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What gives a stroke publication impact? Assessing traditional and alternative metrics of scientific impact for papers published in the journal Stroke 是什么给中风的出版带来影响?评估发表在《中风》杂志上的论文的科学影响的传统和替代指标
Pub Date : 2021-03-16 DOI: 10.12688/AMRCOPENRES.12975.1
L. Wong, B. Drozdowska, Daniel J. Doherty, T. Quinn
Background: The ‘impact’ of a scientific paper is a measure of influence in its field. In recent years, traditional, citation-based measures of impact have been complemented by Altmetrics, which quantify social media footprint. As authors and research institutions seek to increase their visibility both within and beyond the academic community, it is important to identify and compare the determinants of traditional and alternative metrics. We explored this using Stroke – a leading journal in its field. Methods: We described the impact of original research papers published in Stroke (2015-2016) using citation count and Altmetric Attention Score (Altmetrics). Using these two metrics as our outcomes, we assessed univariable and multivariable associations with 21 plausibly relevant publication features. We set the significance threshold at p<0.01. Results: Across 911 papers published in Stroke, there was an average citation count of 21.60 (±17.40) and Altmetric score of 17.99 (±47.37). The two impact measures were weakly correlated (r=0.15, p<0.001). Citations were independently associated with five publication features at a significance level of p<0.01: Time Since Publication (beta=0.87), Number of Authors (beta=0.22), Publication Type (beta=6.76), Number of Previous Publications (beta=0.01) and Editorial (beta=9.45). For Altmetrics, we observed a trend for independent associations with: Time Since Publication (beta=-0.25, p=0.02), Number of References (beta=0.32, p=0.02) and Country of Affiliation (beta=8.59, p=0.01). Our models explained 21% and 3% of variance in citations and Altmetrics, respectively. Conclusion: Papers published in Stroke have impact. Certain aspects of content and format may contribute to impact, but these differ for traditional measures and Altmetrics, and explain only a very modest proportion of variance in the latter. Citation counts and Altmetrics seem to represent different constructs and, therefore, should be used in conjunction to allow a more comprehensive assessment of publication impact.
背景:一篇科学论文的“影响”是衡量其在该领域的影响力。近年来,传统的基于引用的影响力衡量标准已经被Altmetrics所补充,后者量化了社交媒体足迹。随着作者和研究机构寻求在学术界内外增加他们的知名度,识别和比较传统和替代指标的决定因素是很重要的。我们通过《中风》(Stroke)杂志对此进行了探讨。《中风》是该领域的一本领先杂志。方法:我们使用引用计数和Altmetrics注意力评分(Altmetrics Attention Score)来描述发表在《Stroke》(2015-2016)上的原创研究论文的影响。使用这两个指标作为我们的结果,我们评估了单变量和多变量与21个看似相关的出版物特征的关联。我们将显著性阈值设为p<0.01。结果:在《Stroke》发表的911篇论文中,平均被引次数为21.60(±17.40)次,Altmetric评分为17.99(±47.37)次。两种影响指标呈弱相关(r=0.15, p<0.001)。引文与出版时间(beta=0.87)、作者数量(beta=0.22)、出版类型(beta=6.76)、先前出版物数量(beta=0.01)和社论(beta=9.45)这五个出版特征独立相关,显著性水平为p<0.01。对于Altmetrics,我们观察到独立关联的趋势:出版时间(beta=-0.25, p=0.02),参考文献数量(beta=0.32, p=0.02)和所属国家(beta=8.59, p=0.01)。我们的模型分别解释了引用数和Altmetrics中21%和3%的方差。结论:发表在《卒中》杂志上的论文具有一定的影响力。内容和格式的某些方面可能会对影响有所贡献,但这些对于传统度量和另类度量来说是不同的,并且在后者中只能解释非常适度的差异比例。引用计数和Altmetrics似乎代表了不同的结构,因此,应该结合使用,以便对发表影响进行更全面的评估。
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引用次数: 0
Evaluating the use of video communication technology in a hospital specialist palliative care team during the COVID-19 pandemic 评估新冠肺炎大流行期间医院专业姑息治疗团队使用视频通信技术的情况
Pub Date : 2021-01-28 DOI: 10.12688/AMRCOPENRES.12969.1
B. Crosby, S. Hanchanale, S. Stanley, A. Nwosu
Background: Healthcare professionals’ use of video communication technology has increased during the novel coronavirus disease (COVID-19) pandemic, due to infection control restrictions. Currently there is little published data about the experiences of specialist palliative care teams who are using technology to communicate during the COVID-19 pandemic. The aim of this evaluation was to describe the experience of a UK based hospital specialist palliative care team, who were using video communication technology to support care during the COVID-19 pandemic. Methods: An online survey was distributed to the specialist palliative care team at a University teaching hospital in the North West of the UK. We asked participants to provide their views on the scope of use, barriers and future opportunities to use technology for communication in hospital palliative care. Results: The survey was completed by 14 healthcare professionals. Participants indicated that the most common reasons for using the technology was to receive team updates (n= 14, 100%), participate in multidisciplinary team meetings (n=14, 100%), for education (n=12, 86%) and to facilitate cross-site working (n=9, 64%). We identified barriers to using the technology, which were summarised as: (1) user-based difficulties; (2) inadequate technological infrastructure; (3) data security, privacy and ethical concerns; and (4) concerns regarding staff wellbeing. Participants stated that technology can potentially improve care by improving communication with hospital and community teams and increasing access to education. We have used these findings to develop recommendations to help palliative care teams to implement this technology better in clinical practice. Conclusion: Video communication technology has the potential to improve specialist palliative care delivery; however, it is essential that healthcare organisations address the existing barriers to using this technology, to ensure that these systems work meaningfully to improve palliative care for those who are most vulnerable beyond the COVID-19 pandemic.
