Development and Exploration of the Acceptability and Feasibility of a Novel Screening Tool for Anosognosia After Stroke, Designed for Routine Use in Hospital Settings.

Anosognosia, a neurological inability to acknowledge or comprehend one's own (dis)abilities, is a multi-faceted phenomenon which has consistently gained traction in research fields spanning psychology, neurology, and cognition since its conceptual introduction in 1914. Though anosognosia is not limited to following only neurological disease or injury, the majority of research has focused on the prevalence and mechanisms of anosognosia after stroke. Despite this, there is no clear consensus among the literature, and thus in clinical practice, as to how anosognosia after stroke should be assessed. This is startling given the plethora of studies which highlight anosognosia as a barrier to rehabilitation, a risk to safe discharge, and a predictor of poorer psychological and functional outcomes for both patients and their carers. Currently, there exists a vast number of assessment methods for anosognosia after stroke, which vary from performance- and observation-based tasks to self-report and discrepancy-based interviews; clinicians working in stroke make arbitrary choices as to which of these methods to use on a case-by-case basis, risking missed cases and subsequently noncomprehensive care. This research aims to develop a new screening tool for anosognosia that can be routinely implemented with post-stroke patients in hospital settings, to inform care, rehabilitation, and discharge. The study will explore the acceptability and feasibility of the new screening tool among multi-disciplinary staff working on a stroke rehabilitation unit, and provide grounds for future studies to assess the screen's psychometric properties and ability to inform novel interventions for anosognosia. Findings will have great implications for stroke survivors, their carers, and healthcare professionals alike.

开始日期2025-10-01

申办/合作机构

The University of Exeter

NCT07138664

/ RecruitingN/AIIT

Promoting Mental Health Among At-risk Adolescents in Malaysia

The primary objective of this trial is to evaluate a school-based intervention designed to promote mental health among at-risk adolescents from low-income communities in Malaysia. The study will employ a two-arm, cluster randomised controlled trial design, comparing a school-based intervention to a control condition. Adolescents will be recruited from at least 20 secondary schools located in economically disadvantaged rural and urban areas of Malaysia. Assessments will take place at multiple time points: during screening, at baseline (pre-intervention), immediately after the intervention (8 weeks), and at two follow-up points-6 and 12 months post-intervention. The primary outcomes are a reduction in anxiety and depressive symptoms, along with improved mental wellbeing at the 12-month follow-up.

开始日期2025-08-01

申办/合作机构

Roehampton University

[+6]

NCT07125365

/ RecruitingN/AIIT

UK Islet Autoantibody Registry

Type 1 diabetes (T1D) is a life-long condition where the immune system destroys part of the body (the pancreas) which makes the chemical, insulin. Insulin is needed to control blood sugar levels. Treatment involves life-long insulin replacement by injection or insulin pump.
Previous research has shown that the development of T1D occurs through different stages. This starts with a phase where there are no symptoms, which can last months or years, before symptoms of T1D develop and a person becomes unwell. The risk of developing T1D increases with presence of markers in the blood called islet autoantibodies. The risk of developing T1D increases with presence of markers in the blood called islet autoantibodies (IAb). Children with two or more IAb have an 80-90% chance of developing T1D within 15 years. It is almost certain that they will develop the condition in their lifetime. Children with only one IAb have a much lower risk of developing T1D (around 15%). Less is understood about the natural history of being IAb positive in adults, and the investigators hope this study will help them understand more.
The aim of the research is to understand what it is like to live with being at risk of T1D, what information and support people need, and whether they use NHS services more than others, for example due to being anxious about developing T1D. The investigators will work with the public and patient involvement group using information from the research and, with the charity Diabetes UK, to create a policy statement about the type of care that is needed to support these individuals.
To be able to do this research, tbhe investigators need first to recruit these rare individuals into one single registry of children, young people and adults who have islet autoantibodies in their blood. This will also allow the invetigators to collect data from individuals in the registry to compare this to data from other countries, to help understand why people progress from being islet autoantibody positive to requiring insulin in the UK.
People entering the registry will also be told if a drug is licensed in the UK to help delay T1D onset. Participants can also consent to be contacted about any research studies, which are testing drugs or interventions to prevent or delay the start of T1D.

