OBJECTIVETo determine whether early and more frequent mobilization after stroke affects health-related quality of life.
METHODSA Very Early Rehabilitation Trial (AVERT) was an international, ...multicenter (56 sites), phase 3 randomized controlled trial, spanning 2006–2015. People were included if they were aged ≥18 years, presented within 24 hours of a first or recurrent stroke (ischemic or hemorrhagic), and satisfied preordained physiologic criteria. Participants were randomized to usual care alone or very early and more frequent mobilization in addition to usual care. Quality of life at 12 months was a prespecified secondary outcome, evaluated using the Assessment of Quality of Life 4D (AQoL-4D). This utility-weighted scale has scores ranging from −0.04 (worse than death) to 1 (perfect health). Participants who died were assigned an AQoL-4D score of 0.
RESULTSNo significant difference in quality of life at 12 months between intervention (median 0.47, interquartile range IQR 0.07–0.81) and usual care (median 0.49, IQR 0.08–0.81) groups was identified (p = 0.86), nor were there any group differences across the 4 AQoL-4D domains. The same lack of group difference in quality of life was observed at 3 months. When cohort data were analyzed (both groups together), quality of life was strongly associated with acute length of stay, independence in activities of daily living, cognitive function, depressive symptoms, and anxiety symptoms (all p < 0.001). Quality of life in AVERT participants was substantially lower than population norms, and the gap increased with age.
CONCLUSIONSEarlier and more frequent mobilization after stroke did not influence quality of life.
CLINICAL TRIAL REGISTRATIONanzctr.org.au; ACTRN12606000185561
CLASSIFICATION OF EVIDENCEThis study provides Class II evidence that for people with stroke, earlier and more frequent mobilization did not influence quality of life over the subsequent year.
We report spectroelectrochemical studies to investigate the charge storage mechanism of composite polypyrrole/lignin electrodes. Renewable bioorganic electrode materials were produced by ...electropolymerization of pyrrole in the presence of a water-soluble lignin derivative acting as a dopant. The resulting composite exhibited enhanced charge storage abilities due to a lignin-based faradaic process, which was expressed after repeated electrochemical redox of the material. The in situ FTIR spectroelectrochemistry results show the formation of quinone groups, and reversible oxidation-reduction of these groups during charge-discharge experiments in the electrode materials. The most significant IR bands include carbonyl absorption near 1705 cm super(-1), which is attributed to the creation of quinone moieties during oxidation, and absorption at 1045 cm super(-1) which is due to hydroquinone moieties.
Nitroxyl (HNO) is the one-electron reduced and protonated congener of nitric oxide (•NO), owning a distinct chemical profile. Based on real-time detection, we demonstrate that HNO is endogenously ...formed in Arabidopsis. Senescence and hypoxia induce shifts in the redox balance, triggering HNO decay or formation mediated by non-enzymatic •NO/HNO interconversion with cellular reductants. The stimuli-dependent HNO generation supports or competes with •NO signalling, depending on the local redox environment.
The top layer of the systems covering a concrete surface is made of polyurethane. The polyurethane layer should be characterized by high tensile strength and abrasive wear resistance, because this ...material is used in workshops, corridors, and warehouses.Up till now the systems have been a mixture of polyurethane and different fillers. The recyclate from polyurethane waste added to the systems can modify their properties.Our purpose was to produce and to test the composites supplemented with recyclates of different hardness. The influence of the proportion of wastes on the composite properties was investigated as well.As a result we obtained the materials of higher resistance to abrasive wear and of higher values of Young’s modulus and with unchanged resistance to tensile strength, ultimate elongation and bending. Furthermore a permanent deformation of the materials tested was decreased. The recyclates of the 50°ShD hardness increase the abrasive wear resistance of compasites by 50%, whilst the cost of the material is reduced.
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