背景:在新型冠状病毒病(COVID-19)大流行期间,由于感染控制方面的限制,医护人员对视频通信技术的使用有所增加。目前,关于在COVID-19大流行期间使用技术进行沟通的专业姑息治疗团队的经验,几乎没有公开的数据。本次评估的目的是描述英国一家医院专科姑息治疗团队的经验,他们在COVID-19大流行期间使用视频通信技术支持护理。方法:对英国西北部一所大学教学医院的专科姑息治疗团队进行在线调查。我们请与会者就医院姑息治疗中使用技术进行沟通的范围、障碍和未来机会提供意见。结果:调查由14名医护人员完成。参与者表示,使用该技术最常见的原因是接收团队更新(n= 14,100%),参加多学科团队会议(n= 14,100%),教育(n= 12,86%)以及促进跨站点工作(n= 9,64%)。我们确定了使用该技术的障碍,总结为:(1)基于用户的困难;(2)技术基础设施不足;(3)数据安全、隐私和道德问题;(4)对员工福利的关注。与会者指出,技术有可能通过改善与医院和社区团队的沟通以及增加接受教育的机会来改善护理。我们利用这些发现来制定建议,以帮助姑息治疗团队在临床实践中更好地实施这项技术。结论:视频通信技术具有改善专科姑息治疗服务的潜力;然而,医疗机构必须解决使用这项技术的现有障碍,以确保这些系统有效地为COVID-19大流行之后最脆弱的人群改善姑息治疗。
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引用次数: 3
Case Report: Implantable cardioverter defibrillator (ICD) deactivation in palliative care - a case involving best interest decisions for someone lacking capacity at the end of life 病例报告:在姑息治疗中停用植入式心律转复除颤器(ICD) -一个涉及生命末期缺乏能力的人的最佳利益决策的案例
Pub Date : 2021-01-21 DOI: 10.12688/AMRCOPENRES.12972.1
Che-Kim Tan, S. Hanchanale, Emma Sugrue, A. Nwosu
The use of implantable cardioverter-defibrillators (ICD) has increased due to benefits of preventing death from cardiac arrhythmia. However, the increasing use of ICDs has created new challenges for how to proactively manage deactivation of these devices in people who are dying, especially for those who lack capacity to make decisions about their care. The aim of this case report is to discuss the challenges of planning for deactivation of an ICD for a patient who lacked capacity at the end of life. We describe the challenges of managing ICD deactivation in a dying patient with fluctuating capacity who had previously expressed a wish for the ICD to remain active. Although it is preferable to use advance care planning (ACP), to provide care in-line with patient-identified care preferences, we demonstrate how a best interest process can be used to make decisions about ICD deactivation at the end of life.
