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Using biomarkers to allocate patients in a response-adaptive clinical trial. COMMUN STAT-SIMUL C 2023; 52:5946-5965. [PMID: 38045870 PMCID: PMC7615340 DOI: 10.1080/03610918.2021.2004420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 11/05/2021] [Indexed: 10/19/2022]
Abstract
In this paper, we discuss a response adaptive randomization method, and why it should be used in clinical trials for rare diseases compared to a randomized controlled trial with equal fixed randomization. The developed method uses a patient's biomarkers to alter the allocation probability to each treatment, in order to emphasize the benefit to the trial population. The method starts with an initial burn-in period of a small number of patients, who with equal probability, are allocated to each treatment. We then use a regression method to predict the best outcome of the next patient, using their biomarkers and the information from the previous patients. This estimated best treatment is assigned to the next patient with high probability. A completed clinical trial for the effect of catumaxomab on the survival of cancer patients is used as an example to demonstrate the use of the method and the differences to a controlled trial with equal allocation. Different regression procedures are investigated and compared to a randomized controlled trial, using efficacy and ethical measures.
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433 SAME SPECIALITY, DIFFERENT REALITY? Age Ageing 2021. [DOI: 10.1093/ageing/afab119.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The United Kingdom and Spain run government-funded social and health care services, free for the user at the point of delivery. Acute Geriatric Units (AGU) carrying out Comprehensive Geriatric Assessments improve the clinical outcomes of older patients. Little is known about the similarities and differences between countries, and how these may impact on clinical outcomes.
Methods
Prospective observational study of consecutive patients admitted to AGU of 2 hospitals in the UK and 4 hospitals in Spain between the 1st to the 30th of October 2019 and from the 1st to the 29th of February 2020. We followed up the patients for a 90 day period.
Conclusions
Frailty, multimorbidity and polypharmacy were prevalent in both cohorts. English patients were younger, with shorter hospital stay, mortality and use of antipsychotic medication but higher readmission rates. Involvement from Allied health care professionals was higher in UK hospitals.
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A quantum enhanced search for dark matter axions. Nature 2021; 590:238-242. [DOI: 10.1038/s41586-021-03226-7] [Citation(s) in RCA: 92] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 12/08/2020] [Indexed: 11/09/2022]
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4
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Determination of Total Fumonisins in Corn by Competitive Direct Enzyme-Linked Immunosorbent Assay: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/85.2.404] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Fumonisins—mycotoxins produced by some Fusarium species—have been shown to be the causative agent of diseases in horses and other domesticated animals as well as possible carcinogens in humans. A collaborative study was conducted to evaluate the effectiveness of a competitive direct enzyme-linked immunosorbent assay (CD-ELISA) for the determination of total fumonisins (B1, B2, and B3) in corn. The test portion was extracted with methanol–water (7 + 3), filtered, diluted, and tested on the CD-ELISA. Naturally and artificially contaminated corn test portions were sent to 13 collaborators in the United States. Naturally contaminated field test portions were prepared at 3 different levels. Artificially contaminated test portions were spiked at 1.0, 3.0, and 5.0 mg/kg total fumonisins (B1, B2, and B3). Average recoveries of total fumonisins were 120, 100, and 90%, respectively. The relative standard deviations for repeatability ranged from 13.3 to 23.3% and the relative standard deviations for reproducibility ranged from 15.8 to 30.3% across all levels tested. HORRAT values, calculated for each individual sample, ranged from 1.24 to 1.94. This method demonstrated acceptable intra- and interlaboratory precision at the levels tested.
