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- Brady, MC, et al.
(författare)
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Precision rehabilitation for aphasia by patient age, sex, aphasia severity, and time since stroke? A prespecified, systematic review-based, individual participant data, network, subgroup meta-analysis
- 2022
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Ingår i: International journal of stroke : official journal of the International Stroke Society. - : SAGE Publications. - 1747-4949. ; 17:10, s. 1067-1077
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Tidskriftsartikel (refereegranskat)abstract
- Stroke rehabilitation interventions are routinely personalized to address individuals’ needs, goals, and challenges based on evidence from aggregated randomized controlled trials (RCT) data and meta-syntheses. Individual participant data (IPD) meta-analyses may better inform the development of precision rehabilitation approaches, quantifying treatment responses while adjusting for confounders and reducing ecological bias. Aim: We explored associations between speech and language therapy (SLT) interventions frequency (days/week), intensity (h/week), and dosage (total SLT-hours) and language outcomes for different age, sex, aphasia severity, and chronicity subgroups by undertaking prespecified subgroup network meta-analyses of the RELEASE database. Methods: MEDLINE, EMBASE, and trial registrations were systematically searched (inception-Sept2015) for RCTs, including ⩾ 10 IPD on stroke-related aphasia. We extracted demographic, stroke, aphasia, SLT, and risk of bias data. Overall-language ability, auditory comprehension, and functional communication outcomes were standardized. A one-stage, random effects, network meta-analysis approach filtered IPD into a single optimal model, examining SLT regimen and language recovery from baseline to first post-intervention follow-up, adjusting for covariates identified a-priori. Data were dichotomized by age (⩽/> 65 years), aphasia severity (mild–moderate/ moderate–severe based on language outcomes’ median value), chronicity (⩽/> 3 months), and sex subgroups. We reported estimates of means and 95% confidence intervals. Where relative variance was high (> 50%), results were reported for completeness. Results: 959 IPD (25 RCTs) were analyzed. For working-age participants, greatest language gains from baseline occurred alongside moderate to high-intensity SLT (functional communication 3-to-4 h/week; overall-language and comprehension > 9 h/week); older participants’ greatest gains occurred alongside low-intensity SLT (⩽ 2 h/week) except for auditory comprehension (> 9 h/week). For both age-groups, SLT-frequency and dosage associated with best language gains were similar. Participants ⩽ 3 months post-onset demonstrated greatest overall-language gains for SLT at low intensity/moderate dosage (⩽ 2 SLT-h/week; 20-to-50 h); for those > 3 months, post-stroke greatest gains were associated with moderate-intensity/high-dosage SLT (3–4 SLT-h/week; ⩾ 50 hours). For moderate–severe participants, 4 SLT-days/week conferred the greatest language gains across outcomes, with auditory comprehension gains only observed for ⩾ 4 SLT-days/week; mild–moderate participants’ greatest functional communication gains were associated with similar frequency (⩾ 4 SLT-days/week) and greatest overall-language gains with higher frequency SLT (⩾ 6 days/weekly). Males’ greatest gains were associated with SLT of moderate (functional communication; 3-to-4 h/weekly) or high intensity (overall-language and auditory comprehension; (> 9 h/weekly) compared to females for whom the greatest gains were associated with lower-intensity SLT (< 2 SLT-h/weekly). Consistencies across subgroups were also evident; greatest overall-language gains were associated with 20-to-50 SLT-h in total; auditory comprehension gains were generally observed when SLT > 9 h over ⩾ 4 days/week. Conclusions: We observed a treatment response in most subgroups’ overall-language, auditory comprehension, and functional communication language gains. For some, the maximum treatment response varied in association with different SLT-frequency, intensity, and dosage. Where differences were observed, working-aged, chronic, mild–moderate, and male subgroups experienced their greatest language gains alongside high-frequency/intensity SLT. In contrast, older, moderate–severely impaired, and female subgroups within 3 months of aphasia onset made their greatest gains for lower-intensity SLT. The acceptability, clinical, and cost effectiveness of precision aphasia rehabilitation approaches based on age, sex, aphasia severity, and chronicity should be evaluated in future clinical RCTs.
