bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health-related quality of life and its determinants in paediatric arterial ischaemic stroke survivors
Authors: Ghotra Satvinder K , Johnson Jeffrey A , Qiu Weiyu , Newton Amanda S , Rasmussen Carmen , Yager Jerome Y 
Published: March 2018

ObjectiveHealth-related quality of life (HRQL) instruments are patient or proxy-reported outcome measures that provide a comprehensive and subjective assessment of patient’s well-being and hence vital for health outcomes evaluation. A clear and thorough understanding of HRQL and its determinants is especially important to appropriately guide health-improving interventions. In this study, HRQL of paediatric arterial ischaemic stroke survivors was assessed using guidelines recommended for interpretation and reporting of the patient-reported outcome data. Determinants of HRQL were also explored.MethodsChildren diagnosed with arterial ischaemic stroke between 2003 and 2012 were assessed at least 1 year poststroke using the parent–proxy report versions of the Pediatric Quality of Life Inventory 4.0 and Pediatric Stroke Recurrence and Recovery Questionnaire. HRQL data were compared with population norms and used as outcome in multiple linear regression analysis.Results59 children were evaluated. Mean age at diagnosis of stroke was 2.2 years. Mean age at assessment and time elapsed since stroke was 7 years and 5 years, respectively. A total of 41% children had normal global outcome, whereas 51% had moderate to severe deficits. A lower overall HRQL was observed in both self and proxy reports. Parents reported the maximum impairment in emotional domain, whereas children indicated physical functioning to be the most affected. Neurological outcome, site of stroke and socioeconomic status were independently associated with overall HRQL.ConclusionsLower HRQL was demonstrated in children who survived arterial ischaemic stroke. Socioeconomic status of families was an important determinant of HRQL, over and above clinical parameters.
Type 3 neovascularisation: long-term analysis of visual acuity and optical coherence tomography anatomical outcomes
Authors: Chae Bora , Su Daniel , Gal-Or Orly , Freund K Bailey , Sarraf David 
Published: March 2018

BackgroundTo investigate the long-term visual and optical coherence tomography (OCT) anatomical outcomes of type 3 neovascularisation (NV) and to identify any baseline predictors of poor outcomes.MethodsIn this retrospective study, patients diagnosed with treatment naïve type 3 NV were identified and categorised into two groups: good or poor vision based on final vision at 1 year. Baseline demographic features and visual acuity (VA) and baseline and 1-year spectral domain OCT (SD-OCT) anatomical findings were studied and correlated with good versus poor visual outcomes.ResultsTen of 25 eyes were classified as having a poor visual outcome (20/50 or worse) at 1 year. Increased age (P=0.049), male gender (p=0.041) and worse baseline VA (ρs=0.61, p=0.001) were associated with poor vision at 1 year. Greater foveal atrophy was noted at 1 year in the poor visual outcome group (p=0.030). Subretinal hyper-reflective material and choroidal thinning were additional features noted more commonly in this group.ConclusionIncreased age, male gender and lower baseline vision may be important baseline predictors of poor visual outcomes in eyes with type 3 NV. The development of central outer retinal atrophy and fibrosis, as identified with SD-OCT, may limit long-term vision in eyes with type 3 NV.
Modulations in extracellular calcium lead to H+-ATPase-dependent acid secretion: a clarification of PPI failure
Authors: Kitay Alice Miriam , Schneebacher Marie-Therese , Schmitt Anne , Heschl Katharina , Kopic Sascha , Alfadda Tariq , Alsaihati Abrar , Link Alexander , Geibel John Peter 
Published: March 2018

