Treatment of upper limb spasticity with inhibitory repetitive transcranial magnetic stimulation: A randomized placebo-controlled trial.

BACKGROUND: Upper limb dysfunction is a frequent complication after stroke impairing outcome. Inhibitory repetitive transcranial magnetic stimulation (rTMS) applied over the contralesional hemisphere is supposed to enhance the positive effects of conventional rehabilitative treatment. OBJECTIVE: This double-blind randomized placebo-controlled trial investigated whether inhibitory rTMS as add-on to standard therapy improves upper limb spasticity. METHODS: Twenty-eight patients (aged 44 to 80 years) with unilateral stroke in the middle cerebral artery territory were analyzed. Participants were randomly assigned to inhibitory, low-frequency (LF-) rTMS (n = 14) or sham-rTMS (n = 14). The primary outcome measure was the spasticity grade, which was assessed with the Modified Ashworth Scale (MAS). In addition, the Fugl-Meyer-Assessment (FMA) for the upper extremity (UE) and a resting-state fMRI were performed to measure motor functions and the sensorimotor network, respectively. RESULTS: The MAS score was reduced in the LF-rTMS group only, whereas the FMA score improved in both groups over time. Regarding the fMRI data, both groups activated typical regions of the sensorimotor network. In the LF-rTMS group, however, connectivity to the left angular gyrus increased after treatment. CONCLUSION: Changes in functional connectivity in patients receiving inhibitory rTMS over the contralesional motor cortex suggest that processes of neuronal plasticity are stimulated.

Can Community Members Identify Tropical Tree Species for REDD+ Carbon and Biodiversity Measurements?

Biodiversity conservation is a required co-benefit of REDD+. Biodiversity monitoring is therefore needed, yet in most areas it will be constrained by limitations in the available human professional and financial resources. REDD+ programs that use forest plots for biomass monitoring may be able to take advantage of the same data for detecting changes in the tree diversity, using the richness and abundance of canopy trees as a proxy for biodiversity. If local community members are already assessing the above-ground biomass in a representative network of forest vegetation plots, it may require minimal further effort to collect data on the diversity of trees. We compare community members and trained scientists' data on tree diversity in permanent vegetation plots in montane forest in Yunnan, China. We show that local community members here can collect tree diversity data of comparable quality to trained botanists, at one third the cost. Without access to herbaria, identification guides or the Internet, community members could provide the ethno-taxonomical names for 95% of 1071 trees in 60 vegetation plots. Moreover, we show that the community-led survey spent 89% of the expenses at village level as opposed to 23% of funds in the monitoring by botanists. In participatory REDD+ programs in areas where community members demonstrate great knowledge of forest trees, community-based collection of tree diversity data can be a cost-effective approach for obtaining tree diversity information.

Development of working reference materials for clinical virology.

Nucleic acid amplification technique (NAT)-based assays are replacing traditional diagnostic methods in clinical laboratories. However, many of these assays are developed in-house and the lack of standardised reference materials has hindered assay implementation and control. Consequently, in the UK, the Clinical Virology Network (CVN), the National Institute for Biological Standards and Control (NIBSC), and the Health Protection Agency (HPA), are working in collaboration to develop working standards or 'run controls' for diagnostic NAT-based assays, particularly real-time PCR. These run controls are intended for use in microbiology laboratories and are designed to be extracted and amplified in the same way as clinical samples and included in each assay run. The aim is to enable clinical laboratories to continuously monitor the performance of their diagnostic NAT assays on a run-by-run basis allowing inter-laboratory comparisons, and ultimately improving the consistency of results. At present, eight candidate run controls representing clinically relevant viral targets have been prepared for evaluation by CVN laboratories. Data have been returned on the performance of each run control in routine diagnostic assays. Preliminary results presented here indicate a high level of variability in intra- and inter-assay detection of these targets, highlighting the need for standardisation of assays within molecular diagnostics.

Validation of the IDI-MRSA system for use on pooled nose, axilla, and groin swabs and single swabs from other screening sites.

A commercial rapid polymerase chain reaction methicillin-resistant Staphylococcus aureus (MRSA) screening method (IDI-MRSA) is validated for the use with nasal swabs transported in liquid Stuart's medium. We investigated the use of IDI-MRSA for screening for MRSA in pooled nose, axilla, and groin swabs and in single swabs from skin puncture sites, wounds, throat, rectum, and groin using swabs transported in Amies medium without charcoal. We performed the IDI-MRSA test on swabs that had been used for routine MRSA broth culture and which were selected to be about 50% MRSA positive. We compared the IDI-MRSA result with the MRSA culture result. With 201 pooled sets, the sensitivity of IDI-MRSA was 85% and the specificity 95%. With 32 single screening swabs, sensitivity was 94% and specificity 80%. The method is not compromised by swab transport in Amies medium if an additional heating step is used. We had a low rate of initial inhibition (1.3%), which may have been due to the extra heating step used to liquefy gel from the Amies medium. Thus, in this study IDI-MRSA gives similar results to culture with pooled or single swabs from multiple screening sites.

The toxicity of textile reactive azo dyes after hydrolysis and decolourisation.

The toxicity of C.I. Reactive Black 5 and three Procion dyes, as found in textile effluents, was determined using the bioluminescent bacterium Vibrio fischeri. Hydrolysed Reactive Black had a slightly greater toxicity than the parent form (EC(50) 11.4+/-3.68 and 27.5+/-4.01 mg l(-1), respectively). A baffled bioreactor with anaerobic and aerobic compartments was used to decolourise hydrolysed Reactive Black 5 in a synthetic effluent. Decolourisation of hydrolysed Reactive Black resulted in an increased toxicity (EC(50) 0.2+/-0.03 mg l(-1)). Toxicity was not detectable when decolourised Reactive Black 5 was metabolised under aerobic conditions. No genotoxicity was detected after the decolourisation of either the parent or the hydrolysed reactive dyes, either in vitro or in the bioreactor. The toxicity and genotoxicity of decolourised C.I. Acid Orange 7 was due to the production of 1-amino-2-naphthol (EC(50) 0.1+/-0.03 mg l(-1)).