开始日期2025-07-11

申办/合作机构

University of Oxford

[+10]

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0 项与 The University of Exeter 相关的专利（医药）

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19,427

项与 The University of Exeter 相关的文献（医药）

2025-11-01·PATIENT EDUCATION AND COUNSELING

How epilepsy risks might be introduced and discussed in clinical consultations

Article

作者: Tittensor, Phil ; Ashby, Samantha ; Devereux, Luke ; Smart, Cordet ; Newman, Craig ; Shankar, Rohit ; Gates, Louise ; Cock, Hannah

OBJECTIVE:

To explicate practices by which epilepsy expert clinicians broach discussions of risk in specialist epilepsy clinics.

METHODS:

24 recordings of initial telephone appointments at specialist clinics where epilepsy is diagnosed from two specialist outpatient epilepsy services in England were subjected to Conversation Analysis. Data in British English. A single case study, identified as largely typical of the data set but also highlighting points of interest, is included to illustrate the findings. We also present reflections from analysis of 12 extracts examined in joint-analysis sessions with clinicians, researchers and patients.

RESULTS:

The analysis revealed that broaching risk was sensitive and challenging. Conversations involved confronting confusion about risk and negotiation between clinician and patient. Clinicians employ questions to establish the patient's knowledge. They were 'repair implicative' that is including lots of changes of sentence direction to achieve mutual understanding (intersubjectivity). Further, the Joint-Analysis highlighted the significance of epistemic matters - who knows what and how.

CONCLUSION:

Clinicians invite patients to share what they know about risk as a springboard for discussing behaviour change, enabling them to avoid naming specific risks (such as death). However, this often led to interactional trouble, and patients expressed a preference for more direct conversations.

PRACTICE IMPLICATIONS:

Clinicians can carefully calibrate risk information according to what the patient with epilepsy already knows, sensitively broaching risk of death. However, caution is needed to maximise patient engagement in risk management discussions.

2025-08-01·Omega

Using Latent Profile Analysis to Understand Health Practitioners’ Attitudes Toward Voluntary Assisted Dying

Article

作者: Noonan, Kerrie ; Decety, Jean ; Louis, Winnifred R. ; Molenberghs, Pascal ; Forbat, Liz ; Breen, Lauren J. ; Minto, Kiara ; Wibisono, Susilo ; Thomas, Emma F. ; Lizzio-Wilson, Morgana ; Crane, Monique F. ; Amiot, Catherine E. ; Kho, Madison ; Allen, Felicity

Prior work has documented considerable diversity among health practitioners regarding their support for voluntary assisted dying (VAD). We examined whether their attitudes are characterised by different combinations of personal support, normative support by other health practitioners, and whether they are predisposed to vicariously experience others’ emotions (i.e., empathy). We also examined whether these profiles experienced different mental health outcomes (i.e., burnout and posttraumatic stress) in relation to VAD. To test this, 104 Australian health practitioners were surveyed after VAD was legalised in Victoria, Australia in 2019. Results indicated that practitioners’ attitudes were characterised by three profiles: 1) strong personal and normative support (strong VAD supporters), 2) moderate personal and normative support (moderate VAD supporters), and 3) lower personal and normative support (apprehensive practitioners). However, each profile reported similar mental health outcomes. Findings suggest that the normative environments in which health practitioners operate may explain their diverse attitudes on VAD.

2025-06-25·mSphere

The GATA-like transcription factor Gat201 determines alkaline-restricted growth in Cryptococcus neoformans

Article

作者: Tuck, Laura R. ; He, Zhenzhen ; Ballou, Elizabeth R. ; Wallace, Edward W. J. ; Hughes, Elizabeth S.

