Cross-cultural translation and adaptation of the Danish version of the Fugl-Meyer assessment for post stroke sensorimotor function.

PURPOSE: The Fugl-Meyer assessment (FMA) is the most widely used and recommended clinical assessment scale for evaluating sensorimotor impairments in stroke patients, but an official Danish version has not been available. This study aimed to perform a standardized translation and cross-cultural adaptation (TCCA) of the FMA into Danish. METHODS: First, a comprehensive eight-step TCCA procedure including forward and backward translation and step-wise reviewing by proof-reader and bilingual physiotherapists, to ensure conceptual and semantic equivalence was applied to develop a Danish version of the FMA. Second, inter-rater reliability of the Danish FMA was assessed in 10 subacute stroke patients. Svensson's statistical method designed for rank-based paired ordinal data to identify items showing non-systematic or systematic disagreements in relative position or concentration was used to make further improvements on translation. RESULTS: A Danish FMA version was successfully made by the step-wise TCCA procedure. The clinical validation revealed satisfactory to excellent inter-tester reliability across all items (70-100%). Significant systematic disagreement either in position or concentration or both were observed in about 20% of the items. CONCLUSIONS: The Danish version of the FMA was translated and adapted allowing for a wider standardized use of the FMA in stroke rehabilitation in Denmark.Implications for rehabilitationThe Fugl-Meyer assessment (FMA) is the most used and recommended clinical assessment scale for evaluating sensorimotor impairments in stroke patients.The translated and adapted Danish version of the FMA is now available for use in research and clinical practice in Denmark.This allows for a standardized and unified description of stroke motor recovery and severity in neurorehabilitation nationwide as well as the possibility to compare and conduct trials using FMA internationally.

Neuromuscular Electric Stimulation in Addition to Exercise Therapy in Patients with Lower Extremity Paresis Due to Acute Ischemic Stroke. A proof-of-concept randomised controlled trial.

INTRODUCTION: Exercise therapy and neuromuscular electrical stimulation (NMES) during the initial 14 days after stroke may benefit recovery of gait. We aimed to determine whether poststroke NMES of vastus medial and tibial muscles during exercise therapy is more effective than exercise therapy alone. MATERIALS AND METHODS: In this proof-of-concept randomised trial patients with first-ever acute ischemic stroke and a leg paresis (40-85 years of age) were randomised (1:1) to 10 min of daily NMES + exercise therapy or exercise therapy alone. Primary outcome was the between-group difference in change in 6 min Walk Test (6MWT) at 90 days post stroke estimated with a mixed regression model. Secondary outcomes included 10 m Walk Test, Fugl-Meyer Motor Assessment, Guralnik Timed Standing Balance, Sit to Stand, Timed Up and Go, EQ-5D-5L, Montreal Cognitive Assessment and Becks Depression Inventory. RESULTS: 50 stroke survivors (25 in each group) with a mean age of 67 years (range 43-83) were included. An insignificant between-group difference in change of 28.3 m (95%CI -16.0 to 72.6, p = 0.23, adjusted for baseline) in 6MWT at 90-days follow-up was found, in favour of the NMES group. All secondary outcomes showed no statistically significant between-group difference. The conclusion was that adding NMES to exercise therapy had no effect on poststroke walking distance measured by the 6 MWT or any of the secondary outcomes. CONCLUSIONS: In this proof-of-concept RCT, we demonstrated that NMES in addition to exercise therapy during the first 14 days after onset of ischemic stroke did not improve walking distance or any of the secondary outcomes. Future studies with a longer trial period, stratifying patients into subgroups with comparable patterns of expected spontaneous recovery - if possible within 48 h post stroke, and greater sample size, than in this study are suggestions of how rehabilitation research could go on exploring the potential for NMES as an amplifier in stroke recovery.

The estimated accuracy of the EU reference dissection method for pig carcass classification.

This experiment was designed to describe the accuracy of the EU-reference dissection method, and to describe the types of factors influencing the accuracy and assess their size. The experiment was conducted in four different European countries at two abattoirs within each country. A total of 128 carcasses was selected according to carcass weight, fat class and sex, and 8 butchers from different countries dissected the carcasses. Due to the experimental design of the experiment a variation in pig type was found between countries. The accuracy was expressed by the repeatability and reproducibility standard deviation, which were found to be 0.87 and 1.10, respectively, and by the reliability, found to be 0.87. This indicates a high accuracy, although a significant effect was found on the estimation of lean meat percentage (LMP) of butcher, and also that jointing of the carcass was of overall importance to the accuracy of the EU-reference dissection method.

Determination of the lean meat percentage of pig carcasses using magnetic resonance imaging.

