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Objective: To evaluate the feasibility of a multicentre, observer-blind, pilot randomized controlled trial (RCT) of a wristband accelerometer with activity-dependent vibration alerts to prompt impaired arm use after stroke. Design: Parallel-group pilot RCT. Setting: Four English stroke services. Participants: Patients 0–3 months post stroke with a new arm deficit. Intervention: Participants were randomized to wear a prompting or ‘sham’ wristband during a four-week self-directed therapy programme with twice-weekly therapy review. Main outcomes: Recruitment, retention and adherence rates, safety and completion of assessments were reported. Arm recovery was measured by Action Research Arm Test (ARAT) and Motor Activity Log (MAL) without statistical comparison. Results: In total, 33 patients were recruited (0.6 per month/site; median time post stroke: 26 days (interquartile range (IQR):15.5–45)). Baseline, four-week and eight-week median (IQR) ARAT for the control group ( n = 19) were 15 (2–35), 35 (15–26) and 31 (21–55) and those for the intervention group (n = 14) were 37 (16–45), 57 (29–57) and 57 (37–57), respectively; for MAL Amount of Use, the corresponding values in the control group were 0.2 (0.0–1.2), 1.1 (0.3–2.9) and 1.2 (0.7–2.9) and in the intervention group were 1.4 (0.5–2.6), 3.8 (1.9–4.5) and 3.7 (2.1–4.3). Four participants withdrew from the study. Wristbands were worn for 79% of the recommended time. The intervention and control group participants received a median of 6.0 (IQR: 4.3–8.0) and 7.5 (IQR: 6.8–8.0) therapy reviews. A median of 8 (IQR: 6–10) prompts were delivered per intervention participant/day. Research assessments were completed for 28/29 and 25/28 patients at four and eight weeks. Eight serious adverse events were reported, all unrelated to the intervention. Conclusion: A multicentre RCT of wristband accelerometers to prompt arm activity early after stroke is feasible. A total sample of 108 participants would be required.

Background Little is understood of the molecular mechanisms involved in the earliest cell fate decision in human development, leading to the establishment of the trophectoderm (TE) and inner cell mass (ICM) stem cell population. Notably, there is a lack of understanding of how transcriptional networks arise during reorganisation of the embryonic genome post-fertilisation. Results We identified a hierarchical structure of preimplantation gene network modules around the time of embryonic genome activation (EGA). Using network models along with eukaryotic initiation factor (EIF) and epigenetic-associated gene expression we defined two sets of blastomeres that exhibited diverging tendencies towards ICM or TE. Analysis of the developmental networks demonstrated stage specific EIF expression and revealed that histone modifications may be an important epigenetic regulatory mechanism in preimplantation human embryos. Comparison to published RNAseq data confirmed that during EGA the individual 8-cell blastomeres are transcriptionally primed for the first lineage decision in development towards ICM or TE. Conclusions Using multiple systems biology approaches to compare developmental stages in the early human embryo with single cell transcript data from blastomeres, we have shown that blastomeres considered to be totipotent are not transcriptionally equivalent. Furthermore we have linked the developmental interactome to individual blastomeres and to later cell lineage. This has clinical implications for understanding the impact of fertility treatments and developmental programming of long term health. Electronic supplementary material The online version of this article (10.1186/s12864-019-5558-8) contains supplementary material, which is available to authorized users.

Background Despite evidence from clinical trials that intravenous (IV) thrombolysis is a cost-effective treatment for selected acute ischaemic stroke patients, there remain large variations in the rate of IV thrombolysis delivery between stroke services. This study is evaluating whether an enhanced care pathway delivered by paramedics (the Paramedic Acute Stroke Treatment Assessment (PASTA)) could increase the number of patients who receive IV thrombolysis treatment. Methods Study design: Cluster randomised trial with economic analysis and parallel process evaluation. Setting: National Health Service ambulance services, emergency departments and hyper-acute stroke units within three geographical regions of England and Wales. Randomisation: Ambulance stations within each region are the units of randomisation. According to station allocation, paramedics based at a station deliver the PASTA pathway (intervention) or continue with standard stroke care (control). Study intervention: The PASTA pathway includes structured pre-hospital information collection, prompted pre-notification, structured handover of information in hospital and assistance with simple tasks during the initial hospital assessment. Study-trained intervention group paramedics deliver this pathway to adults within 4 h of suspected stroke onset. Study control: Standard stroke care according to national and local guidelines for the pre-hospital and hospital assessment of suspected stroke. Participants: Participants enrolled in the study are adults with confirmed stroke who were assessed by a study paramedic within 4 h of symptom onset. Primary outcome: Proportion of participants receiving IV thrombolysis. Sample size: 1297 participants provide 90% power to detect a 10% difference in the proportion of patients receiving IV thrombolysis. Discussion The results from this trial will determine whether an enhanced care pathway delivered by paramedics can increase thrombolysis delivery rates. Trial registration ISRCTN registry, ISRCTN12418919. Registered on 5 November 2015. Electronic supplementary material The online version of this article (10.1186/s13063-018-3144-z) contains supplementary material, which is available to authorized users.