ABSTRACT:

The fungus Cryptococcus neoformans is an opportunistic human pathogen that causes fatal meningitis through uncontrolled proliferation in host tissues. Evasion of host defenses relies on a protective polysaccharide capsule, regulated, in part, by the GATA-like transcription factor Gat201. Gat201 additionally contributes to virulence through capsule-independent mechanisms. Here, we show that Gat201 affects the proliferation of C. neoformans : in RPMI-1640 cell culture media at an alkaline pH that restricts wild-type cell growth, gat201 ∆ strains show increased budding, growth, and viability. RNA-seq analysis shows that Gat201 pathway genes, including co-factors GAT204 and LIV3, are rapidly activated within minutes of inoculating C. neoformans in RPMI media, and strains mutated for GAT204 and, to a lesser extent, LIV3 also show improved growth. The effect of Gat201 on growth is pH-dependent: gat201 ∆ cells grow better than wild-type cells at high pH but worse than wild-type cells at neutral pH, in otherwise identical media. Together, this identifies the Gat201 pathway as an alkaline-responsive regulator of proliferation: Gat201 appears to govern an environment-dependent trade-off between proliferation and production of the defensive capsule. Furthermore, evolutionary analysis shows that Gat201 is in a subfamily of GATA-like transcription factors that is conserved within diverse fungi but absent in model yeasts. Together, our findings urge improved understanding of proliferation in diverse environmental niches in order to understand the mechanistic basis of fungal pathogenesis.

IMPORTANCE:

Infectious microorganisms must adapt to differences between external and host environments in order to colonize and cause disease. Cryptococcus neoformans is an encapsulated fungal pathogen that can infect human airways and travel to the brain to cause life-threatening meningitis. The airway is a dynamic environment characterized by nutrient limitation, high temperature (37°C), CO 2 , and transiently high pH (>8.5). In both the lung and brain, fungal proliferation through budding is a major driver of pathogenesis; however, the regulators of Cryptococcus proliferation are poorly understood and distinct from other model yeasts. In this work, we explore how Cryptococcus adapts to shifting environments and identify that the transcription factor Gat201, known to regulate capsule production, negatively regulates proliferation under alkaline conditions. Our findings highlight the need for improved understanding of proliferation/adaptation and its regulation in non-model systems.