The H+,K+-ATPase was identified as the primary proton secretory pathway in the gastric parietal cell and is the pharmacological target of agents suppressing acid secretion. Recently, we identified a second acid secretory protein expressed in the parietal cell, the vacuolar H+-ATPase (V-type ATPase). The aim of the present study was to further characterize H+-ATPase activation by modulations in extracellular calcium via the calcium sensing receptor (CaSR). Isolated gastric glands were loaded with the pH indicator dye BCECF-AM [2′,7′-bis-(2-carboxyethyl)-5-(and-6)-carboxyfluorescein acetoxymethyl ester] to measure intracellular pH. Experiments were conducted in the absence of sodium and potassium to monitor H+-ATPase-specific transport activity. CaSR was activated with the calcimimetic R568 (400 nM) and/or by modulations in extracellular Ca2+. Elevation in calcium concentrations increased proton extrusion from the gastric parietal cell. Allosteric modification of the CaSR via R568 and calcium increased vacuolar H+-ATPase activity significantly (ΔpH/minlowCa2+(0.1mM) = 0.001 ± 0.001, ΔpH/minnormalCa2+(1.0mM) = 0.033 ± 0.004, ΔpH/minhighCa2+(5.0mM) = 0.051 ± 0.005). Carbachol significantly suppressed calcium-induced gastric acid secretion via the H+-ATPase under sodium- and potassium-free conditions. We conclude that the V-type H+-ATPase is tightly linked to CaSR activation. We observed that proton pump inhibitor (PPI) exposure does not modulate H+-ATPase activity. This elevated blood calcium activation of the H+-ATPase could provide an explanation for recurrent reflux symptoms while taking a PPI therapy.NEW & NOTEWORTHY This study emphasizes the role of the H+-ATPase in acid secretion. We further demonstrate the modification of this proton excretion pathway by extracellular calcium and the activation of the calcium sensing receptor CaSR. The novelty of this paper is based on the modulation of the H+-ATPase via both extracellular Ca (activation) and the classical secretagogues histamine and carbachol (inactivation). Both activation and inactivation of this proton pump are independent of PPI modulation.
Predicting Long Term Outcome in Patients Treated With Continuous Flow Left Ventricular Assist Device: The Penn—Columbia Risk Score
Authors: Birati Edo Y. , Hanff Thomas C. , Maldonado Dawn , Grandin E. Wilson , Kennel Peter J. , Mazurek Jeremy A. , Vorovich Esther , Seigerman Matthew , Howard Jessica L.L. , Acker Michael A. , Naka Yoshifumi , Wald Joyce , Goldberg Lee R. , Jessup Mariell , Atluri Pavan , Margulies Kenneth B. , Schulze P. Christian , Rame J. Eduardo 
Published: March 2018

Background
Predicting which patients are unlikely to benefit from continuous flow left ventricular assist device (LVAD) treatment is crucial for the identification of appropriate patients. Previously developed scoring systems are limited to past eras of device or restricted to specific devices. Our objective was to create a risk model for patients treated with continuous flow LVAD based on the preimplant variables.

Methods and Results

We performed a retrospective analysis of all patients implanted with a continuous flow LVAD between 2006 and 2014 at the University of Pennsylvania and included a total of 210 patients (male 78%; mean age, 56±15; mean follow‐up, 465±486 days). From all plausible preoperative covariates, we performed univariate Cox regression analysis for covariates affecting the odds of 1‐year survival following implantation (
P
<0.2). These variables were included in a multivariable model and dropped if significance rose above
P
=0.2. From this base model, we performed step‐wise forward and backward selection for other covariates that improved power by minimizing Akaike Information Criteria while maximizing the Harrell Concordance Index. We then used Kaplan–Meier curves, the log‐rank test, and Cox proportional hazard models to assess internal validity of the scoring system and its ability to stratify survival. A final optimized model was identified based on clinical and echocardiographic parameters preceding LVAD implantation. One‐year mortality was significantly higher in patients with higher risk scores (hazard ratio, 1.38;
P
=0.004). This hazard ratio represents the multiplied risk of death for every increase of 1 point in the risk score. The risk score was validated in a separate patient cohort of 260 patients at Columbia University, which confirmed the prognostic utility of this risk score (
P
=0.0237).

Conclusion
We present a novel risk score and its validation for prediction of long‐term survival in patients with current types of continuous flow LVAD support.
Left Ventricular Unloading Using an Impella CP Improves Coronary Flow and Infarct Zone Perfusion in Ischemic Heart Failure
Authors: Watanabe Shin , Fish Kenneth , Kovacic Jason C. , Bikou Olympia , Leonardson Lauren , Nomoto Koichi , Aguero Jaume , Kapur Navin K. , Hajjar Roger J. , Ishikawa Kiyotake 
Published: March 2018

Background

Delivering therapeutic materials, like stem cells or gene vectors, to the myocardium is difficult in the setting of ischemic heart failure because of decreased coronary flow and impaired microvascular perfusion (
MP
). The aim of this study was to determine if mechanical left ventricular (
LV
) unloading with the Impella increases coronary flow and
MP
in a subacute myocardial infarction.

