Publications by authors named "Sandra Neumann"

29 Publications

  • Page 1 of 1

Feasibility of Wave Intensity Analysis in Patients With Conotruncal Anomalies Before and After Pregnancy: New Physiological Insights?

Front Pediatr 2020 4;8:557407. Epub 2021 Mar 4.

Bristol Heart Institute, University Hospitals Bristol, Bristol, United Kingdom.

Conotruncal anomalies (CTA) are associated with ongoing dilation of the aortic root, as well as increased aortic stiffness, which may relate to intrinsic properties of the aorta. Pregnancy hormones lead to hemodynamic changes and remodeling of the , resulting in the opposite effect, i.e., increasing distensibility. These changes normalize post-pregnancy in healthy women but have not been fully investigated in CTA patients. We examined aortic distensibility and ventriculo-arterial coupling before and after pregnancy using cardiovascular magnetic resonance (CMR)-derived wave intensity analysis (WIA). Pre- and post-pregnancy CMR data were retrospectively analyzed. Aortic diameters were measured before, during, and after pregnancy by cardiac ultrasound and before and after pregnancy by CMR. Phase contrast MR flow sequences were used for calculating wave speed () and intensity (WI). A matched analysis was performed comparing results before and after pregnancy. Thirteen women ( = 5, transposition of the great arteries; = 6, tetralogy of Fallot; = 1, double outlet right ventricle, = 1, ) had 19 pregnancies. Median time between delivery and second CMR was 2.3 years (range: 1-6 years). The aortic diameter increased significantly after pregnancy in nine ( = 9) patients by a median of 4 ± 2.3 mm (range: 2-7.0 mm, = 0.01). There was no difference in c pre-/post-pregnancy ( = 0.73), suggesting that increased compliance, typically observed during pregnancy, does not persist long term. A significant inverse relationship was observed between and heart rate (HR) after pregnancy ( = 0.01, = 0.73). There was no significant difference in cardiac output, aortic/pulmonary regurgitation, or WI peaks pre-/post-pregnancy. WIA is feasible in this population and could provide physiological insights in larger cohorts. Aortic distensibility and wave intensity did not change before and after pregnancy in CTA patients, despite an increase in diameter, suggesting that pregnancy did not adversely affect coupling in the long-term.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fped.2020.557407DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7969497PMC
March 2021

A Snapshot of the Response from UK-based Clinical Trials of Investigational Medicinal Products to COVID-19.

Cureus 2020 Sep 23;12(9):e10613. Epub 2020 Sep 23.

Internal Medicine: Geriatrics, Royal United Hospitals Bath National Health Service Foundation Trust, Bath, GBR.

Background/Aims Coronavirus Disease 2019 (COVID-19) has presented an unprecedented challenge for non-COVID related clinical trials of investigational medicinal medicines (CTIMPs). These challenges are considerable for trials run in high -risk groups, such as older adults. Clinical trials must ensure the safety of their participants, whilst also considering the potential, and often long-term, benefits of the trial intervention to public health. Here we sought to provide a brief perspective on the response and conduct of CTIMPs relevant to older adults and neurology in the UK to the COVID-19 pandemic. Methods We performed a cross-sectional study, surveying CTIMP teams running trials broadly relevant to older adults and neurology in the UK, as well as sponsors and Clinical Trials Units (CTU), to understand the response and preparedness to the pandemic. Results Due to the pandemic, active recruitment has been suspended in more than half of the trials. The primary driver for the temporary halt of recruitment activity was considerations of patient safety. Interestingly, the majority of trials, sponsors and CTUs did not consider pandemic or epidemic outbreaks in their risk assessments before January 2020. Conclusion These findings support the need to re-evaluate the risk-management approach whereby clinical trials establish contingency plans for predicted but rare events to minimise the disruption to recruitment and clinical trial delivery.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.10613DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7584312PMC
September 2020

Validity and Reliability of the German Quality of Life-Alzheimer's Disease (QoL-AD) Self-Report Scale.

J Alzheimers Dis 2020 ;77(2):581-590

Inclusive Education of Children with Communication Needs, University Erfurt, Erfurt, Germany.

Background: The Quality of Life-Alzheimer's Disease (QoL-AD) scale is a widely used measure of quality of life (QoL) in dementia. Although the instrument has been validated in several languages, the psychometric properties of the German self-report version have not yet been analyzed.

Objective: This study examines the internal consistency, test-retest reliability, and construct validity of the German QoL-AD self-report scale.

Methods: The sample included 30 patients suffering from mild to moderate Alzheimer's disease or vascular dementia (19 females; mean age 77.3 years; mean Mini-Mental State Examination (MMSE) score 19.7 points). To determine test-retest reliability, the QoL-AD self-report scale was re-administered four to seven days apart. For construct validity analysis, the Dementia Quality of Life instrument (DQoL), Geriatric Depression Scale (GDS), MMSE, and an adapted short form of the Neuropsychiatric Inventory (NPI) were used.

Results: The German QoL-AD self-report scale shows an internal consistency of α= 0.79 and a test-retest reliability of r = 0.75 (p < 0.01). Regarding construct validity, there was a significant positive correlation between the total scores of the QoL-AD and DQoL (r = 0.47, p < 0.05). The analysis revealed no significant correlations with the GDS or the adapted NPI. No association could be observed between the QoL-AD and the MMSE (r = 0.01), confirming divergent validity.