植入式心律转复除颤器(ICD)的使用由于预防心律失常死亡的益处而有所增加。然而,ICDs的使用越来越多,这给如何在垂死的人中主动管理这些设备的停用带来了新的挑战,尤其是对于那些缺乏护理决策能力的人。本病例报告的目的是讨论为临终时缺乏能力的患者计划停用ICD的挑战。我们描述了在一名容量波动的垂死患者中管理ICD停用的挑战,该患者之前曾表示希望ICD保持活跃。尽管最好使用预先护理计划(ACP),以根据患者确定的护理偏好提供护理,但我们展示了如何使用最佳利益流程来在生命结束时做出有关ICD停用的决策。
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引用次数: 0
Optimising Psychoeducation for Transient Ischaemic Attack and Minor Stroke Management (OPTIMISM): Protocol for a feasibility randomised controlled trial 优化短暂性脑缺血发作和轻微卒中管理的心理教育(乐观):一项可行性随机对照试验方案
Pub Date : 2020-06-29 DOI: 10.12688/amrcopenres.12911.1
E. Kontou, M. Walker, Shirley A. Thomas, C. Watkins, H. Griffiths, Miriam R Golding-Day, C. Richardson, N. Sprigg
Background: A transient ischaemic attack (TIA) and minor stroke are medical emergencies and often a warning sign of future strokes if remain untreated. Few studies have investigated the long-term psychosocial effects of TIA and minor stroke. Secondary prevention and medical management are often the primary focus with limited access offered for further psychosocial support. Psychoeducational interventions can provide education and advice to people with physical health conditions and, with suitable tailoring, could be appropriate for people after TIA and minor stroke. This study aims to develop a group psychoeducational intervention for people after TIA and minor stroke and to test whether it is acceptable and feasible. Methods: This mixed-methodology study involves two phases: Phase 1) A qualitative study to determine the content of a suitable intervention; Phase 2) A single-centre feasibility randomised controlled trial to evaluate the acceptability of this intervention. The overall study has ethical approval. Stroke survivors have been involved in designing and monitoring the trial. The aim is to recruit 30-40 participants from a Stroke/TIA Service, within 6 months following their diagnosis. Participants will be randomly allocated to either the usual care control group or the intervention group (psychoeducational programme). The programme will consist of six group sessions based on providing education, psychological and social support. The primary outcomes will relate to the feasibility aims of the study. Outcomes will be collected at 3 and 6 months to assess mood, quality of life, knowledge and satisfaction, and resource use. Discussion: There is a need to develop and evaluate effective interventions that enhance the education provided to people after TIA and minor stroke and to promote their psychosocial wellbeing. Findings will indicate the acceptability of the intervention and parameters needed to conduct a definitive trial. Registration: ClinicalTrials.gov ID NCT02550392; registered on 15 September 2015; status: completed.
背景:短暂性脑缺血发作(TIA)和轻微中风是医疗紧急情况,如果不及时治疗,通常是未来中风的警告信号。很少有研究调查TIA和轻微中风的长期心理社会影响。二级预防和医疗管理往往是主要关注点,提供进一步心理社会支持的机会有限。心理教育干预措施可以为有身体健康状况的人提供教育和建议,通过适当的调整,可以适用于短暂性脑缺血发作和轻微中风后的人。本研究旨在为短暂性脑缺血发作和轻度脑卒中患者开发一种群体心理教育干预措施,并测试其是否可接受和可行。方法:这项混合方法研究包括两个阶段:第一阶段:定性研究,以确定适当干预的内容;阶段2)一项单中心可行性随机对照试验,以评估该干预措施的可接受性。整个研究得到了伦理方面的认可。中风幸存者参与了试验的设计和监测。目的是在诊断后6个月内,从中风/短暂性脑缺血发作服务中心招募30-40名参与者。参与者将被随机分配到常规护理对照组或干预组(心理教育计划)。该方案将包括六个小组会议,以提供教育、心理和社会支持为基础。主要结果将与研究的可行性目标有关。将在3个月和6个月时收集结果,以评估情绪、生活质量、知识和满意度以及资源使用情况。讨论:有必要制定和评估有效的干预措施,以加强对TIA和轻度中风患者的教育,并促进他们的心理健康。研究结果将表明干预措施的可接受性以及进行最终试验所需的参数。注册:ClinicalTrials.gov ID NCT02550392;于2015年9月15日注册;状态:已完成。
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引用次数: 3
PancREatic Cancer and Individualised Supervised Exercise (PRECISE): a feasibility trial protocol for patients with resectable pancreatic ductal adenocarcinoma 胰腺癌和个体化监督运动(PRECISE):可切除胰腺导管腺癌患者的可行性试验方案
Pub Date : 2020-06-08 DOI: 10.12688/amrcopenres.12907.1
Dominic O’Connor, Malcolm Brown, Roy Bowdery, M. Eatock, C. Hulme, A. Maraveyas, R. Robinson, R. Turkington, R. Vince, J. Wadsley, G. Prue
Background: Patients with resectable pancreatic ductal adenocarcinoma (PDAC), undergoing adjuvant chemotherapy can experience an array of complications including fatigue, pain and the loss of physical function. Accumulating evidence from largely early stage breast cancer studies supports exercise as an adjunct therapy to help mitigate treatment complications. However, there is a lack of evidence of its feasibility in pancreatic cancer. The purpose of this study is to explore the initial feasibility of delivering a supervised, individualized, and progressive concurrent exercise intervention to individuals with resectable PDAC who are undergoing adjuvant therapy. Methodology: Ten patients with resectable PDAC undergoing adjuvant chemotherapy will be recruited. Clinical care teams will screen patients against inclusion criteria to determine eligibility. All enrolled participants will complete a 16-week, supervised, tailored, moderate intensity exercise intervention consisting of aerobic and muscle strengthening activities. The primary outcome will be feasibility of delivering a supervised exercise intervention. Secondary outcomes will include measures of physical fitness, fatigue, and quality of life. Outcomes will be measured at baseline (T1), 16 weeks (T2) and 3 months post intervention (T3). The feasibility, acceptability and potential utility of the supervised exercise intervention will be explored qualitatively through semi-structured interviews with key stakeholders (e.g. active participants, eligible participants that declined participation and the research staff including exercise physiologists and recruiting clinicians).  The use of health and social care services, medications and personal expenses incurred during the trial will also be used to determine cost-effectiveness of this intervention and a potential further RCT in PDAC. Discussion: The overall aim of this study is to determine the utility of a supervised, tailored, moderate intensity exercise intervention in PDAC patients undergoing adjuvant chemotherapy.  This feasibility study will help inform the design of future randomised controlled trials to determine the efficacy of the exercise intervention in PDAC.