Methods and Results

Anterior transmural myocardial infarction (infarct size, 26.0±3.4%) was induced in Yorkshire pigs. At 2 weeks after myocardial infarction, 6 animals underwent mechanical
LV
unloading by Impella, whereas 4 animals underwent pharmacological
LV
unloading using sodium nitroprusside for 2 hours.
LV
unloading with Impella significantly reduced end‐diastolic volume (−16±11%,
P
=0.02) and end‐diastolic pressure (EDP; −32±23%,
P
=0.03), resulting in a significant decrease in
LV
end‐diastolic wall stress (
EDWS
) (infarct: 71.6±14.7 to 43.3±10.8 kdynes/cm
2
[
P
=0.02]; remote: 66.6±20.9 to 40.6±13.3 kdynes/cm
2
[
P
=0.02]). Coronary flow increased immediately and remained elevated after 2 hours in Impella‐treated pigs. Compared with the baseline,
MP
measured by fluorescent microspheres significantly increased within the infarct zone (109±81%,
P
=0.003), but not in the remote zone. Although sodium nitroprusside effectively reduced
LV
‐
EDWS
, 2 (50%) of sodium nitroprusside–treated pigs developed profound systemic hypotension. A significant correlation was observed between the infarct
MP
and
EDWS
(
r
2
=0.43,
P
=0.03), suggesting an important role of
EDWS
in regulating
MP
during
LV
unloading in the infarcted myocardium.

Conclusions

LV
unloading using an Impella decreased
EDWS
and increased infarct
MP
without hemodynamic decompensation. Mechanical
LV
unloading is a novel and efficient approach to increase infarct
MP
in patients with subacute myocardial infarction.
Prevention in Psychiatry: Australian Contributions
Authors: Raphael Beverley 
Published: March 2018

Objective To provide a historic context for developing a framework for preventive mental health research in Australia. Method A literature review was undertaken and references were selected for their relevance to describing the contributions of Australian researchers and clinicians to an epidemiological approach to mental health disorders, particularly schizophrenia. Results Australian researchers and clinicians have made major innovative contributions to preventive mental health research. Conclusions Australian mental health services, in collaboration with academic departments, are in a highly favourable position to expand preventive research activities into schizophrenia.
The Epidemiology of the Genetic Liability for Schizophrenia
Authors: Hallmayer Joachim 
Published: March 2018

ObjectiveThe low incidence of schizophrenia prohibits large scale prevention trials, and the question arises whether such studies become more feasible by taking into account genetic factors. The aim of the paper was to inform preventive endeavours with an account of the genetic background to schizophrenia.MethodThe family, twin and adoptive studies of schizophrenia are reviewed and recent molecular genetic data presented.ResultsChildren of a parent diagnosed with schizophrenia have a ten-fold increased risk of developing the disorder. Twin and adoption studies strongly suggest the risk increase is mainly due to genetic factors. On an individual level, a positive family history is the strongest known risk factor for schizophrenia. For a prevention study, very large numbers of families have to be screened in order to reach a sufficient sample size.ConclusionsOne obvious way to increase the accuracy of predicting who is at high risk of developing schizophrenia would be to find specific mutations in the human genome. Attempts to isolate specific genes by means of linkage and association studies have been unsuccessful so far and, given the number of genes involved, it is extremely unlikely that the predictive value of individual genes will be high enough to warrant intervention. Genetic studies also suggest the genetic liability extends beyond the traditional clinical phenotypes. Prevention trials might become possible by adopting a broader approach.
Universal Interventions for the Primary Prevention of Schizophrenia
Authors: McGrath John 
Published: March 2018