Conclusion: The results indicate that the German QoL-AD self-report scale is a suitable instrument for assessing QoL in patients suffering from mild to moderate dementia, thus supporting its use in clinical practice and research.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3233/JAD-200400DOI Listing
January 2020

Value of Eye-Tracking Data for Classification of Information Processing-Intensive Handling Tasks: Quasi-Experimental Study on Cognition and User Interface Design.

JMIR Hum Factors 2020 Jun 3;7(2):e15581. Epub 2020 Jun 3.

Product Development Group Zurich, Institute of Design, Materials and Fabrication, Department of Mechanical and Process Engineering, Swiss Federal Institute of Technology in Zurich, Zürich, Switzerland.

Background: In order to give a wide range of people the opportunity to ensure and support home care, one approach is to develop medical devices that are as user-friendly as possible. This allows nonexperts to use medical devices that were originally too complicated to use. For a user-centric development of such medical devices, it is essential to understand which user interface design best supports patients, caregivers, and health care professionals.

Objective: Using the benefits of mobile eye tracking, this work aims to gain a deeper understanding of the challenges of user cognition. As a consequence, its goal is to identify the obstacles to the usability of the features of two different designs of a single medical device user interface. The medical device is a patient assistance device for home use in peritoneal dialysis therapy.

Methods: A total of 16 participants, with a subset of seniors (8/16, mean age 73.7 years) and young adults (8/16, mean age 25.0 years), were recruited and participated in this study. The handling cycle consisted of seven main tasks. Data analysis started with the analysis of task effectiveness for searching for error-related tasks. Subsequently, the in-depth gaze data analysis focused on these identified critical tasks. In order to understand the challenges of user cognition in critical tasks, gaze data were analyzed with respect to individual user interface features of the medical device system. Therefore, it focused on the two dimensions of dwell time and fixation duration of the gaze.

Results: In total, 97% of the handling steps for design 1 and 96% for design 2 were performed correctly, with the main challenges being task 1 insert, task 2 connect, and task 6 disconnect for both designs. In order to understand the two analyzed dimensions of the physiological measurements simultaneously, the authors propose a new graphical representation. It distinguishes four different patterns to compare the eye movements associated with the two designs. The patterns identified for the critical tasks are consistent with the results of the task performance.

Conclusions: This study showed that mobile eye tracking provides insights into information processing in intensive handling tasks related to individual user interface features. The evaluation of each feature of the user interface promises an optimal design by combining the best found features. In this way, manufacturers are able to develop products that can be used by untrained people without prior knowledge. This would allow home care to be provided not only by highly qualified nurses and caregivers, but also by patients themselves, partners, children, or neighbors.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2196/15581DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7301256PMC
June 2020

COVID-19 in older people: a rapid clinical review.

Age Ageing 2020 07;49(4):501-515

Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.

Introduction: the COVID-19 pandemic poses a high risk to older people. The aim of this article is to provide a rapid overview of the COVID-19 literature, with a specific focus on older adults. We frame our findings within an overview of the disease and have also evaluated the inclusion of older people within forthcoming clinical trials.

Methods: we searched PubMed and bioRxiv/medRxiv to identify English language papers describing the testing, treatment and prognosis of COVID-19. PubMed and bioRxiv/medRxiv searches took place on 20 and 24 March 2020, respectively.

Results: screening of over 1,100 peer-reviewed and pre-print papers yielded n = 22 on COVID-19 testing, n = 15 on treatment and n = 13 on prognosis. Viral polymerase chain reaction (PCR) and serology are the mainstays of testing, but a positive diagnosis may be increasingly supported by radiological findings. The current evidence for the effectiveness of antiviral, corticosteroid and immunotherapies is inconclusive, although trial data are largely based on younger people. In addition to age, male gender and comorbidities, specific laboratory and radiology findings are important prognostic factors. Evidence suggests that social distancing policies could have important negative consequences, particularly if in place for an extended period.

Conclusion: given the established association between increasing age and poor prognosis in COVID-19, we anticipate that this rapid review of the current and emergent evidence might form a basis on which future work can be established. Exclusion of older people, particularly those with comorbidities, from clinical trials is well recognised and is potentially being perpetuated in the field of current COVID-19 research.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/ageing/afaa093DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7239238PMC
July 2020

Retrograde blood flow in the internal jugular veins of humans with hypertension may have implications for cerebral arterial blood flow.

Eur Radiol 2020 Jul 10;30(7):3890-3899. Epub 2020 Mar 10.

BHI CardioNomics Research Group, Clinical Research and Imaging Centre-Bristol, School of Physiology, Pharmacology & Neuroscience, University of Bristol, Bristol, BS8 1TD, UK.

Objectives: To use multi-parametric magnetic resonance imaging (MRI) to test the hypothesis that hypertensives would have higher retrograde venous blood flow (RVBF) in the internal jugular veins (IJV) vs. normotensives, and that this would inversely correlate with arterial inflow and gray matter, white matter, and cerebrospinal fluid volumes.

