Physiotherapy management of contractures after acquired brain injury

The first part of the thesis investigates treatments for contracture management. The hypothesis is that passive stretch is effective when a high intensity is used and when it is combined with treatments that target the underlying causes of contractures. To support this hypothesis, a case report was presented which described a resolution of severe knee contractures following an intensive program of passive stretch administered in conjunction with motor control training. Two randomised controlled trials were conducted to assess if electrical stimulation was an effective adjunct treatment to address spasticity and muscle weakness, factors believed to contribute to contractures. The findings of both studies demonstrate that electrical stimulation administered in conjunction with passive stretch is not more useful than passive stretch alone for people with severe motor and cognitive impairments. This result highlights a need to consider other treatment options in future research. The second part of the thesis investigates the impact of ankle contractures on the knee joint. An observational study establishes the link between ankle contractures and increased knee extension, and identifies the two gait patterns that are associated with simulated ankle contractures. This information contributes to the understanding of gait deviations that are secondary to ankle contractures

Postexposure Treatment of Marburg Virus Infection

Rhesus monkeys are protected from disease when a recombinant vesicular stomatitis virus–based vaccine is administered 20–30 min after infection with Marburg virus. We protected 5/6 monkeys when this vaccine was given 24 h after challenge; 2/6 animals were protected when the vaccine was administered 48 h postinfection

Principles of precision medicine in stroke

The era of precision medicine has arrived and conveys tremendous potential, particularly for stroke neurology. The diagnosis of stroke, its underlying aetiology, theranostic strategies, recurrence risk and path to recovery are populated by a series of highly individualised questions. Moreover, the phenotypic complexity of a clinical diagnosis of stroke makes a simple genetic risk assessment only partially informative on an individual basis. The guiding principles of precision medicine in stroke underscore the need to identify, value, organise and analyse the multitude of variables obtained from each individual to generate a precise approach to optimise cerebrovascular health. Existing data may be leveraged with novel technologies, informatics and practical clinical paradigms to apply these principles in stroke and realise the promise of precision medicine. Importantly, precision medicine in stroke will only be realised once efforts to collect, value and synthesise the wealth of data collected in clinical trials and routine care starts. Stroke theranostics, the ultimate vision of synchronising tailored therapeutic strategies based on specific diagnostic data, demand cerebrovascular expertise on big data approaches to clinically relevant paradigms. This review considers such challenges and delineates the principles on a roadmap for rational application of precision medicine to stroke and cerebrovascular health

Robert Matijašić, Povijest hrvatskih zemalja u kasnoj antici od Dioklecijana do Justinijana

Introduction Pichia pastoris is a methylotrophic yeast that has been genetically engineered to express heterologous. In recent 20 years, over 700 proteins from bacteria to humans have been produced in this yeast. MBP (maltose binding protein) has been utilized as a translational fusion partner to improve the expression of foreign proteins made in E. coli. We initially explored whether MBP would serve as an expression enhancer and purification tag in Pichia pastoris, a popular eukaryotic host for heterologous protein expression. Methods SDS-PAGE and Western analysis were applied to analyze the protein expression. The secreted fusion proteins were purified by the amylose resin, digested by trypsin or endoproteinase Asp-N, and subjected to mass spectrometric analysis. Preliminary results When MBP was fused as an N-terminal partner to several cargo proteins (the two proteins were separated by a Factor Xa protease site) expressed in this yeast, proteolysis occurred between the two peptides and only MBP reached the extracellular region, which suggested that the fusion protein had been proteolyzed between MBP and cargo proteins. Furthermore, western analysis indicated the fusion proteins had been cleaved inside the yeast. Mass spectrometry analysis of MBP-FXa-FKBP12 demonstrated the Cterminus of that fusion protein was IEGR, the FXa sequence. Extensive mutagenesis of this spacer region between MBP and FKBP12 could not inhibit the cleavage. Mass spectrometric data indicated different C-termini in these mutant proteins, suggesting that different cleavage sites were used in the MBP fusions. These results provide new insights into the role of proteases in this expression system

Looking beyond the exome: a phenotype-first approach to molecular diagnostic resolution in rare and undiagnosed diseases.