Objective To speculate on the role of universal (population-based) interventions designed to prevent schizophrenia. Method A nonsystematic review of candidate risk factors for schizophrenia, with particular emphasis on the quality of the evidence, effect size of the risk factor, population attributable risk and potential for population-based intervention. Results In order to design population-based interventions for the prevention of schizophrenia, we need to identify weak but prevalent risk factors. Based on current knowledge, the leading risk factors for schizophrenia include genes, season and place of birth, obstetric complications, prenatal exposure to viruses and prenatal nutrition. For the nongenetic exposures, we need to consider if potential interventions are effective, safe, cheap and acceptable. Conclusions Vaccinations and interventions related to improving prenatal nutrition and antenatal care appear to be the most plausible options for universal prevention.
Use of Quantitative Rating Scales to Assess Outcome in Schizophrenia Prevention Studies
Authors: Halpin Sean A. , Carr Vaughan J. 
Published: March 2018

ObjectiveTo present a summary of quantitative scales relevant to schizophrenia prevention studies.MethodFifteen scales were reviewed and summarised in terms of structure, domains assessed, previous use and psychometric properties. Instruments of symptom measurement, role functioning and global functioning were considered, along with multidimensional instruments and other scales of potential interest to research in schizophrenia prevention.Results and conclusionsNo scales of potential value in measuring premorbid risk for schizophrenia have been sufficiently tested for reliability and validity in the context of primary prevention of schizophrenia. The absence of a sufficiently sensitive and specific means for identifying those at high risk of schizophrenia before the onset of psychosis is a major barrier to valid measurement of the outcome of attempts at primary prevention. However, there have been advances in the development of instruments relevant to the goals of secondary and tertiary prevention. Most studies use instruments developed for patients with established psychoses and have applied them to early psychosis groups with some success, although possible ‘floor’ effects may confound measurement in the ‘prodromal’ period.
A Risk Factor Screening and Assessment Protocol for Schizophrenia and Related Psychosis
Authors: Carr Vaughan , Halpin Sean , Lau Namson , O'Brien Sian , Beckmann Jane , Lewin Terry 
Published: March 2018

ObjectiveThe Psychological Assistance Service (PAS) opened in Newcastle, New South Wales in 1997 as a clinical service for the assessment and treatment of young people at high risk of psychosis and those experiencing a first psychotic episode. The aim of this paper is to describe the assessment protocol of PAS, which is strongly influenced by the neurodevelopmental perspective on early onset psychosis.MethodThe systematic assessment of patients referred to PAS using a protocol over a 2 week period is described. The protocol includes a narrative history, structured diagnostic interview, quantitative assessment of symptoms and other clinical features, a neurological examination and comprehensive neuropsychological test battery.ResultsThe clinic has received over 250 referrals in a 2 year period and accepted 116 patients for a full assessment, of whom 60 were deemed to be ‘at-risk’ of psychosis and 56 were experiencing their first psychotic episode. Both groups were similar with respect to gender and there were minor age differences. The first-episode group experienced more reality distortion, schizotypal and negative symptoms. While both groups showed some neuropsychological and neurological impairment, there were no statistically significant differences between the groups on these variables except for a test of executive functioning in which the first-episode group was more impaired than the ‘at-risk’ group. A low rate of conversion to psychosis occurred in the ‘at-risk’ group.ConclusionsThe minor differences between the two groups may have been related to relatively small sample sizes, although some similarities between the groups were to be expected. The low rate of conversion to psychosis in the ‘at-risk’ group is discussed. Further analyses using larger samples are necessary to determine the validity of the various ‘at-risk’ categories and this will involve following a sufficiently large sample over an adequate time. The most efficient way of doing this would be to pool data across centres with comparable early intervention programs.
The Ethics of Research into Schizophrenia Prevention: A Carer's Perspective
Authors: Peterson Dymphna Rees 
Published: March 2018

Objective To outline from a carer's/family's perspective the ethical concerns raised by research into screening for factors in people at risk of schizophrenia. Method The need for families and carers of people with schizophrenia to seek a voice in the ethics of research into schizophrenia prevention is described. The possibility that societal myths, literature and language have created sustained ignorance about psychotic illnesses, resulting in fear and/or prejudice, is considered. The impact of these factors greatly exacerbating the burden of schizophrenia for sufferers and their families is discussed. Results There is evidence that people with schizophrenia share the disadvantages of other disempowered minorities. It is necessary for ethical constraints to be cognisant of this; research should include critically exploring reasons for attempting to eliminate the condition. Conclusions Development of an ethical framework for prevention research into schizophrenia should include carer/family input. From a carer/family perspective, research into schizophrenia should be directed at ameliorating the effects of the illness by advancing methods of early diagnosis and by finding suitable treatments that do not carry punitive side-effects, thus allowing people with the illness to reach their potential in all aspects of their lives. Therapeutic relief combined with the elimination of social ostracism would greatly benefit people with schizophrenia and their families.
Ethics of Early Prevention in Schizophrenia
Authors: Rosen Alan 
Published: March 2018