Methods: Following local institutional review board approval and written consent, a prospective observational 3-T MRI study of 42 hypertensive patients (53 ± 2 years, BMI 28.2 ± 0.6 kg/m, ambulatory daytime systolic BP 148 ± 2 mmHg, ambulatory daytime diastolic BP 101 ± 2 mmHg) and 35 normotensive patients (48 ± 2 years, BMI 25.2 ± 0.8 kg/m, ambulatory daytime systolic BP 119 ± 3 mmHg, ambulatory daytime diastolic BP 90 ± 2 mmHg) was performed. Phase contrast imaging calculated percentage retrograde venous blood flow (%RVBF), brain segmentation estimated regional brain volumes from 3D T1-weighted images, and pseudo-continuous arterial spin labeling measured regional cerebral blood perfusion. Statistical analysis included two-sample equal variance Student's T tests, two-way analysis of variance with Tukey's post hoc correction, and permutation-based two-group general linear modeling (p < 0.05).

Results: In the left IJV, %RVBF was higher in hypertensives (6.1 ± 1.5%) vs. normotensives (1.1 ± 0.3%, p = 0.003). In hypertensives, there was an inverse relationship of %RVBF (permutation-based general linear modeling) to cerebral blood flow in several brain regions, including the left occipital pole and the cerebellar vermis (p < 0.01). Percentage retrograde flow in the left IJV correlated inversely with the total matter volume (gray plus white matter volume) in hypertensives (r = - 0.49, p = 0.004).

Conclusion: RVBF in the left IJV is greater in hypertensives vs. normotensives and is linked to regional hypoperfusion and brain total matter volume.

Key Points: • Hypertensive humans have higher retrograde cerebral venous blood flow, associated with regional brain hypoperfusion and lower tissue volume, compared with controls. • Cerebral retrograde venous blood flow may add further stress to already hypoperfused tissue in hypertensive patients. • The amount of retrograde venous blood flow in hypertensive patients may predict which patients might be at higher risk of developing cerebral pathologies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00330-020-06752-6DOI Listing
July 2020

Artificial intelligence outperforms human students in conducting neurosurgical audits.

Clin Neurol Neurosurg 2020 05 10;192:105732. Epub 2020 Feb 10.

Department of Physiology and Pharmacology, Clinical Research and Imaging Centre, University of Bristol, UK. Electronic address:

Objectives: Neurosurgical audits are an important part of improving the safety, efficiency and quality of care but require considerable resources, time, and funding. To that end, the advent of the Artificial Intelligence-based algorithms offered a novel, more economically viable solution. The aim of the study was to evaluate whether the algorithm can indeed outperform humans in that task.

Patients & Methods: Forty-six human students were invited to inspect the clinical notes of 45 medical outliers on a neurosurgical ward. The aim of the task was to produce a report containing a quantitative analysis of the scale of the problem (e.g. time to discharge) and a qualitative list of suggestions on how to improve the patient flow, quality of care, and healthcare costs. The Artificial Intelligence-based Frideswide algorithm (FwA) was used to analyse the same dataset.

Results: The FwA produced 44 recommendations whilst human students reported an average of 3.89. The mean time to deliver the final report was 5.80 s for the FwA and 10.21 days for humans. The mean relative error for factual inaccuracy for humans was 14.75 % for total waiting times and 81.06 % for times between investigations. The report produced by the FwA was entirely factually correct. 13 out of 46 students submitted an unfinished audit, 3 out of 46 made an overdue submission. Thematic analysis revealed numerous internal contradictions of the recommendations given by human students.

Conclusion: The AI-based algorithm can produce significantly more recommendations in shorter time. The audits conducted by the AI are more factually accurate (0 % error rate) and logically consistent (no thematic contradictions). This study shows that the algorithm can produce reliable neurosurgical audits for a fraction of the resources required to conduct it by human means.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.clineuro.2020.105732DOI Listing
May 2020

Incidental Follow-up Imaging of Previous Ventricular Tuberculosis and Pneumoencephalography in a 57-year-old man.

Cureus 2019 Dec 10;11(12):e6340. Epub 2019 Dec 10.

Surgery, Bristol Medical School, University of Bristol, Bristol, GBR.

We present a rare case of follow-up by neuroimaging in a 57-year-old man with a previous pneumoencephalography to evaluate ventricular tuberculosis (TB). Magnetic resonance imaging (MRI) of the whole head was performed at 3T using T1-weighted magnetization-prepared rapid gradient echo (T1-MPRAGE). A full quantitative sensory testing battery on the forearm was also performed, alongside a brief clinical examination. All test results were normal with the exception of the T1-MPRAGE which showed enlarged ventricles and a cyst-like focal changes, mistaken for a sign of old ischaemic infarct. The change, however, is consistent with the insertion of a cannula for the pneumoencephalogram. This is the first follow-up report with neuroimaging presented nearly 40 years after the diagnosis of ventricular TB.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.6340DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6952033PMC
December 2019

Cerebral Blood Flow Response to Simulated Hypovolemia in Essential Hypertension: A Magnetic Resonance Imaging Study.

Hypertension 2019 12 28;74(6):1391-1398. Epub 2019 Oct 28.

From the Faculty of Life Sciences, School of Physiology, Pharmacology and Neuroscience (S.N., Z.H.A., J.B., A.K.N., J.P., E.C.H.), University of Bristol, United Kingdom.

