield viscosities up to 2 orders of magnitude lower than that of the host rhyolitic liquid. Importantly, such lowered viscosities inside the filaments implies that rising bubbles can ascend more efficiently through pre-existing filaments that have been generated by earlier ascending bubbles. MicroCT imaging of the run products provides textural confirmation of the phenomenon of bubbles trailing one another through filaments. This phenomenon enhances the relevance of bubble advection in magma mixing scenarios, implying as it does so, an acceleration of bubble ascent due to the decreased viscous resistance facing bubbles inside filaments and yielding enhanced mass flux of mafic melt into felsic melt via entrainment. In magma mixing events involving melts of high volatile content, bubbles may be an essential catalyst for magma mixing. Moreover, the reduced viscosity contrast within filaments implies repeated replenishment of filaments with fresh end-member melt. As a result, complex compositional gradients and therefore diffusion systematics can be expected at the filament-host melt interface, due to the repetitive nature of the process. However, previously magmatic filaments were tacitly assumed to be of single-pulse origin. Consequently, the potential for multi-pulse filaments has to be considered in outcrop analyses. As compositional profiles alone may remain ambiguous for constraining the origin of filaments, and as 3-D visual evidence demonstrates that filaments may have experienced multiple bubbles passages even when featuring standard diffusion gradients, therefore, the calculation of diffusive timescales may be inadequate for constraining timescales in cases where bubbles have played an essential role in magma mixing. Data analysis employing concentration variance relaxation in natural samples can distinguish conventional single-pulse filaments from advection via multiple bubble ascent advection in natural samples, raising the prospect of yet another powerful application of this novel petrological tool

Interactions between interfaces dictate stimuli-responsive emulsion behaviour

Stimuli-responsive emulsions offer a dual advantage, combining long-term storage with controlled release triggered by external cues such as pH or temperature changes. This study establishes that thermo-responsive emulsion behaviour is primarily determined by interactions between, rather than within, interfaces. Consequently, the stability of these emulsions is intricately tied to the nature of the stabilizing microgel particles - whether they are more polymeric or colloidal, and the morphology they assume at the liquid interface. The colloidal properties of the microgels provide the foundation for the long-term stability of Pickering emulsions. However, limited deformability can lead to non-responsive emulsions. Conversely, the polymeric properties of the microgels enable them to spread and flatten at the liquid interface, enabling stimuli-responsive behaviour. Furthermore, microgels shared between two emulsion droplets in flocculated emulsions facilitate stimuli-responsiveness, regardless of their internal architecture. This underscores the pivotal role of microgel morphology and the forces they exert on liquid interfaces in the control and design of stimuli-responsive emulsions and interfaces.ISSN:2041-172

A Homogeneous Actor-Based Monitor Language for Adaptive Behaviour

This paper describes a structured approach to encoding monitors in an actor language. Within a configuration of actors, each of which publishes a history, a monitor is an independent actor that triggers an action based on patterns occurring in the histories. We define a monitor language based on linear temporal logic and show how it can be homogeneously embedded within an actor language. The approach is demonstrated through a number of examples and evaluated in terms of a real-world actor-based simulation

Prevalence of Malaria and Anaemia among HIV Infected Pregnant women Receiving Co-trimoxazole Prophylaxis in Tanzania: A Cross Sectional Study in Kinondoni Municipality.

HIV-infected pregnant women are particularly more susceptible to the deleterious effects of malaria infection particularly anaemia. In order to prevent opportunistic infections and malaria, a policy of daily co-trimoxazole prophylaxis without the standard Suphadoxine-Pyrimethamine intermittent preventive treatment (SP-IPT) was introduced to all HIV infected pregnant women in the year 2011. However, there is limited information about the effectiveness of this policy. This was a cross sectional study conducted among HIV-infected pregnant women receiving co-trimoxazole prophylaxis in eight public health facilities in Kinondoni Municipality from February to April 2013. Blood was tested for malaria infection and anaemia (haemoglobin <11 g/dl). Data were collected on the adherence to co-trimoxazole prophylaxis and other risk factors for malaria infection and anaemia. Pearson chi-square test, Fischer's exact test and multivariate logistic regression were used in the statistical analysis. This study enrolled 420 HIV infected pregnant women. The prevalence of malaria infection was 4.5%, while that of anaemia was 54%. The proportion of subjects with poor adherence to co-trimoxazole was 50.5%. As compared to HIV infected pregnant women with good adherence to co-trimoxazole prophylaxis, the poor adherents were more likely to have a malaria infection (Adjusted Odds Ratio, AOR = 6.81, 95%CI = 1.35-34.43, P = 0.02) or anaemia (AOR = 1.75, 95%CI = 1.03-2.98, P = 0.039). Other risk factors associated with anaemia were advanced WHO clinical stages, current malaria infection and history of episodes of malaria illness during the index pregnancy. The prevalence of malaria was low; however, a significant proportion of subjects had anaemia. Good adherence to co-trimoxazole prophylaxis was associated with reduction of both malaria infection and anaemia among HIV infected pregnant women

Evaluation of the interaction between TGF beta and nitric oxide in the mechanisms of progression of colon carcinoma

