Aerobic exercise is an effective treatment to improve aerobic capacity following stroke and might also improve cognitive impairments in sub-acute stroke survivors. The aim of the study was to assess the effect of high-intensity aerobic exercise on cognitive impairments in sub-acute stroke survivors. A pilot, randomised controlled trial on the effects of aerobic exercise on cognitive impairments of stroke patients in the sub-acute (1-3 months) phase was conducted. Thirty patients with moderate cognitive impairments (maximum score of 5 on at least two items on the cognitive subscales of the Functional Independence Measure [FIM]) were included in the study and randomly assigned to either the intervention group – performing high-intensity aerobic exercise (above 70% of maximum heart rate), or the control group – performing low-intensity aerobic exercise (below 60%). Patients in both groups exercised for 50 min twice a week for 4 weeks. Primary neuropsychological outcome: Trail Making Test B. Thirty stroke patients completed the interventions. The results showed that the high-intensity group, compared with the low-intensity group, achieved significant improvements on Trail Making Test B, which assesses processing speed and divided attention (P = .04 after training and P = .01 at follow-up). However, the significant improvements on Trail Making Test B might relate to a ceiling effect in the control group. This study does not provide evidence to support that aerobic exercise can improve cognition in stroke survivors, even though significant improvement was revealed on the primary outcome in sub-acute stroke survivors following high-intensity aerobic exercise compared with low-intensity general exercise.

Fluxes of the powerful greenhouse gas nitrous oxide (N ₂ O) are mainly quantified using manually operated or automatic non‐steady‐state chambers. With both systems, fluxes are calculated as the change in N ₂ O concentration over time using linear or non‐linear regression, but the type of regression selected can have a strong influence on the N ₂ O flux magnitude. The HMR package, a regression‐based implementation of the Hutchinson & Mosier Regression, is a widely used software for trace gas flux calculation that provides a recommendation on the most appropriate regression method based on several criteria. New parameters were recently introduced which allow for pre‐filtering based on sample variance ( pfvar and pfalpha) , and for constraining the curvilinearity of concentration‐time series( SatPct and SatTimeMin) . Currently, there are no guidelines on how to choose the best parameters for specific user conditions. Here we address this knowledge gap using datasets from manual and automatic chambers, and sensitivity analyses. We found that the effect of parameter settings on the cumulative fluxes was greater for manual chamber data compared to the automatic chamber data, with ranges of up to 67.3% and 1.5%, respectively. The parameter pfvar was identified as highly sensitive for both manual and automatic chambers; it is, therefore, critical to select a threshold for when to allow for non‐linear flux calculation that accurately represents the given measurement precision. This can be estimated from the variance of N ₂ O measurements at ambient concentration levels. The parameter SatTimeMin was critical for manual chamber data where the curvature is much less constrained due to the lower number of observations. The parameter pfalpha was the least sensitive and can be set at a p ‐value equal to 0.05 following common statistical practice. Parameter values depend on the expected flux characteristics with a given chamber design and are currently best selected based on visual inspection of the data. This study identifies where and how specific care should be taken for the selection of parameters in the HMR package, which may contribute to standardizing the methodologies used worldwide for N ₂ O flux calculations, supporting initiatives in which data from many studies need to be combined. Highlights: The HMR package, an implementation of the Hutchinson & Mosier Regression, is a widely used software for trace gas flux calculation that provides a recommendation on the most appropriate regression method based on several criteria. New parameters in the updated HMR package constrains the use of nonlinear flux calculation and inclusion of outliers. The new parameters affect the cumulative emissions of N ₂ O obtained with manual and automated chambers differently. We found that the choice of parameter values led to differences in cumulative N ₂ O emissions of up to 67.3% This study identifies where and how specific care should be taken for the selection of parameters.

