Can data in optometric practice be used to provide an evidence base for ophthalmic public health?

Purpose: The purpose of this paper is to investigate the potential of using primary care optometry data to support ophthalmic public health, research and policy making. Methods: Suppliers of optometric electronic patient record systems (EPRs) were interviewed to gather information about the data present in commercial software programmes and the feasibility of data extraction. Researchers were presented with a list of metrics that might be included in an optometric practice dataset via a survey circulated by email to 102 researchers known to have an interest in eye health. Respondents rated the importance of each metric for research. A further survey presented the list of metrics to 2000 randomly selected members of the College of Optometrists. The optometrists were asked to specify how likely they were to enter information about each metric in a routine sight test consultation. They were also asked if data were entered as free text, menus or a combination of these. Results: Current EPRs allowed the input of data relating to the metrics of interest. Most data entry was free text. There was a good match between high priority metrics for research and those commonly recorded in optometric practice. Conclusions: Although there were plenty of electronic data in optometric practice, this was highly variable and often not in an easily analysed format. To facilitate analysis of the evidence for public health purposes a UK based minimum dataset containing standardised clinical information is recommended. Further research would be required to develop suitable coding for the individual metrics included. The dataset would need to capture information from all sectors of the population to ensure effective planning of any future interventions

Outputs and Growth of Primary Care Databases in the United Kingdom: Bibliometric Analysis.

BACKGROUND: Electronic health database (EHD) data is increasingly used by researchers. The major United Kingdom EHDs are the 'Clinical Practice Research Datalink' (CPRD), 'The Health Improvement Network' (THIN) and 'QResearch'. Over time, outputs from these databases have increased, but have not been evaluated. OBJECTIVE: This study compares research outputs from CPRD, THIN and QResearch assessing growth and publication outputs over a 10-year period (2004-2013). CPRD was also reviewed separately over 20 years as a case study. METHODS:  Publications from CPRD and QResearch were extracted using the Science Citation Index (SCI) of the Thomson Scientific Institute for Scientific Information (Web of Science). THIN data was obtained from University College London and validated in Web of Science. All databases were analysed for growth in publications, the speciality areas and the journals in which their data have been published. RESULTS: These databases collectively produced 1,296 publications over a ten-year period, with CPRD representing 63.6% (n=825 papers), THIN 30.4% (n=394) and QResearch 5.9% (n=77). Pharmacoepidemiology and General Medicine were the most common specialities featured. Over the 9-year period (2004-2013), publications for THIN and QResearch have slowly increased over time, whereas CPRD publications have increased substantially in last 4 years with almost 75% of CPRD publications published in the past 9 years. CONCLUSION: These databases are enhancing scientific research and are growing yearly, however display variability in their growth. They could become more powerful research tools if the National Health Service and general practitioners can provide accurate and comprehensive data for inclusion in these databases

Peer support for discharge from inpatient to community mental health services: Study protocol clinical trial (SPIRIT Compliant).

INTRODUCTION: In the period shortly after discharge from inpatient to community mental health care, people are at increased risk of self-harm, suicide, and readmission to hospital. Discharge interventions including peer support have shown potential, and there is some evidence that community-based peer support reduces readmissions. However, systematic reviews of peer support in mental health services indicate poor trial quality and a lack of reporting of how peer support is distinctive from other mental health support. This study is designed to establish the clinical and cost effectiveness of a peer worker intervention to support discharge from inpatient to community mental health care, and to address issues of trial quality and clarity of reporting of peer support interventions. METHODS: This protocol describes an individually randomized controlled superiority trial, hypothesizing that people offered a peer worker discharge intervention in addition to usual follow-up care in the community are less likely to be readmitted in the 12 months post discharge than people receiving usual care alone. A total of 590 people will be recruited shortly before discharge from hospital and randomly allocated to care as usual plus the peer worker intervention or care as usual alone. Manualized peer support provided by trained peer workers begins in hospital and continues for 4 months in the community post discharge. Secondary psychosocial outcomes are assessed at 4 months post discharge, and service use and cost outcomes at 12 months post discharge, alongside a mixed methods process evaluation. DISCUSSION: Clearly specified procedures for sequencing participant allocation and for blinding assessors to allocation, plus full reporting of outcomes, should reduce risk of bias in trial findings and contribute to improved quality in the peer support evidence base. The involvement of members of the study team with direct experience of peer support, mental distress, and using mental health services, in coproducing the intervention and designing the trial, ensures that we theorize and clearly describe the peer worker intervention, and evaluate how peer support is related to any change in outcome. This is an important methodological contribution to the evidence base. TRIAL REGISTRATION: This study was prospectively registered as ISRCTN 10043328 on November 28, 2016

