Men’s health – the impact of stroke

Stroke is a leading cause of adult death and the most common cause of complex disability in the UK. This article discusses the incidence and impact of stroke, focusing on a range of issues from a male perspective, including stroke prevention, psychological needs, sexuality and return to work. There are some gender differences in modifiable risk factors for stroke, and women have better knowledge of stroke symptomatology. For men, the development of post-stroke depression is associated with greater physical disability. (c) Sherborne Gibbs Limite

Dissolved methane recovery from anaerobic effluents using hollow fibre membrane contactors

Hollow fibre membrane contactor (HFMC) systems have been studied for the desorption of dissolved methane from both analogue and real anaerobic effluents to ascertain process boundary conditions for separation. When using analogue effluents to establish baseline conditions, up to 98.9% methane removal was demonstrated. Elevated organic concentrations have been previously shown to promote micropore wetting. Consequently, for anaerobic effluent from an upflow anaerobic sludge blanket reactor, which was characterised by a high organic concentration, a nonporous HFMC was selected. Interestingly, mass transfer data from real effluent exceeded that produced with the analogue effluent and was ostensibly due to methane supersaturation of the anaerobic effluent which increased the concentration gradient yielding enhanced mass transfer. However, at high liquid velocities a palpable decline in removal efficiency was noted for the nonporous HFMC which was ascribed to the low permeability of the nonporous polymer provoking membrane controlled mass transfer. For anaerobic effluent from an anaerobic membrane bioreactor (MBR), a microporous HFMC was used as the permeate comprised only a low organic solute concentration. Mass transfer data compared similarly to that of an analogue which suggests that the low organic concentration in anaerobic MBR permeate does not promote pore wetting in microporous HFMC. Importantly, scale-up modelling of the mass transfer data evidenced that whilst dissolved methane is in dilute form, the revenue generated from the recovered methane is sufficient to offset operational and investment costs of a single stage recovery process, however, the economic return is diminished if discharge is to a closed conduit as this requires a multi-stage array to achieve the required dissolved methane consent of 0.14 mg l−1.Yorkshire Water; Severn Trent Water; Anglian Water; Northumbrian Water; EPSR

Evaluation of a rehabilitation support service after acute stroke: Feasibility and patient/carer benefit

Background: Stroke survivors returning home after discharge from hospital and their carers require support to meet their rehabilitation needs (independence in Activities of Daily Living, exercise, psychosocial support). Voluntary or charitable care providers may be able to address some of these needs. Objective: To explore the feasibility of delivering and evaluating enhanced support to stroke survivors and their carers, with a Rehabilitation Support Worker (RSW). Methods: 16 consecutive stroke survivors and their carers were included. All participants received usual hospital care. Seven of these patients and their carers were also allocated an RSW from a charitable care provider. The RSW accompanied therapy training sessions with the patient, carer and therapist in hospital. On discharge, the RSW visited the patient and carer at home over the initial 6 week post-discharge period to support them in practising rehabilitation skills. Patient function (Barthel Index) and patient/carer confidence were independently assessed at discharge (Week 0). The above assessments and patient/carer mood (GHQ-12) and Carer Giver Strain were also assessed at Weeks 1, 6 and 12. RSWs were interviewed for their views about the service. Results: Participants’ functional ability at Week 1 post-discharge was significantly higher in the RSW group. At 6 and 12 weeks post-discharge, functional ability was not significantly different between groups. Carers in the intervention group were less confident at all time points, however, this was not significant. There was no significant effect on carer strain or well-being. Interviews with RSWs highlighted areas of their training that could be enhanced and the need for greater clarity as to their role. Conclusions: The results showed that a definitive trial of rehabilitation support is feasible. A number of obstacles however would need to be overcome including: difficulty in identifying suitable patients, clarity of the RSW role, and appropriate training content

Does repetitive task training improve functional activity after stroke? A Cochrane systematic review and meta-analysis.

Repetitive task training resulted in modest improvement across a range of lower limb outcome measures, but not upper limb outcome measures. Training may be sufficient to have a small impact on activities of daily living. Interventions involving elements of repetition and task training are diverse and difficult to classify: the results presented are specific to trials where both elements are clearly present in the intervention, without major confounding by other potential mechanisms of action

A systematic review of repetitive task training with modelling of resource use, costs and effectiveness