157

项与 The University of Exeter 相关的新闻（医药）

2025-08-30

·ioncology

哪些早期乳腺癌女性易发生第二癌

点击蓝字，关注我们乳腺癌女性与普通女性相比，被认为容易发生第二癌，包括新的原发乳腺癌以及其他部位的原发癌。第二癌的风险和类型，可能受到首发乳腺癌治疗方法以及人口统计学特征、生活方式和遗传因素（包括可能导致首发乳腺癌的因素）的影响。既往关于第二癌的许多研究往往基于单一机构经验，而其他研究则基于人群。然而，大多数既往研究的规模或持续时间不足以分析这些长期风险的特征或评定患者特征、首发乳腺癌与第二癌风险的关联。乳腺癌康复者和临床医师需要了解第二癌的长期绝对风险，并考虑患者、肿瘤和治疗相关因素。 2025年8月27日，国际四大医学期刊之一、创刊于1840年的英国医学会官方期刊《英国医学杂志》在线发表牛津大学、埃克塞特大学、英格兰全国疾病登记中心的研究报告，对1993年至2016年英格兰47.6万例确诊早期乳腺浸润癌女性患者初次手术后发生第二癌的长期风险进行分析。该人群队列观察研究对英格兰全国癌症登记分析中心定期收集的数据进行筛选，其中1993年1月至2016年12月英格兰登记首发乳腺浸润癌术后年龄20至75岁女性共计47万6373例，随访数据截至2021年10月。主要结局衡量指标包括：与普通人群相比，第二癌（对侧原发乳腺癌和非乳腺第二原发癌）发生率和累积风险，与患者特征、首发肿瘤特征和术后治疗方法的相关性。结果发现，虽然6万4747例女性发生第二癌，但是与普通人群相比，20年累计风险绝对值相差不大：非乳腺癌症：13.59%比11.46%（相差2.13个百分点）对侧乳腺癌：5.55%比2.48%（相差3.07个百分点）不过，年轻女性与老年女性相比，对侧乳腺癌累计风险绝对值相差较大。对于不同类型的非乳腺癌症，乳腺癌女性与普通人群相比，20年累计风险绝对值相差最大的是子宫癌和肺癌。乳腺癌女性与普通人群相比，虽然子宫癌、软组织癌、骨关节癌、唾液腺癌和急性白血病的标准化发病率高1.5倍，但是各种非乳腺癌症类型20年累计风险绝对值相差都小于1%。根据术后治疗对患者进行分类时，放疗后对侧乳腺癌和肺癌风险略增加，内分泌治疗后子宫癌风险略增加、对侧乳腺癌风险略减少，化疗后急性白血病风险略增加。这些与随机对照研究报告结果一致，后者还发现与软组织癌、头颈癌、卵巢癌和胃癌的相关性，而既往研究并未观察到这些相关性。这表明，该队列全部6万4747例第二癌大约仅有2%可能归因于术后治疗，与普通人群相比多出来的1万5813例第二癌大约仅有7%可能归因于术后治疗，而且术后治疗获益大于风险。因此，该研究结果表明，1993年1月至2016年12月英格兰早期乳腺浸润癌治疗后女性与普通女性相比，20年第二癌累计风险略高。对侧乳腺癌大约占总风险增加的60%，而且年轻女性风险增加较高。术后治疗相关风险较低。对此，英国癌症患者独立之声组织和牛津大学纳菲尔德人口健康系发表同期观点：患者需要了解早期乳腺癌后第二癌风险。早期乳腺癌患者常常担心治疗后发生第二癌的风险。自从确诊并且治疗以后，患者既担心将来乳腺癌转移的风险，又担心乳腺癌病史和治疗相关疾病的风险，希望临床医师能够提供更多关于这些风险的详细信息。查找关于乳腺癌后发生第二癌风险的详细信息尤其困难，患者从与亲朋好友的交流得知，许多人认为确诊乳腺癌意味着患者可能容易发生其他癌症。现在我们知道，事实并非如此。当患者首次被确诊乳腺癌时，最关心的就是生存。随着时间的推移，发生第二癌的可能性开始让患者更加担心。经验表明，许多乳腺癌患者认为自己发生第二癌的风险比实际高得多。因此，当网络媒体虽然提供关于第二癌的信息，但是并未解释其风险时，患者可能更担心。本研究结果表明，第二癌的风险非常低，这让患者感到安心，值得广泛分享。该研究还表明内分泌治疗的重要性，有助于治疗原发癌并降低再次发生乳腺癌的风险。乳腺癌患者在经历治疗后，希望了解治疗的获益，该研究有助于正确看待治疗的长期风险；例如，患者通常认为放疗增加肺癌的风险，但是实际上该风险增加不到1%。如果现在建议患者接受放疗或药物治疗早期乳腺癌，可以提供将来发生第二癌风险的具体数据，让患者可以立即接受所需的治疗，因为将来可能导致其他癌症的风险很低。一般而言，治疗保护患者避免乳腺癌复发的获益远远超过潜在的负面影响。与患者讨论术后治疗时，临床医师应该提供此类信息。对于患者处于人生最艰难的时期之一，相信该研究结果应该可以给予一些安慰，此时有很多知识需要消化，虽然并非每位患者都想了解全部细节，但是这些信息应该提供给那些想要了解以及之后寻求帮助的患者。风险信息应该随时可以获取，有助于患者规划生活，并提前思考未来。 BMJ. 2025 Aug 27;390:e083975. IF: 42.7 Second cancers in 475000 women with early invasive breast cancer diagnosed in England during 1993-2016: population based observational cohort study. McGale P, Dodwell D, Challenger A, Cutter D, Williams A, Broggio J, Darby S, Mannu G, Taylor C. Nuffield Department of Population Health, University of Oxford, Oxford, UK; Oxford University Hospitals NHS Trust, Oxford, UK; University of Exeter Medical School, Exeter, UK; National Disease Registration Service (NDRS), NHS England, Birmingham, UK. OBJECTIVE: To describe long term risks of second non-breast primary cancers and contralateral breast cancers among women with early invasive breast cancer after primary surgery. DESIGN: Population based observational cohort study. SETTING: Routinely collected data from the National Cancer Registration and Analysis Service for England. PARTICIPANTS: