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- Van Tiggelen, H., et al.
(författare)
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Standardising the classification of skin tears : validity and reliability testing of the International Skin Tear Advisory Panel (ISTAP) Classification System in 44 countries
- 2020
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Ingår i: British Journal of Dermatology. - : Wiley-Blackwell Publishing Inc.. - 0007-0963 .- 1365-2133. ; 183:1, s. 146-154
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Skin tears are acute wounds that are frequently misdiagnosed and underreported. A standardised and globally adopted skin tear classification system with supporting evidence for diagnostic validity and reliability is required to allow assessment and reporting in a consistent way.OBJECTIVES: To measure the validity and reliability of the International Skin Tear Advisory Panel (ISTAP) Classification System internationally.METHODS: A multi-country study was set up to validate the content of the ISTAP Classification System through expert consultation in a two-round Delphi procedure involving 17 experts from 11 countries. An online survey including 24 skin tear photographs was conducted in a convenience sample of 1601 healthcare professionals from 44 countries to measure diagnostic accuracy, agreement, inter-rater reliability, and intra-rater reliability of the instrument.RESULTS: A definition for the concept of a "skin flap" in the area of skin tears was developed and added to the initial ISTAP Classification System consisting of three skin tear types. The overall agreement with the reference standard was 0.79 (95% CI 0.79-0.80) and sensitivity ranged from 0.74 (95% CI 0.73-0.75) to 0.88 (95% CI 0.87-0.88). The inter-rater reliability was 0.57 (95% CI 0.57-0.57). The Cohen's Kappa measuring intra-rater reliability was 0.74 (95% CI 0.73-0.75).CONCLUSIONS: The ISTAP Classification System is supported by evidence for validity and reliability. The ISTAP Classification System should be used for a systematic assessment and reporting of skin tears in clinical practice and research globally.
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- Dunk, M., et al.
(författare)
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Evidence for a late Cambrian juvenile arc and a buried suture within the Laurentian Caledonides of Scotland : Comparisons with hyperextended Iapetan margins in the Appalachian Mountains (North America) and Norway
- 2019
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Ingår i: Geology. - 0091-7613 .- 1943-2682. ; 47:8, s. 734-738
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Tidskriftsartikel (refereegranskat)abstract
- Uranium-lead (U-Pb) zircon dating establishes a late Cambrian (Drumian) protolith age of 503 ± 2 Ma for a trondhjemitic gneiss of the calc-alkaline Strathy Complex, northern Scottish Caledonides. Positive εHf and εNd values from trondhjemitic gneisses and co-magmatic amphibolites, respectively, and an absence of any inheritance in zircon populations support published geochemistry that indicates a juvenile origin distal from Laurentia. In order to account for its present location within a stack of Laurentia-derived thrust sheets, we interpret the complex as allochthonous and located along a buried suture. We propose that a microcontinental ribbon was detached from Laurentia during late Neoproterozoic to Cambrian rifting; the intervening oceanic tract closed by subduction during the late Cambrian and formed a juvenile arc, the protolith of the Strathy Complex. The microcontinental ribbon was reattached to Laurentia during the Grampian orogeny, which transported the Strathy Complex as a tectonic slice within a nappe stack. Peak metamorphic conditions for the Strathy Complex arc (650–700 °C, 0.6–0.75 GPa) are intermediate in pressure between those published previously for Grampian mineral assemblages in structurally overlying low-pressure migmatites (670–750 °C, <0.4 GPa) that we deduce to have been derived from an adjacent backarc basin, and structurally underlying upper amphibolite rocks (650–700 °C, 1.1–1.2 GPa) that we interpret to represent the partially subducted Laurentian margin. This scenario compares with that of the northern Appalachian Mountains and Norway where microcontinental blocks are interpreted to have their origins in detachment from passive margins of the Iapetus Ocean during Cambrian rifting and to have been re-amalgamated during Caledonian orogenesis.
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- Dunk, Michelle M., et al.
(författare)
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Plasma oxysterols are associated with serum lipids and dementia risk in older women
- 2024
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Ingår i: Alzheimer's & Dementia. - 1552-5260 .- 1552-5279.