Hypertension is associated with raised cerebral vascular resistance and cerebrovascular remodeling. It is currently unclear whether the cerebral circulation can maintain cerebral blood flow (CBF) during reductions in cardiac output (CO) in hypertensive patients thereby avoiding hypoperfusion of the brain. We hypothesized that hypertension would impair the ability to effectively regulate CBF during simulated hypovolemia. In the present study, 39 participants (13 normotensive, 13 controlled, and 13 uncontrolled hypertensives; mean age±SD, 55±10 years) underwent lower body negative pressure (LBNP) at -20, -40, and -50 mmHg to decrease central blood volume. Phase-contrast MR angiography was used to measure flow in the basilar and internal carotid arteries, as well as the ascending aorta. CBF and CO decreased during LBNP (<0.0001). Heart rate increased during LBNP, reaching significance at -50 mmHg (<0.0001). There was no change in mean arterial pressure during LBNP (=0.3). All participants showed similar reductions in CBF (=0.3, between groups) and CO (=0.7, between groups) during LBNP. There was no difference in resting CBF between the groups (=0.36). In summary, during reductions in CO induced by hypovolemic stress, mean arterial pressure is maintained but CBF declines indicating that CBF is dependent on CO in middle-aged normotensive and hypertensive volunteers. Hypertension is not associated with impairments in the CBF response to reduced CO.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1161/HYPERTENSIONAHA.119.13229DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7069391PMC
December 2019

Imaging the carotid atherosclerotic plaque.

Vasc Biol 2019 28;1(1):H53-H58. Epub 2019 Jun 28.

Research and Imaging Centre (CRIC) Bristol, University of Bristol, Bristol, UK.

This mini review provides a concise overview of imaging techniques that are currently used to image the atheroscletoric plaque in the carotid artery . The main techniques include ultrasound imaging, X-ray imaging, magnetic resonance imaging and positron emission tomography imaging. Each technique has advantages and limitations and may be chosen depending on the availability, cost and clinical justification for its use. Common to all the imaging techniques presented here is the need for a skilled imaging professional to allow for high reliability and repeatability. While ultrasound-based imaging currently is regarded as a first line technique in clinical practice, the use of other techniques such as computed tomography angiography or magnetic resonance angiography need to be considered in the presence of significant stenosis with or without symptoms. Advancements in these two modalities, as well as in positron emission tomography imaging, are increasingly moving toward a better understanding of the risk-stratification and pre-interventional monitoring of patients at risk of plaque rupture as well as early identification of plaque development and better understanding of plaque composition (e.g. metabolic imaging).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1530/VB-19-0010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7439847PMC
June 2019

Diagnostic accuracy of frontotemporal dementia. An artificial intelligence-powered study of symptoms, imaging and clinical judgement.

Adv Med Sci 2019 Sep 2;64(2):292-302. Epub 2019 Apr 2.

Bristol Institute of Clinical Neurosciences, University of Bristol, Southmead Hospital, Bristol, UK.

Purpose: Frontotemporal dementia (FTD) is a neurodegenerative disorder associated with a poor prognosis and a substantial reduction in quality of life. The rate of misdiagnosis of FTD is very high, with patients often waiting for years without a firm diagnosis. This study investigates the current state of the misdiagnosis of FTD using a novel artificial intelligence-based algorithm.

Patients & Methods: An artificial intelligence algorithm has been developed to retrospectively analyse the patient journeys of 47 individuals diagnosed with FTD (age range 52-80). The algorithm analysed the efficiency of patient pathways by utilizing a reward signal of ‒1 to +1 to assess the symptoms, imaging techniques, and clinical judgement in both behavioural and language variants of the disease.

Results: On average, every patient was subjected to 4.93 investigations, of which 67.4% were radiological scans. From first presentation it took on average 939 days for a firm diagnosis. The mean time between appointments was 204 days, and the average patient had their diagnosis altered 7.37 times during their journey. The algorithm proposed improvements by evaluating the interventions that resulted in a decreased reward signal to both the individual and the population as a whole.

Conclusions: The study proves that the algorithm can efficiently guide clinical practice and improve the accuracy of the diagnosis of FTD whilst making the process of auditing faster and more economically viable.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.advms.2019.03.002DOI Listing
September 2019

Quality of life in adults with neurogenic speech-language-communication difficulties: A systematic review of existing measures.

J Commun Disord 2019 May - Jun;79:24-45. Epub 2019 Feb 11.

Pedagogics and Therapy in Speech-Language Disorders, Faculty of Human Sciences, University of Cologne, Klosterstr. 79b, 50931 Cologne, Germany. Electronic address:

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jcomdis.2019.01.003DOI Listing
July 2020

Validation of the German Version of the Transsexual Voice Questionnaire for Male-to-Female Transsexuals.

J Voice 2020 Jan 29;34(1):68-77. Epub 2018 Aug 29.

Department of Health Services Research, School of Medicine and Health Sciences, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany.

Objective: The purpose of this study was to examine the psychometric properties of the German translation of the Transsexual Voice Questionnaire for Male-to-Female Transsexuals (TVQ), an instrument assessing the voice-related quality of life (VrQoL) in trans women.

Study Design: This is a cross-sectional study.

Method: The conducted online survey contained the TVQ as well as a generic measurement of VrQoL (Voice Handicap Index) and items on transition. Data of 127 trans women were analyzed computing coefficients of reliability and convergent validity. Additionally, confirmatory factor analysis and model modification were performed.