All 476373 women with breast cancer as their first invasive (index) cancer registered in England from January 1993 to December 2016 with follow-up until October 2021. MAIN OUTCOME MEASURES: Rates and cumulative risks of subsequent primary cancers, compared with those occurring in the general population; associations with characteristics of patients, index tumours, and adjuvant treatments. RESULTS: Although 64747 women developed a second primary cancer, the absolute excess risks compared with risks in the general population were small. By 20 years, 13.6% (95% confidence interval 13.5% to 13.7%) of women had developed a non-breast cancer, 2.1% (2.0% to 2.3%) more than expected in the general population, and 5.6% (5.5% to 5.6%) had developed a contralateral breast cancer, 3.1% (3.0% to 3.2%) more than expected. The absolute excess risk of contralateral breast cancer was greater in younger than in older women. Among specific types of non-breast cancer, the largest 20 year absolute excess risks were for uterine and lung cancers. Although for cancers of the uterus, soft tissue, bones and joints, and salivary glands, as well as acute leukaemias, standardised incidence ratios exceeded those of the general population by a factor of at least 1.5, absolute excess risks at 20 years were <1% for every individual non-breast cancer type. When patients were categorised according to adjuvant treatment, radiotherapy was associated with increased contralateral breast and lung cancer, endocrine therapy with increased uterine cancer (but reduced contralateral breast cancer), and chemotherapy with increased acute leukaemia. These were consistent with effects reported in randomised trials, but positive associations for soft tissue, head and neck, ovarian, and stomach cancers were also identified, and these have not previously been observed in trials. This suggested that approximately 2% of all the 64747 second cancers and 7% of the 15813 excess second cancers in the cohort may be attributable to adjuvant therapies. CONCLUSIONS: The risk of a second primary cancer in women treated for early invasive breast cancer is slightly higher than for women in the general population. Contralateral breast cancer accounts for around 60% of the overall increase, with higher risks in younger women. The risk associated with adjuvant therapies is small. PMID: 40865997 DOI: 10.1136/bmj-2024-083975 BMJ. 2025 Aug 27;390:r1584. IF: 42.7 Patients need information on the risk of second cancer after early breast cancer. MacKenzie M, Stobart H, Dodwell D, Taylor C. Independent Cancer Patients' Voice (ICPV), London, UK; Nuffield Department of Population Health, University of Oxford, Oxford, UK. PMID: 40866002 DOI: 10.1136/bmj.r1584 （来源：SIBCS）声明凡署名原创的文章版权属《肿瘤瞭望》所有，欢迎分享、转载。本文仅供医疗卫生专业人士了解最新医药资讯参考使用，不代表本平台观点。该等信息不能以任何方式取代专业的医疗指导，也不应被视为诊疗建议，如果该信息被用于资讯以外的目的，本站及作者不承担相关责任。