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5
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The effectiveness of hand grip dynamometry in assessing the nutritional status of renal inpatients. Clin Nutr ESPEN 2019. [DOI: 10.1016/j.clnesp.2018.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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6
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Evaluation of OX40 receptor density, influence of IgG Isotype and dosing paradigm in anti-OX40-mediated efficacy and biomarker responses with PD-1 blockade. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy288.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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7
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Preclinical evaluation of a non-depleting, first-in-class humanized IgG4 agonist anti-ICOS antibody. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy303.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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8
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School Level Education to Increase Organ Donation and The Effect Of Deprivation. Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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9
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The National Student Association of Medical Research (NSAMR) Publication Pathway. Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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10
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Comparing immediate-type food allergy in humans and companion animals-revealing unmet needs. Allergy 2017; 72:1643-1656. [PMID: 28394404 DOI: 10.1111/all.13179] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2017] [Indexed: 12/15/2022]
Abstract
Adverse food reactions occur in human as well as veterinary patients. Systematic comparison may lead to improved recommendations for prevention and treatment in both. In this position paper, we summarize the current knowledge on immediate-type food allergy vs other food adverse reactions in companion animals, and compare this to the human situation. While the prevalence of food allergy in humans has been well studied for some allergens, this remains to be investigated for animal patients, where owner-reported as well as veterinarian-diagnosed food adverse reactions are on the increase. The characteristics of the disease in humans vs dogs, cats, and horses are most often caused by similar, but sometimes species-dependent different pathophysiological mechanisms, prompting the specific clinical symptoms, diagnoses, and treatments. Furthermore, little is known about the allergen molecules causative for type I food allergy in animals, which, like in human patients, could represent predictive biomarkers for risk evaluation. The definite diagnosis of food allergy relies-as in humans-on elimination diet and provocation tests. Besides allergen avoidance in daily practice, novel treatment options and tolerization strategies are underway. Taken together, numerous knowledge gaps were identified in veterinary food allergy, which need to be filled by systematic comparative studies.
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THE SUBCUTANEOUS IMPLANTABLE CARDIOVERTER DEFIBRILLATOR EXPERIENCE IN BRITISH COLUMBIA – PROVINCIAL COORDINATION ENABLES DISTRIBUTED PATIENT ACCESS TO NEW TECHNOLOGY. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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12
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Efficacy of home-based visuomotor feedback training in stroke patients with chronic hemispatial neglect. Neuropsychol Rehabil 2017; 29:251-272. [DOI: 10.1080/09602011.2016.1273119] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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13
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Well-being in Chronic Fatigue Syndrome: Relationship to Symptoms and Psychological Distress. Clin Psychol Psychother 2016; 24:859-869. [DOI: 10.1002/cpp.2051] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 09/23/2016] [Accepted: 09/27/2016] [Indexed: 01/30/2023]
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14
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Using molecular tools to guide management of invasive alien species: assessing the genetic impact of a recently introduced island bird population. DIVERS DISTRIB 2015. [DOI: 10.1111/ddi.12364] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Ancestral origins and invasion pathways in a globally invasive bird correlate with climate and influences from bird trade. Mol Ecol 2015; 24:4269-85. [PMID: 26172573 PMCID: PMC4657503 DOI: 10.1111/mec.13307] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Revised: 06/28/2015] [Accepted: 07/06/2015] [Indexed: 01/15/2023]
Abstract
Invasive species present a major threat to global biodiversity. Understanding genetic patterns and evolutionary processes that reinforce successful establishment is paramount for elucidating mechanisms underlying biological invasions. Among birds, the ring-necked parakeet (Psittacula krameri) is one of the most successful invasive species, established in over 35 countries. However, little is known about the evolutionary genetic origins of this species and what population genetic signatures tell us about patterns of invasion. We reveal the ancestral origins of populations across the invasive range and explore the potential influence of climate and propagule pressure from the pet trade on observed genetic patterns. Ring-necked parakeet samples representing the ancestral native range (n = 96) were collected from museum specimens, and modern samples from the invasive range (n = 855) were gathered from across Europe, Mauritius and Seychelles, and sequenced for two mitochondrial DNA markers comprising 868 bp of cytochrome b and control region, and genotyped at 10 microsatellite loci. Invasive populations comprise birds that originate predominantly from Pakistan and northern areas of India. Haplotypes associated with more northerly distribution limits in the ancestral native range were more prevalent in invasive populations in Europe, and the predominance of Asian haplotypes in Europe is consistent with the higher number of Asian birds transported by the pet trade outside the native range. Successful establishment of invasive species is likely to be underpinned by a combination of environmental and anthropogenic influences.
