Constraint-induced Aphasia Therapy versus Intensive Semantic Treatment in Fluent Aphasia

Objective: To compare the effectiveness of two intensive therapy methods: Constraint- 4 Induced Aphasia Therapy (CIAT) and semantic therapy (BOX). Method: Nine patients with chronic fluent aphasia participated in a therapy programme 6 to establish behavioral treatment outcomes. Participants were randomly assigned to one of two groups (CIAT or BOX). Results: Intensive therapy significantly improved verbal communication. However, BOX 9 treatment showed a more pronounced improvement on two communication measures, namely on a standardized assessment for verbal communication, the Amsterdam Nijmegen Everyday Language Test (Blomert, Koster, & Kean, 1995) and on a subjective rating scale, the Communicative Effectiveness Index (Lomas et al., 1989). All 13 participants significantly improved on one (or more) subtests of the Aachen Aphasia Test (Graetz et al., 1992), an impairment-focused assessment. There was a treatment-specific effect. Therapy with BOX had a significant effect on language comprehension and on semantics, while of CIAT affected language production and phonology. Conclusion: The findings indicate that in patients with fluent aphasia (1) intensive treatment has a significant effect on language and verbal communication, (2) intensive therapy results in selective treatment effects and (3) an intensive semantic treatment shows a more striking mean improvement on verbal communication in comparison to communication-based CIAT-treatment

Optimisation of at-sea culture and harvest conditions for cultivated Macrocystis pyrifera: yield, biofouling and biochemical composition of cultured biomass

Seaweed cultivation is gaining interest world-wide for both food and non-food applications. Global seaweed aquaculture production currently exceeds 32 Mt WW per annum but is dominated (86% of total) by Asian countries. To meet future demand for seaweed products, regions beyond Asia with aquaculture production potential are being explored. The goal of this study was to assess the suitability of the native kelp Macrocystis pyrifera (Phaeophyceae, Laminariales), for aquaculture in Tasmania, south-eastern Australia. M. pyrifera was cultivated on seeded twine on loops (1 – 5 m depth) along 100-m longlines at two sites (Okehampton Bay and Great Taylor Bay) from April-November 2020. Temporal and spatial variability in (1) yield (kg m-1, WW), (2) biofouling (% coverage), and (3) biochemical composition (including proximate composition, fatty acids, dietary minerals, heavy metal profiling, C, N, H, S concentrations and C:N ratio, antioxidants (phenolic compounds), and pigments (Chl-a, Chl-c, fucoxanthin)) was compared amongst the two cultivation sites, at two depths (1 and 5 m) from harvests between July – November 2020. Yield (kg m-1, WW) did not significantly change across harvest times, but was greater at a depth of 1 m compared to 5 m. Biofouling on the kelp blades increased significantly in early spring (September). The biochemical composition of the cultured biomass varied over time, between sites and with depth for most of the compounds analysed. Higher lipid, protein and ash content was reported for cultures cultivated at Okehampton Bay compared to Great Taylor Bay and at 5 m compared to 1 m depth, and levels of these macronutrients decreased during the harvest period. The iodine content was slightly above the tolerable content for dried seaweed products in Australia and New Zealand. The combined results of yield, biofouling, and biochemical composition suggest that, for an April deployment at the sites investigated, M. pyrifera should be harvested in July-August (mid to late winter) to optimise yield and quality of the cultured kelp biomass. These findings provide a better understanding of the variation in growth and quality of cultivated M. pyrifera biomass in the region, and inform future management and development of kelp aquaculture in south-eastern Australia and in a global context

Feeding Behaviour, Swimming Activity and Boldness Explain Variation in Feed Intake and Growth of Sole (Solea solea) Reared in Captivity

The major economic constraint for culturing sole (Solea solea) is its slow and variable growth. The objective was to study the relationship between feed intake/efficiency, growth, and (non-) feeding behaviour of sole. Sixteen juveniles with an average (SD) growth of 2.7 (1.9) g/kg0.8/d were selected on their growth during a 4-week period in which they were housed communally with 84 other fish. Selected fish were housed individually during a second 4-week period to measure individual feed intake, growth, and behaviour. Fish were hand-fed three times a day during the dark phase of the day until apparent satiation. During six different days, behaviour was recorded twice daily during 3 minutes by direct observations. Total swimming activity, frequency of burying and of escapes were recorded. At the beginning and end of the growth period, two sequential behavioural tests were performed: “Novel Environment” and “Light Avoidance”. Fish housed individually still exhibited pronounced variation in feed intake (CV = 23%), growth (CV = 25%) and behavior (CV = 100%). Differences in feed intake account for 79% of the observed individual differences in growth of sole. Fish with higher variation in feed intake between days and between meals within days had significantly a lower total feed intake (r = −0.65 and r = −0.77) and growth. Active fish showed significantly higher feed intake (r = 0.66) and growth (r = 0.58). Boldness during both challenge tests was related to fast growth: (1) fish which reacted with a lower latency time to swim in a novel environment had significantly higher feed intake (r = −0.55) and growth (r = −0.66); (2) fish escaping during the light avoidance test tended to show higher feed intake (P<0.1) and had higher growth (P<0.05). In conclusion, feeding consistency, swimming activity in the tank, and boldness during behavioral tests are related to feed intake and growth of sole in captivity

