A randomised controlled trial evaluating family mediated exercise (FAME) therapy following stroke

<p>Abstract</p> <p>Background</p> <p>Stroke is a leading cause of disability among adults worldwide. Evidence suggests that increased duration of exercise therapy following stroke has a positive impact on functional outcome following stroke. The main objective of this randomised controlled trial is to evaluate the impact of additional family assisted exercise therapy in people with acute stroke.</p> <p>Methods/Design</p> <p>A prospective multi-centre single blind randomised controlled trial will be conducted. Forty patients with acute stroke will be randomised into either an experimental or control group. The experimental group will receive routine therapy and additional lower limb exercise therapy in the form of family assisted exercises. The control group will receive routine therapy with no additional formal input from their family members. Participants will be assessed at baseline, post intervention and followed up at three months using a series of standardised outcome measures. A secondary aim of the project is to evaluate the impact of the family mediated exercise programme on the person with stroke and the individual(s) assisting in the delivery of exercises using a qualitative methodology. The study has gained ethical approval from the Research Ethics Committees of each of the clinical sites involved in the study.</p> <p>Discussion</p> <p>This study will evaluate a structured programme of exercises that can be delivered to people with stroke by their 'family members/friends'. Given that the progressive increase in the population of older people is likely to lead to an increased prevalence of stroke in the future, it is important to reduce the burden of this illness on the individual, the family and society. Family mediated exercises can maximise the carry over outside formal physiotherapy sessions, giving patients the opportunity for informal practice.</p> <p>Trial Registration</p> <p>The protocol for this study is registered with the US NIH Clinical trials registry (NCT00666744)</p

Tradeoffs and Synergies in Tropical Forest Root Traits and Dynamics for Nutrient and Water Acquisition: Field and Modeling Advances

Vegetation processes are fundamentally limited by nutrient and water availability, the uptake of which is mediated by plant roots in terrestrial ecosystems. While tropical forests play a central role in global water, carbon, and nutrient cycling, we know very little about tradeoffs and synergies in root traits that respond to resource scarcity. Tropical trees face a unique set of resource limitations, with rock-derived nutrients and moisture seasonality governing many ecosystem functions, and nutrient versus water availability often separated spatially and temporally. Root traits that characterize biomass, depth distributions, production and phenology, morphology, physiology, chemistry, and symbiotic relationships can be predictive of plants’ capacities to access and acquire nutrients and water, with links to aboveground processes like transpiration, wood productivity, and leaf phenology. In this review, we identify an emerging trend in the literature that tropical fine root biomass and production in surface soils are greatest in infertile or sufficiently moist soils. We also identify interesting paradoxes in tropical forest root responses to changing resources that merit further exploration. For example, specific root length, which typically increases under resource scarcity to expand the volume of soil explored, instead can increase with greater base cation availability, both across natural tropical forest gradients and in fertilization experiments. Also, nutrient additions, rather than reducing mycorrhizal colonization of fine roots as might be expected, increased colonization rates under scenarios of water scarcity in some forests. Efforts to include fine root traits and functions in vegetation models have grown more sophisticated over time, yet there is a disconnect between the emphasis in models characterizing nutrient and water uptake rates and carbon costs versus the emphasis in field experiments on measuring root biomass, production, and morphology in response to changes in resource availability. Closer integration of field and modeling efforts could connect mechanistic investigation of fine-root dynamics to ecosystem-scale understanding of nutrient and water cycling, allowing us to better predict tropical forest-climate feedbacks

Brazilian Consensus on Photoprotection

Brazil is a country of continental dimensions with a large heterogeneity of climates and massive mixing of the population. Almost the entire national territory is located between the Equator and the Tropic of Capricorn, and the Earth axial tilt to the south certainly makes Brazil one of the countries of the world with greater extent of land in proximity to the sun. The Brazilian coastline, where most of its population lives, is more than 8,500 km long. Due to geographic characteristics and cultural trends, Brazilians are among the peoples with the highest annual exposure to the sun. Epidemiological data show a continuing increase in the incidence of nonmelanoma and melanoma skin cancers. Photoprotection can be understood as a set of measures aimed at reducing sun exposure and at preventing the development of acute and chronic actinic damage. Due to the peculiarities of Brazilian territory and culture, it would not be advisable to replicate the concepts of photoprotection from other developed countries, places with completely different climates and populations. Thus the Brazilian Society of Dermatology has developed the Brazilian Consensus on Photoprotection, the first official document on photoprotection developed in Brazil for Brazilians, with recommendations on matters involving photoprotection

Resources required for processing ambiguous complex features in vision and audition are modality specific

Abstract Processing multiple complex features to create co-hesive representations of objects is an essential aspect of both the visual and auditory systems. It is currently unclear whether these processes are entirely modality specific or whether there are amodal processes that contribute to complex object pro-cessing in both vision and audition. We investigated this using a dual-stream target detection task in which two concurrent streams of novel visual or auditory stimuli were presented.We manipulated the degree to which each stream taxed processing conjunctions of complex features. In two experiments, we found that concurrent visual tasks that both taxed conjunctive processing strongly interfered with each other but that con-current auditory and visual tasks that both taxed conjunctive processing did not. These results suggest that resources for processing conjunctions of complex features within vision and audition are modality specific

Simulations of Microbial-Enhanced Oil Recovery: Adsorption and Filtration

In the context of microbial-enhanced oil recovery (MEOR) with injection of surfactant-producing bacteria into the reservoir, different types of bacteria attachment and growth scenarios are studied using a 1D simulator. The irreversible bacteria attachment due to filtration similar to the deep bed filtration (DBF) is examined along with the commonly used reversible equilibrium adsorption (REA). The characteristics of the two models are highlighted. The options for bacteria growth are the uniform growth in both phases and growth of attached bacteria only. It is found that uniform growth scenario applied to filtration model provides formation of two oil banks during recovery. This feature is not reproduced by application of REA model or DBF with growth in attached phase. This makes it possible to select a right model based on the qualitative analysis of the experimental data. A criterion is introduced to study the process efficiency: the dimensionless time at which average recovery between pure water injection and maximum surfactant effect is reached. This characteristic recovery period (CRP) was studied as a function of the different MEOR parameters such as bacterial activity, filtration coefficients, and substrate injection concentrations. For both growth scenarios, there is a zone of optimal activity at which the CRP is minimal. Dependence of the CRP on substrate concentration for uniform growth scenario has also an optimal zone. Therefore, growth rate and the substrate concentration should be above a certain threshold value and still not be too high to obtain the minimum CRP. On the other hand, no such zone was found if the bacteria could grow only in the attached phase. Dependencies on both the injected concentration and filtration coefficient are monotonous in this case