Results: Analyses revealed excellent internal consistency (α = 0.97), split-half reliability (r = 0.95) and good convergent validity. Significant associations were found between the total scores of the German TVQ and the Voice Handicap Index (r = 0.88; P < 0.001) as well as the vocal self-perception (r = -0.57; P < 0.001). An acceptable model with a two-factor structure including 22 of the 30 items was found.

Conclusions: The TVQ is the first German reliable and valid measurement of VrQoL for trans women. Therefore, its utilization can be recommended for clinical and research purposes in the fields of voice therapy and surgery.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jvoice.2018.06.010DOI Listing
January 2020

Frideswide - An artificial intelligence deep learning algorithm for audits and quality improvement in the neurosurgical practice.

Int J Surg 2017 Jul 24;43:56-57. Epub 2017 May 24.

Department of Physiology and Pharmacology, Clinical Research and Imaging Centre, University of Bristol, 60 St Michael's Hill, BS2 8DX, Bristol, UK. Electronic address:

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijsu.2017.05.038DOI Listing
July 2017

The German Focus on the Outcomes of Communication Under Six (FOCUS-G): Reliability and Validity of a Novel Assessment of Communicative Participation.

J Speech Lang Hear Res 2017 03;60(3):675-681

Department of Special Education and Rehabilitation, Faculty of Human Sciences, University of Cologne, Germany.

Purpose: Our purpose was to explore the validity and reliability of the German Focus on the Outcomes of Communication Under Six (FOCUS-G; Thomas-Stonell, Oddson, Robertson, & Rosenbaum, 2010, 2012), which is an authorized adaptation of the Focus on the Outcomes of Communication Under Six (Thomas-Stonell et al., 2010) tool, which measures communicative participation in preschool children.

Method: Parents of typically developing children (TDC) and of children with speech impairment (CSI) completed the FOCUS-G and the Questionnaire for Measuring Health-Related Quality of Life in Children (KiddyKINDL; Ravens-Sieberer & Bullinger, 2000). To determine test-retest reliability, the FOCUS-G was readministered to a subsample of parents 1 week later.

Results: The FOCUS-G had high values for internal consistency (α = .959, Ω = .941), test-retest reliability (intraclass correlation coefficient = .974), and split-half reliability (r = .832). Total scores on the FOCUS-G and KiddyKINDL demonstrated significant associations. FOCUS-G total scores and subdomain scores for both samples showed significant correlations, indicating good construct validity. The discriminatory ability of the FOCUS-G was indicated by significantly higher mean scores for TDC (M = 6.03, SD = 0.65) than CSI (M = 5.47, SD = 1.02).

Conclusion: The overall good psychometric properties of this novel assessment of communicative participation support its use by speech-language pathologists for clinical and research purposes with German-speaking children.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1044/2016_JSLHR-L-15-0219DOI Listing
March 2017

The German Intelligibility in Context Scale (ICS-G): reliability and validity evidence.

Int J Lang Commun Disord 2017 09 29;52(5):585-594. Epub 2016 Dec 29.

University of Cologne, Faculty of Human Sciences, Department of Special Education and Rehabilitation, Pedagogics and Therapy in Speech-Language Disorders, Cologne, Germany.

Background: In 2012 the Intelligibility in Context Scale (ICS) was published as a parent-report screening assessment that considers parents' perceptions of their children's functional intelligibility with a range of communication partners that differ in levels of authority and familiarity in real-life situations. To date, the ICS has been translated into 60 languages (including German).

Aims: To evaluate the psychometric properties of the German translation of the ICS ( = ICS-G), especially its reliability and validity, using four objective measures of speech sound disorder (SSD) severity: percentage of consonants correct (PCC); percentage of initial consonants correct (PICC); percentage of vowels correct (PVC); and percentage of phonemes correct (PPC).

Methods & Procedures: Children who were typically developing (TD) and children with SSD (n = 181; 90 males, 81 females; mean age = 4.18 years, SD = 0.79 years, range = 3;0-5;11 years) were recruited through 13 kindergartens and 15 speech-language pathologists (SLPs) in Germany. All children's parents completed the ICS-G. To obtain an insight into the severity of SSD (n = 30), children's speech skills were assessed with PLAKSS-II. For the analysis of test-retest reliability the ICS-G was re-administered with a subsample of parents (n = 36) after 1 week.

Outcomes & Results: The ICS-G had high internal consistency (α = .95, p < .001) and high test-retest reliability (r = .998, p < .001). The ICS-G total scores and item scores for both samples showed significant correlations, indicating good construct validity. Analyses revealed low but significant correlations with external factors (e.g., age, social class). Criterion validity was established through significant correlations between the ICS-G and scores for PCC (r = .43), PICC (r = .43), PVC (r = .62) and PPC (r = .47). The discriminatory ability of the ICS-G was indicated by significantly higher mean scores for the TD group (mean = 4.49, SD = 0.47) than the SSD group (mean = 3.97, SD = 0.63).

Conclusions & Implications: The overall good psychometric properties of the ICS-G support its use by SLPs for clinical and research purposes with German-speaking children.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/1460-6984.12303DOI Listing
September 2017

Is High Blood Pressure Self-Protection for the Brain?

Circ Res 2016 Dec 26;119(12):e140-e151. Epub 2016 Sep 26.