Objective To represent a cross-section of current thinking on the ethics of early (primary) prevention in schizophrenia. Method Ethical considerations presented at the First Australian Schizophrenia Prevention Conference, Sydney, March 1999, particularly from the final session on ‘Ethics’, are recorded here together with complementary referenced material. Results Ethical concerns arise in the arenas of research over clinical priorities; screening ethics, including stigma, confidentiality, informed consent and support required through waiting periods; and the ethics of prolonged assessments in the absence of disorder, the right not to know and the possible ethical prematurity or otherwise of screening for schizophrenia. Conclusions There are several legitimate ethical concerns that must be understood and addressed by those undertaking the developing of primary preventive measures in schizophrenia. Such measures must still be regarded as more experimental the further ahead the measures are undertaken from the onset of the disorder. Anticipatory ethical guidelines should be developed to inform such research.
Traumatic life events and development of post-traumatic stress disorder among female factory workers in a developing country
Authors: Fitch Taylor Jennelle , Yu Xiao , Chien Lung-Chang , Karim Mohammad Monjurul , Alamgir Hasanat 
Published: March 2018

Background: Post-traumatic stress disorder (PTSD) may be more prevalent and burdensome in developing countries. Aims: The goals of this study were to (1) determine the prevalence of PTSD, (2) identify types and number of traumas related to screening positive for PTSD and (3) determine other sociodemographic risk factors and health/medical conditions that may be correlated to PTSD among garment-factory workers and a comparable working population in Bangladesh. Method: A survey was administered to a convenient sample of 607 lower socio-economic status (SES) working women in Bangladesh, 310 of who were garment workers. The primary outcome PTSD was measured by the PTSD Checklist. The Life Events Checklist determined the number and type of traumatic events. Results: The prevalence of PTSD was found to be 17.79% – 7.25% in garment workers and 21.55% in the comparison worker group. In multivariate analysis, PTSD was found to be significantly associated with age, income, chronic pain and number of stressful events. Participants between 45–50 years of age had the greatest odds of reporting PTSD – 15.68 fold (95% confidence interval (CI) = 4.08, 60.29) compared with those younger than 24 years. PTSD was more common in those with lower income (2,000–4,000 taka) (odds ratio (OR) = 1.60; 95% CI = 0.79, 3.26), who had chronic pain (OR = 2.48; 95% CI = 1.51, 4.07) and who experienced over three traumatic life events (OR = 11.25; 95% CI = 4.59, 27.59). The mean number of traumatic events experienced by this entire population was 4.9 with PTSD being more likely in those who experienced physical assault (OR = 6.35; 95% CI = 4.07, 9.90), who caused serious harm or death to someone else (OR = 4.80; 95% CI = 1.36, 16.87) and who had exposure to combat or war (OR = 4.76; 95% CI = 1.17, 19.34). Conclusion: Undiagnosed and untreated PTSD impacts the quality of life and decrease worker productivity among working-age women in this developing country.
Photostress Recovery Times in Cases of Central Serous Retinopathy
Authors: Natsikos V E , Dean Hart J C 
Published: March 2018

Photostress recovery times were measured in 50 normal individuals in the age group 20–50 years and in 27 patients who had developed central serous retinopathy. A flash generator of a commercially available fundus camera was used to provide the appropriate stimulus. The results showed that photostress recovery times were grossly abnormal in patients with central serous retinopathy for the first few weeks after the onset of symptoms, but gradually returned to normal values by 5 months and remained so thereafter. In a few patients during the recovery phase a transient paradoxical response was noted, whereby the photostress recovery times became less than in the unaffected control eye. It appears that the use of a fundus camera to provide photostress stimulus has merit because the light source is subject only to slight variation in intensity, standardization of responses is possible and the technique can be employed on patients about to have fluorescein angiographic studies for diagnostic or documentation purposes.