A Randomized Controlled Trial on Very Early Speech and Language Therapy in Acute Stroke Patients with Aphasia

Background: Aphasia affects one third of acute stroke patients. There is a considerable spontaneous recovery in aphasia, but impaired communication ability remains a great problem. Communication difficulties are an impediment to rehabilitation. Early treatment of the language deficits leading to increased communication ability would improve rehabilitation. The aim of this study is to elucidate the efficacy of very early speech and language therapy (SLT) in acute stroke patients with aphasia. Methods: A prospective, open, randomized, controlled trial was carried out with blinded endpoint evaluation of SLT, starting within 2 days of stroke onset and lasting for 21 days. 123 consecutive patients with acute, first-ever ischemic stroke and aphasia were randomized. The SLT treatment was Language Enrichment Therapy, and the aphasia tests used were the Norsk grunntest for afasi (NGA) and the Amsterdam-Nijmegen everyday language test (ANELT), both performed by speech pathologists, blinded for randomization. Results: The primary outcome, as measured by ANELT at day 21, was 1.3 in the actively treated patient group and 1.2 among controls. NGA led to similar results in both groups. Patients with a higher level of education (>12 years) improved more on ANELT by day 21 than those with Conclusions: Very early intensive SLT with the Language Enrichment Therapy program over 21 days had no effect on the degree of aphasia in unselected acute aphasic stroke patients. In aphasic patients with more fluency, SLT resulted in a significant improvement as compared to controls. A higher educational level of >12 years was beneficial

Solution-processed semiconductors for next-generation photodetectors

Efficient light detection is central to modern science and technology.Current photodetectors mainly use photodiodes based on crystalline inorganic elementalsemiconductors, such as silicon, or compounds such as III–V semiconductors. Photodetectorsmade of solution-processed semiconductors — which include organic materials, metal-halideperovskites and quantum dots — have recently emerged as candidates for next-generation lightsensing. They combine ease of processing, tailorable optoelectronic properties, facile integrationwith complementary metal–oxide–semiconductors, compatibility with flexible substrates andgood performance. Here, we review the recent advances and the open challenges in the field ofsolution-processed photodetectors, examining the topic from both the materials and the deviceperspective and highlighting the potential of the synergistic combination of materials and deviceengineering. We explore hybrid phototransistorsand their potential to overcome trade-offsin noise, gain and speed, as well as the rapid advances in metal-halide perovskite photodiodesand their recent application in narrowband filterless photodetection

Acute effect of the dual angiotensin‐converting enzyme and neutral endopeptidase 24‐11 inhibitor mixanpril on insulin sensitivity in obese Zucker rat

1. The aim of this study was to determine whether acute dual angiotensin-converting enzyme (ACE)/neutral endopeptidase 24-11 (NEP) inhibition could improve whole body insulin-mediated glucose disposal (IMGD) more than ACE inhibition alone and whether this effect was mediated by the kinin-nitric oxide (NO) pathway activation. 2. We therefore compared in anaesthetized obese (fa/fa) Zucker rats (ZOs) the effects of captopril (2 mg kg(−1), i.v.+2 mg kg(−1) h(−1)), retrothiorphan (25 mg kg(−1), i.v. +25 mg  kg(−1) h(−1)), a selective NEP inhibitor, and mixanpril (25 mg kg(−1), i.v.+25 mg kg(−1) h(−1)), a dual ACE/NEP inhibitor, on IMGD using hyperinsulinaemic euglycaemic clamp technique. The role of the kinin-NO pathway in the effects of mixanpril was tested using a bradykinin B2 receptor antagonist (Hoe-140, 300 μg kg(−1)) and a NO-synthase inhibitor (N(ω)-nitro-L-arginine methyl ester, L-NAME, 10 mg kg(−1) i.v. +10 mg kg(−1) h(−1)) as pretreatments. 3. Insulin sensitivity index (ISI) was lower in ZO controls than in lean littermates. Increases in ISI were observed in captopril- and retrothiorphan-treated ZOs. In mixanpril-treated ZOs, ISI was further increased, compared to captopril- and retrothiorphan-treated ZOs. 4. In ZOs, Hoe-140 and L-NAME alone did not significantly alter and slightly reduced the ISI respectively. Hoe-140 and L-NAME markedly inhibited the ISI improvement induced by mixanpril. 5. These results show that in obese insulin-resistant Zucker rats, under acute conditions, NEP or ACE inhibition can improve IMGD and that dual ACE/NEP inhibition improves IMGD more effectively than does either single inhibition. This effect is linked to an increased activation of the kinin-NO pathway