It is recognised that stromal cells determine cancer progression. We have previously shown that active TGFbeta produced by rat colon carcinoma cells modulated NO production in rat endothelial cells. To elucidate the role of TGFbeta and NO in the mechanisms of interaction of colon carcinoma cells with stromal cells and in cancer progression, we transfected REGb cells, a regressive colon carcinoma clone secreting latent TGFbeta, with a cDNA encoding for a constitutively-secreted active TGFbeta. Out of 20 injected rats only one tumour progressed, which was resected and sub-cultured (ReBeta cells). ReBeta cells secreted high levels of active TGFbeta. The adhesive properties of REGb and Rebeta cells to endothelial cells were similar, showing that the secretion of active TGFbeta is not involved in tumour cell adhesion to endothelial cells. ReBeta, but not REGb, cell culture supernatants inhibited cytokine-dependent NO secretion by endothelial cells, but inhibition of NO production was similar in co-cultures of REGb or ReBeta cells with endothelial cells. Therefore, secretion of active TGFbeta regulated endothelial NO synthase activity when tumour cells were distant from, but not in direct contact with, endothelial cells. However, only ReBeta cells inhibited cytokine-dependent secretion of NO in coculture with macrophages, indicating that the active-TGFbeta-NO axis confers an advantage for tumour cells in their interaction with macrophages rather than endothelial cells in cancer progression

Use of a Semi-field System to Evaluate the Efficacy of Topical Repellents under user Conditions Provides a Disease Exposure free Technique Comparable with Field Data.

Before topical repellents can be employed as interventions against arthropod bites, their efficacy must be established. Currently, laboratory or field tests, using human volunteers, are the main methods used for assessing the efficacy of topical repellents. However, laboratory tests are not representative of real life conditions under which repellents are used and field-testing potentially exposes human volunteers to disease. There is, therefore, a need to develop methods to test efficacy of repellents under real life conditions while minimizing volunteer exposure to disease. A lotion-based, 15% N, N-Diethyl-3-methylbenzamide (DEET) repellent and 15% DEET in ethanol were compared to a placebo lotion in a 200 sq m (10 m x 20 m) semi-field system (SFS) against laboratory-reared Anopheles arabiensis mosquitoes and in full field settings against wild malaria vectors and nuisance-biting mosquitoes. The average percentage protection against biting mosquitoes over four hours in the SFS and field setting was determined. A Poisson regression model was then used to determine relative risk of being bitten when wearing either of these repellents compared to the placebo. Average percentage protection of the lotion-based 15% DEET repellent after four hours of mosquito collection was 82.13% (95% CI 75.94-88.82) in the semi-field experiments and 85.10% (95% CI 78.97-91.70) in the field experiments. Average percentage protection of 15% DEET in ethanol after four hours was 71.29% (CI 61.77-82.28) in the semi-field system and 88.24% (84.45-92.20) in the field. Semi-field evaluation results were comparable to full-field evaluations, indicating that such systems could be satisfactorily used in measuring efficacy of topically applied mosquito repellents, thereby avoiding risks of exposure to mosquito-borne pathogens, associated with field testing

Analysing and Recommending Options for Maintaining Universal Coverage with Long-Lasting Insecticidal Nets: The Case of Tanzania in 2011.

Tanzania achieved universal coverage with long-lasting insecticidal nets (LLINs) in October 2011, after three years of free mass net distribution campaigns and is now faced with the challenge of maintaining high coverage as nets wear out and the population grows. A process of exploring options for a continuous or "Keep-Up" distribution system was initiated in early 2011. This paper presents for the first time a comprehensive national process to review the major considerations, findings and recommendations for the implementation of a new strategy. Stakeholder meetings and site visits were conducted in five locations in Tanzania to garner stakeholder input on the proposed distribution systems. Coverage levels for LLINs and their decline over time were modelled using NetCALC software, taking realistic net decay rates, current demographic profiles and other relevant parameters into consideration. Costs of the different distribution systems were estimated using local data. LLIN delivery was considered via mass campaigns, Antenatal Care-Expanded Programme on Immunization (ANC/EPI), community-based distribution, schools, the commercial sector and different combinations of the above. Most approaches appeared unlikely to maintain universal coverage when used alone. Mass campaigns, even when combined with a continuation of the Tanzania National Voucher Scheme (TNVS), would produce large temporal fluctuations in coverage levels; over 10 years this strategy would require 63.3 million LLINs and a total cost of $444 million USD. Community mechanisms, while able to deliver the required numbers of LLINs, would require a massive scale-up in monitoring, evaluation and supervision systems to ensure accurate application of identification criteria at the community level. School-based approaches combined with the existing TNVS would reach most Tanzanian households and deliver 65.4 million LLINs over 10 years at a total cost of$449 million USD and ensure continuous coverage. The cost of each strategy was largely driven by the number of LLINs delivered. The most cost-efficient strategy to maintain universal coverage is one that best optimizes the numbers of LLINs needed over time. A school-based approach using vouchers targeting all students in Standards 1, 3, 5, 7 and Forms 1 and 2 in combination with the TNVS appears to meet best the criteria of effectiveness, equity and efficiency