Stroke Risk Screening Scales (SRSS): Identification of Domain and Item Generation

Academic research values: Conceptualization and initial steps of scale development

We draw on value theory in social psychology to conceptualize the range of motives that can influence researchers' attitudes, decisions, and actions. To conceptualize academic research values, we integrate theoretical insights from the literature on personal, work, and scientific work values, as well as the outcome of interviews and a survey among 255 participants about values relating to academic research. Finally, we propose a total of 246 academic research value items spread over 11 dimensions and 34 sub-themes. We relate our conceptualization and proposed items to existing work and provide recommendations for future scale development. Gaining a better understanding of researchers' different values can improve careers in science, attract a more diverse range of people to enter science, and elucidate some of the mechanisms that lead to both exemplary and questionable scientific practices.

The Evaluation of Content Relevance and Representativeness of the New Stroke Risk Screening Scales

Stroke is a leading cause of death and disability worldwide. Early and comprehensive risk identification is essential for identifying individuals at high risk for stroke. This study aimed to evaluate each question in the new Stroke Risk Screening Scales (SRSS) and assess the domains for content relevance and representativeness. Initially, six stroke experts were invited to evaluate the SRSS questions. The content validity index (CVI), including the item-CVI (I-CVI) and the average-CVI (Ave-CVI), was then calculated. In our study, the acceptable standards for I-CVI and Ave-CVI were ≥0.78 and ≥0.9, respectively. The results showed that all invited experts accepted the invitation and evaluated the SRSS questions. The previous version of the SRSS consisted of 33 questions. Of these, 30 questions reached an I-CVI of ≥0.78, indicating good content validity. Three questions had an I-CVI of 0.67 and were considered invalid; thus, they were deleted. The overall instrument achieved an Ave-CVI of 0.95. Comprehensive SRSS are essential for effective stroke prevention planning. By facilitating the early identification of individuals at high risk for stroke, these scales help reduce the incidence and impact of stroke. The high content validity found in this study supports the reliability of the SRSS as a screening tool. In the future, implementing such validated scales in clinical practice can improve early intervention strategies, ultimately enhancing health outcomes and optimizing the use of healthcare resources.

A prospective study of Acupuncture Combined With Modified Blood and Vessel Expelling Blood Stasis Tang in Treating Poststroke Facial Paralysis With Insomnia

OBJECTIVE

This study aimed to assess the clinical efficacy of acupuncture combined with modified Blood and Vessel Expelling Blood Stasis Tang in the treatment of poststroke patients experiencing facial paralysis and insomnia.

METHODS

A total of 120 patients with poststroke facial paralysis and insomnia were selected from the Department of Acupuncture and Moxibustion at the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine between January 2021 and January 2023. They were randomly assigned to either a control group or a study group, with 60 patients in each group. The control group received conventional treatment, while the study group received acupuncture combined with modified Blood and Vessel Expelling Blood Stasis Tang. The neurological function, facial paralysis, and sleep quality of the patients in both groups were compared.

RESULTS

The study group exhibited a significantly higher total effective rate compared with the control group (86.67% versus 66.67%). After treatment, both groups showed a significant reduction in National Institutes of Health Stroke Scale scores, with the study group demonstrating significantly lower scores than the control group. The Functional Disability Index scores for somatic functioning and social life functioning significantly improved in both groups after treatment, with the study group achieving significantly lower scores compared with the control group. The Sleep-Related Symptom Scale and Pittsburgh Sleep Quality Index scores significantly decreased in both groups after treatment, with the study group achieving significantly lower scores than the control group.

CONCLUSIONS

Acupuncture combined with modified Blood and Vessel Expelling Blood Stasis Tang effectively promotes recovery of neurological function and significantly improves facial paralysis and insomnia in patients with poststroke facial paralysis and insomnia. However, further research is warranted to validate these findings.

A Retrospective Analysis of the Underlying Health Status of Patients Treated for Stroke in the Emergency Department of a Community Hospital Situated in a Health Professional Shortage Area