From the Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff University, United Kingdom (E.A.H.W., R.G.W.); CardioNomics Research Group, Clinical Research and Imaging Centre (J.C.L.R., A.E.B., S.N., L.E.K.R., N.E.M., A.K.N., J.F.R.P., E.C.H.) and School of Physiology, Pharmacology, and Neuroscience, Biomedical Sciences (J.C.L.R., S.N., L.E.K.R., Z.A., J.F.R.P., E.C.H.), University of Bristol, United Kingdom; University Hospitals Bristol NHS Foundation Trust, United Kingdom (S.N., L.E.K.R., Z.A., J.F.R.P., E.C.H.); Department of Radiology, University of Calgary, Canada (A.D.H.); and CAIR Program, Alberta Children's Hospital Research Institute, University of Calgary, Hotchkiss Brain Institute, Canada (A.D.H.).

Rationale: Data from animal models of hypertension indicate that high blood pressure may develop as a vital mechanism to maintain adequate blood flow to the brain. We propose that congenital vascular variants of the posterior cerebral circulation and cerebral hypoperfusion could partially explain the pathogenesis of essential hypertension, which remains enigmatic in 95% of patients.

Objective: To evaluate the role of the cerebral circulation in the pathophysiology of hypertension.

Methods And Results: We completed a series of retrospective and mechanistic case-control magnetic resonance imaging and physiological studies in normotensive and hypertensive humans (n=259). Interestingly, in humans with hypertension, we report a higher prevalence of congenital cerebrovascular variants; vertebral artery hypoplasia, and an incomplete posterior circle of Willis, which were coupled with increased cerebral vascular resistance, reduced cerebral blood flow, and a higher incidence of lacunar type infarcts. Causally, cerebral vascular resistance was elevated before the onset of hypertension and elevated sympathetic nerve activity (n=126). Interestingly, untreated hypertensive patients (n=20) had a cerebral blood flow similar to age-matched controls (n=28). However, participants receiving antihypertensive therapy (with blood pressure controlled below target levels) had reduced cerebral perfusion (n=19). Finally, elevated cerebral vascular resistance was a predictor of hypertension, suggesting that it may be a novel prognostic or diagnostic marker (n=126).

Conclusions: Our data indicate that congenital cerebrovascular variants in the posterior circulation and the associated cerebral hypoperfusion may be a factor in triggering hypertension. Therefore, lowering blood pressure may worsen cerebral perfusion in susceptible individuals.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1161/CIRCRESAHA.116.309493DOI Listing
December 2016

First description of Escherichia coli producing CTX-M-15- extended spectrum beta lactamase (ESBL) in out-patients from south eastern Nigeria.

Ann Clin Microbiol Antimicrob 2012 Jul 23;11:19. Epub 2012 Jul 23.

Department of Applied Microbiology, Faculty of Biological Sciences, Ebonyi State University, P.M.B. 053, Abakaliki, Nigeria.

We studied the presence of extended spectrum beta lactamases (ESBLs) in 44 clinical isolates of Escherichia coli collected from out-patients in two university teaching hospitals in South-Eastern Nigeria. Species identification was performed by standard microbiology methods and re-confirmed by MALDI-TOF technology. Phenotypic characterization of ESBL enzymes was done by double disc synergy test and presence of ESBL genes was determined by specific PCR followed by sequencing. Transfer of plasmid DNA was carried out by transformation using E. coli DH5 as recipient strain. Phenotypic characterization identified all isolates to be ESBL positive. 77% of strains were from urine, 13.6% from vaginal swabs and 9.0% from wound swabs. 63.6% were from female patients, 68% were from outpatients and 95.5% from patients younger than 30 years. All ESBL producers were positive in a PCR for bla(CTX-M-1) cluster, in exemplary strains bla(CTX-M-15) was found by sequencing. In all strains ISEcp1 was found upstream and ORF477 downstream of bla(CTX-M). PCR for bla(TEM) and bla(OXA-1) was positive in 93.1% of strains, whereas bla(SHV) was not detected, aac(6')-Ib-cr was found in 97.7% of strains. RAPD analysis revealed seven different clonal groups named A through G with the majority of the strains (65.9%) belonging to clone A. Transfer of an ESBL plasmid with co-resistance to gentamicin, kanamycin, tobramycin, doxycycline and trimethropim-sulfamethoxazole was successful in 19 (43.2%) strains. This study showed a high rate of CTX-M-1 cluster - ESBLs in South-Eastern Nigeria and further confirms the worldwide spread of CTX-M ESBL in clinical isolates.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/1476-0711-11-19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3473344PMC
July 2012

Application of the International Classification of Functioning, Disability, and Health-Children and Youth Version (ICF-CY) to cleft lip and palate.

Cleft Palate Craniofac J 2012 May 31;49(3):325-46. Epub 2012 Jan 31.

Pedagogics and Therapy of Speech and Language Disorders, Faculty of Human Sciences, University of Cologne, Klosterstrasse 79b, D-50931 Köln, Germany.

Objective: In recent health policy discussions, the World Health Organization has urged member states to implement the International Classification of Functioning, Disability, and Health: Children and Youth Version in their clinical practice and research. The purpose of this study was to identify codes from the International Classification of Functioning, Disability, and Health: Children and Youth Version relevant for use among children with cleft lip and/or palate, thereby highlighting the potential value of these codes for interprofessional cleft palate-craniofacial teams.