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Invasion success of a global avian invader is explained by within-taxon niche structure and association with humans in the native range. DIVERS DISTRIB 2015. [DOI: 10.1111/ddi.12325] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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17
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Pediatric thyroid nodules: role of the pediatric interventional radiologist and review of a pediatric specific entity. J Vasc Interv Radiol 2015. [DOI: 10.1016/j.jvir.2014.12.548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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18
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Moderators and Predictors of Response to Eating Disorder Risk Factor Reduction Programs in Collegiate Female Athletes. PSYCHOLOGY OF SPORT AND EXERCISE 2014; 15:713-720. [PMID: 25400505 PMCID: PMC4228963 DOI: 10.1016/j.psychsport.2014.02.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE The primary aim of this paper was to investigate moderators and predictors of response to two programs designed to reduce eating disorder risk factors in collegiate female athletes. This study served as an ancillary study to a parent trial that investigated the feasibility of an athlete modified cognitive dissonance-based program (AM-DBP) and an athlete modified healthy weight intervention program (AM-HWI). DESIGN 157 female collegiate athletes were randomized to either the AM-DBP or the AM-HWI program. Participants completed surveys at baseline, post-intervention, 6 weeks, and 1 year. METHODS After classifying sports as either lean or non-lean, we investigated if sport type acted as a moderator of program response to AM-DBP and AM-HWI using ANOVAs. Next, we examined whether baseline thin-ideal internalization, weight concern, shape concern, bulimic pathology, dietary restraint, and negative affect acted as predictors of changes in bulimic pathology using linear regression models. RESULTS Athletes in non-lean sports who received AM-DBP showed more improvement in negative affect versus non-lean sport athletes in AM-HWI. Higher baseline scores of bulimic pathology predicted greater response in bulimic pathology to both programs at 6-weeks. In contrast, athletes with higher dietary restraint and negative affect baseline scores showed decreased response to both interventions at 6-weeks. Finally, athletes with higher baseline shape concern showed a decreased response to the AM-HWI intervention at the post intervention time point. CONCLUSION Results from the present study indicate that lean/non-lean sport may not play a strong role in determining response to efficacious programs. Further, factors such as pre-existing bulimic pathology, dietary restraint, negative affect, and shape concern may affect general response to intervention versus specific responses to specific interventions.
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A CANADIAN CARDIAC RATE BOOK: CARDIAC IMPLANTABLE ELECTRONIC DEVICE IMPLANTS (2006 to 2012). Can J Cardiol 2014. [DOI: 10.1016/j.cjca.2014.07.584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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20
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THERE IS NO DIFFERENCE IN LONGEVITY OF IMPLANTABLE CARDIOVERTER-DEfiBRILLATORS BETWEEN MANUFACTURERS. Can J Cardiol 2014. [DOI: 10.1016/j.cjca.2014.07.529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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21
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LONG-TERM SURVIVAL AFTER IMPLANTABLE CARDIOVERTER DEFIBRILLATOR IMPLANTATION: A POPULATION-BASED STUDY. Can J Cardiol 2014. [DOI: 10.1016/j.cjca.2014.07.603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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22
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Separated response function ratios in exclusive, forward π(±) electroproduction. PHYSICAL REVIEW LETTERS 2014; 112:182501. [PMID: 24856691 DOI: 10.1103/physrevlett.112.182501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Indexed: 06/03/2023]
Abstract
The study of exclusive π(±) electroproduction on the nucleon, including separation of the various structure functions, is of interest for a number of reasons. The ratio RL=σL(π-)/σL(π+) is sensitive to isoscalar contamination to the dominant isovector pion exchange amplitude, which is the basis for the determination of the charged pion form factor from electroproduction data. A change in the value of RT=σT(π-)/σT(π+) from unity at small -t, to 1/4 at large -t, would suggest a transition from coupling to a (virtual) pion to coupling to individual quarks. Furthermore, the mentioned ratios may show an earlier approach to perturbative QCD than the individual cross sections. We have performed the first complete separation of the four unpolarized electromagnetic structure functions above the dominant resonances in forward, exclusive π(±) electroproduction on the deuteron at central Q(2) values of 0.6, 1.0, 1.6 GeV(2) at W=1.95 GeV, and Q(2)=2.45 GeV(2) at W=2.22 GeV. Here, we present the L and T cross sections, with emphasis on RL and RT, and compare them with theoretical calculations. Results for the separated ratio RL indicate dominance of the pion-pole diagram at low -t, while results for RT are consistent with a transition between pion knockout and quark knockout mechanisms.