A minor population of glioblastoma stem-like cells (GSCs) has been implicated in the relapse and resistance of glioblastoma to therapeutic treatments. Based on knowledge of the involvement of multiple microRNAs in GSC propagation, we designed a combinational approach to target the GSC population with multiple miRNA-based therapeutics. As carriers for the targeted delivery we took advantage of two aptamers that bind to, and inhibit, the receptor tyrosine kinases, Axl and PDGFR beta. We showed that the aptamer conjugates are transported through an in vitro blood-brain barrier (BBB) model. Furthermore, combining miR-137 and antimiR-10b synergizes with the receptor inhibitory function of aptamer carriers and prevents GSC expansion. Results highlighted the potential of combining multifunctional RNA-based therapeutics for selective targeting of GSCs and offer a proof of principle strategy to potentially fulfill the still unmet need for effective and safe treatment of glioma. (C) 2016 Elsevier B.V. All rights reserved.

BackgroundIntravenous thrombolysis is a key element of emergency treatment for acute ischaemic stroke, but hospital service delivery is variable. The Paramedic Acute Stroke Treatment Assessment (PASTA) multicentre cluster randomised controlled trial evaluated whether an enhanced paramedic-initiated stroke assessment pathway could improve thrombolysis volume. This paper reports the findings of a parallel process evaluation which explored intervention paramedics’ experience of delivering the enhanced assessment.MethodsInterviewees were recruited from 453 trained intervention paramedics across three UK ambulance services hosting the trial: North East, North West and Welsh Ambulance Services. A semistructured interview guide aimed to (1) explore the stroke-specific assessment and handover procedures which were part of the PASTA pathway and (2) enable paramedics to share relevant views about expanding their role and any barriers/enablers they encountered. Interviews were audiorecorded, transcribed verbatim and analysed following the principles of the constant comparative method.ResultsTwenty-six interviews were conducted (11 North East, 10 North West and 5 Wales). Iterative data analysis identified four key themes, which reflected paramedics’ experiences at different stages of the care pathway: (1) Enhanced assessment at scene: paramedics felt this improved their skillset and confidence. (2) Prealert to hospital: a mixed experience dependent on receiving hospital staff. (3) Handover to hospital team: standardisation of format was viewed as the primary benefit of the PASTA pathway. (4) Assisting in hospital and feedback: due to professional boundaries, paramedics found these aspects harder to achieve, although feedback from the clinical team was valued when available.ConclusionParamedics believed that the PASTA pathway enhanced their skills and the emergency care of stroke patients, but a continuing clinical role postadmission was challenging. Future studies should consider whether interdisciplinary training is needed to enable more radical extension of professional boundaries for paramedics.

Human embryonic stem cells (hESCs) derived from the pluripotent Inner cell mass (ICM) of the blastocyst are fundamental tools for understanding human development, yet are not identical to their tissue of origin. To investigate this divergence we compared the transcriptomes of genetically paired ICM and trophectoderm (TE) samples with three hESC lines: MAN1, HUES3 and HUES7 at similar passage. We generated inferred interactome networks using transcriptomic data unique to the ICM or TE, and defined a hierarchy of modules (highly connected regions with shared function). We compared network properties and the modular hierarchy and show that the three hESCs had limited overlap with ICM specific transcriptome (6%-12%). However this overlap was enriched for network properties related to transcriptional activity in ICM (p=0.016); greatest in MAN1 compared to HUES3 (p=0.048) or HUES7 (p=0.012). The hierarchy of modules in the ICM interactome contained a greater proportion of MAN1 specific gene expression (46%) compared to HUES3 (28%) and HUES7 (25%) (p=9.0×10−4).These findings show that traditional methods based on transcriptome overlap are not sufficient to identify divergence of hESCs from ICM. Our approach also provides a valuable approach to the quantification of differences between hESC lines.And Manchester Academic Health Sciences Centre