Background Hypertension, diabetes, and hyperlipidemia are known contributors to the incidence of stroke. These and other risk factors such as smoking can be managed with effective primary care, but living in a medically underserved area and racial background can limit access, thereby deleteriously affecting underlying medical conditions and disproportionately contributing to negative stroke outcomes. Our goal is to learn about the on-admission health of 1,731 stroke patients who presented to the Crouse Hospital emergency department (ED) between January 2019 and January 2021 to better understand the circumstances affecting these patients. Crouse Hospital is a community hospital in Syracuse, New York, and an award-winning comprehensive stroke center in the region. The hospital is located in a health professional shortage area (HPSA) and serves both rural and urban patients of various ethnic backgrounds and socioeconomic statuses. Methodology We retrospectively examined the stroke patient data to determine how access to primary care and race affected smoking status, arrival time following the onset of symptoms, stroke severity, thrombolytic administration, and metrics relating to hypertension, diabetes, hyperlipidemia, and depression. Results We determined that, while most patients stated that they had a primary care provider, stroke incidents were typically associated with high blood pressure and high blood glucose despite the prevalence of prescriptions to treat these conditions and that both conditions affected the underserved and non-White patients (Black, Hispanic, Asian, Indigenous, and Other) more so than the served and White populations. Underserved and non-White patients, were also more likely to be associated with smoking behavior. Conclusions The data indicated the major health factors affecting the patients and highlighted those influenced by limited access to primary care and racial background. As a result, we developed a survey to gauge patients' perspectives on primary care and underlying medical conditions before and after their stroke. This patient-centered approach will help refine our stroke education efforts to improve stroke outcomes in the community.

Handlungsempfehlungen zur Risikominimierung beim Einsatz von Januskinase-Inhibitoren zur Therapie chronisch-entzündlicher Hauterkrankungen

Der Ausschuss für Risikobewertung (PRAC) der Europäischen Arzneimittelagentur (EMA) hat gemäß Artikel 20 der Verordnung (EG) Nr. 726/2004 die Sicherheit für Januskinase‐Inhibitoren für die Behandlung von Entzündungserkrankungen neu bewertet und von den bisherigen Hinweisen in den jeweiligen Fachinformationen der betreffenden Präparate abweichende Sicherheitsangaben formuliert. Diese beziehen sich arzneistoff‐ und indikationsübergreifend auf die Beachtung eines möglicherweise erhöhten Risikos für venöse thromboembolische oder schwere kardiovaskuläre Ereignisse, eine erhöhte Infektionsrate sowie eine Erhöhung der Prävalenz von Hautkrebs. Deshalb wird empfohlen, bei Patienten mit unabhängigen Risikofaktoren (Alter ab 65 Jahre, Raucher oder ehemalige Raucher, Patientinnen mit oraler Kontrazeption beziehungsweise Hormonersatztherapie sowie anderen Risikofaktoren) Januskinase‐Inhibitoren nur dann therapeutisch einzusetzen, wenn es keine geeigneten Behandlungsalternativen gibt. Um im klinischen Alltag eine pragmatische und sorgfältige Erfassung von Risikopatienten zu ermöglichen, wurde interdisziplinär eine Checkliste erarbeitet, die aus der Perspektive des Dermatologen als Arbeitsmittel geeignet ist.

Recommendations for risk minimization when using Janus kinase inhibitors for the treatment of chronic inflammatory skin diseases

In accordance with article 20 of Regulation (EC) No 726/2004, the Pharmacovigilance Risk Assessment Committee (PRAC) of the European Medicines Agency (EMA) has re-evaluated the safety of Janus kinase inhibitors for the treatment of inflammatory diseases and formulated safety information deviating from the previous indications in the respective summary of product characteristics of the products concerned. These refer to the consideration of a possibly increased risk of venous thromboembolic or severe cardiovascular events, an increased infection rate and an increase in the prevalence of skin cancer across drugs and indications. Therefore, in patients with independent risk factors (age 65 years and older, smokers or former smokers, patients with oral contraception or hormone replacement therapy and other risk factors), it is recommended to use Janus kinase inhibitors therapeutically only if there are no suitable treatment alternatives. To facilitate a pragmatic and thorough detection of high-risk patients in everyday clinical practice, an interdisciplinary checklist was developed that is suitable as a working tool from the perspective of the dermatologist.

Machine learning-based patient classification system for adults with stroke: A systematic review

OBJECTIVE

To evaluate the existing evidence of a machine learning-based classification system that stratifies patients with stroke.

METHODS

The authors carried out a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations for a review article. PubMed, MEDLINE, Web of Science, and CINAHL Plus Full Text were searched from January 2015 to February 2021.

RESULTS

There are twelve studies included in this systematic review. Fifteen algorithms were used in the included studies. The most common forms of machine learning (ML) used to classify stroke patients were the support vector machine (SVM) (n = 8 studies), followed by random forest (RF) (n = 7 studies), decision tree (DT) (n = 4 studies), gradient boosting (GB) (n = 4 studies), neural networks (NNs) (n = 3 studies), deep learning (n = 2 studies), and k-nearest neighbor (k-NN) (n = 2 studies), respectively. Forty-four features of inputs were used in the included studies, and age and gender are the most common features in the ML model.

DISCUSSION

There is no single algorithm that performed better or worse than all others at classifying patients with stroke, in part because different input data require different algorithms to achieve optimal outcomes.