Stroke treatment academic industry roundtable recommendations for individual data pooling analyses in stroke

Pooled analysis of individual patient data from stroke trials can deliver more precise estimates of treatment effect, enhance power to examine prespecified subgroups, and facilitate exploration of treatment-modifying influences. Analysis plans should be declared, and preferably published, before trial results are known. For pooling trials that used diverse analytic approaches, an ordinal analysis is favored, with justification for considering deaths and severe disability jointly. Because trial pooling is an incremental process, analyses should follow a sequential approach, with statistical adjustment for iterations. Updated analyses should be published when revised conclusions have a clinical implication. However, caution is recommended in declaring pooled findings that may prejudice ongoing trials, unless clinical implications are compelling. All contributing trial teams should contribute to leadership, data verification, and authorship of pooled analyses. Development work is needed to enable reliable inferences to be drawn about individual drug or device effects that contribute to a pooled analysis, versus a class effect, if the treatment strategy combines ≥2 such drugs or devices. Despite the practical challenges, pooled analyses are powerful and essential tools in interpreting clinical trial findings and advancing clinical care

Letter by Scheitz et al regarding article, "Randomized controlled trial of early versus delayed statin therapy in patients with acute ischemic stroke: ASSORT trial (administration of statin on acute ischemic stroke patient)"

No abstract available

Cancer and communication: similarities and differences of men with cancer from six different ethnic groups.

Objective To report the communication aspects of a pilot study, which explored the cancer meanings and experiences of six men with cancer and their significant others from different ethnic groups. Design Case study design using the principles of phenomenology. In-depth semi-structured individual interviews with men with cancer and their wives were conducted. Setting London, UK. Interviews took place in participants’ own homes. Respondents Six men with cancer and their wives from different ethnic groups. Intervention The pilot study explored the participants’ experiences and meanings of cancer. However, this paper only deals with the communication aspects of the findings. Results Ten themes emerged from the comparative analysis of the study’s data, with communication as a cross-cutting theme. Further analysis of this theme revealed similarities and differences of the participants’ experiences of communicating with health professionals; families or friends; and God/Allah. In addition, similarities and differences of communicating meanings of cancer in different cultures were revealed. Conclusion The findings revealed similarities in the way that men from these six cultures communicate with health professionals and their families following a diagnosis of cancer, and differences in how they communicated with God/Allah, which depended on their religious beliefs and practices

Developing culturally competent researchers

Background Whilst we live in multi-cultural societies most health researchers tend to take the cultural perspective of the majority ethnic group at the expense of the perspective of minority ethnic groups. Aim This paper discusses the need for the development of culturally competent health researchers in all areas of research and proposes a model for the achievement of this. Design A snapshot review of research textbooks used in nursing curricula was conducted to identify whether culturally competent research was being promoted. Results The review found that whilst a few textbooks touched on ethnicity, race and culture, none of them addressed the issue of culturally competence. Subsequently the authors adapted their existing model of culturally competent health care practice, and in this paper they propose it as a model for the development of culturally competent researchers. Discussion The model put forward by the authors consists of four concepts: cultural awareness, cultural knowledge, cultural sensitivity and cultural competence. A culturally competent researcher is one who is able to apply the related skills and knowledge in project design, data collection, analysis, report writing and dissemination. Furthermore, the authors identify two layers of cultural competence, those of culture-generic (knowledge and skills that are applicable across ethnic groups) and culture-specific competence (knowledge and skills that relate to a particular ethnic group). The relationship between these two layers is a dynamic and spiralling process as illustrated by the model. Conclusion Current health policy in many developed countries focuses on inequalities of health and managing diversity, including ethnicity. Thus the authors conclude that the development of culturally competent researchers will lead to both valid research and culturally competent practice by health care professionals

Insulator–metal transitions in Pr0.7Ca0.3MnO3 induced by a magnetic field

A magnetic field induced insulator to metal transition has been observed in both polycrystalline and single crystals samples of Pr0.7Ca0.3MnO3. Application of a magnetic field leads to a first-order phase transition from an insulating to a conducting state at low temperatures. The hysteresis associated with this transition allows the resistivity at 4 K to be varied by more than eight orders of magnitude depending on the field history of the sample

Magnetic properties of geometrically frustrated SrGd2O4

A study of the magnetic properties of the frustrated rare earth oxide SrGd2O4 has been completed using bulk property measurements of magnetization, susceptibility and specific heat on single crystal samples. Two zero-field phase transitions have been identified at 2.73 and 0.48 K. For the field, H, applied along the a and b axes, a single boundary is identified that delineates the transition from a low field, low temperature magnetically ordered regime to a high field, high temperature paramagnetic phase. Several field-induced transitions, however, have been observed with H || c. The measurements have been used to map out the magnetic phase diagram of SrGd2O4, suggesting that it is a complex system with several competing magnetic interactions. The low-temperature magnetic behavior of SrGd2O4 is very different compared to the other SrLn2O4 (Ln = Lanthanide) compounds, even though all of the SrLn2O4 compounds are isostructural, with the magnetic ions forming a low-dimensional lattice of zigzag chains that run along the c axis. The differences are likely to be due to the fact that in the ground state Gd3+ has zero orbital angular momentum and therefore the spin-orbit interactions, which are crucial for other SrLn2O4 compounds, can largely be neglected. Instead, given the relatively short Gd3+-Gd3+ distances in SrGd2O4, dipolar interactions must be taken into account for this antiferromagnet alongside the Heisenberg exchange terms.Comment: 10 pages, 9 figure

Remotely triggered scaffolds for controlled release of pharmaceuticals

Fe3O4-Au hybrid nanoparticles (HNPs) have shown increasing potential for biomedical applications such as image guided stimuli responsive drug delivery. Incorporation of the unique properties of HNPs into thermally responsive scaffolds holds great potential for future biomedical applications. Here we successfully fabricated smart scaffolds based on thermo-responsive poly(N-isopropylacrylamide) (pNiPAM). Nanoparticles providing localized trigger of heating when irradiated with a short laser burst were found to give rise to remote control of bulk polymer shrinkage. Gold-coated iron oxide nanoparticles were synthesized using wet chemical precipitation methods followed by electrochemical coating. After subsequent functionalization of particles with allyl methyl sulfide, mercaptodecane, cysteamine and poly(ethylene glycol) thiol to enhance stability, detailed biological safety was determined using live/dead staining and cell membrane integrity studies through lactate dehydrogenase (LDH) quantification. The PEG coated HNPs did not show significant cytotoxic effect or adverse cellular response on exposure to 7F2 cells (p < 0.05) and were carried forward for scaffold incorporation. The pNiPAM-HNP composite scaffolds were investigated for their potential as thermally triggered systems using a Q-switched Nd:YAG laser. These studies show that incorporation of HNPs resulted in scaffold deformation after very short irradiation times (seconds) due to internal structural heating. Our data highlights the potential of these hybrid-scaffold constructs for exploitation in drug delivery, using methylene blue as a model drug being released during remote structural change of the scaffold