PurposeTo describe examples of missed pathogenic variants on whole-exome sequencing (WES) and the importance of deep phenotyping for further diagnostic testing.MethodsGuided by phenotypic information, three children with negative WES underwent targeted single-gene testing.ResultsIndividual 1 had a clinical diagnosis consistent with infantile systemic hyalinosis, although WES and a next-generation sequencing (NGS)-based ANTXR2 test were negative. Sanger sequencing of ANTXR2 revealed a homozygous single base pair insertion, previously missed by the WES variant caller software. Individual 2 had neurodevelopmental regression and cerebellar atrophy, with no diagnosis on WES. New clinical findings prompted Sanger sequencing and copy number testing of PLA2G6. A novel homozygous deletion of the noncoding exon 1 (not included in the WES capture kit) was detected, with extension into the promoter, confirming the clinical suspicion of infantile neuroaxonal dystrophy. Individual 3 had progressive ataxia, spasticity, and magnetic resonance image changes of vanishing white matter leukoencephalopathy. An NGS leukodystrophy gene panel and WES showed a heterozygous pathogenic variant in EIF2B5; no deletions/duplications were detected. Sanger sequencing of EIF2B5 showed a frameshift indel, probably missed owing to failure of alignment.ConclusionThese cases illustrate potential pitfalls of WES/NGS testing and the importance of phenotype-guided molecular testing in yielding diagnoses

Quality-of-Life Impact of an Investigational Subunit-Adjuvanted Herpes Zoster Vaccine in Adults ≥50 Years of Age

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Incorporating connectivity into conservation planning for the optimal representation of multiple species and ecosystem services

Funding was provided by the Rainforest Trust foundation. Support was also provided by the Sabah Forest Department, Forest Research Centre, the South East Asia Rainforest Research Partnership, the U.N. Development Programme, the Universiti Malaysia Sabah (FRGS0414-STWN-1/2015), PACOS Trust, BC Initiative, the Natural Environment Research Council UK (grant NE/R009597/1), and the Universities of Aberdeen, Montana, and York. We are grateful to the numerous researchers that collected the data used in our analyses, as well as the local communities and government staff who manage forested areas across Sabah.Peer reviewedPostprin

Choral singing therapy following stroke or Parkinsons disease: An exploration of participants experiences

© 2015 Informa UK Ltd. Purpose: People with stroke or Parkinsons disease (PD) live with reduced mood, social participation and quality of life (QOL). Communication difficulties affect 90% of people with PD (dysarthria) and over 33% of people with stroke (aphasia). These consequences are disabling in many ways. However, as singing is typically still possible, its therapeutic use is of increasing interest. This article explores the experiences of and factors influencing participation in choral singing therapy (CST) by people with stroke or PD and their significant others. Method: Participants (eight people with stroke, six with PD) were recruited from a community music therapy choir running CST. Significant others (seven for stroke, two for PD) were also recruited. Supported communication methods were used as needed to undertake semi-structured interviews (total N = 23). Results: Thematic analysis indicated participants had many unmet needs associated with their condition, which motivated them to explore self-management options. CST participation was described as an enjoyable social activity, and participation was perceived as improving mood, language, breathing and voice. Conclusions: Choral singing was perceived by people with stroke and PD to help them self-manage some of the consequences of their condition, including social isolation, low mood and communication difficulties.Implications for RehabilitationChoral singing therapy (CST) is sought out by people with stroke and PD to help self-manage symptoms of their condition.Participation is perceived as an enjoyable activity which improves mood, voice and language symptoms.CST may enable access to specialist music therapy and speech language therapy protocols within community frameworks

Conservation assessment and spatial distribution of endemic orchids in Sabah, Borneo

Orchids are among the most threatened plants due to habitat loss and illegal harvesting for horticultural demands. Sabah is a centre of orchid diversity, with approximately 1300 species of which 250 orchid taxa are endemic to Sabah. In this study, we conducted an IUCN Red List assessment on 136 endemic species and used Maximum Entropy (MaxEnt) to develop species distribution models for 47 species. The species distribution models were developed using presence-only data and six environmental predictors. The accuracy of the models were assessed using the area under the curve (AUC) and models with an AUC of higher than 0.8 stacked together to produce a species richness heatmap. We found that 83% of the researched species were threatened, of which 14 species were assessed to be Critically Endangered, eight species as Endangered and 93 species as Vulnerable. The heatmap shows that all of the species occurred within the Totally Protected Area (TPA) network in western Sabah. The heatmap highlighted the mid-altitude areas adjacent to the Kinabalu and Crocker Range parks and Ulu Sipitang regions as areas with a high species richness that were outside the TPA network. These areas are also important for the conservation of the majority of the species assessed as Critically Endangered and Endangered. Urgent conservation actions are needed to protect these species from extinction. The results from this work will be used as part of an intensive conservation action plan for threatened endemic orchids of Sabah and used to identify important plant areas currently not within the existing TPA networ