"Functional electrical stimulation (FES) impacted on important aspects of my life" - A qualitative exploration of chronic stroke patients' and carers' perceptions of FES in the management of dropped foot.

Our purpose was to explore the impact of functional electrical stimulation (FES), as applied in the management of dropped foot, on patients with chronic stroke and their carers. A qualitative phenomenological study was undertaken. Participants were recruited from the Lothian FES clinic. Data were collected by using semistructured face-to-face interviews and analysed by using the framework of interpretative phenomenological analysis (IPA). Thirteen patients and nine carers consented to participate in the study. The overarching theme that emerged from the data was that "FES impacted on important aspects of my life." Four subthemes were identified: 1) "Walking with FES is much better"; 2) "FES helped regain control of life"; 3) "Feeling good comes with using FES"; and 4) "FES is not perfect but it is of value." This study provides insights into the perceptions of patients and carers of the impact of FES. These results have implications for clinicians delivering an FES service for the management of dropped foot after stroke. © Informa Healthcare. USA, Inc

The effect of equine hyperimmune sera on TNF alpha activity in a L929 cell bioassay

In this pilot study we examined the effect of sera from a proprietary hyperimmune plasma product (Equiplas) on the activity of TNF: in an in vitro L929 cell bioassay. In brief, we report observations from 2 accessions of sera. Accession 1 describes the antiTNF: activity of 3 hyperimmune sera and an untreated serum sample that were provided blind to the study. Accession 2 reports a comparison of antiTNFalpha activity found in 3 paired hyperimmune sera collected following a multiple endotoxin vaccination regimen

Pre-transplant CDKN2A expression in kidney biopsies predicts renal function and is a future component of donor scoring criteria

CDKN2A is a proven and validated biomarker of ageing which acts as an off switch for cell proliferation. We have demonstrated previously that CDKN2A is the most robust and the strongest pre-transplant predictor of post- transplant serum creatinine when compared to “Gold Standard” clinical factors, such as cold ischaemic time and donor chronological age. This report shows that CDKN2A is better than telomere length, the most celebrated biomarker of ageing, as a predictor of post-transplant renal function. It also shows that CDKN2A is as strong a determinant of post-transplant organ function when compared to extended criteria (ECD) kidneys. A multivariate analysis model was able to predict up to 27.1% of eGFR at one year post-transplant (p = 0.008). Significantly, CDKN2A was also able to strongly predict delayed graft function. A pre-transplant donor risk classification system based on CDKN2A and ECD criteria is shown to be feasible and commendable for implementation in the near future

User experiences, preferences and choices relating to functional electrical stimulation and ankle foot orthoses for foot-drop after stroke

Objectives: To explore experiences, preferences and choices relating to the use of ankle foot orthoses (AFOs) and functional electrical stimulation (FES) for foot-drop by people who have suffered a stroke and their carers, with the aim of informing clinical decision-making. Design: Semi-structured interviews explored individual experiences through a phenomenological approach. The Interpretative Phenomenological Analysis framework was used to enable organisation and interpretation of qualitative interview data. Setting: Participants who had used both transcutaneous FES and one of several types of AFO were recruited from a single FES clinic. Participants: Nine people who had suffered a stroke and four carers were recruited purposively, including people between 2 and 9 years post stroke, with different degrees of difficulty in walking. Results: Participants described experiences, preferences and choices relating to AFO and FES use. All but one person expressed a preference for FES use and related this to being able to move the ankle more freely; walk more normally, safely and independently; and greater comfort. Several people also used AFOs when the FES equipment failed, when travelling and near water. One person rationed their use of FES on a daily basis due to allergic reactions. Conclusions: The consensus in this sample demonstrated positive and negative experiences of both FES and AFO use. Participants weighed up the pros and cons, and despite predominant preferences for FES, many also used AFOs due to some drawbacks of FES. Further research and development are required to reduce drawbacks and further explore users' experiences. © 2010 Chartered Society of Physiotherapy

A pilot randomised controlled trial to reduce suffering and emotional distress in patients with advanced cancer