背景:接受辅助化疗的可切除胰腺导管腺癌(PDAC)患者可能会出现一系列并发症,包括疲劳、疼痛和身体功能丧失。从癌症早期研究中积累的大量证据支持将锻炼作为辅助治疗来帮助减轻治疗并发症。然而,缺乏证据表明其在癌症中的可行性。本研究的目的是探索向正在接受辅助治疗的可切除PDAC患者提供有监督、个性化和渐进式同时运动干预的初步可行性。方法:将招募10名接受辅助化疗的可切除PDAC患者。临床护理团队将根据纳入标准对患者进行筛选,以确定是否符合资格。所有注册参与者将完成为期16周的有监督、量身定制的中等强度运动干预,包括有氧和肌肉强化活动。主要结果将是提供有监督的运动干预的可行性。次要结果将包括身体素质、疲劳和生活质量的测量。将在基线(T1)、干预后16周(T2)和3个月(T3)测量结果。监督运动干预的可行性、可接受性和潜在效用将通过对关键利益相关者(如积极参与者、拒绝参与的合格参与者以及包括运动生理学家和招募临床医生在内的研究人员)的半结构化访谈进行质量探索。试验期间产生的健康和社会护理服务、药物和个人费用的使用也将用于确定该干预措施的成本效益以及PDAC中潜在的进一步随机对照试验。讨论:本研究的总体目的是确定在接受辅助化疗的PDAC患者中,有监督、有针对性的中等强度运动干预的效用。这项可行性研究将有助于为未来随机对照试验的设计提供信息,以确定运动干预对PDAC的疗效。
{"title":"PancREatic Cancer and Individualised Supervised Exercise (PRECISE): a feasibility trial protocol for patients with resectable pancreatic ductal adenocarcinoma","authors":"Dominic O’Connor, Malcolm Brown, Roy Bowdery, M. Eatock, C. Hulme, A. Maraveyas, R. Robinson, R. Turkington, R. Vince, J. Wadsley, G. Prue","doi":"10.12688/amrcopenres.12907.1","DOIUrl":"https://doi.org/10.12688/amrcopenres.12907.1","url":null,"abstract":"Background: Patients with resectable pancreatic ductal adenocarcinoma (PDAC), undergoing adjuvant chemotherapy can experience an array of complications including fatigue, pain and the loss of physical function. Accumulating evidence from largely early stage breast cancer studies supports exercise as an adjunct therapy to help mitigate treatment complications. However, there is a lack of evidence of its feasibility in pancreatic cancer. The purpose of this study is to explore the initial feasibility of delivering a supervised, individualized, and progressive concurrent exercise intervention to individuals with resectable PDAC who are undergoing adjuvant therapy. Methodology: Ten patients with resectable PDAC undergoing adjuvant chemotherapy will be recruited. Clinical care teams will screen patients against inclusion criteria to determine eligibility. All enrolled participants will complete a 16-week, supervised, tailored, moderate intensity exercise intervention consisting of aerobic and muscle strengthening activities. The primary outcome will be feasibility of delivering a supervised exercise intervention. Secondary outcomes will include measures of physical fitness, fatigue, and quality of life. Outcomes will be measured at baseline (T1), 16 weeks (T2) and 3 months post intervention (T3). The feasibility, acceptability and potential utility of the supervised exercise intervention will be explored qualitatively through semi-structured interviews with key stakeholders (e.g. active participants, eligible participants that declined participation and the research staff including exercise physiologists and recruiting clinicians).  The use of health and social care services, medications and personal expenses incurred during the trial will also be used to determine cost-effectiveness of this intervention and a potential further RCT in PDAC. Discussion: The overall aim of this study is to determine the utility of a supervised, tailored, moderate intensity exercise intervention in PDAC patients undergoing adjuvant chemotherapy.  This feasibility study will help inform the design of future randomised controlled trials to determine the efficacy of the exercise intervention in PDAC.","PeriodicalId":72183,"journal":{"name":"AMRC open research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47318597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Detrimental effect of zwitterionic buffers on lysosomal homeostasis in cell lines and iPSC-derived neurons. 带微聚酰亚胺的缓冲液对细胞系和 iPSC 衍生神经元溶酶体稳态的有害影响
