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

Strong frequency conversion in heterogeneously integrated GaAs resonators

n this contribution, we demonstrate the first integrated gallium arsenide (GaAs) ring resonator for second harmonic generation (SHG) on a GaAs-on-insulator platform. Such resonators exhibit high nonlinear optical coefficients, a strong optical confinement, and intrinsic quality factors exceeding 2.6 × 105, which makes them very attractive for nonlinear optical applications. The fabricated resonators exhibit a great potential for frequency conversion: when 61 μW of pump power at 2 μm wavelength is coupled into the cavity, the absolute internal conversion efficiency is 4%. We predict an external SHG efficiency beyond 1 000 000%/W based on the GaAs resonance devices. Such nonlinear resonant devices of GaAs and its aluminum GaAs alloy can be directly integrated with active components in nonlinear photonic integrated circuits (PICs). This work paves a way for ultra-high efficient and compact frequency conversion elements in PICs

P2X receptors (version 2019.4) in the IUPHAR/BPS Guide to Pharmacology Database

P2X receptors (nomenclature as agreed by the NC-IUPHAR Subcommittee on P2X Receptors [46, 134]) have a trimeric topology [118, 132, 177] with two putative TM domains, gating primarily Na+, K+ and Ca2+, exceptionally Cl-. The Nomenclature Subcommittee has recommended that for P2X receptors, structural criteria should be the initial criteria for nomenclature where possible. X-ray crystallography indicates that functional P2X receptors are trimeric and three agonist molecules are required to bind to a single receptor in order to activate it [132, 88, 96, 161]. Native receptors may occur as either homotrimers (e.g. P2X1 in smooth muscle) or heterotrimers (e.g. P2X2:P2X3 in the nodose ganglion [251], P2X1:P2X5 in mouse cortical astrocytes [146], and P2X2:P2X5 in mouse dorsal root ganglion, spinal cord and mid pons [50, 207]. P2X2, P2X4 and P2X7 receptors have been shown to form functional homopolymers which, in turn, activate pores permeable to low molecular weight solutes [229]. The hemi-channel pannexin-1 has been implicated in the pore formation induced by P2X7 [188], but not P2X2 [38], receptor activation

Courts, climate litigation and the evolution of earth system law

Numerous scientific reports have evidenced the transformation of the earth system due to human activities. These changes – captured under the term ‘Anthropocene’ – require a new perspective on global law and policy. The concept of ‘earth system law’ situates law in an earth system context and offers a new perspective to interrogate the role of law in governing planetary challenges such as climate change. The discourse on earth system law has not yet fully recognised courts as actors that could shape climate governance, while climate litigation discourse has insufficiently considered aspects of earth system law. We posit that courts play an increasingly influential climate governance role and that they need to be recognised as Anthropocene institutions within the earth system law paradigm. Drawing on a set of prominent climate cases, we discuss five inter-related domains that are relevant for earth system law and where the potential influence of courts can be discerned: establishing accountability, redefining power relations, remedying vulnerabilities and injustices, increasing the reach and impact of international climate law and applying climate science to adjudicate legal disputes. We suggest that their innovative work in these domains could provide a basis for positioning courts as planetary climate governance actors

P2X receptors (version 2020.4) in the IUPHAR/BPS Guide to Pharmacology Database

P2X receptors (nomenclature as agreed by the NC-IUPHAR Subcommittee on P2X Receptors [48, 141]) have a trimeric topology [124, 139, 188] with two putative TM domains, gating primarily Na+, K+ and Ca2+, exceptionally Cl-. The Nomenclature Subcommittee has recommended that for P2X receptors, structural criteria should be the initial criteria for nomenclature where possible. X-ray crystallography indicates that functional P2X receptors are trimeric and three agonist molecules are required to bind to a single receptor in order to activate it [139, 93, 101, 170]. Native receptors may occur as either homotrimers (e.g. P2X1 in smooth muscle) or heterotrimers (e.g. P2X2:P2X3 in the nodose ganglion [265], P2X1:P2X5 in mouse cortical astrocytes [155], and P2X2:P2X5 in mouse dorsal root ganglion, spinal cord and mid pons [52, 221]. P2X2, P2X4 and P2X7 receptor activation can also lead to influx of large cationic molecules, such as NMDG, Yo-Pro, ethidium or propidium iodide [200]. The hemi-channel pannexin-1 was initially implicated in the action of P2X7 [201], but not P2X2, receptors [40], but this interpretation is probably misleading. Convincing evidence now supports the view that the activated P2X7 receptor is immediately permeable to large cationic molecules, but influx proceeds at a much slower pace than that of the small cations Na+, K+, and Ca2+ [64]