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British Dietetic Association evidence-based guidelines for the protein requirements of adults undergoing maintenance haemodialysis or peritoneal dialysis. J Hum Nutr Diet 2013; 26:315-28. [PMID: 23731266 DOI: 10.1111/jhn.12052] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Existing nutritional guidelines suggest that protein requirements of adults with stage five chronic kidney disease undergoing haemodialysis (HD) or peritoneal dialysis (PD) are increased as a result of protein losses during dialysis. The present review aimed to update previous guidance and develop evidence-based practice guidelines on the protein requirements of adults undergoing maintenance dialysis. METHODS Following a PICO approach (Participants or Population, Intervention or Exposure, Comparison and Outcome), four research questions were formulated to investigate the total protein requirement and protein quality required by adults undergoing HD and PD. A comprehensive, systematic review was undertaken using the databases Medline, EMBASE and the Cochrane Library from 2005 to September 2009 for HD studies and from 1997 to September 2009 for PD studies. RESULTS The literature search yielded 2931 studies, which were assessed for inclusion. Following appraisal, 19 studies in HD and 18 studies in PD met the inclusion criteria and were systematically reviewed. Limited good quality evidence supports the recommendations that: (i) adults undergoing maintenance HD require a minimum protein intake of 1.1 g kg(-1) ideal body weight (IBW) per day; and (ii) adults undergoing maintenance PD require a minimum protein intake of 1.0-1.2 kg(-1) IBW per day, in conjunction with an adequate energy intake. There were no studies that addressed the quality of protein for either HD or PD. CONCLUSIONS Evidence suggests that nutritional status may be maintained with lower protein intakes than previously recommended. However, the evidence base is limited and further randomised controlled trials are required to establish the optimal protein intake for dialysis patients.
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Long term improvements in activities of daily living in patients with hemispatial neglect. Behav Neurol 2011; 23:237-9. [PMID: 21422564 PMCID: PMC5434380 DOI: 10.3233/ben-2010-0304] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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25
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Comparison of screening tools in patients undergoing haemodialysis. J Hum Nutr Diet 2011. [DOI: 10.1111/j.1365-277x.2011.01175_8.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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26
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Dosimetry, toxicity, and response in a phase IIa trial of no-carrier added iobenguane I-131 (nca-MIBG): A New Approach to Neuroblastoma Therapy (NANT) study. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.9512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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The detection of malingering in memory performance: The sensitivity and specificity of four measures in a UK population. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2011; 44:333-41. [PMID: 16252435 DOI: 10.1348/014466505x35687] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To investigate the validity of a clinical neuropsychological battery for the detection of malingering on tests of memory. METHODS A simulated scenario design was developed to investigate the effectiveness of a battery of four neuropsychological tests in the detection of malingering; the Coin in the Hand Test (CIH), Autobiographical Memory Index (AMI), Rey I 5-Item Test (RIT),and the Wechsler Mental Control Test (MCT). The performances of patients with an acquired brain injury (N = 40) were compared with two groups of controls instructed either to simulate a head injury performance (N = 40) or do their best (N = 40). RESULTS The CIH and MCT demonstrated good validity and displayed high sensitivity and specificity. The RIT and the AMI was relatively poor in distinguishing between simulators and patients. CONCLUSIONS The sensitivity and specificity of all four tests to the detection of malingering has been assessed. Two of the tests the CIH and MCT would be useful as a quick and accurate screening tool for detecting malingering.
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STUDIES OF DISEASES OF THE LYMPHOID AND MYELOID TISSUES. I : THE CHEMICAL METABOLISM OF NORMAL AND PATHOLOGICAL LYMPH NODES. ACTA ACUST UNITED AC 2010; 52:547-60. [PMID: 19869787 PMCID: PMC2131896 DOI: 10.1084/jem.52.4.547] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
From a study of the metabolism of 71 lymph nodes and tumors one may conclude: 1. The nature of a tumor can not be predicted from the metabolism because too much overlapping of metabolic rates exists between the pathological groups. 2. There is no evidence metabolically one way or another as to whether malignant lymphomata of any type should be classed as neoplastic or as infectious processes. 3. The degree of cell differentiation can in most cases be foretold by the percentage difference between the aerobic and the anaerobic glycolysis. The greater the differentiation the greater the percentage difference. Sarcomata in general constitute an exception to this rule. 4. The degree of malignancy in carcinoma, but not in other tumors, can, with certain exceptions, be predicted from the height of the value U. 5. Human sarcomata appear to have a metabolism far more closely comparable to that of benign tumors than to that of carcinomata. They do not behave as malignant tumors under the Warburg classification. Their energy requirements are not of the same order as those of carcinoma. 6. One can not from the value U or from the glycolytic rates predict whether or not a tissue should be classed as neoplastic. 7. Warburg's findings for carcinomata are confirmed and amplified.