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Apolipoprotein E4 (APOE4) carriers’ tendency toward hypercholesterolemia may contribute to Alzheimer's disease (AD) risk through oxysterols, which traverse the blood-brain barrier.METHODS: Relationships between baseline plasma oxysterols, APOE status, serum lipids, and cognitive impairment risk were examined in 328 postmenopausal women from the Women's Health Initiative Memory Study. Women were followed for 25 years or until incident dementia or cognitive impairment.RESULTS: Levels of 24(S)-hydroxycholesterol (24-OHC), 27-hydroxycholesterol (27-OHC), and 24-OHC/27-OHC ratio did not differ by APOE status (p’s > 0.05). Higher 24-OHC and 27-OHC were associated with higher total, low density lipoprotein (LDL), non-high density lipoprotein (HDL), remnant, LDL/HDL, and total/HDL cholesterol and triglycerides (p’s < 0.05). Higher 24-OHC/27-OHC was associated with greater dementia risk (hazard ratio = 1.51, 95% confidence interval:1.02-2.22), which interaction analyses revealed as significant for APOE3 and APOE4+, but not APOE2+ carriers.DISCUSSION: Less favorable lipid profiles were associated with higher oxysterol levels. A higher ratio of 24-OHC/27-OHC may contribute to dementia risk in APOE3 and APOE4+ carriers.
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- Daniel, Terry C., et al.
(författare)
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Contributions of cultural services to the ecosystem services agenda
- 2012
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Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - : Proceedings of the National Academy of Sciences. - 0027-8424 .- 1091-6490. ; 109:23, s. 8812-8819
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Tidskriftsartikel (refereegranskat)abstract
- Cultural ecosystem services (ES) are consistently recognized but not yet adequately defined or integrated within the ES framework. A substantial body of models, methods, and data relevant to cultural services has been developed within the social and behavioral sciences before and outside of the ES approach. A selective review of work in landscape aesthetics, cultural heritage, outdoor recreation, and spiritual significance demonstrates opportunities for operationally defining cultural services in terms of socioecological models, consistent with the larger set of ES. Such models explicitly link ecological structures and functions with cultural values and benefits, facilitating communication between scientists and stakeholders and enabling economic, multicriterion, deliberative evaluation and other methods that can clarify tradeoffs and synergies involving cultural ES. Based on this approach, a common representation is offered that frames cultural services, along with all ES, by the relative contribution of relevant ecological structures and functions and by applicable social evaluation approaches. This perspective provides a foundation for merging ecological and social science epistemologies to define and integrate cultural services better within the broader ES framework.
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- Yang, Wenzhe, et al.
(författare)
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Association of cognitive reserve with the risk of dementia in the UK Biobank : role of polygenic factors
- 2024
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Ingår i: British Journal of Psychiatry. - 0007-1250 .- 1472-1465.
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIt remains unclear whether cognitive reserve can attenuate dementia risk among people with different genetic predispositions.Aims We aimed to examine the association between cognitive reserve and dementia, and further to explore whether and to what extent cognitive reserve may modify the risk effect of genetic factors on dementia.Method Within the UK Biobank, 210 631 dementia-free participants aged >= 60 years were followed to detect incident dementia. Dementia was ascertained through medical and death records. A composite cognitive reserve indicator encompassing education, occupation and multiple cognitively loaded activities was created using latent class analysis, categorised as low, moderate and high level. Polygenic risk scores for Alzheimer's disease were constructed to evaluate genetic risk for dementia, categorised by tertiles (high, moderate and low). Data were analysed using Cox models and Laplace regression.Results In multi-adjusted Cox models, the hazard ratio (HR) of dementia was 0.66 (95% confidence interval (CI) 0.61-0.70) for high cognitive reserve compared with low cognitive reserve. In Laplace regression, participants with high cognitive reserve developed dementia 1.62 (95% CI 1.35-1.88) years later than those with low cognitive reserve. In stratified analysis by genetic risk, high cognitive reserve was related to more than 30% lower dementia risk compared with low cognitive reserve in each stratum. There was an additive interaction between low cognitive reserve and high genetic risk on dementia (attributable proportion 0.24, 95% CI 0.17-0.31).Conclusions High cognitive reserve is associated with reduced risk of dementia and may delay dementia onset. Genetic risk for dementia may be mitigated by high cognitive reserve. Our findings underscore the importance of enhancing cognitive reserve in dementia prevention.
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