Inter-rater agreement of the Quality of Life-Alzheimer's Disease (QoL-AD) self-rating and proxy rating scale: secondary analysis of RightTimePlaceCare data

Background: To assess the quality of life of people with dementia, measures are required for self-rating by the person with dementia, and for proxy rating by others. The Quality of Life in Alzheimer's Disease scale (QoL-AD) is available in two versions, QoL-AD-SR (self-rating) and QoL-AD-PR (proxy rating). The aim of our study was to analyse the inter-rater agreement between self-and proxy ratings, in terms of both the total score and the items, including an analysis specific to care setting, and to identify factors associated with this agreement.Methods: Cross-sectional QoL-AD data from the 7th Framework European RightTimePlaceCare study were analysed. A total of 1330 cases were included: n = 854 receiving home care and n = 476 receiving institutional long-term nursing care. The proxy raters were informal carers (home care) and best-informed professional carers (institutional long-term nursing care). Inter-rater agreement was investigated using Bland-Altman plots for the QoL-AD total score and by weighted kappa statistics for single items. Associations were investigated by regression analysis.Results: The overall QoL-AD assessment of those with dementia revealed a mean value of 33.2 points, and the proxy ratings revealed a mean value of 29.8 points. The Bland-Altman plots revealed a poor agreement between self-and proxy ratings for the overall sample and for both care settings. With one exception (item 'Marriage' weighted kappa 0.26), the weighted kappa values for the single QoL-AD items were below 0.20, indicating poor agreement. Home care setting, dementia-related behavioural and psychological symptoms, and the functional status of the person with dementia, along with the caregiver burden, were associated with the level of agreement. Only the home care setting was associated with an increase larger than the predefined acceptable difference between self-and proxy ratings.Conclusions: Proxy quality of life ratings from professional and informal carers appear to be lower than the self-ratings of those with dementia. QoL-AD-SR and QoL-AD-PR are therefore not interchangeable, as the inter-rater agreement differs distinctly. Thus, a proxy rating should be judged as a complementary perspective for a self-assessment of quality of life by those with dementia, rather than as a valid substitute

Automatic determination of the dynamic geometry of abdominal aortic aneurysm from MR with application to wall stress simulations

The current surgical intervention criterion for abdominal aortic aneurysm is based on the maximum transverse diameter of the aorta. Recent research advances indicate that a better rupture predictor may be derived from the wall stress, which can be computed with the finite element method. An essential prerequisite for this modelling is an accurate description of the geometry of the aneurysm. We developed an automatic method to derive the dynamic patient-specific aneurysm geometry from non-contrast enhanced MRA balanced turbo field images. The slices of our 2D-scanned volumes are registered onto 3D-scanned volumes to restore spatial coherence. The resulting images are noise-filtered and the enddiastolic volume is segmented with an active objects technique (deformable models). The resulting geometrical model is propagated to the remaining phases using the correlation between grey value profiles on the surface as an external force for the active object. From our segmentations we derived tetrahedral finite element meshes which were used as the input for finite element wall stress simulations

CPAnet Registry-An International Chronic Pulmonary Aspergillosis Registry

Chronic pulmonary aspergillosis (CPA) is a chronic fungal infection of the lung associated with high morbidity and mortality. The CPA Research network (CPAnet) registry established in 2018 is an international multicenter collaboration aiming to improve CPA knowledge and patient care. This study's aim was to describe the data collection process and content of CPAnet registry with preliminary clinical data. In the CPAnet registry, clinical data are collected through a web-based questionnaire. Data include CPA phenotype, comorbidities, treatment, outcome, and follow-up from several international centers. An exemplary descriptive analysis was performed on 74 patients, who were registered online before April 2020. CPA patients were predominantly (72%) male, 39% had chronic obstructive pulmonary disease, and 68% had a history of smoking. Chronic cavitary pulmonary aspergillosis was the most common CPA subtype (62%). In 32 patients (52%), voriconazole was the preferred first-line therapy. The multicenter multinational CPAnet registry is a valuable approach to gather comprehensive data on a large study population and reflects real-world clinical practice rather than focusing on specific patient populations in more specialized centers. Additional CPA reference centers are being encouraged to join this promising clinical research collaboration

High-Performance Liquid Chromatographic Analysis of Drugs of Abuse in Biologic Samples

Recently, drug abuse has become a serious social problem world wide. In Japan, methamphetamine (MP) is the most popular drug of abuse. In addition to MP, the use of 4,5-methylenedioxymethamphetamine (MDMA), called ecstacy, is rapidly increasing, especially among young people. The development of simple and convenient analytical methods for the analysis of these drugs of abuse is necessary for the prediction of and protection from human health risks. Many useful methods have been developed for qualification and quantification of drugs of abuse. Among these, gas chromatography with mass spectrometry (MS) and high-performance liquid chromatography with MS (HPLC-MS or LC-MS) or fluorescence (HPLC-FL) detection are widely used. As highly sensitive methods, precolumn or postcolumn derivatization methods are commonly utilized in HPLC. This review focuses on HPLC methods used for the practical analysis of drugs of abuse, mainly for amphetamine derivatives and MDMAs in biologic samples such as urine, blood, and hair

Treatment outcome definitions in chronic pulmonary aspergillosis: a CPAnet consensus statement

International audienc