Design: The scope of recent published research in the area of cleft lip and/or palate was reviewed and compared with meaningful terms identified from the International Classification of Functioning, Disability, and Health: Children and Youth Version. In a five-step procedure, a consensus-based list of terms was developed that was linked separately to International Classification of Functioning, Disability, and Health: Children and Youth Version categories and codes. This provided a first draft of a core set for use in the cleft lip and/or palate field.

Conclusions: Adopting International Classification of Functioning, Disability, and Health: Children and Youth Version domains in cleft lip and/or palate may aid experts in identifying appropriate starting points for assessment, counseling, and therapy. When used as a clinical tool, it encourages health care professionals to go beyond treatment and outcome perspectives that are focused solely on the child and to include the children's environment and their familial/societal context. In order to establish improved, evidence-based interdisciplinary treatments for children with cleft lip and/or palate, more studies are needed that seek to identify all the influencing conditions of activities, children's participation, and barriers/facilitators in their environments.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1597/10-145DOI Listing
May 2012

Construction and characterization of three knockout mutants of the fbl gene in Staphylococcus lugdunensis.

APMIS 2012 Feb 25;120(2):108-16. Epub 2011 Oct 25.

Department of Medical Microbiology, Institute for Hygiene and Microbiology, Ruhr-University Bochum, Germany.

Staphylococcus lugdunensis is an important human pathogen that causes infectious diseases similar to those caused by Staphylococcus aureus. In contrast to S. aureus, only a very few pathogenicity factors of S. lugdunensis have been characterized. Notably, a genetic manipulation of S. lugdunensis has not yet been described. Ours is the first report where transformation of three different plasmids (pBT2, pRB473, and pT181) into S. lugdunensis and a directed genetic manipulation of S. lugdunensis are described. We constructed fbl knockout mutants from three different strains of S. lugdunensis to show that at least in these strains, the fibrinogen binding is exclusively mediated by Fbl.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/j.1600-0463.2011.02819.xDOI Listing
February 2012

Effectiveness of nasopharyngoscopic biofeedback in clients with cleft palate speech: a systematic review.

Logoped Phoniatr Vocol 2012 Oct 7;37(3):95-106. Epub 2011 Dec 7.

Pedagogics and Therapy of Speech and Language Disorders, University of Cologne, Germany.

Objective: To conduct a systematic review analyzing the effectiveness of nasopharyngoscopic biofeedback in clients with cleft lip and palate and velopharyngeal dysfunction.

Method: Extensive electronic search and analysis of the databases of Cochrane Library, MEDLINE, EMBASE, ERIC, PsycInfo, CINAHL, AMED, [email protected], and German Databases, including all papers published since 1970 plus a manual search of the Cleft Palate-Craniofacial Journal (1970-3/2010).

Results: Six studies met the inclusion criteria. Their analysis reflects a low level of evidence and a broad heterogeneity concerning age range, intervention methods, and outcome measurement.

Conclusion: The analyzed studies show that nasopharyngoscopy may be effective only in combination with traditional speech therapy in helping patients with cleft palate speech optimize their velopharyngeal closure in articulation, but the quantity and quality of studies are limited.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3109/14015439.2011.638669DOI Listing
October 2012

Fbl is not involved in the invasion of eukaryotic epithelial and endothelial cells by Staphylococcus lugdunensis.

FEMS Microbiol Lett 2011 Nov 12;324(1):48-55. Epub 2011 Sep 12.

Institute for Hygiene and Microbiology, Department of Medical Microbiology, Ruhr-University of Bochum, Bochum, Germany.

For several Staphylococci, such as Staphylococcus aureus, Staphylococcus saprophyticus, and Staphylococcus epidermidis, invasion of eukaryotic cells has been described and this mechanism has been considered an important part of the infection process. The fibrinogen-binding protein (Fbl) of Staphylococcus lugdunensis, a homolog of the clumping factor A of S. aureus, has been described as fibrinogen-binding adhesin and might promote invasion of cells. We therefore characterized several clinical strains of S. lugdunensis in terms of whole cell fibrinogen and fibronectin binding and correlated these results with the invasion of epithelial and endothelial cells by S. lugdunensis. We described for the first time invasion of cells by S. lugdunensis. As invasion of cells by S. lugdunensis was only partly inhibited by cytochalasin D in contrast to a complete inhibition of invasion of cells by S. aureus, further invasion mechanisms are likely to be present in S. lugdunensis. In addition, the Fbl of S. lugdunensis is not involved in the invasion of cells as ruled out by an isogenic fbl mutant.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/j.1574-6968.2011.02382.xDOI Listing
November 2011

Occurrence of genes of putative fibrinogen binding proteins and hemolysins, as well as of their phenotypic correlates in isolates of S. lugdunensis of different origins.

BMC Res Notes 2011 Apr 8;4:113. Epub 2011 Apr 8.

Institute for Hygiene and Microbiology, Dept, for Medical Microbiology, University Bochum Universitätsstraße 150, Bochum, Germany.

Background: Staphylococcus lugdunensis is an important human pathogen that causes potentially fatal endocarditis, osteomyelitis and skin and soft tissue infections similar to diseases caused by Staphylococcus aureus. Nevertheless, in contrast to S. aureus, data on pathogenicity factors of S. lugdunensis is scarce. Two adhesins, a fibrinogen and a von Willebrand factor binding protein, and a S. lugdunensis synergistic hemolysin (SLUSH) have been previously described. Moreover, the newly sequenced genome of S. lugdunensis revealed genes of other putative fibrinogen binding adhesins and hemolysins. The aim of this study was to gain more insight into the occurrence of genes likely coding for fibrinogen binding adhesins and hemolysins using clinical strains of S. lugdunensis.

