2,205 research outputs found

    Acupuncture for the treatment of phantom limb syndrome in lower limb amputees: a randomised controlled feasibility study

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    Background: Post amputation, the complication phantom limb pain (PLP) is prevalent and difficult to manage. This study aimed to determine whether it was feasible and acceptable to undertake a definitive multi-centred randomised controlled trial assessing the effectiveness of acupuncture for treating lower limb amputees with PLP. Methods: A mixed methods embedded design including a randomised controlled trial and semi-structured interviews was undertaken. A total of 15 participants with PLP were randomly assigned to receive either 8 pragmatic Traditional Chinese Medicine acupuncture treatments and usual care or usual care alone over four weeks. Outcomes measures were completed at baseline, weekly throughout the study and at one month post completion of the study and included; a numerical pain rating scale, Short-Form McGill Pain Questionnaire 2, EQ-5D-5L, Hospital Anxiety and Depression Scale, Perceived Stress Scale 10 item, Insomnia Severity Index, Patient Global Impression of Change. Post completion of the trial, participants in the acupuncture group were interviewed about their experience. Feasibility specific data were also collected. Results: Of 24 amputees meeting the study inclusion criteria 15 agreed to participate (recruitment rate 62.50%). Qualitatively acupuncture was perceived to be beneficial and effective. Quantitatively acupuncture demonstrated clinically meaningful change in average pain intensity (raw change=2.69) and worst pain intensity (raw change = 4.00). Feasibility specific data identified that before undertaking a definitive trial, recruitment, practitioner adherence to the acupuncture protocol, completion of outcome measures at one month follow up and blinding should be addressed. Appropriate outcome measures were identified for use in a definitive trial. Data were generated for future sample size calculations (effect size 0.64). Allowing for a 20% dropout rate, a sample size of 85 participants per group would be needed in a future definitive trial. Conclusions: A future definitive trial may be possible if the areas identified in this study are addressed. As acupuncture may be effective at treating PLP and as this feasibility study suggests a definitive trial may be possible, a multi-centred trial with adequate sample size and blinding is now needed. Trial registration: ClinicalTrials.gov: NCT02126436. Registration date: 9.4.2014

    A coherent middle Pliocene magnetostratigraphy, Wanganui Basin, New Zealand

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    We document magnetostratigraphies for three river sections (Turakina, Rangitikei, Wanganui) in Wanganui Basin and interpret them as corresponding to the Upper Gilbert, the Gauss and lower Matuyama Chrons of the Geomagnetic Polarity Timescale, in agreement with foraminiferal biostratigraphic datums. The Gauss-Gilbert transition (3.58 Ma) is located in both the Turakina and Wanganui River sections, while the Gauss-Matuyama transition (2.58 Ma) is located in all three sections, as are the lower and upper boundaries of the Mammoth (3.33–3.22 Ma) and Kaena (3.11–3.04 Ma) Subchrons. Our interpretations are based in part on the re-analysis of existing datasets and in part on the acquisition and analysis of new data, particularly for the Wanganui River section. The palaeomagnetic dates of these six horizons provide the only numerical age control for a thick (up to 2000 m) mudstone succession (Tangahoe Mudstone) that accumulated chiefly in upper bathyal and outer neritic palaeoenvironments. In the Wanganui River section the mean sediment accumulation rate is estimated to have been about 1.8 m/k.y., in the Turakina section it was about 1.5 m/k.y., and in the Rangitikei section, the mean rate from the beginning of the Mammoth Subchron to the Hautawa Shellbed was about 1.1 m/k.y. The high rates may be associated with the progradation of slope clinoforms northward through the basin. This new palaeomagnetic timescale allows revised correlations to be made between cyclothems in the Rangitikei River section and the global Oxygen Isotope Stages (OIS) as represented in Ocean Drilling Program (ODP) Site 846. The 16 depositional sequences between the end of the Mammoth Subchron and the Gauss-Matuyama Boundary are correlated with OIS MG2 to 100. The cyclothems average 39 k.y. in duration in our age model, which is close to the 41 k.y. duration of the orbital obliquity cycles. We support the arguments advanced recently in defence of the need for local New Zealand stages as a means of classifying New Zealand sedimentary successions, and strongly oppose the proposal to move stage boundaries to selected geomagnetic polarity transitions. The primary magnetisation of New Zealand mudstone is frequently overprinted with secondary components of diagenetic origin, and hence it is often difficult to obtain reliable magnetostratigraphic records. We suggest specific approaches, analytical methods, and criteria to help ensure robustness and coherency in the palaeomagnetic identification of chron boundaries in typical New Zealand Cenozoic mudstone successions