Studies of Brazilian cinema came to the fore in the 1960s and 1970s with the emergence of the avant-garde, politicized Cinema Novo, which dialogued with New Wave cinemas in Europe, particularly France, and in other parts of Latin America. Several landmark studies by scholars such as Ismail Xavier and Randal Johnson analyzed the movement in depth and remain key works. Since then, scholarship in both Portuguese and English has broadened its scope to embrace commercially oriented Brazilian films dating back to the early sound era, including popular genres (such as in the work of João Luiz Vieira, Stephanie Dennison, and Lisa Shaw), as well as the historical evolution of Brazilian cinema, and the relationship between the film industry and the state throughout the 20th century and into the new millennium. Most recently, various scholars in Brazil and abroad, notably Lúcia Nagib, have analyzed the nation’s cinematic output, particularly since its “rebirth” in the mid-1990s—the so-called retomada—from a thematic perspective, focusing on the reworking of themes from Cinema Novo—such as poverty and violence—in nonpoliticized, box-office hits, such as Central do Brasil (Central Station, 1998, dir. Walter Salles) and Cidade de Deus (City of God, 2002, dirs. Fernando Meirelles and Kátia Lund), or within the wider context of Latin American production. Following in the wake of the seminal work of Robert Stam, issues of race and ethnicity continue to provide a focus for studies of Brazilian cinema, as do questions of sexuality and gender. Scholars are increasingly turning their attentions to questions of the national and the transnational in post-retomada films, and are now looking at Brazilian film history from new perspectives, such as the role and significance of film stars and their marketing, as well as cinema’s relationship with other media and arts.

Background Frequent practice of functional movements after stroke may optimise motor recovery; however, it is challenging for patients to remember to integrate an impaired limb into daily activities. We report the activity responses of stroke patients receiving a vibrating alert delivered by a tri-axial accelerometer wristband to prompt movement of the impaired arm if hourly activity levels fell. Methods Adults with upper limb impairment ≤28 days post-stroke wore the device for four weeks. Therapists and patients reviewed movement activity data twice weekly to agree ongoing rehabilitation activities and programme the wristband with a personalised prompt threshold (median baseline activity + 5%, 25% or 50%). Results: Seven patients completed the programme (five males; mean ± standard deviation (age) 64 ± 5 years; days post-stroke 13 ± 7; baseline/four-week Action Research Arm Test median (Interquartile range (IQR)) 39 (8, 44)/56 (11, 57)). Wristbands were worn for 89% of programme duration. A total of 1,288 prompts were delivered, with a median of four (IQR 3,7) prompts per patient per day. Mean activity increases following a prompt ranged from 11% to 29%. Conclusions Feedback delivered by a programmable accelerometer increased impaired arm activity. Improvements are required in device reliability before conducting a pragmatic clinical trial to examine the impact upon recovery.

Summary Background Intensive antiplatelet therapy with three agents might be more effective than guideline treatment for preventing recurrent events in patients with acute cerebral ischaemia. We aimed to compare the safety and efficacy of intensive antiplatelet therapy (combined aspirin, clopidogrel, and dipyridamole) with that of guideline-based antiplatelet therapy. Methods We did an international, prospective, randomised, open-label, blinded-endpoint trial in adult participants with ischaemic stroke or transient ischaemic attack (TIA) within 48 h of onset. Participants were assigned in a 1:1 ratio using computer randomisation to receive loading doses and then 30 days of intensive antiplatelet therapy (combined aspirin 75 mg, clopidogrel 75 mg, and dipyridamole 200 mg twice daily) or guideline-based therapy (comprising either clopidogrel alone or combined aspirin and dipyridamole). Randomisation was stratified by country and index event, and minimised with prognostic baseline factors, medication use, time to randomisation, stroke-related factors, and thrombolysis. The ordinal primary outcome was the combined incidence and severity of any recurrent stroke (ischaemic or haemorrhagic; assessed using the modified Rankin Scale) or TIA within 90 days, as assessed by central telephone follow-up with masking to treatment assignment, and analysed by intention to treat. This trial is registered with the ISRCTN registry, number ISRCTN47823388. Findings 3096 participants (1556 in the intensive antiplatelet therapy group, 1540 in the guideline antiplatelet therapy group) were recruited from 106 hospitals in four countries between April 7, 2009, and March 18, 2016. The trial was stopped early on the recommendation of the data monitoring committee. The incidence and severity of recurrent stroke or TIA did not differ between intensive and guideline therapy (93 [6%] participants vs 105 [7%]; adjusted common odds ratio [cOR] 0·90, 95% CI 0·67–1·20, p=0·47). By contrast, intensive antiplatelet therapy was associated with more, and more severe, bleeding (adjusted cOR 2·54, 95% CI 2·05–3·16, p Interpretation Among patients with recent cerebral ischaemia, intensive antiplatelet therapy did not reduce the incidence and severity of recurrent stroke or TIA, but did significantly increase the risk of major bleeding. Triple antiplatelet therapy should not be used in routine clinical practice. Funding National Institutes of Health Research Health Technology Assessment Programme, British Heart Foundation.

