Potentially inappropriate prescribing in middle-aged adults: a significant problem with a lack of action and evidence to address it

Potentially inappropriate prescribing (PIP), prescribing where the potential harms outweigh the potential benefits, or where a medication that a patient would benefit from is not prescribed, is an important healthcare challenge. PIP has been well characterised among older adults and is linked to adverse drug reactions (ADRs), hospitalisations, and increased healthcare costs.1 While studies have been conducted to address PIP in older adults, middle-aged adults remain overlooked despite also being vulnerable to PIP due to age-related chronic conditions.2</p

Is rapid scientific publication also high quality? Bibliometric analysis of highly disseminated COVID-19 research papers

The impact of COVID-19 has underlined the need for reliable information to guide clinical practice and policy. This urgency has to be balanced against disruption to journal handling capacity and the continued need to ensure scientific rigour. We examined the reporting quality of highly disseminated COVID-19 research papers using a bibliometric analysis examining reporting quality and risk of bias (RoB) amongst 250 top scoring Altmetric Attention Score (AAS) COVID-19 research papers between January and April 2020. Method-specific RoB tools were used to assess quality. After exclusions, 84 studies from 44 journals were included. Forty-three (51%) were case series/studies, and only one was an randomized controlled trial. Most authors were from institutions based in China (n = 44, 52%). The median AAS and impact factor was 2015 (interquartile range [IQR] 1,105-4,051.5) and 12.8 (IQR 5-44.2) respectively. Nine studies (11%) utilized a formal reporting framework, 62 (74%) included a funding statement, and 41 (49%) were at high RoB. This review of the most widely disseminated COVID-19 studies highlights a preponderance of low-quality case series with few research papers adhering to good standards of reporting. It emphasizes the need for cautious interpretation of research and the increasingly vital responsibility that journals have in ensuring high-quality publications

Room- and Low-Temperature Crystallographic Study of the Ambient Pressure Organic Superconductor (Bisethylene dithiotetrathiofulvalene)₄Hg_2.89Br₈

(BEDT-TTF)4Hg2.89Br8 (BEDT-TTF = bisethylene dithiotetrathiofulvalene) is an ambient pressure low-temperature superconductor (Tc = 4.3K) with an incommensurate two-sublattice structure. It crystallizes in orthorhombic and monoclinic modifications. Only the monoclinic phase becomes superconducting on cooling, as confirmed in this study. Its Hg sublattice undergoes a transition when the temperature is reduced, during which the Hg columns gradually shift in a direction parallel to the column axis. Since the symmetry is lowered, twinning occurs, but the structure of the conducting layers of BEDT-TTF molecules is little affected. The structures at room temperature and 40K are analyzed using four-dimensional superspace group theory

A systematic review of the prevalence, determinants, and impact of potentially inappropriate prescribing in middle-aged adults

Purpose Potentially inappropriate prescribing (PIP) is common in older adults and is associated with adverse clinical outcomes, such as adverse drug events, and increased economic costs. However, PIP in middle-aged adults (MAA) has not been well-characterised. Objective This review reports the prevalence, determinants, and impact of PIP in MAA. Methods  A systematic review and meta-analysis were conducted following PRISMA reporting guidelines (PROSPERO CRD42020206617–7 October 2020). Searches were performed of OVID MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Web of Science, ProQuest Dissertation and Thesis Database, ClinicalTrials.gov, World Health Organization International Clinical Trials Registry Platform, and OpenGrey. Studies that included adults aged 45–64 years and applied explicit PIP criteria were eligible through to September 2020. Data collected from studies were pre-specified and recorded using a data extraction sheet, details of which are available in our PROSPERO protocol. Meta-analysis of PIP prevalence was conducted using Stata version 16. All other outcomes were examined by narrative synthesis. Risk of bias and overall certainty of findings were assessed with the QUIPS (Quality in Prognosis Study) and GRADE (grading of recommendations assessment, development, and evaluation) tools, respectively. Results Of 8183 citations screened, 22 studies were included in the review. PIP was defined using 15 different criteria, with only one specifically designed for MAA (PROMPT criteria). Four studies that had disaggregated prevalence data for MAA (n = 753,193) were included in a meta-analysis (PIP prevalence 38%; 95% confidence interval [CI] 25–52; p I2 > 99%], although heterogeneity was high. Female sex and polypharmacy were associated with PIP. Only one study reported healthcare utilisation and quality of life and found no association with PIP. One cohort study reported that adverse drug reactions had a significant association with PIP (adjusted odds ratio 3.65; 95% CI 1.13–11.78; p Conclusion PIP is common in MAA. There was moderate certainty for our findings for the prevalence of PIP and its association with female sex and polypharmacy. Certainty for other findings was either low or very low. No data were available to assess some of our pre-specified outcomes. Further studies are needed to examine whether PIP is associated with negative outcomes in MAA.</p

