34 research outputs found

    Integrated exposure response function (age group 55–60 years for IHD and stroke).

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    Integrated exposure response function (age group 55–60 years for IHD and stroke).</p

    Percentage reduction in mortality resulting from total removal of traffic emissions (for COPD and IHD, age group is 50–55 years).

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    Percentage reduction in mortality resulting from total removal of traffic emissions (for COPD and IHD, age group is 50–55 years).</p

    Data_Sheet_1_Applications for open access normalized synthesis in metastatic prostate cancer trials.docx

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    Recent metastatic castration-resistant prostate cancer (mCRPC) clinical trials have integrated homologous recombination and DNA repair deficiency (HRD/DRD) biomarkers into eligibility criteria and secondary objectives. These trials led to the approval of some PARP inhibitors for mCRPC with HRD/DRD indications. Unfortunately, biomarker-trial outcome data is only discovered by reviewing publications, a process that is error-prone, time-consuming, and laborious. While prostate cancer researchers have written systematic evidence reviews (SERs) on this topic, given the time involved from the last search to publication, an SER is often outdated even before publication. The difficulty in reusing previous review data has resulted in multiple reviews of the same trials. Thus, it will be useful to create a normalized evidence base from recently published/presented biomarker-trial outcome data that one can quickly update. We present a new approach to semi-automating normalized, open-access data tables from published clinical trials of metastatic prostate cancer using a data curation and SER platform. Clinicaltrials.gov and Pubmed.gov were used to collect mCRPC clinical trial publications with HRD/DRD biomarkers. We extracted data from 13 publications covering ten trials that started before 22nd Apr 2021. We extracted 585 hazard ratios, response rates, duration metrics, and 543 adverse events. Across 334 patients, we also extracted 8,180 patient-level survival and biomarker values. Data tables were populated with survival metrics, raw patient data, eligibility criteria, adverse events, and timelines. A repeated strong association between HRD and improved PARP inhibitor response was observed. Several use cases for the extracted data are demonstrated via analyses of trial methods, comparison of treatment hazard ratios, and association of treatments with adverse events. Machine learning models are also built on combined and normalized patient data to demonstrate automated discovery of therapy/biomarker relationships. Overall, we demonstrate the value of systematically extracted and normalized data. We have also made our code open-source with simple instructions on updating the analyses as new data becomes available, which anyone can use even with limited programming knowledge. Finally, while we present a novel method of SER for mCRPC trials, one can also implement such semi-automated methods in other clinical trial domains to advance precision medicine.</p

    A systematic review and meta-analysis of the impact of curbs on crash outcomes

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    Road traffic crashes involving vertical curbs are commonly reported to occur on highways and expressways in India. We found a gap in terms of systematically assessing the evidence of the impact of curbs on road safety outcomes in the real world. We conducted a systematic review and meta-analysis of the impact of curbs on the risk of road traffic injuries. We used keywords in a database of records prepared by an earlier evidence gap map (EGM). The EGM used a comprehensive search strategy including 6 academic database, 17 organizational websites, hand searching, contacting experts and back referencing. We found 4 studies that evaluated impact of a curbed median or a curbed shoulder. We found that the presence of a curb on a median increases the risk for all crashes, all single-vehicle crashes, all median-related crashes and median-related injury crashes. The data also indicate that the severity of accidents reduces for curbs on median while it increases for curbs on shoulder, though the latter effect is not statistically significant. All the epidemiological studies were conducted on rural highways and did not report effects for different traffic speeds or vehicle types. However, our review of crash tests and simulation studies indicates that the impact of a curb design may be highly sensitive to speed and vehicle types. The safety impacts of a curb depend on the context of the road. In an urban road, a curb should ensure safety of pedestrians from an errant vehicle. On high-speed rural roads, curbs should be avoided and treatments should facilitate safe departure of the vehicle from the roadway.</p

    Developing a national database of police-reported fatal road traffic crashes for road safety research and management in India

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    Strengthening crash surveillance is an urgent priority for road safety in low- and middle-income countries. We reviewed the online availability and completeness of First Information Reports (FIRs; police reports) of road traffic crashes in India. We developed a relational database to record information extracted from FIRs, and implemented it for one state (Chhattisgarh, 2017–2019). We found that FIRs can be downloaded in bulk from government websites of 15 states and union territories. Another 14 provide access online but restrict bulk downloading, and 7 do not provide online access. For Chhattisgarh, 87% of registered FIRs could be downloaded. Most FIRs reported the date, time, collision-type, and vehicle-types, but important crash characteristics (e.g. infrastructure attributes) were missing. India needs to invest in building the crash surveillance capacity for research and safety management. However, in the interim, maintaining a national database of a sample of FIRs can provide useful policy guidance.</p
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