The purpose of Workpackage 3 of the European Eupigclass project was to test indirect methods of measuring the lean meat percentage of a carcass that would be less costly, at least as accurate and more consistent than dissection. Magnetic resonance imaging was one of the three indirect methods tested to measure the lean meat weight and the lean meat percentage of pig carcasses, the other methods being X-ray CT and vision techniques. One hundred and twenty carcasses from three different genotypes and from both sexes were slaughtered. The left parts of the carcasses were fully dissected and the right parts were investigated with an indirect method using a 1.5T MRI system. The acquisition protocol was chosen to give an optimized contrast between fat and muscle tissues. Two different approaches, image segmentation and PLS regression, were used to extract information from the images. Automatic image segmentation was performed to quantify the volume of muscle in the images and gave a standard error of prediction using a linear regression with the dissection of the left half carcasses of 586g and 1.10% for lean meat weight and lean meat percentage, respectively. PLS regression using the signal intensities histograms gave an estimation error of 465g for lean meat weight. These results showed that MRI could be used in place of full dissection for authorizing and monitoring classification equipment of pig carcasses.

Responses to potential vasoactive substances of isolated mammary blood vessels from lactating sows.

The purpose of the investigation was to examine the response of the milk vein and the mammary artery to potential vasoactive substances in lactating sows. The response on artery and vein segments from the same sow was measured for the following substances: noradrenaline (NA), serotonin (5-HT), prostaglandin F2alpha (PGF2alpha), prostacyclin (PGI2), histamine (Hi) and potassium (K+). Interestingly, the contractile force in the mammary vein segments expressed per weight unit (mN/mg) was 1.5-2.5 fold larger than in the artery segments when NA, 5-HT and PGF2alpha were used, but similar for K+, Hi and PGI2. In vein segments, the order of sensitivity to the substances expressed by their pD2 values was 5-HT > NA = PGF2alpha > Hi > K+. The present findings suggest that NA, 5-HT, PGF2alpha, PGI2, and Hi are involved in mammary blood flow regulation in the sow, and the mammary venous system may be as important as the mammary arterial system in this regulation.

VsENBP1 regulates the expression of the early nodulin PsENOD12B.

A DNA-binding protein, VsENBP1, previously isolated from Vicia sativa was shown to bind in a sequence-specific manner to the early nodulin ENOD12 gene promoter from Pisum sativum. Here, the functional importance of the VsENBP1 binding sites on the PsENOD12B promoter has been studied in vivo. A promoter-gusA fusion in which a mutation was introduced at the putative target sequence, AATAA, was inactive in nodules of transgenic Vicia hirsuta roots. Gel retardation assays showed that VsENBP1 does not bind to the mutated promoter segment, suggesting that VsENBP1 activates the PsENOD12B expression in nodules through its interaction with its target sequence. In the presence of the 35S enhancer, an ENOD12 promoter-GUS construct gave expression in root vascular tissue in addition to the root nodules. Overexpression of Vsenbp1 in transgenic V. hirsuta roots reduced the leaky expression in root vascular tissue in contrast to nodules in which a small increase in GUS expression was observed. The results indicate that VsENBP1 acts as a repressor of ENOD12 expression in root tissue.

Localization of TFF3, a new mucus-associated peptide of the human respiratory tract.

Trefoil factor family (TFF)-domain peptides (formerly P-domain peptides, trefoil factors) represent major mucin-associated peptides of the gastrointestinal tract. Here, the first localization studies on TFF3 in the lower respiratory tract of human material are presented. Immunohistochemistry revealed significant accumulation of TFF3 to mucous cells in the acini of submucosal glands and varying amounts in goblet cells at the ductular portions and the surface epithelium. TFF3 appears also as a component of the mucus, for example from patients with chronic bronchitis. Expression of TFF3 was also shown by use of the polymerase chain reaction. In contrast, TFF1 and TFF2 transcripts were hardly detectable in the human respiratory tract. Thus, a structural function of TFF3 for the airway mucus is discussed, possibly together with the mucins MUC5B and MUC5AC.

Determination of lean meat in pig carcasses with the Autofom classification system.

A fully automatic classification equipment called Autofom for use at pig abattoirs has been developed and tested. It measures fat- and meat depth in carcasses by use of ultrasound. Measurement with Autofom is very fast (measuring up to 1250 carcasses per hour). It is non-invasive and low maintenance costs can be expected due to lack of moving parts. The repeatability and reproducibility have been estimated. An equation for calculating lean meat percentage on the basis of Autofom measurements has been calculated. The accuracy of the equation, expressed by residual mean square error and by standard error of prediction, is 1.84 and 1.95, respectively. A functionality test shows that, when installed on-line at the abattoir, 99% of the carcasses can be classified by Autofom. The equipment will be a suitable alternative to automatic on-line determination of lean meat percentage in pig carcasses.