临床研究临床结果

2025-08-26

·PRNewswire

Cerecin Joins NIHR HealthTech Research Centre in Brain Health as an Industry Partner

DENVER, Aug. 26, 2025 /PRNewswire/ -- Cerecin, a global biotech company focused on neurometabolism, is proud to announce its partnership with the NIHR HealthTech Research Centre (HRC) in Brain Health, joining a distinguished group of industry leaders including GE Healthcare, Novo Nordisk, Roche Diagnostics, and Camtech Innovations. Continue Reading The HRC, based at King's College London and the South London and Maudsley NHS Foundation Trust, is dedicated to advancing the diagnosis, care, and treatment of dementia through cutting-edge technologies. The Centre will leverage brain scanning, blood sampling, computerized testing, and digital tools to develop more effective and earlier methods of diagnosing dementia, aiming to reduce its societal impact. Led by Professor Dag Aarsland, Director of the Centre for Healthy Brain Ageing at the Institute of Psychiatry, Psychology and Neuroscience, and Professor Clive Ballard of the University of Exeter, the HRC brings together academic excellence and industry innovation to tackle one of the most pressing challenges in neuroscience. Commenting on the partnership, Dr. Charles Stacey, President & CEO of Cerecin, said: "We are excited to join the HRC as an industry partner. King's College London has a world-class reputation in neuroscience research, and we believe that close collaboration between academia and industry is essential to accelerate innovation and bring impactful solutions to market. We are honored to join other industry leaders in advancing the future of brain health." Dr. Richard Siow, Director of Ageing Research at King's (ARK) and Industry Lead for the NIHR HealthTech Research Centre in Brain Health, added: "We are pleased to welcome Cerecin as an industry partner. Cerecin is at the forefront of neurometabolism, a critical area of neuroscience research with the potential for significant impact to enhance healthy brain ageing. We look forward to working together to explore opportunities across Cerecin's pipeline and beyond." As Cerecin advances the ALTER AD study, its pivotal Phase 3 program in Alzheimer's disease dementia with lead compound, tricaprilin, the company is actively pursuing strategic partnerships to strengthen its leadership in the field. These collaborations will support the development of both its current pipeline and future innovations, both independently and in concert with other industry leaders. About Cerecin Cerecin is a US-based clinical-stage biotechnology company focused on developing drugs that target the metabolic basis of neurological diseases. Cerecin's development programs leverage its extensive experience in neurology drug development and lipid science. Cerecin is supported by multinational partners; Nestlé, Wilmar and IOI. By combining the deep expertise of its leadership team with a highly differentiated drug development program, Cerecin is becoming a global leader in neurology therapeutics. Cerecin's lead compound, tricaprilin, is currently in Phase 3, the ALTER AD study, for mild to moderate Alzheimer's disease dementia. Tricaprilin enhances ketone production by delivering medium-chain fatty acids directly to hepatic mitochondria, where they are rapidly metabolized to acetyl-CoA. This acetyl-CoA enters the ketogenesis pathway, producing ketone bodies such as β-hydroxybutyrate (BHB), which are transported to extrahepatic tissues, converted back to acetyl-CoA, and utilized in the TCA cycle to generate ATP. This mechanism bypasses impaired glucose metabolism and supports energy production in metabolically compromised cells. For more information, visit or follow us on LinkedIn. SOURCE Cerecin, Inc WANT YOUR COMPANY'S NEWS FEATURED ON PRNEWSWIRE.COM? 440k+ Newsrooms & Influencers 9k+ Digital Media Outlets 270k+ Journalists Opted In GET STARTED

临床3期

2025-07-10

·药物分子设计

删铜绿假单胞菌限制系统用于分离噬菌体

噬菌体治疗是一种很有前途的治疗多重耐药细菌感染的方法。由于其高度的宿主特异性，噬菌体必须与目标临床菌株相匹配。高效地鉴定合适的噬菌体并为临床使用生产足够滴度，需要全面的噬菌体库和多种扩增宿主。一个理想的系统将使用一个高度通用的细菌宿主来分离更广谱的噬菌体，并简化噬菌体生产过程。抗噬菌体防御系统限制了细菌宿主的通用性，例如识别并切割外源DNA的限制修饰系统。近日，来自埃克塞特大学的Ben Temperton等人在在预印本bioRxiv上线文章“Eliminating the type I restriction endonuclease from Pseudomonas aeruginosa PAO1 for optimised phage isolation”作者将铜绿假单胞菌PAO1中的I型限制性内切酶HsdR删除，以构建一个更具通用性的噬菌体分离和扩增宿主。删除该内切酶使噬菌体扩增效率提高了一倍以上，并且从淡水样品中分离到的噬菌体数量是在野生型PAO1中的七倍。综上，作者认为本文为临床噬菌体疗法生产用于分离和扩增噬菌体的优化铜绿假单胞菌菌株的重要一步。（蔡世杰摘译）

微生物疗法

100 项与 The University of Exeter 相关的药物交易

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100 项与 The University of Exeter 相关的转化医学

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