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- Allaria, E., et al.
(författare)
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Highly coherent and stable pulses from the FERMI seeded free-electron laser in the extreme ultraviolet
- 2012
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Ingår i: Nature Photonics. - 1749-4885. ; 6:10, s. 699-704
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Tidskriftsartikel (refereegranskat)abstract
- Free-electron lasers (FELs) are promising devices for generating light with laser-like properties in the extreme ultraviolet and X-ray spectral regions. Recently, FELs based on the self-amplified spontaneous emission (SASE) mechanism have allowed major breakthroughs in diffraction and spectroscopy applications, despite the relatively large shot-to-shot intensity and photon-energy fluctuations and the limited longitudinal coherence inherent in the SASE mechanism. Here, we report results on the initial performance of the FERMI seeded FEL, based on the high-gain harmonic generation configuration, in which an external laser is used to initiate the emission process. Emission from the FERMI FEL-1 source occurs in the form of pulses carrying energy of several tens of microjoules per pulse and tunable throughout the 65 to 20 nm wavelength range, with unprecedented shot-to-shot wavelength stability, low-intensity fluctuations, close to transform-limited bandwidth, transverse and longitudinal coherence and full control of polarization.
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- Barret, B., et al.
(författare)
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Intercomparisons of trace gases profiles from the Odin/SMR and Aura/MLS limb sounders
- 2006
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Ingår i: Journal of Geophysical Research. - 0148-0227 .- 2156-2202. ; 111:D21
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Tidskriftsartikel (refereegranskat)abstract
- This paper presents the intercomparison of O(3), HNO(3), ClO, N(2)O and CO profiles measured by the two spaceborne microwave instruments MLS ( Microwave Limb Sounder) and SMR ( Submillimetre Radiometer) on board the Aura and Odin satellites, respectively. We compared version 1.5 level 2 data from MLS with level 2 data produced by the French data processor version 222 and 225 and by the Swedish data processor version 2.0 for several days in September 2004 and in March 2005. For the five gases studied, an overall good agreement is found between both instruments. Most of the observed discrepancies between SMR and MLS are consistent with results from other intercomparison studies involving MLS or SMR. O(3) profiles retrieved from the SMR 501.8 GHz band are noisier than MLS profiles but mean biases between both instruments do not exceed 10%. SMR HNO(3) profiles are biased low relative to MLS's by similar to 30% above the profile peak. In the lower stratosphere, MLS ClO profiles are biased low by up to 0.3 ppbv relative to coincident SMR profiles, except in the Southern Hemisphere polar vortex in the presence of chlorine activation. N(2)O profiles from both instruments are in very good agreement with mean biases not exceeding 15%. Finally, the intercomparison between SMR and MLS CO profiles has shown a good agreement from the middle stratosphere to the middle mesosphere in spite of strong oscillations in the MLS profiles. In the upper mesosphere, MLS CO concentrations are biased high relative to SMR while negative values in the MLS retrievals are responsible for a negative bias in the tropics around 30 hPa.
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- Berthet, G., et al.
(författare)
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Nighttime chlorine monoxide observations by the Odin satellite and implications for the ClO/Cl2O2 equilibrium
- 2005
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Ingår i: Geophysical Research Letters. - 1944-8007 .- 0094-8276. ; 32:11, s. 1-5
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Tidskriftsartikel (refereegranskat)abstract
- We use measurements of chlorine monoxide (ClO) by the SMR instrument onboard the Odin satellite to study the nighttime thermal equilibrium between ClO and its dimer Cl2O2. Observations performed in the polar vortex during the 2002-2003 Arctic winter showed enhanced amounts of nighttime ClO over a wide range of stratospheric temperatures (185
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