An Umbrella Review of Aphasia Intervention descriPtion In Research: the AsPIRE project

Background: Recent reviews conclude that aphasia intervention is effective. However, replication and implementation require detailed reporting of intervention is and a specification of participant profiles. To date, reviews concentrate more on efficacy than on intervention reporting quality. Aims: The aim of this project is to review the descriptions of aphasia interventions and participants appearing in recent systematic reviews of aphasia intervention effectiveness. The relationship between the quality of these descriptions and the robustness of research design is explored, and the replicability of aphasia interventions is evaluated. Methods and Procedures: The scope of our search was an analysis of the aphasia intervention studies included in the Brady et al. 2016 and EBRSR 2018 systematic reviews, and in the RCSLT 2014 literature synthesis. Intervention descriptions published separately from the intervention study (i.e. published online, in clinical tools, or a separate trial protocols) were not included. The criteria for inclusion were that participants had aphasia, the intervention involved language and/or communication, and included the following research designs: Randomised Controlled Trial (RCT), comparison or control, crossover design, case series. Exclusion criteria included non-SLT interventions, studies involving fewer than four participants, conference abstracts, studies not available in English. Studies were evaluated for completeness of intervention description using the TIDieR Checklist. Additionally, we rated the quality of patient and intervention description, with particular reference to replicability. Outcomes and Results: Ninety-three studies were included. Only 14 studies (15%) had >50 participants. Fifty-six studies (60%) did not select participants with a specific aphasia profile, and a further 10 studies only described participants as non-fluent. Across the studies, an average of eight (of 12) TIDieR checklist items were given but information on where, tailoring, modification and fidelity items was rarely available. Studies that evaluated general aphasia intervention approaches tended to use RCT designs, whereas more specific intervention studies were more likely to use case series designs. Conclusions: Group studies were generally under-powered and there was a paucity of research looking at specific aphasia interventions for specific aphasia profiles. There was a trade-off between the robustness of the design and the level of specificity of the intervention described. While the TIDieR framework is a useful guide to information which should be included in an intervention study, it is insufficiently sensitive for assessing replicability. We consider possible solutions to the challenges of making large-scale trials more useful for determining effective aphasia intervention

Geldanamycin Derivative Ameliorates High Fat Diet-Induced Renal Failure in Diabetes

Diabetic nephropathy is a serious complication of longstanding diabetes and its pathogenesis remains unclear. Oxidative stress may play a critical role in the pathogenesis and progression of diabetic nephropathy. Our previous studies have demonstrated that polyunsaturated fatty acids (PUFA) induce peroxynitrite generation in primary human kidney mesangial cells and heat shock protein 90β1 (hsp90β1) is indispensable for the PUFA action. Here we investigated the effects of high fat diet (HFD) on kidney function and structure of db/db mice, a widely used rodent model of type 2 diabetes. Our results indicated that HFD dramatically increased the 24 h-urine output and worsened albuminuria in db/db mice. Discontinuation of HFD reversed the exacerbated albuminuria but not the increased urine output. Prolonged HFD feeding resulted in early death of db/db mice, which was associated with oliguria and anuria. Treatment with the geldanamycin derivative, 17-(dimethylaminoehtylamino)-17-demethoxygeldanamycin (17-DMAG), an hsp90 inhibitor, preserved kidney function, and ameliorated glomerular and tubular damage by HFD. 17-DMAG also significantly extended survival of the animals and protected them from the high mortality associated with renal failure. The benefit effect of 17-DMAG on renal function and structure was associated with a decreased level of kidney nitrotyrosine and a diminished kidney mitochondrial Ca2+ efflux in HFD-fed db/db mice. These results suggest that hsp90β1 is a potential target for the treatment of nephropathy and renal failure in diabetes