    Odonata from the BEFTA Project area, Riau Province, Sumatra, Indonesia

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    The Odonata found during work on the Biodiversity and Ecosystem Function in Tropical Agriculture (BEFTA) Project in Riau Province, Sumatra, Indonesia are reported. Prior to the BEFTA project we are only aware of published records of 37 species of Odonata from Riau Province (these are listed in an appendix). Seventy five species have been recorded during the BEFTA project, including five that have not (Archibasis incisura, Archibasis rebeccae and Pseudagrion williamsoni), or not definitely (Argiocnemis species and Mortonagrion species cf aborense), been recorded in Sumatra before. Macromia dione is recorded for the first time since its description. The number of species now known from Riau Province is 88; 51 of these are reported from the province for the first time here.Sinar Mas Agro Resources and Technology Research Institute (donation) and Isaac Newton Trust, Cambridg

    RNA Docking and Local Translation Regulate Site-Specific Axon Remodeling In Vivo

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    Nascent proteins can be positioned rapidly at precise subcellular locations by local protein synthesis (LPS) to facilitate localized growth responses. Axon arbor architecture, a major determinant of synaptic connectivity, is shaped by localized growth responses, but it is unknown whether LPS influences these responses in vivo. Using high-resolution live imaging, we examined the spatiotemporal dynamics of RNA and LPS in retinal axons during arborization in vivo. Endogenous RNA tracking reveals that RNA granules dock at sites of branch emergence and invade stabilized branches. Live translation reporter analysis reveals that de novo ß-actin hotspots colocalize with docked RNA granules at the bases and tips of new branches. Inhibition of axonal ß-actin mRNA translation disrupts arbor dynamics primarily by reducing new branch emergence and leads to impoverished terminal arbors. The results demonstrate a requirement for LPS in building arbor complexity and suggest a key role for pre-synaptic LPS in assembling neural circuits.This work was supported by Cambridge Trust, Croucher Foundation, Sir Edward Youde Memorial Fund (H.H.-W.W.), Gates Cambridge (J.Q.L.), Fundac¸ a˜ o para a Cieˆ ncia e Tecnologia (C.M.R.), Wellcome Trust Senior Investigator Award (100329/Z/ 12/Z) (W.A.H.), EPSRC Grant (EP/H018301/1), MRC Grant (MR/K015850/1 and MR/K02292X/1), Wellcome Trust (089703/Z/09/Z) (C.F.K.), Wellcome Trust Programme Grant (085314/Z/08/Z), and ERC Advanced Grant (322817) (C.E.H.)

    Effect of maternal panic disorder on mother-child interaction and relation to child anxiety and child self-efficacy

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    To determine whether mothers with panic disorder with or without agoraphobia interacted differently with their children than normal control mothers, 86 mothers and their adolescents (aged between 13 and 23 years) were observed during a structured play situation. Maternal as well as adolescent anxiety status was assessed according to a structured diagnostic interview. Results showed that mothers with panic disorder/agoraphobia showed more verbal control, were more criticizing and less sensitive during mother-child interaction than mothers without current mental disorders. Moreover, more conflicts were observed between mother and child dyadic interactions when the mother suffered from panic disorder. The comparison of parenting behaviors among anxious and non-anxious children did not reveal any significant differences. These findings support an association between parental over-control and rejection and maternal but not child anxiety and suggest that particularly mother anxiety status is an important determinant of parenting behavior. Finally, an association was found between children’s perceived self-efficacy, parental control and child anxiety symptoms

