Derivation and validation of a modified short form of the stroke impact scale

Background: The Stroke Impact Scale (SIS) is a stroke-specific, quality of life measure recommended for research and clinical practice. Completion rates are suboptimal and could relate to test burden. We derived and validated a short form-SIS. Methods and Results: We examined data from the Virtual International Stroke Trial Archive, generating derivation and validation populations. We derived a short form (SF-SIS) by selecting one item per domain of SIS, choosing items most highly correlated with total domain score. Our validation described agreement of SF-SIS with original SIS and the SIS-16, and correlation with Barthel Index, modified Rankin Scale, NIHSS, and EQ-5D visual analogue scales. We assessed discriminative validity, (associations between SF-SIS and factors known to influence outcome [age, physiological parameters and comorbidity]). We assessed face validity and acceptability by sharing the SF-SIS with a focus group of stroke survivors and multidisciplinary stroke healthcare staff. From 5549 acute study patients (mean age: 68.5 (SD:13) years; mean SIS :64 [SD:32]) and 332 rehabilitation patients (mean age 65.7 [SD:11]; mean SIS:61 [SD:11]), we derived an 8-item SF-SIS that demonstrated good agreement with original SIS and good correlation with our chosen functional and QOL measures (all rho>0.70; p<0.0001). Significant associations were seen with our chosen predictors of stroke outcome in the acute group (p<0.0001). The focus group agreed with the choice of items for SF-SIS across 7/8 domains. Conclusions: Using multiple, complementary methods we have derived a short form SIS and demonstrated content, convergent and discriminant validity. This shortened SIS should allow collection of robust quality of life data with less associated test burden

Enhanced Inflammasome Activity in Systemic Lupus Erythematosus Is Mediated via Type I Interferon–Induced Up‐Regulation of Interferon Regulatory Factor 1

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138234/1/art40166_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138234/2/art40166.pd

Late Cretaceous (Maastrichtian) shallow water hydrocarbon seeps from Snow Hill and Seymour Islands, James Ross Basin, Antarctica

Fossil hydrocarbon seeps are present in latest Cretaceous (Maastrichtian) volcaniclastic shallow shelf sediments exposed on Snow Hill and Seymour Islands, James Ross Basin, Antarctica. The seeps occur in the Snow Hill Island Formation on Snow Hill Island and are manifest as large-sized, cement-rich carbonate bodies, containing abundant thyasirid bivalves and rarer ammonites and solemyid bivalves. These bodies have typical seep cement phases, with δ13C values between 20.4 and 10.7‰ and contain molecular fossils indicative of terrigenous organic material and the micro-organisms involved in the anaerobic oxidation of methane, including methanotrophic archaea and sulphate-reducing bacteria. On Seymour Island the seeps occur as micrite-cemented burrow systems in the López de Bertodano Formation and are associated with thyasirid, solemyid and lucinid bivalves, and background molluscan taxa. The cemented burrows also have typical seep cement phases, with δ13C values between 58.0 and 24.6‰. There is evidence from other data that hydrocarbon seepage was a common feature in the James Ross Basin throughout the Maastrichtian and into the Eocene. The Snow Hill and Seymour Island examples comprise the third known area of Maastrichtian hydrocarbon seepage. But compared to most other ancient and modern seep communities, the James Ross Basin seep fauna is of very low diversity, being dominated by infaunal bivalves, all of which probably had thiotrophic chemosymbionts, but which were unlikely to have been seep obligates. Absent from the James Ross Basin seep fauna are ‘typical’ obligate seep taxa from the Cretaceous and the Cenozoic. Reasons for this may have been temporal, palaeolatitudinal, palaeobathymetric, or palaeoecological

Associations between social support, mental wellbeing, self-efficacy and technology use in first-time antenatal women: data from the BaBBLeS cohort study