The Amsterdam Studies of Acute Psychiatry I (ASAP-I); A prospective cohort study of determinants and outcome of coercive versus voluntary treatment interventions in a metropolitan area

Background The overall number of involuntary admissions is increasing in many European countries. Patients with severe mental illnesses more often progress to stages in which acute, coercive treatment is warranted. The number of studies that have examined this development and possible consequences in terms of optimizing health care delivery in emergency psychiatry is small and have a number of methodological shortcomings. The current study seeks to examine factors associated with compulsory admissions in the Amsterdam region, taking into account a comprehensive model with four groups of predictors: patient vulnerability, social support, responsiveness of the health care system and treatment adherence. Methods/Design This paper describes the design of the Amsterdam Study of Acute Psychiatry-I (ASAP-I). The study is a prospective cohort study, with one and two-year follow-up, comparing patients with and without forced admission by means of a selected nested case-control design. An estimated total number of 4,600 patients, aged 18 years and over, consecutively coming into contact with the Psychiatric Emergency Service Amsterdam (PESA) are included in the study. From this cohort, a randomly selected group of 125 involuntary admitted subjects and 125 subjects receiving non-coercive treatment are selected for further evaluation and comparison. First, socio-demographic, psychopathological and network characteristics, and prior use of health services will be described for all patients who come into contact with PESA. Second, the in-depth study of compulsory versus voluntary patients will examine which patient characteristics are associated with acute compulsory admission, also taking into account social network and healthcare variables. The third focus of the study is on the associations between patient vulnerability, social support, healthcare characteristics and treatment adherence in a two-year follow-up for patients with or without involuntarily admittance at the index consultation. Discussion The current study seeks to establish a picture of the determinants of acute compulsory admissions in the Netherlands and tries to gain a better understanding of the association with the course of illness and patient's perception of services and treatment adherence. The final aim is to find specific patient and health care factors that can be influenced by adjusting treatment programs in order to reduce the number of involuntary admissions

Design of a randomized controlled double-blind crossover clinical trial to assess the effects of saliva substitutes on bovine enamel and dentin in situ

<p>Abstract</p> <p>Background</p> <p>Hyposalivation is caused by various syndromes, diabetes, drugs, inflammation, infection, or radiotherapy of the salivary glands. Patients with hyposalivation often show an increased caries incidence. Moreover, hyposalivation is frequently accompanied by oral discomfort and impaired oral functions, and saliva substitutes are widely used to alleviate oral symptoms. However, preference of saliva substitutes due to taste, handling, and relief of oral symptoms has been discussed controversially. Some of the marketed products have shown demineralizing effects on dental hard tissues <it>in vitro</it>. This demineralizing potential is attributed to the undersaturation with respect to calcium phosphates. Therefore, it is important to modify the mineralizing potential of saliva substitutes to prevent carious lesions. Thus, the aim of the present study was to evaluate the effects of a possible remineralizing saliva substitute (SN; modified Saliva natura) compared to a demineralizing one (G; Glandosane) on mineral parameters of sound bovine dentin and enamel as well as on artificially demineralized enamel specimens <it>in situ</it>. Moreover, oral well-being after use of each saliva substitute was recorded.</p> <p>Methods/Design</p> <p>Using a randomized, double-blind, crossover, phase II/III <it>in situ </it>trial, volunteers with hyposalivation utilize removable dentures containing bovine specimens during the experimental period. The volunteers are divided into two groups, and are required to apply both saliva substitutes for seven weeks each. After both test periods, differences in mineral loss and lesion depth between values before and after exposure are evaluated based on microradiographs. The oral well-being of the volunteers before and after therapy is determined using questionnaires. With respect to the microradiographic analysis, equal mineral losses and lesion depths of enamel and dentin specimens during treatment with SN and G, and no differences in patients' experienced oral comfort after SN compared to G usage are expected (H₀).</p> <p>Discussion</p> <p>Up to now, 14 patients have been included in the study, and no reasons for early termination of the trial have been identified. The design seems suitable for determining the effects of saliva substitutes on dental hard tissues <it>in situ</it>, and should provide detailed information on the oral well-being after use of different saliva substitutes in patients with hyposalivation.</p> <p>Trial registration</p> <p><b>ClinicalTrials.gov ID. </b><a href="http://www.clinicaltrials.gov/ct2/show/NCT01165970">NCT01165970</a></p

Assessing the potential for sea-based macroalgae cultivation and its application for nutrient removal in the Baltic Sea