    Single clad coiled optical fibre for high power lasers and amplifiers

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    We demonstrate a new concept in development of high power fibre lasers based on single clad coiled fibres. Combination of a highly efficient Yb-doped fibre and glass-air waveguide for multi-point pump injection allows to reduce device length to less than 3

    The effects of catchment and riparian forest quality on stream environmental conditions across a tropical rainforest and oil palm landscape in Malaysian Borneo

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    Freshwaters provide valuable habitat and important ecosystem services, but are threatened worldwide by habitat loss and degradation. In Southeast Asia, rainforest streams are particularly threatened by logging and conversion to oil palm, but we lack information on the impacts of this on freshwater environmental conditions, and the relative importance of catchment versus riparian-scale disturbance. We studied sixteen streams in Sabah, Borneo, including old growth forest, logged forest, and oil palm sites. We assessed forest quality in riparian zones and across the whole catchment, and compared it with stream environmental conditions including water quality, structural complexity and organic inputs. We found that streams with the highest riparian forest quality were nearly 4 °C cooler, over 20 cm deeper, had over 40% less sand, greater canopy cover, more stored leaf litter and wider channels than oil palm streams with the lowest riparian forest quality. Other variables were significantly related to catchment-scale forest quality, with streams in the highest quality forest catchments having 40% more bedrock and 20 times more dead wood, along with higher phosphorus, and lower nitrate-N levels compared to streams with the lowest catchment-scale forest quality. Although riparian buffer strips went some way to protecting waterways, they did not maintain fully forest-like stream conditions. In addition, logged forest streams still showed signs of disturbance 10-15 years after selective logging. Our results suggest that maintenance and restoration of buffer strips can help to protect healthy freshwater ecosystems, but logging practices and catchment-scale forest management also need to be considered.During this work SHL was funded by a Natural Environment Research Council (NERC) studentship (number 1122589), Proforest, the Varley Gradwell Travelling Fellowship, Tim Whitmore Fund, Panton Trust and the Cambridge University Commonwealth Fund. MP and RME were supported by European Research Council Project number 281986. HB was funded by the S.T. Lee Fund

    Target product profiles for protecting against outdoor malaria transmission.

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    BACKGROUND\ud \ud Long-lasting insecticidal nets (LLINs) and indoor residual sprays (IRS) have decimated malaria transmission by killing indoor-feeding mosquitoes. However, complete elimination of malaria transmission with these proven methods is confounded by vectors that evade pesticide contact by feeding outdoors.\ud \ud METHODS\ud \ud For any assumed level of indoor coverage and personal protective efficacy with insecticidal products, process-explicit malaria transmission models suggest that insecticides that repel mosquitoes will achieve less impact upon transmission than those that kill them outright. Here such models are extended to explore how outdoor use of products containing either contact toxins or spatial repellents might augment or attenuate impact of high indoor coverage of LLINs relying primarily upon contact toxicity.\ud \ud RESULTS\ud \ud LLIN impact could be dramatically enhanced by high coverage with spatial repellents conferring near-complete personal protection, but only if combined indoor use of both measures can be avoided where vectors persist that prefer feeding indoors upon humans. While very high levels of coverage and efficacy will be required for spatial repellents to substantially augment the impact of LLINs or IRS, these ambitious targets may well be at least as practically achievable as the lower requirements for equivalent impact using contact insecticides.\ud \ud CONCLUSIONS\ud \ud Vapour-phase repellents may be more acceptable, practical and effective than contact insecticides for preventing outdoor malaria transmission because they need not be applied to skin or clothing and may protect multiple occupants of spaces outside of treatable structures such as nets or houses
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