OBJECTIVES: To determine whether repetitive functional task practice (RFTP) after stroke improves limb-specific or global function or activities of daily living and whether treatment effects are dependent on the amount of practice, or the type or timing of the intervention. Also to provide estimates of the cost-effectiveness of RFTP. DATA SOURCES: The main electronic databases were searched from inception to week 4, September 2006. Searches were also carried out on non-English-language databases and for unpublished trials up to May 2006. REVIEW METHODS: Standard quantitative methods were used to conduct the systematic review. The measures of efficacy of RFTP from the data synthesis were used to inform an economic model. The model used a pre-existing data set and tested the potential impact of RFTP on cost. An incremental cost per quality-adjusted life-year (QALY) gained for RFTP was estimated from the model. Sensitivity analyses around the assumptions made for the model were used to test the robustness of the estimates. RESULTS: Thirty-one trials with 34 intervention-control pairs and 1078 participants were included. Overall, it was found that some forms of RFTP resulted in improvement in global function, and in both arm and lower limb function. Overall standardised mean difference in data suitable for pooling was 0.38 [95% confidence interval (CI) 0.09 to 0.68] for global motor function, 0.24 (95% CI 0.06 to 0.42) for arm function and 0.28 (95% CI 0.05 to 0.51) for functional ambulation. Results suggest that training may be sufficient to have an impact on activities of daily living. Retention effects of training persist for up to 6 months, but whether they persist beyond this is unclear. There was little or no evidence that treatment effects overall were modified by time since stroke or dosage of task practice, but results for upper limb function were modified by type of intervention. The economic modelling suggested that RFTP was cost-effective. Given a threshold for cost-effectiveness of 20,000 pounds per QALY gained, RFTP is cost-effective so long as the net cost per patient is less than 1963 pounds. This result showed some sensitivity to the assumptions made for the model. The cost-effectiveness of RFTP tends to stem from the relatively modest cost associated with this intervention. CONCLUSIONS: The evidence suggests that some form of RFTP can be effective in improving lower limb function at any time after stroke, but that the duration of intervention effect is unclear. There is as yet insufficient good-quality evidence to make any firm recommendations for upper limb interventions. If task-specific training is used, adverse effects should be monitored. While the effectiveness of RFTP is relatively modest, this sort of intervention appears to be cost-effective. Owing to the large number of ongoing trials, this review should be updated within 2 years and any future review should include a comparison against alternative treatments. Further research should evaluate RFTP upper limb interventions and in particular constraint-induced movement therapy, address practical ways of delivering RFTP interventions, be directed towards the evaluation of suitable methods to maintain functional gain, and be powered to detect whether RFTP interventions are cost-effective

A review of sample analysis at mars-evolved gas analysis laboratory analog work supporting the presence of perchlorates and chlorates in gale crater, mars

Funding Information: The research reviewed in this paper was funded by the Mars Science Laboratory (MSL) project office. M.-P.Z. acknowledges funding from the Ministerio de Ciencia e Innovacion (ref. PID2019-104205GB-C21). The authors are grateful to the engineers and scientists of the MSL Curiosity team, who have made the mission possible and the reported data available. The authors would also like to thank the two anonymous reviewers who provided careful reviews that increased the quality of this manuscript. The authors would like to remember and recognize the contributions of Rafael Navarro-Gonzalez, a dedicated SAM and HABIT team member who passed away on 28 January 2021. Navarro-Gonzalez, who was a distinguished researcher, conducted laboratory experiments that demonstrated that chloromethanes could form through a reaction between perchlorates and organics during sample heating, which greatly advanced our understanding of perchlorates and organic detection on Mars. Data Availability Statement: SAM data are publicly available through the NASA Planetary Data System at: http://pds-geosciences.wustl.edu/missions/msl/sam.htm, which was updated in March 2021. See references for the original research articles that contain the data reviewed in this paper.Peer reviewedPublisher PD

Abiotic Input of Fixed Nitrogen by Bolide Impacts to Gale Crater During the Hesperian : Insights From the Mars Science Laboratory

We acknowledge the NASA Mars Science Laboratory Program, Centre National d'Études Spatiales, the Universidad Nacional Autónoma de México (PAPIIT IN109416, IN111619, and PAPIME PE103216), and the Consejo Nacional de Ciencia y Tecnología de México (CONACyT 220626) for their support. We thank Fred Calef for constructing Figure 4 and appreciate the interest and support received from John P. Grotzinger and Joy A. Crisp throughout the Curiosity mission. The authors are grateful to the SAM and MSL teams for successful operation of the SAM instrument and the Curiosity rover. The data used in this paper are listed in the supporting information, figures, and references. SAM Data contained in this paper are publicly available through the NASA Planetary Data System at http://pds‐geosciences.wustl.edu/missions/msl/sam.htm. We would like to express gratitude to Pierre‐Yves Meslin from the Research Institute in Astrophysics and Planetology at Toulouse, France, and five anonymous reviewers whose comments/suggestions on earlier drafts helped improve and clarify this manuscript. The authors declare no conflicts of interests.Peer reviewedPublisher PD

Copernicus Ocean State Report, issue 6

The 6th issue of the Copernicus OSR incorporates a large range of topics for the blue, white and green ocean for all European regional seas, and the global ocean over 1993–2020 with a special focus on 2020