Marine eutrophication is a pervasive and growing threat to global sustainability. Macroalgal cultivation is a promising circular economy solution to achieve nutrient reduction and food security. However, the location of production hotspots is not well known. In this paper the production potential of macroalgae of high commercial value was predicted across the Baltic Sea region. In addition, the nutrient limitation within and adjacent to macroalgal farms was investigated to suggest optimal site-specific configuration of farms. The production potential of Saccharina latissima was largely driven by salinity and the highest production yields are expected in the westernmost Baltic Sea areas where salinity is >23. The direct and interactive effects of light availability, temperature, salinity and nutrient concentrations regulated the predicted changes in the production of Ulva intestinalis and Fucus vesiculosus. The western and southern Baltic Sea exhibited the highest farming potential for these species, with promising areas also in the eastern Baltic Sea. Macroalgal farming did not induce significant nutrient limitation. The expected spatial propagation of nutrient limitation caused by macroalgal farming was less than 100–250 m. Higher propagation distances were found in areas of low nutrient and low water exchange (e.g. offshore areas in the Baltic Proper) and smaller distances in areas of high nutrient and high water exchange (e.g. western Baltic Sea and Gulf of Riga). The generated maps provide the most sought-after input to support blue growth initiatives that foster the sustainable development of macroalgal cultivation and reduction of in situ nutrient loads in the Baltic Sea.</p

Measuring communication as a core outcome in aphasia trials: Results of the ROMA-2 international core outcome set development meeting

BACKGROUND: Evidence-based recommendations for a core outcome set (COS; minimum set of outcomes) for aphasia treatment research have been developed (the Research Outcome Measurement in Aphasia-ROMA, COS). Five recommended core outcome constructs: communication, language, quality of life, emotional well-being and patient-reported satisfaction/impact of treatment, were identified through three international consensus studies. Constructs were paired with outcome measurement instruments (OMIs) during an international consensus meeting (ROMA-1). Before the current study (ROMA-2), agreement had not been reached on OMIs for the constructs of communication or patient-reported satisfaction/impact of treatment. AIM: To establish consensus on a communication OMI for inclusion in the ROMA COS. METHODS & PROCEDURES: Research methods were based on recommendations from the Core Outcome Measures in Effectiveness Trials (COMET) Initiative. Participants with expertise in design and conduct of aphasia trials, measurement instrument development/testing and/or communication outcome measurement were recruited through an open call. Before the consensus meeting, participants agreed on a definition of communication, identified appropriate OMIs, extracted their measurement properties and established criteria for their quality assessment. During the consensus meeting they short-listed OMIs and participants without conflicts of interest voted on the two most highly ranked instruments. Consensus was defined a priori as agreement by ≥ 70% of participants. OUTCOMES & RESULTS: In total, 40 researchers from nine countries participated in ROMA-2 (including four facilitators and three-panel members who participated in pre-meeting activities only). A total of 20 OMIs were identified and evaluated. Eight short-listed communication measures were further evaluated for their measurement properties and ranked. Participants in the consensus meeting (n = 33) who did not have conflicts of interest (n = 29) voted on the top two ranked OMIs: The Scenario Test (TST) and the Communication Activities of Daily Living-3 (CADL-3). TST received 72% (n = 21) of 'yes' votes and the CADL-3 received 28% (n = 8) of 'yes' votes. CONCLUSIONS & IMPLICATIONS: Consensus was achieved that TST was the preferred communication OMI for inclusion in the ROMA COS. It is currently available in the original Dutch version and has been adapted into English, German and Greek. Further consideration must be given to the best way to measure communication in people with mild aphasia. Development of a patient-reported measure for satisfaction with/impact of treatment and multilingual versions of all OMIs of the COS is still required. Implementation of the ROMA COS would improve research outcome measurement and the quality, relevance, transparency, replicability and efficiency of aphasia treatment research. WHAT THIS PAPER ADDS: What is already known on this subject International consensus has been reached on five core constructs to be routinely measured in aphasia treatment studies. International consensus has also been established for OMIs for the three constructs of language, quality of life and emotional well-being. Before this study, OMIs for the constructs of communication and patient-reported satisfaction/impact of treatment were not established. What this paper adds to existing knowledge We gained international consensus on an OMI for the construct of communication. TST is recommended for inclusion in the ROMA COS for routine use in aphasia treatment research. What are the potential or actual clinical implications of this work? The ROMA COS recommends OMIs for a minimum set of outcomes for adults with post-stroke aphasia within phases I-IV aphasia treatment research. Although not intended for clinical use, clinicians may employ the instruments of the ROMA COS, considering the quality of their measurement properties. The systematic inclusion of a measure of communication, such as TST, in clinical practice could ultimately support the implementation of research evidence and best practices