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Non-lateralized impairments in anti- but not pro-pointing in patients with hemispatial neglect. J Vis 2010. [DOI: 10.1167/8.6.50] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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30
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Pointing and bisection in open and closed loop reaching in patients with hemispatial neglect. J Vis 2010. [DOI: 10.1167/8.6.305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Suicide attempt in first-episode psychosis: a 7.4 year follow-up study. Schizophr Res 2010; 116:1-8. [PMID: 19864115 DOI: 10.1016/j.schres.2009.10.009] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2009] [Revised: 10/05/2009] [Accepted: 10/10/2009] [Indexed: 11/18/2022]
Abstract
BACKGROUND Individuals with first-episode psychosis demonstrate high rates of suicide attempt (SA). AIMS 1) To examine the prevalence of, and risk factors for, SA in a first-episode psychosis (FEP) cohort over a 7.4 year follow-up period. 2) To investigate differences between single versus multiple suicide attempters. METHODS This study reports baseline and follow-up data from a naturalistic, prospective follow-up of 413 FEP patients treated at a specialist early psychosis centre. Assessments were conducted at treatment entry, initial symptom remission or stabilization, and long term follow-up. Binary logistic regression models were used to assess unadjusted and adjusted associations between early illness and sociodemographic characteristics and two outcome measures: any SA during follow-up; and multiple SAs. RESULTS Follow-up data were available for 282 participants. Sixty-one (21.6%) made a suicide attempt over the follow-up period, including 12 successful suicides. The following baseline risk factors increased the risk of any SA: history of self-harm (OR=4.27; p<0.001), suicidal tendencies (OR=2.30; p=0.022), being depressed for >50% of the initial psychotic episode (OR=2.49; p=0.045), and hopelessness (OR=2.03; p=0.030). History of problem alcohol use increased the risk of multiple SAs (OR=4.43; 95% CI (1.05-18.7); p=0.043). DISCUSSION The prevalence of suicide attempt in this study exceeds reports from short-term FEP studies but is comparable to longer term follow-up studies, indicating that risk remains elevated for at least 7 years following commencement of treatment. The key predictor of future suicide attempt was previous self-harm, indicating that interventions for self-harm are required.
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George Frederic Still. Arch Dis Child 2009; 94:915. [PMID: 19847009 DOI: 10.1136/adc.2009.161224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Metabolic studies with certain ethyleneimine derivatives in relation to diuresis. BRITISH JOURNAL OF PHARMACOLOGY AND CHEMOTHERAPY 2009; 25:223-7. [PMID: 19108202 DOI: 10.1111/j.1476-5381.1965.tb01776.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Antifertility activity of alkyl esters of nitro- and acetamido-benzenesulphonic acids. Andrologia 2009; 6:263-8. [PMID: 4440884 DOI: 10.1111/j.1439-0272.1974.tb01213.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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Home enteral nutrition patients in NSW: Results from a one month audit of new and existing HEN patients from NSW public healthcare facilities. Nutrition 2008. [DOI: 10.1016/j.nut.2008.01.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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37
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Establishing a NSW HEN registry. Nutrition 2008. [DOI: 10.1016/j.nut.2008.01.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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38
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The role of interleukin 6 in megakaryocyte formation, megakaryocyte development and platelet production. CIBA FOUNDATION SYMPOSIUM 2007; 167:160-70; discussion 170-3. [PMID: 1425011 DOI: 10.1002/9780470514269.ch10] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Megakaryocytopoiesis is the cellular amplification and differentiation of precursors into immature megakaryocytes, and the cytoplasmic maturation of these megakaryocytes, a process terminating in the release of platelets into the circulation. Interleukin 6 (IL-6) stimulates megakaryocytopoiesis in the bone marrow, increasing platelet numbers in the circulation. IL-6 alone is poorly active on the growth of stem cell populations, but acts in synergy with stem cell factor (c-kit ligand) to expand the committed myeloid progenitor compartments but not the megakaryocyte progenitors. IL-6 has a direct action on megakaryocyte progenitors but only in synergy with low doses of interleukin 3 (IL-3), increasing the number of immature megakaryocytes and enhancing the processes of development into mature megakaryocytes. IL-6 is about 10 times more active on megakaryocytes than on megakaryocyte progenitors in cell culture. It is active alone and will stimulate increases in cell size and DNA content. IL-6 does not appear to stimulate the process of platelet release. IL-6 is found in bone marrow, in both macrophage subsets and megakaryocytes, indicating that it may be an important physiological regulator of both paracrinal (microenvironmental) and autocrinal mechanisms controlling megakaryocyte development in bone marrow.