In this study, we have described the establishment of an antigen‐specific T cell proliferation assay based on recall stimulation with Newcastle disease (ND) antigen; further, we have described the results obtained after recall stimulation of animals containing different major histocompatibility complex (MHC) haplotypes, vaccinated against ND. First optimization of the assay was performed to lower unspecific proliferation and to enhance antigen‐specific T cell proliferation. These two issues were achieved using ethylene diamine tetra acetic acid as stabilizing agent in blood samples and autologous immune serum in culture medium. The optimized assay was used to screen chickens with different MHC haplotypes for their ability to perform T cell proliferation. Results showed that the antigen‐specific response of CD4⁺ and CD8⁺ T cells from B12 chickens was generally low, whereas B13, B130 and B201 chickens were medium in CD4⁺ or CD8⁺ T cell responses. High responses were seen only in few animals of each haplotype and not in general. A polymorphism in the chicken CD8α gene was found in our experimental chicken lines, resulting in incapability to detect CD8α⁺ T cells using antibodies from the CT8 clone. Screening chickens with alternative antibodies showed that antibodies from the 2‐398 clone were able to discriminate all CD8α⁺ cells from CD8α⁻ cells, and consequently this antibody was used in a second vaccination experiment performed with chickens of the haplotypes B13 and B130. This experiment showed a significant difference in antigen‐specific proliferation of CD4⁺ T cells between the two lines, but not in CD8α⁺ T cell proliferation.

Primary objective: Rehabilitation scales following neurological injury can be useful for monitoring patient progress. However, too often, rehabilitation scales are administered unnecessarily placing an extra burden on clinicians and patients. The primary objective was to reduce redundant testing by providing guidelines for the concurrent use of the Functional Independence Measure (FIM) and Early Functional Abilities (EFA) scales during rehabilitation in patients with brain injury. Methodology: In total, 3289 concurrent FIM and EFA scores from 929 patients were examined. We proposed, using clinically sound and operational criterion, that the FIM should be used throughout rehabilitation, EFA should be used as a supplement when the FIM is ≤36 and FIM should be administered before the EFA on each testing occasion. Results: Around 24% of patients should be measured with the FIM and EFA throughout rehabilitation, 35% of patients should be measured with the EFA and FIM initially but not require EFA measurements when there is an increase in function and 39% of patients should only be measured with the FIM. According to these guidelines, the EFA was administered unnecessarily 53% of the time. Conclusions and implications: These guidelines ensure that the EFA is used when it is sensitive. This will optimize clinician time and minimize redundant testing, without compromising the measurement of clinical progress.

Background. The impact of age on rehabilitation outcome after traumatic brain injury (TBI) as measured by changes in the Functional Independence Measure (FIM) has been addressed in several seemingly conflicting reports. Differences may be explained by different study populations and different ways of analyzing data. Objective. To investigate the role of data analysis in the interpretation of the age effect on rehabilitation outcome after TBI by comparing classical analyses of the total FIM score with a new item-wise analysis that unfolds the comprehensive amount of information contained in the FIM measurement otherwise concealed by the total score. Methods. We analyzed admission and discharge FIM data from 411 consecutive TBI patients admitted to inpatient rehabilitation during 1998-2011 by both methods. Results. The classical analysis indicated similar rehabilitation outcome in the 18 to 39, 40 to 64, and 65+ years age groups, which could be explained by selection of strong elderly patients and/or methodological problems with classical data analyses, whereas the item-wise analysis demonstrated profound age effect on most FIM items throughout the age interval covered. Conclusions. The item-wise analysis meets requirements of proper data analysis, avoids concealing diversity in rehabilitation outcome behind the total FIM score, and provides a flexible, informative, and clinically relevant data analysis.

Assessing primary rehabilitation needs in patients with acquired brain injury is a challenge due to case complexity and the heterogeneity of symptoms after brain injury. The Rehabilitation Complexity Scale-Extended (RCS-E) is an instrument used in assessment of rehabilitation complexity in patients with severe brain injury. The aim of the present study was to translate and test the face validity of the RCS-E as a referral tool for primary rehabilitation. Face validity was tested in a sample of patients with acquired brain injury. Ten clinicians and records from 299 patients with acquired brain injury were used in the translation, cross-cultural adaptation and face validation study of the RCS-E. RCS-E was translated into Danish by a standardized forward-backward translation by experts in the field. Face validity was assessed by a multi-professional team assessing 299 patients. The team was asked their opinion on whether the RCS-E presents a sufficient description of the patients. The RCS-E was translated according to international guidelines and tested by health professionals; some adaptations were required due to linguistic problems and differences in the national health system structures. The patients in the study had a mean age of 63.9 years (SD 14.7); 61 % were male. We found an excellent face validity with a mean score of 8.2 (SD 0.34) assessed on a 0–10 scale. The RCS-E demonstrated to be a valid assessment of primary rehabilitation needs in patients with acquired brain injury. Excellent face validity indicates that the RCS-E is feasible for assessing primary rehabilitation needs and the present study suggests its applicability to the Danish health care system.