Exposure to estrogenic compounds has been shown to epigenetically reprogram the prostate and may contribute to prostate cancer. The goal of this study was to determine the effect of physiological doses of estradiol and bisphenol A (BPA) on the expression of histone modifying enzymes (HMEs) in prostate cancer. Using two human prostate cancer cell lines we examined the expression of Set8, a histone methyltransferase, and Sirt1, a histone deacetylase, after exposure to estrogen or BPA. These experiments were carried out in the presence of natural hormones to understand the impact of additional exposure to estrogen or BPA on HME expression. We found differential expression of the HMEs in the different models and between the different compounds. Further, we determined that the changes in gene expression occurred via estrogen receptor signaling using the ER antagonist, ICI 182,780 (fulvestrant). Interestingly we found that the combination of ICI with estrogen or BPA greatly affected the expression of Set8, even when the hormone alone had no effect. This study demonstrates that the effects of estrogen and BPA on HME expression vary and that the presence of both the estrogen receptor and androgen receptor may be important for therapeutic intervention.

Background: Rapid treatment of stroke can improve the chances of recovery. Procedures to reduce delays and improve access to thrombolysis treatment are currently needed. Paramedics may be able to play a more important role. The PASTA trial is evaluating whether an enhanced assessment by paramedics could increase the number of patients who receive thrombolysis.Method:Study design: Multicentre cluster randomised trial with cost-effectiveness analysis and parallel process evaluation.Setting: NHS ambulance services, emergency departments and stroke units within three geographical regions of England and Wales.Study intervention: A Paramedic Acute Stroke Treatment Assessment (PASTA) pathway initiated by paramedics and continued initially in hospital to facilitate the speed of brain imaging and delivery of thrombolysis when clinically appropriate.Study control: Usual care according to national and local guidelines for the pre-hospital and hospital assessment of suspected stroke.Randomisation: Ambulance stations within each region randomised to delivering the PASTA pathway or continuing with usual stroke care.Participants: Intervention paramedics deliver the PASTA pathway to adults within 4 hours of suspected stroke onset. Participants enrolled in the study are adults with confirmed stroke who were assessed by a study paramedic within 4 hours of onset.Primary outcome: Proportion of participants receiving intravenous thrombolysis.Process evaluation: Semi-structured interviews with a subsample of participants and staff to gain insight into perceptions and experience of the PASTA pathway.Sample size: 1297 participants provide 90% power to detect a 10% difference in the proportion of patients receiving thrombolysis.Study progress:This study opened to recruitment in December 2015 and is currently running in 15 NHS Trusts. At 30 November 2017, 858 participants had been enrolled.

New Argentine and Brazilian Cinema: Reality Effects, Jens Andermann and Alvaro Fernandez Bravo (eds) (2013) New York: Palgrave Macmillan, 228 pp., ISBN 978-1-137-30482-7 (hbk), £57.50 Spanish Queer Cinema, Chris Perriam (2013) Edinburgh: Edinburgh University Press, 192 pp., ISBN 978-07486-6586-0 (hbk), £65 Spanish Practices: Literature, Cinema, Television, Paul Julian Smith (2012) Oxford: Legenda, x + 166 pp., ISBN 978-1-907975-04-2 (hbk), £45 Screening the Americas/Proyectando las Americas: Narration of Nation in Documentary Film/Narracion de la nacion en el cine documental, Josef Raab, Sebastian Thies and Daniela Noll-Opitz (eds) (2011) Trier, Germany and Tempe, Arizona: Wissenschaftlicher Verlag Trier and Bilingual Press/Editorial Bilingue, 460 pp., ISBN 978-3868213317, EUR 29.50 (pbk)

