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Background: It is suggested that community based neurorehabilitation can provide benefits to both patients and health care providers in the shape of improved clinical outcomes and lower costs relative to inpatient care in tertiary centres. National guidelines within the UK have also called for care to be delivered 'closer to home'. However, there is very little research on community based models of care for complex neurological patients and little evidence of how these models can deliver improved outcomes. Content: This article describes the model of care employed by Central Surrey Health and presents data from an audit of clinical records to support its effectiveness. Conclusions: This article has shown that the Neurorehabilitation Pathways Team (NRPT) achieve important clinical improvements for our patients whether treated as inpatients or in the community. As a group of experienced senior clinicians the NRPT accurately predict the likely clinical outcomes for each patient (90-97%) and give health care purchasers accurate predictions of the care pathway each patient will follow (84%). This provides a model of care which meets national guidelines and is potentially delivering both good clinical outcomes and cost savings for the health service compared to the former and more common model of care used in the UK. [ABSTRACT FROM AUTHOR]

There are many celebrated examples of ambiguous perceptual configurations such as the Necker cube that abruptly and repeatedly "switch" among possible perceptual states. When such ambiguous configurations are presented intermittently, observers tend to see the same perceptual state on successive trials. The outcome of each trial apparently serves to "prime" the outcome of the following. We sought to determine how long the influence of a past trial persists by using ambiguous motion quartets as stimuli. We found large, significant effects of all four most recent trials, but the results were not consistent with any priming model. The results could be explained instead as perceptual completion of two kinds of temporal patterns, repeating and alternating. We conclude that the visual system does not passively remember perceptual state: it analyzes recent perceptual history and attempts to predict what will come next. These predictions can alter what is seen. [ABSTRACT FROM AUTHOR]

summary. Hepatitis B virus (HBV) is responsible for > 350 million cases of chronic hepatitis B worldwide and 1.2 million deaths each year. To explore the use of ribozymes as a novel therapy for HBV infection, nuclease-resistant ribozymes that target highly conserved regions of HBV RNA were screened in cell culture. These synthetic ribozymes have the potential to cleave all four major HBV RNA transcripts and to block the HBV lifecycle by cleavage of the pregenomic RNA. A number of the screened ribozymes demonstrate activity in cell culture systems, as measured by decreased levels of HBV surface antigen, HBV e antigen and HBV DNA. In addition, a lead anti-HBV ribozyme maintains activity against a lamivudine-resistant HBV variant in cell culture. Treatment of HBV transgenic mice with lead anti-HBV ribozymes significantly reduced viraemia compared with saline-treated animals and was as effective as treatment with lamivudine. In conclusion, the therapeutic use of a ribozyme alone or in combination with current therapies (lamivudine or interferons) may lead to improved HBV therapy. [ABSTRACT FROM AUTHOR]

The constancy in time of the ratio of unidirectional tracer fluxes, passing in opposite directions through a membrane that has transport properties varying arbitrarily with the distance from a boundary face, has been established recently for successively more sophisticated mathematical models of tracer transport within the membrane. Such results are important in that, when constancy is not observed experimentally, inferences can be drawn about the dimensionality of distributions of transport properties of the membrane. The known theoretical results are shown here to follow from much more general theorems, valid for a wide class of models based on linear-operator equations, including elliptic and hyperbolic partial differential equations as well as the essentially parabolic equations of interest in membrane transport problems. These theorems have the general character of “reciprocity theorems” known for a long time in other areas, such as mechanics, acoustics and elasticity. The general results obtained here clarify the conditions on membrane properties under which constancy of a flux ratio can be expected. In addition, flux ratio theorems of a new type are proved to hold under suitable conditions, for the normal components of flux vectors at points on either side of a membrane, as distinct from previously established theorems for total fluxes through membrane faces. Possible new experiments are suggested by the analysis. [ABSTRACT FROM PUBLISHER]