Findings: Most of the putative adhesin genes and hemolysin genes investigated in this study were highly prevalent, except for the SLUSH gene cluster. In contrast to previous reports, binding to fibrinogen was detected in 29.3% of the S. lugdunensis strains. In most strains, hemolysis on blood agar plates was weak after 24 h and distinct after 48 h of incubation. The fibrinogen binding and hemolysis phenotypes were also independent of the type of clinical specimen, from which the isolates were obtained.

Conclusion: In this study we described a pyrrolidonyl arylamidase negative S. lugdunensis isolate. Our data indicate that a matrix-assisted laser desorption ionisation time-of-flight MS-based identification of S. lugdunensis or species-specific PCR's should be performed in favour of pyrrolidonyl arylamidase testing. In contrast to the high occurrence of putative fibrinogen binding protein genes, 29.3% of the S. lugdunensis strains bound to fibrinogen. Putative hemolysin genes were also prevalent in most of the S. lugdunensis strains, irrespective of their hemolysis activity on Columbia blood agar plates. Similar to a previous report, hemolysis after 48 h of incubation is also indicative for S. lugdunensis. The SLUSH gene cluster was detected in an estimated 50% of the strains, indicating that this locus is different or non-prevalent in many strains.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/1756-0500-4-113DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3089787PMC
April 2011

Specific interactions between four molybdenum-binding proteins contribute to Mo-dependent gene regulation in Rhodobacter capsulatus.

J Bacteriol 2009 Aug 5;191(16):5205-15. Epub 2009 Jun 5.

Lehrstuhl für Biologie der Mikroorganismen, Fakultät für Biologie und Biotechnologie, Ruhr-Universität Bochum, 44780 Bochum, Germany.

The phototrophic purple bacterium Rhodobacter capsulatus encodes two transcriptional regulators, MopA and MopB, with partially overlapping and specific functions in molybdate-dependent gene regulation. Both MopA and MopB consist of an N-terminal DNA-binding helix-turn-helix domain and a C-terminal molybdate-binding di-MOP domain. They formed homodimers as apo-proteins and in the molybdate-bound state as shown by yeast two-hybrid (Y2H) studies, glutaraldehyde cross-linking, gel filtration chromatography, and copurification experiments. Y2H studies suggested that both the DNA-binding and the molybdate-binding domains contribute to dimer formation. Analysis of molybdate binding to MopA and MopB revealed a binding stoichiometry of four molybdate oxyanions per homodimer. Specific interaction partners of MopA and MopB were the molybdate transporter ATPase ModC and the molbindin-like Mop protein, respectively. Like other molbindins, the R. capsulatus Mop protein formed hexamers, which were stabilized by binding of six molybdate oxyanions per hexamer. Heteromer formation of MopA and MopB was shown by Y2H studies and copurification experiments. Reporter gene activity of a strictly MopA-dependent mop-lacZ fusion in mutant strains defective for either mopA, mopB, or both suggested that MopB negatively modulates expression of the mop promoter. We propose that depletion of the active MopA homodimer pool by formation of MopA-MopB heteromers might represent a fine-tuning mechanism controlling mop gene expression.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1128/JB.00526-09DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2725593PMC
August 2009

Cosmetic surgery: customer service or professional misconduct.

Authors:
Sandra Neumann

Can Vet J 2008 May;49(5):501-4

Arlington Animal Hospital, 3010-B Arlington Avenue, Saskatoon, Saskatchewan S7J 2J9.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2359499PMC
May 2008

The codes of practice.

Authors:
Sandra Neumann

Can Vet J 2008 Mar;49(3):218

View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2249711PMC
March 2008

Complete DNA sequence of the atp operon of the sodium-dependent F1Fo ATP synthase from Ilyobacter tartaricus and identification of the encoded subunits.

Biochim Biophys Acta 2003 Jan;1625(2):221-6

Institut für Mikrobiologie, Eidgenössische Technische Hochschule, Schmelzbergstrasse 7, LFV, CH-8092 Zürich, Switzerland.

The atp operon of Ilyobacter tartaricus, strain DSM 2382, was completely sequenced using conventional and inverse polymerase chain reaction (i-PCR) techniques. It contains nine open reading frames that were attributed to eight structural genes of the F(1)F(o) ATP synthase and the atpI gene, which is not part of the enzyme complex. The initiation codons of all atp genes, except that of atpB coding for the a subunit, were identified by the corresponding N-terminal amino acid sequence. The hydrophobic a subunit was identified by MALDI mass spectrometry. The atp genes of I. tartaricus are arranged in one operon with the sequence atpIBEFHAGDC comprising 6,992 base pairs with a GC content of 38.1%. The F(1)F(o) ATP synthase of I. tartaricus has a calculated molecular mass of 510 kDa and includes 4,810 amino acids. The gene sequences and products reveal significant identities to atp genes of other Na(+)-translocating F(1)F(o) ATP synthases, especially in the F(o) subunits a and c which are directly involved in ion translocation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/s0167-4781(02)00625-5DOI Listing
January 2003