Translational validity of neuropsychological tasks of sustained attention between rodents and humans: A systematic review of three rodent tasks.

Atypical sustained attention is a symptom in a number of neurological and psychological conditions. Investigations into its neural underpinnings are required for improved management and treatment. Rodents are useful in investigating the neurobiology underlying atypical sustained attention and several rodent tasks have been developed for use in touchscreen testing platforms that mimic methodology used in human clinical attention assessment. This systematic review was conducted to assess how translatable these rodent tasks are to equivalent clinical human tasks. Studies using the rodent Continuous Performance Task (rCPT), Sustained Attention Task (SAT), and 5-choice CPT (5C-CPT) were sought and screened. Included in the review were 138 studies, using the rCPT (n = 21), SAT (n = 90), and 5C-CPT (n = 27). Translatability between rodent and human studies was assessed based on (1) methodological similarity, (2) performance similarity, and (3) replication of results. The 5C-CPT was found to be the most translatable cross-species paradigm with good utility, while the rCPT and SAT require adaptation and further development to meet these translatability benchmarks. With greater replication and more consistent results, greater confidence in the translation of sustained attention results between species will be engendered.

Palliative long-term abdominal drains for the management of refractory ascites due to cirrhosis: a consensus document.

Palliative care remains suboptimal in advanced cirrhosis, in part relating to a lack of evidence-based interventions. Ascites remains the most common cirrhosis complication resulting in hospitalisation. Many patients with refractory ascites are not candidates for liver transplantation or transjugular intrahepatic portosystemic shunt, and therefore, require recurrent palliative large volume paracentesis in hospital. We review the available evidence on use of palliative long-term abdominal drains in cirrhosis. Pending results of a national trial (REDUCe 2) and consistent with recently published national and American guidance, long-term abdominal drains cannot be regarded as standard of care in advanced cirrhosis. They should instead be considered only on a case-by-case basis, pending definitive evidence. This manuscript provides consensus to help standardise use of long-term abdominal drains in cirrhosis including patient selection and community management. Our ultimate aim remains to improve palliative care for this under researched and vulnerable cohort.

Services for liver disease in district general hospitals in the UK: a national questionnaire-based survey.

The burden of liver disease in the UK is increasing and much of this is managed in district general hospitals (DGHs). Previous studies of liver services have focused on specialist units. This study assessed the provision of liver services in non-specialist units. A questionnaire-based survey was conducted to assess resources, staffing and clinical management of liver disease. Replies were received from 61 consultant gastroenterologists working in DGHs across the UK. The data show inadequate consultant numbers and limited availability of nurse specialists, hepatobiliary pathologists and radiologists. There is marked variability in the management of hepatitis C, variceal bleeding and hepatorenal syndrome. Liver databases and outcomes are rarely kept. There are significant shortfalls in the provision of liver services across DGHs. This supports the need for managed clinical networks and data collection as proposed in the National Plan for Liver Services.