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THE REDUCTION OF INTRACRANIAL PRESSURE IN CEREBRAL INJURY BY THE INTRAVENOUS USE OF HYPERTONIC SUCROSE SOLUTION. Ann Surg 2007; 106:161-8. [PMID: 17857026 PMCID: PMC1390491 DOI: 10.1097/00000658-193708000-00001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
OBJECTIVE While rates and correlates of comorbidity have been investigated in the early course of psychosis, little is known about comorbidity in the medium-to-longer term or its relationship with outcome. METHOD A total of 182 first-episode psychosis (FEP) patients who met DSM-IV criteria for a current psychotic disorder 8 years after index presentation were grouped according to concurrent comorbidity [no concurrent axis I disorder; concurrent substance use disorder (SUD); other concurrent axis I disorder; concurrent SUD and other axis I disorder]. Outcomes were compared between groups controlling for relevant covariates. RESULTS As much as 39% met criteria for one or more concurrent axis 1 diagnoses. Comorbidity was associated with greater severity of general psychopathology, but not with measures of functioning, treatment or negative symptoms. CONCLUSION Specific combinations of comorbid disorders may influence patterns of psychotic symptomatology. Routine examination of axis I disorders is warranted in the ongoing management of psychosis.
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An improved synthetic procedure for the preparation of 195mPt labelled anti-tumour complexes. J Labelled Comp Radiopharm 2006. [DOI: 10.1002/jlcr.2580291004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Does lesion size determine the success rate of photodynamic therapy for age-related macular degeneration? Eye (Lond) 2006; 20:43-5. [PMID: 15832188 DOI: 10.1038/sj.eye.6701787] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Photodynamic therapy (PDT) is a new evidence-based treatment modality available for choroidal neovascularisation (CNV) secondary to age-related macular degeneration (AMD). Eligibility for PDT is based on the morphological classification of the neovascular complex, the benefit being greater in classic with no occult lesions. Lesion size is also shown to be a predictive factor for treatment benefit. This retrospective case series looked at effect of initial and final lesion size on the visual outcome of patients with subfoveal classic with no occult CNV and found that increasing initial and final lesion size is associated with poorer visual outcome.
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The lipochromes of sea anemones: Carotenoid pigments of Actinia equina, Anemonia sulcata, Actinoloba dianthus and Tealia felina. Biochem J 2006; 29:1384-8. [PMID: 16745804 PMCID: PMC1266640 DOI: 10.1042/bj0291384] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Pigmented marine animal oils: Pigments from the angler fish (Lophius piscatorius), the prawn (Nephrops norvegicus) and the whale. Biochem J 2006; 28:1698-701. [PMID: 16745566 PMCID: PMC1253391 DOI: 10.1042/bj0281698] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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The iron and copper contents and the haemopoietic activities of stomach and liver preparations. Biochem J 2006; 29:330-7. [PMID: 16745674 PMCID: PMC1266492 DOI: 10.1042/bj0290330] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
BACKGROUND Large clinical trials have emphasized that blood pressure control provides a major clinical benefit in reducing the risk of blindness in patients with diabetic retinopathy. METHODS This audit was carried out to assess the quality of care for hypertension in 100 consecutive type II diabetics with diabetic retinopathy. RESULTS The target blood pressure of 140/80 mmHg was achieved only in 38% of the patients. We also observed that 65% of the patients requiring diabetic macular laser treatment in this cohort had suboptimal control. The factors associated with suboptimal blood pressure control are identified and discussed. CONCLUSION Despite the unequivocal fact that lowering BP significantly reduces morbidity and mortality in diabetics, the majority of patients are not treated to a goal BP.
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Photodynamic therapy for age-related macular degeneration. Eye (Lond) 2005; 19:1027-8. [PMID: 15467697 DOI: 10.1038/sj.eye.6701722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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