Search

A substantial body of research on prediction models for upper limb (UL) function after stroke has emerged during recent years. Despite considerable evidence supporting the use of prediction models, their implementation into clinical practice has not been examined. To investigate whether physiotherapists (PTs) and occupational therapists (OTs) who evaluate and rehabilitate stroke patients know about and apply prediction models for the recovery of UL function. Furthermore, to examine their attitudes toward prognosis for UL function in clinical practice. The authors developed an online survey using REDCap®, specifically aimed to investigate this study's objectives. Physiotherapists and occupational therapists from Danish hospitals with acute stroke or rehabilitation wards were invited to participate. Data were analyzed using STATA 15.1. Of the 380 therapists invited, 58% responded to the survey. Among those, 35% reported that they knew of prediction models for UL function after stroke. More physiotherapists than occupational therapists were familiar with prediction models (p =.03). Of all respondents, 9% confirmed the use of prediction models for UL function in clinical practice. Most therapists (89%) stated that it was important to know how UL function will develop after stroke. Results from this study indicate that prediction models for UL function after stroke are not yet a part of daily practice in Danish stroke rehabilitation. At the same time, knowledge of prognosis seems to be relevant for most therapists in their clinical work. [ABSTRACT FROM AUTHOR]

Recent findings are consistent with a slow but constant shift towards reduced sensitivity of Mycosphaerella graminicola to azole fungicides, which target the CYP51 gene. The goal of this study was to elucidate the evolutionary mechanisms through which CYP51-based mutations associated with altered sensitivity have evolved in M. graminicola over space and time. To accomplish this, we sequenced and compared a portion of the CYP51 gene encompassing the main mutations associated with altered sensitivity towards demethylation inhibitor fungicides. The CYP51 gene showed an extraordinary dynamic shift consistent with a selective haplotype replacement both in space and in time. No mutations associated with increased resistance to azoles were found in non-European populations. These mutations were also absent in the oldest collections from Europe, whereas they dominated in the recent European populations. Intragenic recombination was identified as an important evolutionary process in populations affected by high fungicide selection, suggesting the creation of novel alleles among existing mutations as a potential source of novel resistance alleles. We propose that CYP51 mutations giving resistance in M. graminicola arose only locally (perhaps in Denmark or the UK) and were then spread eastward across Europe through wind-dispersed ascospores. We conclude that recurring cycles of recombination coupled with selection due to the widespread use of azole fungicides will increase the frequency of novel mutants or recombinants with higher resistance. Long-distance gene flow due to wind dispersal of ascospores will move the resulting new alleles to new areas following the prevailing wind directions. A selective replacement favouring haplotypes with various coding mutations at the target site for azole fungicides during the last 5–10 years is the most likely cause of the decrease in sensitivity reported for many azole fungicides in the same period. [ABSTRACT FROM AUTHOR]