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Introduction. The role of gender in functional independence for activities of daily living after ischemic stroke is still controversial. We aim to a) compare clinical characteristics of men and women at inpatient rehabilitation admission b) compare their functional independence at admission and discharge c) identify predictors of functional independence. Materials and methods. Retrospective observational cohort study. State-of-the-art variables were used for admission and discharge comparisons and to predict total FIM (Functional Independence Measure) at discharge, FIM gain, FIM efficiency and FIM effectiveness using multivariate linear regressions. Results. 144 patients (33% women) admitted to inpatient rehabilitation in a Spanish specialized center, with less than 3 weeks since ischemic stroke onset were included. Men were older (p = 0.039), 19.6% of men had diabetes mellitus (6.4% of women) (p = 0.038), with 52.6% of men being non-smokers (72.3% of women) (p = 0.022). No significant differences were observed in FIM at admission, discharge, FIM gain, efficiency or effectiveness (total, motor either cognitive FIM). Regression analysis identified sex (beta = -0.13), stroke severity (beta = -0.25) and admission total FIM (beta = -0.69) as significant predictors of total FIM gain (R-2 = 0.42). The same variables predicted discharge total FIM: sex (beta = -0.12), severity (beta = -0.23) and admission total FIM (beta = 0.59) (R-2 = 0.51). FIM efficiency was predicted by admission total FIM (beta = -0.64), severity (beta = -0.24), age (beta = -0.17) and length of stay (beta = -0.45) (R-2 = 39.9). FIM effectiveness model explained only 13.5% of the variance. Conclusions. No functional differences between men and women in any independence measure were found. Sex was a significant predictor but leaving half of the variance unexplained.

Plasmodium vivax, the most widely distributed human malaria parasite, causes severe clinical syndromes despite low peripheral blood parasitemia. This conundrum is further complicated as cytoadherence in the microvasculature is still a matter of investigations. Previous reports in Plasmodium knowlesi, another parasite species shown to infect humans, demonstrated that variant genes involved in cytoadherence were dependent on the spleen for their expression. Hence, using a global transcriptional analysis of parasites obtained from spleen-intact and splenectomized monkeys, we identified 67 P. vivax genes whose expression was spleen dependent. To determine their role in cytoadherence, two Plasmodium falciparum transgenic lines expressing two variant proteins pertaining to VIR and Pv-FAM-D multigene families were used. Cytoadherence assays demonstrated specific binding to human spleen but not lung fibroblasts of the transgenic line expressing the VIR14 protein. To gain more insights, we expressed five P. vivax spleen-dependent genes as recombinant proteins, including members of three different multigene families (VIR, Pv-FAM-A, Pv-FAM-D), one membrane transporter (SECY), and one hypothetical protein (HYP1), and determined their immunogenicity and association with clinical protection in a prospective study of 383 children in Papua New Guinea. Results demonstrated that spleen-dependent antigens are immunogenic in natural infections and that antibodies to HYP1 are associated with clinical protection. These results suggest that the spleen plays a major role in expression of parasite proteins involved in cytoadherence and can reveal antigens associated with clinical protection, thus prompting a paradigm shift in P. vivax biology toward deeper studies of the spleen during infections.

INTRODUCTION: Stroke is a leading cause of long-term disabilities worldwide. A great deal of meta-analyses of randomized controlled trials (RCTs) address rehabilitation in chronic stroke, several of them with focus on activities and participation, considered critical outcomes of successful rehabilitation. Nevertheless, substantial heterogeneity might exist between studies, the reported associations may be causal, but they might also be flawed, as inherent study biases such as residual confounding and selective reporting of positive results may exaggerate the effect of interventions in chronic phase. Furthermore, most RCTs might focus on specific rehabilitation domains, not paying the same attention to others. EVIDENCE ACQUSITION: Formal evaluation of published systematic reviews of meta-analyses (January 2008 to November 2018) of rehabilitation in chronic phase to 1) assess the strength of evidence: participants, publication biases, heterogeneity, prediction intervals (PI s) 2) grade the evidence to perform qualitative analysis on effects sizes and heterogeneity, 3) perform meta-regressions and sensitivity analysis on relevant covariates 4) map outcomes to activities and participation domain of the World Health Organization's International Classification of Functioning, Disability and Health (ICF). Systematic review on meta-analyses of RCT s addressing activities and participation will be performed in Medline, Web of Science, Scopus, Cochrane and Google Scholar. EVIDENCE SYNTHESIS : A total of 97 meta-analyses on 31 different rehabilitation interventions involving 25,275 participants were included. Thirty-nine meta-analyses (40.74%) reported statistically significant findings (P