P2X receptors in GtoPdb v.2023.1

P2X receptors (nomenclature as agreed by the NC-IUPHAR Subcommittee on P2X Receptors [49, 146]) have a trimeric topology [118, 128, 144, 197] with two putative TM domains per P2X subunit, gating primarily Na+, K+ and Ca2+, exceptionally Cl-. The Nomenclature Subcommittee has recommended that for P2X receptors, structural criteria should be the initial basis for nomenclature where possible. X-ray crystallography indicates that functional P2X receptors are trimeric and three agonist molecules are required to bind to a single trimeric assembly in order to activate it [118, 144, 95, 103, 177]. Native receptors may occur as either homotrimers (e.g. P2X1 in smooth muscle) or heterotrimers (e.g. P2X2:P2X3 in the nodose ganglion [280], P2X1:P2X5 in mouse cortical astrocytes [162], and P2X2:P2X5 in mouse dorsal root ganglion, spinal cord and mid pons [53, 234]. P2X2, P2X4 and P2X7 receptor activation can lead to influx of large cationic molecules, such as NMDG+, Yo-Pro, ethidium or propidium iodide [211]. The permeability of the P2X7 receptor is modulated by the amount of cholesterol in the plasma membrane [193]. The hemi-channel pannexin-1 was initially implicated in the action of P2X7 [212], but not P2X2, receptors [41], but this interpretation is probably misleading [215]. Convincing evidence now supports the view that the activated P2X7 receptor is immediately permeable to large cationic molecules, but influx proceeds at a much slower pace than that of the small cations Na+, K+, and Ca2+ [66]

Fatigue Intervention by Nurses Evaluation - The FINE Trial. A randomised controlled trial of nurse led self-help treatment for patients in primary care with chronic fatigue syndrome: study protocol. [ISRCTN74156610]

Background: Chronic fatigue syndrome, also known as ME (CFS/ME), is a condition characterised primarily by severe, disabling fatigue, of unknown origin, which has a poor prognosis and serious personal and economic consequences. Evidence for the effectiveness of any treatment for CFS/ME in primary care, where most patients are seen, is sparse. Recently, a brief, pragmatic treatment for CFS/ME, based on a physiological dysregulation model of the condition, was shown to be successful in improving fatigue and physical functioning in patients in secondary care. The treatment involves providing patients with a readily understandable explanation of their symptoms, from which flows the rationale for a graded rehabilitative plan, developed collaboratively with the therapist. The present trial will test the effectiveness and cost-effectiveness of pragmatic rehabilitation when delivered by specially trained general nurses in primary care. We selected a client-centred counselling intervention, called supportive listening, as a comparison treatment. Counselling has been shown to be as effective as cognitive behaviour therapy for treating fatigue in primary care, is more readily available, and controls for supportive therapist contact time. Our control condition is treatment as usual by the general practitioner (GP). Methods and design: This study protocol describes the design of an ongoing, single-blind, pragmatic randomized controlled trial of a brief (18 week) self-help treatment, pragmatic rehabilitation, delivered by specially trained nurse-therapists in patients' homes, compared with nurse-therapist delivered supportive listening and treatment as usual by the GP. An economic evaluation, taking a societal viewpoint, is being carried out alongside the clinical trial. Three adult general nurses were trained over a six month period to deliver the two interventions. Patients aged over 18 and fulfilling the Oxford criteria for CFS are assessed at baseline, after the intervention, and again one year later. Primary outcomes are self-reported physical functioning and fatigue at one year, and will be analysed on an intention-to-treat basis. A qualitative study will examine the interventions' mechanisms of change, and also GPs' drivers and barriers towards referral

A comparative framework: how broadly applicable is a 'rigorous' critical junctures framework?

The paper tests Hogan and Doyle's (2007, 2008) framework for examining critical junctures. This framework sought to incorporate the concept of ideational change in understanding critical junctures. Until its development, frameworks utilized in identifying critical junctures were subjective, seeking only to identify crisis, and subsequent policy changes, arguing that one invariably led to the other, as both occurred around the same time. Hogan and Doyle (2007, 2008) hypothesized ideational change as an intermediating variable in their framework, determining if, and when, a crisis leads to radical policy change. Here we test this framework on cases similar to, but different from, those employed in developing the exemplar. This will enable us determine whether the framework's relegation of ideational change to a condition of crisis holds, or, if ideational change has more importance than is ascribed to it by this framework. This will also enable us determined if the framework itself is robust, and fit for the purposes it was designed to perform — identifying the nature of policy change