Background High blood pressure (BP) during acute stroke is associated with poorer stroke outcome. Trials of treatments to lower BP have not resulted in improved outcome, but this may be because treatment commenced too late. Emergency medical service staff (paramedics) are uniquely placed to administer early treatment; however, experience of prehospital randomised controlled trials (RCTs) is very limited. Methods We conducted a pilot RCT to determine the feasibility of a definitive prehospital BP-lowering RCT in acute stroke. Paramedics were trained to identify, consent and deliver a first dose of lisinopril or placebo to adults with suspected stroke and hypertension while responding to the emergency call. Further treatment continued in hospital. Study eligibility, recruitment rate, completeness of receipt of study medication and clinical data (eg, BP) were collected to inform the design of a definitive RCT. Results In 14 months, 14 participants (median age=73 years, median National Institute of Health Stroke Scale=4) were recruited and received the prehospital dose of medication. Median time from stroke onset (as assessed by paramedic) to treatment was 70 min. Four participants completed 7 days of study treatment. Of ambulance transported suspected stroke patients, 1% were both study eligible and attended by a PIL-FAST paramedic. Conclusions It is possible to conduct a paramedic initiated double-blind RCT of a treatment for acute stroke. However, to perform a definitive RCT in a reasonable timescale, a large number of trained paramedics across several ambulance services would be needed to recruit the number of patients likely to be required. Clinical trial registration http://www.clinicaltrials.gov. Unique identifier: NCT01066572.

Background Loss of upper limb function affects up to 85 % of acute stroke patients. Recovery of upper limb function requires regular intensive practise of specific upper limb tasks. To enhance intensity of practice interventions are being developed to encourage patients to undertake self-directed exercise practice. Most interventions do not translate well into everyday activities and stroke patients continue to find it difficult remembering integration of upper limb movements into daily activities. A wrist-worn device has been developed that monitors and provides ‘live’ upper limb activity feedback to remind patients to use their stroke arm in daily activities (The CueS wristband). The aim of this trial is to assess the feasibility of a multi-centre, observer blind, pilot randomised controlled trial of the CueS wristband in clinical stroke services. Methods/design This pilot randomised controlled feasibility trial aims to recruit 60 participants over 15 months from North East England. Participants will be within 3 months of stroke which has caused new reduced upper limb function and will still be receiving therapy. Each participant will be randomised to an intervention or control group. Intervention participants will wear a CueS wristband (between 8 am and 8 pm) providing “live” feedback towards pre-set movement goals through a simple visual display and vibration prompts whilst undertaking a 4-week upper limb therapy programme (reviewed twice weekly by an occupational/physiotherapist). Control participants will also complete the 4-week upper limb therapy programme but will wear a ‘sham’ CueS wristband that monitors upper limb activity but provides no feedback. Outcomes will determine study feasibility in terms of recruitment, retention, adverse events, adherence and collection of descriptive clinical and accelerometer motor performance data at baseline, 4 weeks and 8 weeks. Discussion The WAVES study will address an important gap in the evidence base by reporting the feasibility of undertaking an evaluation of emerging and affordable technology to encourage impaired upper limb activity after stroke. The study will establish whether the study protocol can be supported by clinical stroke services, thereby informing the design of a future multi-centre randomised controlled trial of clinical and cost-effectiveness. Trial registration ISRCTN:82306027. Registered 12 July 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1628-2) contains supplementary material, which is available to authorized users.

We propose that people forgive to serve particular functions, depending on the extent to which forgiveness is intended to benefit the self, the offender, and their relationship. Three studies on personally experienced transgressions in valued relationships (N s = 233, 239, and 83) indicate that victims are more likely to forgive for the sake of the self and the relationship than for an offender. Relationship focus is associated with increased benevolence and relationship quality and decreased revenge and avoidance. Offender focus is associated with nonvengeful motivations. Self focus is associated with avoidance and lower relationship closeness; in the immediate aftermath of a transgression, it is also related to unforgiving responses and reduced relationship satisfaction. The findings have important implications for forgiveness theorizing and application.

