The Meta VCI Map consortium for meta-analyses on strategic lesion locations for vascular cognitive impairment using lesion-symptom mapping: design and multicenter pilot study

Introduction: The Meta VCI Map consortium performs meta-analyses on strategic lesion locations for vascular cognitive impairment using lesion-symptom mapping. Integration of data from different cohorts will increase sample sizes, to improve brain lesion coverage and support comprehensive lesion-symptom mapping studies. Methods: Cohorts with available imaging on white matter hyperintensities or infarcts and cognitive testing were invited. We performed a pilot study to test the feasibility of multicenter data processing and analysis and determine the benefits to lesion coverage. Results: Forty-seven groups have joined Meta VCI Map (stroke n = 7800 patients; memory clinic n = 4900; population-based n = 14,400). The pilot study (six ischemic stroke cohorts, n = 878) demonstrated feasibility of multicenter data integration (computed tomography/magnetic resonance imaging) and achieved marked improvement of lesion coverage. Discussion: Meta VCI Map will provide new insights into the relevance of vascular lesion location for cognitive dysfunction. After the successful pilot study, further projects are being prepared. Other investigators are welcome to join

A multi-center study on the attitudes of Malaysian emergency health care staff towards allowing family presence during resuscitation of adult patients

BACKGROUND The practice of allowing family members to witness on-going active resuscitation has been gaining ground in many developed countries since it was first introduced in the early 1990s. In many Asian countries, the acceptability of this practice has not been well studied. AIM We conducted a multi-center questionnaire study to determine the attitudes of health care professionals in Malaysia towards family presence to witness ongoing medical procedures during resuscitation. METHODS Using a bilingual questionnaire (in Malay and English language), we asked our respondents about their attitudes towards allowing family presence (FP) as well as their actual experience of requests from families to be allowed to witness resuscitations. Multiple logistic regression was used to analyze the association between the many variables and a positive attitude towards FP. RESULTS Out of 300 health care professionals who received forms, 270 responded (a 90% response rate). Generally only 15.8% of our respondents agreed to allow relatives to witness resuscitations, although more than twice the number (38.5%) agreed that relatives do have a right to be around during resuscitation. Health care providers are significantly more likely to allow FP if the procedures are perceived as likely to be successful (e.g., intravenous cannulation and blood taking as compared to chest tube insertion). Doctors were more than twice as likely as paramedics to agree to FP (p-value = 0.002). This is probably due to the Malaysian work culture in our health care systems in which paramedics usually adopt a 'follow-the-leader' attitude in their daily practice. CONCLUSION The concept of allowing FP is not well accepted among our Malaysian health care providers

Analysis of shared heritability in common disorders of the brain

Paroxysmal Cerebral Disorder

The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day-Case Cholecystectomy Using the CholeS Data Set

Background Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables. Methods Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set. Results Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Same-day discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15–0.23), higher ASA scores (OR 0.19, 95% CI 0.15–0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58–0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48–0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34–0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of ≤5 was associated with 80.8% successful day-case cholecystectomy compared with 19.2% associated with a CAAD score >5 (p < 0.001). Conclusions The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy

Chemical Speciation of Arsenic and Antimony in Natural Water Systems and its Applications to Environmental Problems

A method for the speciation of trivalent and pentavalent states of inorganic arsenic (As) and antimony (Sb) in natural waters has been developed. The proposed method first extracts the trivalent As(III) and Sb(III) as pyrrolidinecarbodithioate (PCDT) complexes into chloroform, followed by a nitric acid back-extraction to recover the elements. Arsenic and Sb in the acid solution are determined by neutron activation analysis (NAA). The pentavalent species, As(V) and Sb(V), are reduced to the trivalent state using potassium iodide and sodium thiosulfate and then are extracted with PCDT for NAA. The two-step preconcentration procedure provides a large enrichment factor, eliminates the interfering matrix species, and extends the useful working range of NAA for As and Sb. The extraction method has also been applied to the determination of low levels of As and Sb in biological samples by NAA. The speciation method has been used to evaluate the distribution of As(III) and As(V) and its relation to other water quality parameters in the groundwater system of a major lead-zinc mine in the Coeur d'Alene Mining District of northern Idaho. It is known that mine wastes containing pyrite (FeS2) are capable of producing acid waters under oxidizing conditions, and the redox status of groundwater is an important factor in determining the degree of acid water formation and subsequent leaching of metals from mine tailings and ore bodies in this mining area. The results obtained from this study show that the relative concentrations of the arsenic redox pair are correlated with the quality of the mine waters studied and the ratio of As(V)/As(III) has the potential to be a redox indicator for groundwater systems. The river sediments of the South Fork and the Main Stem of the Coeur d'Alene River are contaminated with As, Sb, and other heavy metals from past mining activities. The distribution of As and Sb species in the river waters has been studied. Trivalent As(III) is the predominant form of arsenic in the South Fork and the Main Stem, whereas the unpolluted North Fork generally has a higher concentration of As(V). The major Sb species in the three branches of the river is Sb(V). Mobilization of sediment As and Sb during sediHent-water interactions has been investigated using laboratory leaching experiments. The releases of As and Sb are related to the free iron oxides and free manganese oxides of the sediments. The effects of the contaminated sediments on the water quality, with respect to As and Sb, of the creeks surrounding the Blackbird area in east-central Idaho have also been investigated. The pentavalent As(V) and Sb(V) are the major species observed in the creek waters. The field observations are consistent with the leaching experiments performed in the laboratory. The contaminated sediments are non-point sources of pollution which should be considered for water quality management planning of the mining areas studied

Vascular cognitive impairment

The term vascular cognitive impairment (VCI) was introduced around the start of the new millennium and refers to the contribution of vascular pathology to any severity of cognitive impairment, ranging from subjective cognitive decline and mild cognitive impairment to dementia. Although vascular pathology is common in elderly individuals with cognitive decline, pure vascular dementia (that is, dementia caused solely by vascular pathology) is uncommon. Indeed, most patients with vascular dementia also have other types of pathology, the most common of which is Alzheimer disease (specifically, the diffuse accumulation of amyloid-\u3b2 plaques and neurofibrillary tangles composed of tau). At present, the main treatment for VCI is prevention by treating vascular diseases and other risk factors for VCI, such as hypertension and diabetes mellitus. Despite the current paucity of disease-modifying pharmacological treatments, we foresee that eventually, we might be able to target specific brain diseases to prevent cognitive decline and dementia

Augmentation of 5-lipoxygenase activity and expression during dengue serotype-2 infection

10.1186/1743-422X-10-322Virology Journal1032