On-line pork carcass grading with the Autofom ultrasound system.

On-line pork carcass grading with the Autofom ultrasound system is described. The system consists of 16 ultrasound transducers positioned in a frame. The carcass is measured fully automatically at 3,200 positions to a depth of approximately 12 cm with a depth resolution of .19 mm. The ultrasound data form a three-dimensional ultrasound image, which is processed for noise reduction, orientation detection, and extraction of 127 features describing the carcass composition. The image features are used in a multivariate regression model, that is used for on-line predictions. On-line tests performed at line speeds up to 1,150 carcasses/h provide predictions of the meat percentage with an accuracy of 1.58 to 1.95%. Good predictions of the fat thickness and primal meat cuts have also been made.

[Vibrio vulnificus infections in Denmark during the summer of 1994]. / Vibrio vulnificus-infektioner i Danmark sommeren 1994.

The clinical manifestations and epidemiological data of 11 patients infected with Vibrio vulnificus found in Denmark during the unusually warm summer of 1994 are reported. All patients had been exposed to seawater prior to illness, but none had consumed seafood. Nine patients, including four with bacteraemia, developed skin manifestations of various degrees of severity. One patient died of septic shock despite surgery and treatment with relevant antibiotics. Four patients contracted the disease while fishing. High seawater temperature increases the risk of V. vulnificus infections even in temperate climates such as the Danish. Exposure to seawater, including handling of fresh seafood, during warm periods carries a risk of infection with V. vulnificus.

Preferential relaxation of supercoiled DNA containing a hexadecameric recognition sequence for topoisomerase I.

In prokaryotes, the degree of supercoiling of DNA can profoundly influence the use of specific promoters. In eukaryotes, a variety of indirect observations suggest that DNA topology has a similar importance in proper gene expression. Much attention has therefore been focused on the cellular proteins that control DNA supercoiling, among which are the enzymes topoisomerase I and II. A hexadecameric sequence functions as a strong attraction site for topoisomerase I. Here we report that the interaction of topoisomerase I with this sequence motif is highly specific, because a single base-pair substitution prevents strand cleavage and thereby catalytic activity at the sequence. Thus, supercoiled DNA containing the recognition sequence is relaxed preferentially by topoisomerase I compared to a control, but no difference in the relaxation rate is observed for supercoiled DNA carrying the mutated sequence. The preference for the recognition sequence seems to be an intrinsic property of all eukaryotic type I topoisomerases, suggesting that the interaction might be important in a fundamental biological process.

Defective monocyte function in Legionnaires' disease complicating hairy cell leukaemia.

We describe a case of Legionnaires' disease in a 64-year-old man, in which hairy cell leukaemia was diagnosed after the onset of the infection. Immunological studies revealed a complete suppression of blood monocyte chemotactic and oxidative burst activities. We suggest that in hairy cell leukaemia both monocytopenia and defective functions of monocytes underlie the increased susceptibility to intracellular infections including Legionnaires' disease.

The cultivation and rapid enzyme identification of DF-2.

The investigation of two clinical isolates and two reference strains of DF-2 showed that supplementary cysteine and incubation in a humid atmosphere were important growth-promoting factors for these fastidious, gram-negative bacteria. Broth-base media with phenol red indicator were proven to be satisfactory for carbohydrate fermentation tests. Two four-hour enzyme assays (API ZYM and Rosco Diagnostic Tablets) were used to compare the enzymatic activity of DF-2 with that of 27 species of other non-enterobacterial organisms. The Rosco assay revealed that only the DF-2 strains had a positive alpha-fucosidase reaction, suggesting that this character may provide the means for rapid characterization and identification of these bacteria and also be of value for taxonomic classification. The incongruent results of the API ZYM assay seem to be due to the different substrates of the two assay systems.

Rapid identification of Capnocytophaga isolated from septicemic patients.

Four Capnocytophaga strains from blood cultures of immunocompromised patients with malignant disease and the type strains of three Capnocytophaga species were examined and compared to strains representing five other genera that are hard to differentiate from Capnocytophaga. With three rapid identification methods, negative catalase and oxidase reactions and positive ONPG assay, Capnocytophaga was easily separated from Eikenella corrodens, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, and CDC group DF-2. Haemophilus aphrophilus was excluded by leucine, valine and cystine arylamidase and alpha-glucosidase reactions (API ZYM). Further confirmatory reactions constituted gelatin hydrolysis, haemin requirement, and carbohydrate and esculin breakdown. Although rapid identification of Capnocytophaga to the genus level was feasible, differentiation on a species level proved impossible.