This article interrogates the presence of Afro-Brazilian popular culture in Paris in 1922 in the context of bi-directional transatlantic currents between performance spaces in the French capital and in the city of Rio de Janeiro during this era. It focuses on a group of predominantly Afro-Brazilian musicians, the Oito Batutas, who performed in Paris between February and August 1922. This article highlights how transatlantic dialogues informed the performance of Brazilian “race” in Paris and Brazil in the 1920s. Via an examination of the impact that the Parisian sojourn and the cultural interactions it led to had on the Oito Batutas, both in terms of their musical repertoire and their visual style, it situates their self-representation in Paris within dominant discourses of the era surrounding black US musicians and the African continent. Taking as its point of departure Hermano Vianna's acknowledgement of the varied agents associated with samba's consecration as “national” music, the wider ambiti...

Glioblastoma Multiforme (GB) is the most common malignant human glioma and is currently incurable. Further understanding of the epigenetic mechanisms underpinning GB progression could facilitate earlier diagnosis and improve prognosis. MicroRNAs (miRNAs) are regions of RNA that reduce translation of proteins. Identifying dysregulated circulating miRNA(s) in sera could provide a potential biomarker for diagnosis, accessible through a blood test. GB and control sera supplied by Brain Tumour North West tissue bank was used to profile the circulating expression of miRNAs -20a, -34a, and -92a using quantitative PCR technology. The results were analysed according to age and sex, as well as overall comparison. MiRNA20a was reduced in GB samples as well as in 20–39 year-old (yo), 40–59 yo and male GB patients, but increased expression in GB patients aged 60 and over. MiRNA92a expression was reduced in 40-60yo GB patients however GB patients over the age of 60 showed an increased expression. MiRNA34a was reduced in GB patients overall, in both sexes and two out of three age groups (40–59, and 20–39 yo) when compared to age and sex matched control samples. The effect of miRNA 34a on cellular migration was analysed in human glioma and control human astrocyte cell lines by overexpression and knockdown. The cell lines were cultured in media containing pooled sera from GB patients, healthy individuals, standard fetal bovine serum and exosome depleted serum. Wound healing assays were performed to ascertain cell migration. Inhibition of miRNA 34a-5p significantly increased rate of migration in glioma cells cultured in human control sera. Acknowledgement should be made to Brain Tumour North West for providing the serum samples used in this study.

This article considers the process of celebritisation that Carmen Miranda rapidly underwent after arriving in the United States for the first time in 1939. It focuses upon the period she spent in New York (1939–41), performing on Broadway, prior to her move to Hollywood, and examines how she negotiated her move from Brazil to North America via a conscious process of auto-exoticisation, knowingly appropriating the self-tropicalising agenda of the regime of Brazilian president, Getulio Vargas (1930–45), as exemplified in the Brazilian Pavilion at the World's Fair in New York of 1939–40. It analyses her celebrity text by examining intertexts such as press releases, interviews and reviews published in newspapers and magazines, and interrogates the impact of her involvement in product endorsement, chiefly in the area of women's high-street fashion. It aims to show the extent of her agency in the construction of her celebrity text, focusing in particular upon how her ethnic identity shifted in the move from Sou...

Introduction/Background Encouraging impaired limb use during routine and rehabilitation activities after stroke is challenging. We evaluated changes in stroke arm activity related to vibration prompts delivered by a wrist-worn accelerometer (“CueS wristband”). Material and method A pilot randomised controlled trial was conducted with adults Activity counts per minute (CPM) were calculated from CueS mean signal vector magnitude (1 s epoch) at the first (baseline) and the last (endpoint) review. Standard accelerometers recorded natural arm activity over 72 h starting at 4 and 8 weeks post-baseline. Mann Whitney U test compared CPM between groups, and for 1 hour before/after prompts amongst intervention participants. Results Thirty-three participants (14 intervention; 19 control) enrolled over 16 months: mean age 71 years (SD11); 13 male; mean days post-stroke 30 (SD19); median baseline Action Research Arm Test 20/57 [IQR 3.5,41]. Median number of prompts delivered were 7 per participant/day [IQR: 6,8]. Median CPM during 1 hour before/after prompts was 651 versus 759 (+16.6%; P = 0.002). CPM increased immediately after prompting, suggesting a direct behavioural impact. Compared to control, the intervention group continued to increase CPM beyond wristband removal. Whilst these results are encouraging, this was a small study and data may not reflect only arm activity. Conclusion Personalised prompts delivered by a wrist-worn accelerometer may enhance self-directed arm activity after stroke.

e18526Background: The prevalence of germline BRCA mutations (BRCAm) in patients with high grade ovarian cancer (HGOC) is approximately 18%. In the era of therapeutic PARP inhibition, identifying BR...