Pub Date : 2020-05-18 DOI: 10.12688/amrcopenres.12903.1
Sophie R Cook, Rafael A Badell-Grau, Emily D Kirkham, Kimberley M Jones, Brendan P Kelly, Jincy Winston, Helen Waller-Evans, Nicholas D Allen, Emyr Lloyd-Evans

Good's buffers are commonly used for cell culture and, although developed to have minimal to no biological impact, they cause alterations in cellular processes such as autophagy and lysosomal enzyme activity. Using Chinese hamster ovary cells and induced pluripotent stem cell-derived neurons, this study explores the effect of zwitterionic buffers, specifically HEPES, on lysosomal volume and Ca2+ levels. Certain zwitterionic buffers lead to lysosomal expansion and reduced lysosomal Ca2+. Care should be taken when selecting buffers for growth media to avoid detrimental impacts on lysosomal function.

固氏缓冲液常用于细胞培养,虽然开发时认为其对生物的影响极小甚至没有影响,但它们会改变自噬和溶酶体酶活性等细胞过程。本研究利用中国仓鼠卵巢细胞和诱导多能干细胞衍生的神经元,探讨了滋养剂缓冲液(特别是 HEPES)对溶酶体容量和 Ca2+ 水平的影响。某些齐聚物缓冲液会导致溶酶体膨胀和溶酶体Ca2+减少。在选择生长培养基缓冲液时应注意避免对溶酶体功能产生不利影响。
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引用次数: 0
Real-world Independent Testing of e-ASPECTS Software (RITeS): statistical analysis plan. e-ASPECTS软件(RITeS)的实际独立测试:统计分析计划。
Pub Date : 2020-04-28 DOI: 10.12688/amrcopenres.12904.1
Grant Mair, Francesca Chappell, Chloe Martin, David Dye, Philip M Bath, Keith W Muir, Rüdiger von Kummer, Rustam Al-Shahi Salman, Peter A G Sandercock, Malcolm Macleod, Nikola Sprigg, Philip White, Joanna M Wardlaw

Background: Artificial intelligence-based software may automatically detect ischaemic stroke lesions and provide an Alberta Stroke Program Early CT score (ASPECTS) on CT, and identify arterial occlusion and provide a collateral score on CTA. Large-scale independent testing will inform clinical use, but is lacking. We aim to test e-ASPECTS and e-CTA (Brainomix, Oxford UK) using CT scans obtained from a range of clinical studies. Methods: Using prospectively collected baseline CT and CTA scans from 10 national/international clinical stroke trials or registries (total >6600 patients), we will select a large clinically representative sample for testing e-ASPECTS and e-CTA compared to previously acquired independent expert human interpretation (reference standard). Our primary aims are to test agreement between software-derived and masked human expert ASPECTS, and the diagnostic accuracy of e-ASPECTS for identifying all causes of stroke symptoms using follow-up imaging and final clinical opinion as diagnostic ground truth. Our secondary aims are to test when and why e-ASPECTS is more or less accurate, or succeeds/fails to produce results, agreement between e-CTA and human expert CTA interpretation, and repeatability of e-ASPECTS/e-CTA results. All testing will be conducted on an intention-to-analyse basis. We will assess agreement between software and expert-human ratings and test the diagnostic accuracy of software.  Conclusions: RITeS will provide comprehensive, robust and representative testing of e-ASPECTS and e-CTA against the current gold-standard, expert-human interpretation.