A systematic review of the prevalence, determinants, and impact of potentially inappropriate prescribing in middle-aged adults

Purpose Potentially inappropriate prescribing (PIP) is common in older adults and is associated with adverse clinical outcomes, such as adverse drug events, and increased economic costs. However, PIP in middle-aged adults (MAA) has not been well-characterised. Objective This review reports the prevalence, determinants, and impact of PIP in MAA. Methods  A systematic review and meta-analysis were conducted following PRISMA reporting guidelines (PROSPERO CRD42020206617–7 October 2020). Searches were performed of OVID MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Web of Science, ProQuest Dissertation and Thesis Database, ClinicalTrials.gov, World Health Organization International Clinical Trials Registry Platform, and OpenGrey. Studies that included adults aged 45–64 years and applied explicit PIP criteria were eligible through to September 2020. Data collected from studies were pre-specified and recorded using a data extraction sheet, details of which are available in our PROSPERO protocol. Meta-analysis of PIP prevalence was conducted using Stata version 16. All other outcomes were examined by narrative synthesis. Risk of bias and overall certainty of findings were assessed with the QUIPS (Quality in Prognosis Study) and GRADE (grading of recommendations assessment, development, and evaluation) tools, respectively. Results Of 8183 citations screened, 22 studies were included in the review. PIP was defined using 15 different criteria, with only one specifically designed for MAA (PROMPT criteria). Four studies that had disaggregated prevalence data for MAA (n = 753,193) were included in a meta-analysis (PIP prevalence 38%; 95% confidence interval [CI] 25–52; p I2 > 99%], although heterogeneity was high. Female sex and polypharmacy were associated with PIP. Only one study reported healthcare utilisation and quality of life and found no association with PIP. One cohort study reported that adverse drug reactions had a significant association with PIP (adjusted odds ratio 3.65; 95% CI 1.13–11.78; p Conclusion PIP is common in MAA. There was moderate certainty for our findings for the prevalence of PIP and its association with female sex and polypharmacy. Certainty for other findings was either low or very low. No data were available to assess some of our pre-specified outcomes. Further studies are needed to examine whether PIP is associated with negative outcomes in MAA.</p

Supplementary document for Cubic-wavelength mode volume photonic crystal nanobeam cavities in a monolithic CMOS platform - 6247408.pdf

supplementary documen

Supplementary document for Polarization insensitive 1D grating coupler based on a zero-birefringence subwavelength corelet waveguide - 5869367.pdf

Supplemental documen

supp_data_pigc_OLpaper.zip

Expanded simulation and measurement data.</p

Suppl. Figure 1 from A Phase I Study of the AKT Inhibitor MK-2206 in Combination with Hormonal Therapy in Postmenopausal Women with Estrogen Receptor–Positive Metastatic Breast Cancer

This supplementary figure shows the appearance of the rash and the histology of the skin biopsy. This needs to be a colored figure.</p

Supplementary Table 1 and Figure legend for Suppl. Figure 1 from A Phase I Study of the AKT Inhibitor MK-2206 in Combination with Hormonal Therapy in Postmenopausal Women with Estrogen Receptor–Positive Metastatic Breast Cancer

Supplementary Table 1 shows the clinical benefit rate and time to progression in subgroups divided according to treatment setting when enrolled on the trial and the trial regimens received.</p