Introduction: A pilot trial was carried out to determine if a focussed narrative interview could alleviate the components of suffering and anxiety and depression in advanced cancer patients. InterventionPatients recruited were invited to participate in a focussed narrative interview and reflect on their perspectives on their sense of “meaning”, regarding suffering and their psychological, physical, social and spiritual well being – the emphasis was on allowing the patient to tell their story. Patients were encouraged to share what resources they themselves had utilised in addition to what professional care they may have received, to maintain a sense of well being. Method: Patients with advanced metastatic disease were recruited from hospices in the North West of England – the only exclusion criteria were not being able to understand written and spoken English and a non cancer diagnosis. At recruitment patients were asked to complete a numerical scale for suffering; the Brief Edinburgh Depression Scale, Edmonton Symptom Assessment Scale (ESAS), FACIT Spiritual well being questionnaire, Demographic information was collected and patients were randomised to either the intervention arm of the trial or the usual care arm of the study. Patients in both groups were invited to complete each measure at 2, 4 and 8 weeks. Results: One hundred people were recruited into the study – 49 were randomised to intervention group and 51 to control group. The median age of patients was 66 years age range (31–89 years) and 68% of patients were female. At baseline the ECOG performance of 75% of patients recruited was 1 or 2. The median survival of all patients in the study was 169.5 days (range 10 days to still alive at end of study). There was no significant difference at any timepoint in scores on suffering measure between intervention group and control group. At each time point the intervention demonstrated mean improvement in scores for depression and anxiety on ESAS – the greatest changes for both depression and anxiety were seen at 4 weeks. Conclusion: This pilot randomised controlled trial of a focussed narrative intervention demonstrated an improvement in mean changes in scores for depression and anxiety at 2, 4, and 8 weeks. We suggest this intervention may have beneficial effects on depression and anxiety, but a larger powered trial is required to determine the full effects

Myocardial collagen deposition and inflammatory cell infiltration in cats with pre-clinical hypertrophic cardiomyopathy

The histological features of feline hypertrophic cardiomyopathy (HCM) have been well documented, but there are no reports describing the histological features in mild pre-clinical disease, since cats are rarely screened for the disease in the early stages before clinical signs are apparent. Histological changes at the early stage of the disease in pre-clinical cats could contribute to an improved understanding of disease aetiology or progression. The aim of this study was to evaluate the histological features of HCM in the left ventricular (LV) myocardium of cats diagnosed with pre-clinical HCM. Clinically healthy cats with normal (n = 11) and pre-clinical HCM (n = 6) were identified on the basis of echocardiography; LV free wall dimensions (LVFWd) and/or interventricular septal wall (IVSd) dimensions during diastole of 6–7 mm were defined as HCM, while equivalent dimension

Trail cameras are a key monitoring tool for determining target and non-target bait-take during rodent removal operations: evidence from Desecheo Island rat eradication

Efforts to remove invasive rodents (e.g. Rattus spp. and Mus musculus) from islands often use toxicant-laced baits containing the anticoagulants brodifacoum or diphacinone. Rodenticide baits are generally delivered through aerialor hand-broadcast, or in bait stations. These baits are not rodent-specific and are subject to non-target consumption or secondary exposure (e.g. an individual preying upon another individual that has consumed bait). During rodenticide applications, it is generally unknown which animals are visiting and consuming bait; and to quantify this, we recommend using trail cameras (e.g. Reconyxtm motion-activated infra-red) positioned to monitor individual bait pellets. To demonstrate the importance and effectiveness of using trail cameras during such operations, we report results of target (Rattus rattus, black rat) and non-target (native land crab, lizard, insect) bait-interactions after an aerial-broadcast of (Rattus rattus, black rat) and non-target (native land crab, lizard, insect) bait-interactions after an aerial-broadcast of Brodifacoum-25D Conservation to eradicate rats from Desecheo Island, Puerto Rico. During the first five days following bait application, trail cameras (n = 15) revealed that there were 40 incidences of animals contacting bait pellets: 50% rat, 32% hermit crab, 13% Ameiva lizard, and 5% insect. Trail cameras provide temporal and spatial information regarding the eff ectiveness of rodent removal, and the last rat pictured by trail cameras on Desecheo was six days after bait application began. Trail cameras revealed 30 incidences of animals contacting bait pellets 6–20 days after bait application began: 47% hermit crab, 37% Ameiva lizard, 13% insect, and 3% black crab. Despite viewing ~69,000 images from trail cameras, lizards were never pictured consuming bait on Desecheo; therefore, any brodifacoum exposure to Desecheo lizards likely occurred via secondary pathways (e.g. consumption of contaminated insects). Scaling up, we estimate that \u3e 75% of the total bait distributed on Desecheo was not consumed by rats. Trail cameras help inform the hazards of rodenticide use and can be easily incorporated into rodent removal operations