背景:基于人工智能的软件可以自动检测缺血性卒中病变并在CT上提供阿尔伯塔卒中计划早期CT评分(ASPECTS),识别动脉闭塞并在CTA上提供侧支评分。大规模的独立测试将为临床使用提供信息,但目前还缺乏。我们的目标是使用从一系列临床研究中获得的CT扫描来测试e-ASPECTS和e-CTA (Brainomix, Oxford UK)。方法:使用前瞻性收集的基线CT和CTA扫描,来自10个国家/国际临床卒中试验或注册中心(总数>6600例患者),我们将选择一个具有临床代表性的大样本来测试e-ASPECTS和e-CTA,并与之前获得的独立专家人类解释(参考标准)进行比较。我们的主要目的是测试软件衍生的和隐藏的人类专家方面之间的一致性,以及e-ASPECTS的诊断准确性,以识别中风症状的所有原因,使用随访成像和最终临床意见作为诊断的基础事实。我们的第二个目标是测试e-ASPECTS何时以及为什么更准确或更不准确,或成功/失败产生结果,e-CTA和人类专家CTA解释之间的一致性,以及e-ASPECTS/e-CTA结果的可重复性。所有测试将在意向分析的基础上进行。我们将评估软件和专家-人类评级之间的协议,并测试软件的诊断准确性。结论:RITeS将提供全面、稳健和具有代表性的e-ASPECTS和e-CTA测试,以对抗当前的金标准、专家-人类解释。
{"title":"Real-world Independent Testing of e-ASPECTS Software (RITeS): statistical analysis plan.","authors":"Grant Mair,&nbsp;Francesca Chappell,&nbsp;Chloe Martin,&nbsp;David Dye,&nbsp;Philip M Bath,&nbsp;Keith W Muir,&nbsp;Rüdiger von Kummer,&nbsp;Rustam Al-Shahi Salman,&nbsp;Peter A G Sandercock,&nbsp;Malcolm Macleod,&nbsp;Nikola Sprigg,&nbsp;Philip White,&nbsp;Joanna M Wardlaw","doi":"10.12688/amrcopenres.12904.1","DOIUrl":"https://doi.org/10.12688/amrcopenres.12904.1","url":null,"abstract":"<p><p><b>Background:</b> Artificial intelligence-based software may automatically detect ischaemic stroke lesions and provide an Alberta Stroke Program Early CT score (ASPECTS) on CT, and identify arterial occlusion and provide a collateral score on CTA. Large-scale independent testing will inform clinical use, but is lacking. We aim to test e-ASPECTS and e-CTA (Brainomix, Oxford UK) using CT scans obtained from a range of clinical studies. <b>Methods:</b> Using prospectively collected baseline CT and CTA scans from 10 national/international clinical stroke trials or registries (total >6600 patients), we will select a large clinically representative sample for testing e-ASPECTS and e-CTA compared to previously acquired independent expert human interpretation (reference standard). Our primary aims are to test agreement between software-derived and masked human expert ASPECTS, and the diagnostic accuracy of e-ASPECTS for identifying all causes of stroke symptoms using follow-up imaging and final clinical opinion as diagnostic ground truth. Our secondary aims are to test when and why e-ASPECTS is more or less accurate, or succeeds/fails to produce results, agreement between e-CTA and human expert CTA interpretation, and repeatability of e-ASPECTS/e-CTA results. All testing will be conducted on an intention-to-analyse basis. We will assess agreement between software and expert-human ratings and test the diagnostic accuracy of software.  <b>Conclusions:</b> RITeS will provide comprehensive, robust and representative testing of e-ASPECTS and e-CTA against the current gold-standard, expert-human interpretation.</p>","PeriodicalId":72183,"journal":{"name":"AMRC open research","volume":"2 ","pages":"20"},"PeriodicalIF":0.0,"publicationDate":"2020-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7612993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9151595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Social prescribing for autistic people: A framework for service provision 自闭症患者的社会处方:服务提供框架
Pub Date : 2020-04-27 DOI: 10.12688/amrcopenres.12901.1
R. Charlton, Catherine J. Crompton, Amanda Roestorf, C. Torry
Social Prescribing (SP) is the referral of patients to non-clinical services for practical, physical or psychosocial support. Recent guidelines from the National Health Service England mean that SP will become commonplace for people with complex healthcare needs. Autistic adults make up over 1% of the population and commonly have co-existing physical and mental health conditions, therefore they are likely to be referred to SP services. As yet, no studies have examined the efficacy of SP for autistic adults. In this letter, we review the existing literature examining the efficacy of SP in the general population. We further examine the factors that should be considered when offering SP to autistic adults in order to optimise outcomes for physical and mental well-being.