Background: Information and communication technologies are used increasingly to facilitate social networks and support women during the perinatal period. This paper presents data on how technology use affects the association between women’s social support and, (i) mental wellbeing and, (ii) self-efficacy in the antenatal period. Methods: Data were collected as part of an ongoing study - the BaBBLeS study - exploring the effect of a pregnancy and maternity software application (app) on maternal wellbeing and self-efficacy. Between September 2016 and February 2017, we aimed to recruit first-time pregnant women at 12–16 gestation weeks in five maternity sites across England and asked them to complete questionnaires. Outcomes included maternal mental wellbeing (Warwick-Edinburgh Mental Wellbeing Scale), and antenatal self-efficacy (antenatal version of the Tool to Measure Parenting Self-Efficacy). Other variables assessed were perceived social support (Multidimensional Scale of Perceived Social Support), general technology use (adapted from Media and Technology Usage and Attitudes Scale). Potential confounders were age, ethnicity, education, socioeconomic deprivation, employment, relationship status and recruitment site. Linear regression models were developed to analyse the relationship between social support and the outcomes. Results: Participants (n = 492, median age = 28 years) were predominantly white British (64.6%). Half of them had a degree or higher degree (49.3%), most were married/living with a partner (83.6%) and employed (86.2%). Median (LQ-UQ) overall scores were 81.0 (74.0–84.0) for social support (range 12–84), 5.1 (4.7–5.4) for technology use (range 1–6), 54.0 (48.0–60.0) for mental well-being (range 14–70), and 319.0 (295.5–340) for self-efficacy (range 0–360). Social support was significantly associated with antenatal mental well-being adjusting for confounders [adj R2 = 0.13, p < .001]. The addition of technology use did not alter this model [adj R2 = 0.13, p < .001]. Social support was also significantly associated with self-efficacy after adjustment [adj R2 = 0.14, p < .001]; technology had limited impact on this association [adj R2 = 0.13, p < .001]. Conclusions: Social support is associated with mental well-being and self-efficacy in antenatal first-time mothers. This association was not significantly affected by general technology use as measured in our survey. Future work should investigate whether pregnancy-specific technologies yield greater potential to enhance the perceived social support, wellbeing and self-efficacy of antenatal women

Tyrosine Kinases in Autoimmune and Inflammatory Skin Diseases

Tyrosine kinases relay signals from diverse leukocyte antigen receptors, innate immune receptors, and cytokine receptors, and therefore mediate the recruitment and activation of various leukocyte populations. Non-receptor tyrosine kinases of the Jak, Src, Syk, and Btk families play major roles in various immune-mediated disorders, and small-molecule tyrosine kinase inhibitors are emerging novel therapeutics in a number of those diseases. Autoimmune and inflammatory skin diseases represent a broad spectrum of immune-mediated diseases. Genetic and pharmacological studies in humans and mice support the role of tyrosine kinases in several inflammatory skin diseases. Atopic dermatitis and psoriasis are characterized by an inflammatory microenvironment which activates cytokine receptors coupled to the Jak-Stat signaling pathway. Jak kinases are also implicated in alopecia areata and vitiligo, skin disorders mediated by cytotoxic T lymphocytes. Genetic studies indicate a critical role for Src-family kinases and Syk in animal models of autoantibody-mediated blistering skin diseases. Here, we review the various tyrosine kinase signaling pathways and their role in various autoimmune and inflammatory skin diseases. Special emphasis will be placed on identification of potential therapeutic targets, as well as on ongoing preclinical and clinical studies for the treatment of inflammatory skin diseases by small-molecule tyrosine kinase inhibitors

Measuring quality of life in women with endometriosis: tests of data quality, score reliability, response rate and scaling assumptions of the Endometriosis Health Profile Questionnaire

To test the data quality, scaling assumptions and scoring algorithms underlying the Endometriosis Health Profile-30 (EHP-30) questionnaire: a questionnaire developed to measure the health-related quality of life (HRQoL) of women with endometriosis. METHODS: A cross-sectional postal survey to 727 women with surgically confirmed endometriosis recruited from an existing genetic linkage study (OXEGENE), The National Endometriosis Society (NES), UK and the outpatient gynaecology clinics of the Women’s Centre, John Radcliffe Hospital, Oxford. Tests of data quality included secondary factor analysis, internal reliability consistency, descriptive statistics of the data, missing data levels, floor and ceiling effects and corrected item to total correlation scores. RESULTS: Six hundred and ten women (83.9%) returned the questionnaire. Secondary factor analysis verified the domain structure of the EHP-30. All 11 dimensions were internally reliable with Cronbach’s scores ranging from 0.80 to 0.96. Missing response rates ranged from 0.2 to 1.3%, and all items were found to be most highly correlated with their own (corrected) scale. CONCLUSIONS: Results confirmed the factor structure, scoring and scaling assumptions of the questionnaire. The high rate of data completeness indicated that the EHP-30 was acceptable and understandable to the respondents, thereby verifying its suitability for measuring the HRQoL of women with endometriosis