Impact of changing US cigarette smoking patterns on incident cancer: Risks of 20 smoking-related cancers among the women and men of the NIH-AARP cohort

Background: Historically, US women started smoking at a later age than men and had lower relative risks for smoking-related cancers. However, more recent birth cohorts of women and men have similar smoking histories and have now reached the high-risk age for cancer. The impact of these changes on cancer incidence has not been systematically examined. Methods: Relative risks (RR), 95% confidence intervals (CI) and attributable fractions were calculated for cigarette smoking and incidence of 20 smoking-related cancers in 186 057 women and 266 074 men of the National Institutes of Health-AARP cohort, aged 50 to 71 years in 1995 and followed for 11 years. Results: In the cohort, which included participants born between 1924 and 1945, most women and men started smoking as teenagers. RRs for current vs never smoking were similar in women and men for the following cancers: lung squamous-cell (RR women: 121.4, 95% CI: 57.3–257.4; RR men:114.6, 95% CI: 61.2–214.4), lung adenocarcinoma (RR women: 11.7, 95% CI: 9.8–14.0; RR men: 15.6, 95% CI: 12.5–19.6), laryngeal (RR women: 37.0, 95% CI: 14.9–92.3; RR men: 13.8, 95% CI: 9.3–20.2), oral cavity-pharyngeal (RR women:4.4, 95% CI: 3.3–6.0; RR men: 3.8, 95% CI: 3.0–4.7), oesophageal squamous cell (RR women: 7.3, 95% CI: 3.5–15.5; RR men: 6.2, 95% CI: 2.8–13.7), bladder (RR women: 4.7, 95% CI: 3.7–5.8; RR men: 4.0, 95% CI: 3.5–4.5), colon (RR women: 1.3, 95% CI: 1.2–1.5; RR men: 1.3, 95% CI: 1.1–1.4), and at other sites, with similar attributable fractions. Conclusions: RRs for current smoking and incidence of many smoking-related cancers are now similar in US women and men, likely reflecting converging smoking patterns

Promyelocytic leukemia nuclear bodies associate with transcriptionally active genomic regions

Cancer Research UK

Brodifacoum residues in fish three years after an island-wide rat eradication attempt in the tropical Pacific

Invasive rats are known to threaten natural resources and human health and safety. Island-wide rat eradication attempts have been increasing in number and scale during the past several decades, as has the frequency of eradication success. The most common method to remove all rats from an island is to broadcast anticoagulant rodenticide bait into every rat’s home range on the island. Broadcast of toxicants can put humans and other nontarget species in marine and terrestrial environments at risk of exposure. The persistence of anticoagulant residues is somewhat unknown, particularly in marine environments. Three years after ~ 18,000 kg of 25 mg/kg brodifacoum bait was broadcast across Wake Atoll to eliminate rats, we collected whole-body fish samples from six near-shore sites and one intermittently land- locked pond to test for brodifacoum residues. Of the 69 samples tested using high- performance liquid chromatography with fluorescence detection, 20 were suspected of brodifacoum contamination and therefore subject to more selective liquid chromatography-mass spectrometry analysis. Of those 20 fish, brodifacoum was detected in two individuals of blacktail snapper (Lutjanus fulvus), although at levels too low to be accurately quantified. Both fish containing detectable brodifacoum residues were caught within an intermittently land-locked pond in an area of the island that received heavy brodifacoum baiting, and not truly in the “marine environment”. Brodifacoum was not detected in any of the samples collected within the lagoon of the atoll or within near-shore waters outside the lagoon. These results demonstrate that under some circumstances very low levels of brodifacoum can occur in a low proportion of fish tissues for as long as three years after the application of the rodenticide to an environment. Such information is valuable in assessing the relative environmental risks associated with rodenticide use in rodent eradications for protection of threatened species and restoration of island ecosystems. The overall result is one of declining incidence and magnitude of residue concentrations over time and within limited environmental circumstances