社会处方(SP)是指将患者转介到非临床服务机构,以获得实际、身体或社会心理支持。英国国民健康服务最近的指导方针意味着SP将成为有复杂医疗需求的人的普遍选择。成年自闭症患者占总人口的1%以上,他们通常同时存在身体和精神健康问题,因此他们很可能被转介到特殊服务机构。到目前为止,还没有研究检验SP对自闭症成年人的疗效。在这封信中,我们回顾了现有的文献检查SP在一般人群中的功效。我们进一步研究了在为自闭症成人提供SP时应该考虑的因素,以优化身心健康的结果。
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引用次数: 8
Clinical and radiological features that predict malignant transformation in cystic lesions of the pancreas: a retrospective case note review. 预测胰腺囊性病变的临床和放射学特征:回顾性病例回顾。
Pub Date : 2020-01-16 DOI: 10.12688/amrcopenres.12860.2
Margaret G Keane, Hannah R Dadds, Ghassan El Sayed, Tu Vinh Luong, Brian R Davidson, Guiseppe K Fusai, Douglas Thorburn, Stephen P Pereira

Background: Pancreatic cystic lesions (PCL) are being detected with increasing frequency. Current methods of stratifying risk of malignant transformation are imperfect. This study aimed to determine the frequency of pancreatic malignancy in patients with PCL and define clinical and radiological features that predict malignant transformation in patients managed by surgery and/or surveillance. Methods: A retrospective cohort of adults who were evaluated in a tertiary hepatopancreaticobiliary centre between January 2000 - December 2013 with a confirmed PCL and followed up for at least 5 years. All cystic lesions were discussed at a weekly multidisciplinary meeting. Results: Of the 1,090 patients diagnosed with a PCL, 768 patients were included in the study: 141 patients were referred for immediate pancreatic resection, 570 entered surveillance while 57 had a malignant PCL which was unresectable at diagnosis (n=47) or were unfit for surgery (n=10). In those who were resected following presentation, malignancy was present in 38%. During follow-up 2% of those entering a surveillance programme underwent malignant transformation. Clinical and radiological features associated with a high-risk PCL included older age, symptoms, associated solid component or dilated main pancreatic duct. In intraductal papillary mucinous neoplasms, larger size was not a feature of malignant transformation (benign vs. malignant 30mm vs. 23mm; P= 0.012). Conclusion: The sensitivity of standard diagnostic tests leading to immediate surgery for high-risk PCL (malignant or mucinous) was 92% but with a specificity of just 5%. Surveillance of PCL without high-risk features within a multidisciplinary meeting was associated with a low incidence of cancer development, supporting the use of worrisome clinical and radiological features in the initial stratification of PCL.

背景:胰腺囊性病变(PCL)越来越多地被发现。目前的恶性转化风险分级方法尚不完善。本研究旨在确定PCL患者胰腺恶性肿瘤的频率,并确定临床和放射学特征,以预测通过手术和/或监测治疗的患者的恶性转化。方法:对2000年1月至2013年12月在三级肝胰胆中心确诊PCL的成年人进行回顾性队列研究,随访至少5年。所有囊性病变均在每周多学科会议上讨论。结果:在诊断为PCL的1090例患者中,768例患者纳入研究:141例患者转诊立即行胰腺切除术,570例进入监测,57例诊断时无法切除的恶性PCL (n=47)或不适合手术(n=10)。在表现后切除的患者中,恶性肿瘤占38%。在随访期间,进入监测规划的患者中有2%发生恶性转化。与高危PCL相关的临床和影像学特征包括年龄、症状、相关的实性成分或主胰管扩张。在导管内乳头状黏液性肿瘤中,较大的尺寸并不是恶性转化的特征(良性vs恶性30mm vs 23mm;P = 0.012)。结论:高危PCL(恶性或黏液性)即刻手术的标准诊断试验敏感性为92%,特异性仅为5%。在多学科会议中监测无高危特征的PCL与低癌症发展发生率相关,支持在PCL的初始分层中使用令人担忧的临床和放射学特征。
{"title":"Clinical and radiological features that predict malignant transformation in cystic lesions of the pancreas: a retrospective case note review.","authors":"Margaret G Keane,&nbsp;Hannah R Dadds,&nbsp;Ghassan El Sayed,&nbsp;Tu Vinh Luong,&nbsp;Brian R Davidson,&nbsp;Guiseppe K Fusai,&nbsp;Douglas Thorburn,&nbsp;Stephen P Pereira","doi":"10.12688/amrcopenres.12860.2","DOIUrl":"https://doi.org/10.12688/amrcopenres.12860.2","url":null,"abstract":"<p><p><b>Background:</b> Pancreatic cystic lesions (PCL) are being detected with increasing frequency. Current methods of stratifying risk of malignant transformation are imperfect. This study aimed to determine the frequency of pancreatic malignancy in patients with PCL and define clinical and radiological features that predict malignant transformation in patients managed by surgery and/or surveillance. <b>Methods:</b> A retrospective cohort of adults who were evaluated in a tertiary hepatopancreaticobiliary centre between January 2000 - December 2013 with a confirmed PCL and followed up for at least 5 years. All cystic lesions were discussed at a weekly multidisciplinary meeting. <b>Results:</b> Of the 1,090 patients diagnosed with a PCL, 768 patients were included in the study: 141 patients were referred for immediate pancreatic resection, 570 entered surveillance while 