© 2017 Elsevier Inc. Brain swelling is a major predictor of mortality in pediatric cerebral malaria (CM). However, the mechanisms leading to swelling remain poorly defined. Here, we combined neuroimaging, parasite transcript profiling, and laboratory blood profiles to develop machine-learning models of malarial retinopathy and brain swelling. We found that parasite var transcripts encoding endothelial protein C receptor (EPCR)-binding domains, in combination with high parasite biomass and low platelet levels, are strong indicators of CM cases with malarial retinopathy. Swelling cases presented low platelet levels and increased transcript abundance of parasite PfEMP1 DC8 and group A EPCR-binding domains. Remarkably, the dominant transcript in 50% of swelling cases encoded PfEMP1 group A CIDRα1.7 domains. Furthermore, a recombinant CIDRα1.7 domain from a pediatric CM brain autopsy inhibited the barrier-protective properties of EPCR in human brain endothelial cells in vitro. Together, these findings suggest a detrimental role for EPCR-binding CIDRα1 domains in brain swelling. Brain swelling is associated with cerebral malaria mortality, but the parasite and host factors responsible for development of brain swelling are unknown. Kessler et al. demonstrate an association of low platelet count and EPCR-binding PfEMP1 with brain swelling in children with cerebral malaria.

A recent verification study compared 11 large-scale cardiac electrophysiology solvers on an unambiguously defined common problem. An unexpected amount of variation was observed between the codes, including significant error in conduction velocity in the majority of the codes at certain spatial resolutions. In particular, the results of the six finite element codes varied considerably despite each using the same order of interpolation. In this present study, we compare various algorithms for cardiac electrophysiological simulation, which allows us to fully explain the differences between the solvers. We identify the use of mass lumping as the fundamental cause of the largest variations, specifically the combination of the commonly used techniques of mass lumping and operator splitting, which results in a slightly different form of mass lumping to that supported by theory and leads to increased numerical error. Other variations are explained through the manner in which the ionic current is interpolated. We also investigate the effect of different forms of mass lumping in various types of simulation. © 2012 John Wiley and Sons, Ltd.

Chaste is a software library and set of test suites for modelling phenomena in the domain of computational biology. Specifically these the modelling problems arise in the fields of cancer modelling, cardiac simulation and soft-tissue engineering (Chaste stands for ‘Cancer, heart and soft-tissue environment’). It is released under the LGPL 2.1 licence. Chaste has been developed using agile programming methods. The project began 5 years when it was reasoned that the modelling of a variety of physio-logical phenomena requires both a generic mathematical modelling framework, and a generic computational/simulation framework. The Chaste project was formed as part of the larger Integrative Biology e-Science (IB) Project ([14]), an inter-institutional project aimed at developing a suitable IT infrastructure to support physiome-level computational modelling, with a focus on cardiac and cancer modelling.

Simulation of cardiac electrical activity using the bidomain equations can be a massively computationally demanding problem. This study provides a comprehensive guide to numerical bidomain modelling. Each component of bidomain simulations-discretisation, ODE-solution, linear system solution, and parallelisation-is discussed, and previously-used methods are reviewed, new methods are proposed, and issues which cause particular difficulty are highlighted. Particular attention is paid t

Information regarding the propagation dynamics of intramural electrical wavefronts in the 3D volume of the ventricles is critical in gaining a better understanding of normal and pathological cardiac function. However, investigation into such phenomena using cardiac modelling has so far been impaired due to limitations in the structural details included in current cardiac computational models. Here, we describe the technological pipeline required for the construction of realistic, highly-detailed and personalised whole ventricular models directly from high-resolution MR images and their use within a reliable, fully tested cardiac simulation software (Chaste). Simulations of cardiac propagation in the structurally-detailed model are presented that reveal the importance of complex structural geometry, fibre orientation, blood vessels and other heterogeneities in propagation of activation wavefronts through the ventricular volume. The tools and techniques presented in this study are expected to be key in the development and application of the next generation of cardiac models.