57 had a malignant PCL which was unresectable at diagnosis (n=47) or were unfit for surgery (n=10). In those who were resected following presentation, malignancy was present in 38%. During follow-up 2% of those entering a surveillance programme underwent malignant transformation. Clinical and radiological features associated with a high-risk PCL included older age, symptoms, associated solid component or dilated main pancreatic duct. In intraductal papillary mucinous neoplasms, larger size was not a feature of malignant transformation (benign vs. malignant 30mm vs. 23mm; P= 0.012). <b>Conclusion:</b> The sensitivity of standard diagnostic tests leading to immediate surgery for high-risk PCL (malignant or mucinous) was 92% but with a specificity of just 5%. Surveillance of PCL without high-risk features within a multidisciplinary meeting was associated with a low incidence of cancer development, supporting the use of worrisome clinical and radiological features in the initial stratification of PCL.</p>","PeriodicalId":72183,"journal":{"name":"AMRC open research","volume":"1 ","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2020-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7176489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37862983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Post-stroke cognition with the Oxford Cognitive Screen vs Montreal Cognitive Assessment: a multi-site randomized controlled study (OCS-CARE) 脑卒中后认知与牛津认知筛查和蒙特利尔认知评估:一项多地点随机对照研究(OCS-CARE)
Pub Date : 2019-08-13 DOI: 10.12688/AMRCOPENRES.12882.1
N. Demeyere, Shuo Sun, E. Milosevich, K. Vancleef
Background: Cognitive impairment is common following stroke. The Oxford Cognitive Screen (OCS) was designed to assess focal post-stroke cognitive deficits in five domains. Here, we investigated whether results generated by the OCS vs the domain-general Montreal Cognitive Assessment (MoCA) at baseline impacted patient outcomes at 6 months follow-up.   Methods: Patients <2 months post-stroke were randomized to receive either the OCS and corresponding information leaflet or standard care with the MoCA at baseline. After 6 months, patients received both the OCS and MoCA. The primary registered outcome measures were the Stroke Impact Scale (SIS) and change in stroke severity (National Institutes of Health Stroke Scale; NIHSS) at 6 months. The secondary outcome was change in cognitive performance from baseline to 6-month follow-up. The relationship between scores from the two cognitive screens at follow-up was also explored. Results: A total of 821 patients from 37 different hospital or rehabilitation sites (England, UK) were recruited to the OCS-CARE study, with 467 completing 6-month follow-up. Patient outcomes defined by overall SIS scores and changes in NIHSS did not differ between the OCS or MoCA groups. There were high accordance rates between the OCS and MoCA at 6 months, with severity of cognitive impairment reflected in both screening tools. Cognitive performance in both groups over the 6-month follow-up declined in 22% of patients. A larger proportion of OCS group patients demonstrated improvements in cognitive scores (49% vs 40% in MoCA). Conclusions: The type of cognitive screening test did not impact broad stroke outcome measures, and the two screening tools showed a high overall accordance. The results suggest that more of the domain-specific deficits in OCS recover subacutely, providing a more granular picture of cognitive recovery as well as decline.             Registration: ISRCTN50857950; registered on 27/03/2014.
背景:脑卒中后认知障碍很常见。牛津认知筛查(OCS)旨在评估中风后五个领域的局灶性认知缺陷。在这里,我们调查了OCS和领域通用蒙特利尔认知评估(MoCA)在基线时产生的结果是否影响患者6个月随访的结果。方法:卒中后<2个月的患者随机接受OCS和相应的信息单张,或基线时MoCA的标准治疗。6个月后,患者同时接受OCS和MoCA。主要登记的结局指标是卒中影响量表(SIS)和卒中严重程度的变化(美国国立卫生研究院卒中量表;NIHSS) 6个月。次要结果是从基线到6个月随访期间认知表现的变化。在随访中还探讨了两种认知屏幕得分之间的关系。结果:共有来自37家不同医院或康复中心(英格兰、英国)的821名患者被招募到OCS-CARE研究中,其中467名完成了6个月的随访。由总体SIS评分和NIHSS变化定义的患者结局在OCS组和MoCA组之间没有差异。6个月时,OCS和MoCA的符合率很高,两种筛查工具都反映了认知障碍的严重程度。在6个月的随访中,两组患者的认知能力下降了22%。更大比例的OCS组患者表现出认知评分的改善(49% vs MoCA组的40%)。结论:认知筛查测试的类型不影响广泛的脑卒中结局测量,两种筛查工具显示出高度的总体一致性。研究结果表明,OCS中更多的领域特异性缺陷会亚急性恢复,从而提供了认知恢复和衰退的更详细的图景。注册:ISRCTN50857950;注册日期:27/03/2014
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引用次数: 23
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AMRC open research
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