Small cell lung cancer cell lines secrete predominantly ACTH precursor peptides not ACTH.

A panel of 18 well characterised human small cell lung cancer (SCLC) cell lines was assessed for the production of adrenocorticotrophin (ACTH) and its precursor peptides, pro-opiomelanocortin (POMC) and pro-ACTH. These precursor peptides were measured directly using a novel two-site immunoradiometric assay (IRMA) based on monoclonal antibodies, in conjunction with a similar IRMA for ACTH 1-39. Significant concentrations of ACTH precursors were secreted by 10 of the 18 cell lines (56%). The low levels of ACTH immunoreactivity detected in seven cell lines could be accounted for by the known cross-reactivity of precursors in the ACTH IRMA. This suggests there is little, if any, processing of ACTH precursors to ACTH. Cell pellet extracts contained undetectable or low levels of ACTH precursors and ACTH, indicating that these peptides are not stored intracellularly. During the growth of the SCLC cells in vitro ACTH precursors accumulated progressively in the culture medium. Thus the combination of a direct assay for the ACTH precursors and the panel of SCLC cell lines provides a valuable in vitro model for the expression of POMC in human tumours

The mass-metallicity gradient relation of early-type galaxies

We present a newly observed relation between galaxy mass and radial metallicity gradients of early-type galaxies. Our sample of 51 early-type galaxies encompasses a comprehensive mass range from dwarf to brightest cluster galaxies. The metallicity gradients are measured out to one effective radius by comparing nearly all of the Lick absorption-line indices to recent models of single stellar populations. The relation shows very different behaviour at low and high masses, with a sharp transition being seen at a mass of ~ 3.5 x 10^10 M_sun (velocity dispersion of ~140 km/s, M_B ~ -19). Low-mass galaxies form a tight relation with mass, such that metallicity gradients become shallower with decreasing mass and positive at the very low-mass end. Above the mass transition point several massive galaxies have steeper gradients, but a clear downturn is visible marked by a broad scatter. The results are interpreted in comparison with competing model predictions. We find that an early star-forming collapse could have acted as the main mechanism for the formation of low-mass galaxies, with star formation efficiency increasing with galactic mass. The high-mass downturn could be a consequence of merging and the observed larger scatter a natural result of different merger properties. These results suggest that galaxies above the mass threshold of ~ 3.5 x 10^10 M_sun might have formed initially by mergers of gas-rich disc galaxies and then subsequently evolved via dry merger events. The varying efficiency of the dissipative merger-induced starburst and feedback processes have shaped the radial metallicity gradients in these high-mass systems.Comment: 5 pageg, 3 figures, accepted by ApJ Lette

Prevalence and Properties of Dark Matter in Elliptical Galaxies

Given the recently deduced relationship between X-ray temperatures and stellar velocity dispersions (the "T-sigma relation") in an optically complete sample of elliptical galaxies (Davis & White 1996), we demonstrate that L>L_* ellipticals contain substantial amounts of dark matter in general. We present constraints on the dark matter scale length and on the dark-to-luminous mass ratio within the optical half-light radius and within the entire galaxy. For example, we find that minimum values of dark matter core radii scale as r_dm > 4(L_V/3L_*)^{3/4}h^{-1}_80 kpc and that the minimum dark matter mass fraction is >~20% within one optical effective radius r_e and is >~39-85% within 6r_e, depending on the stellar density profile and observed value of beta_spec. We also confirm the prediction of Davis & White (1996) that the dark matter is characterized by velocity dispersions that are greater than those of the luminous stars: sigma_dm^2 ~ 1.4-2 sigma_*^2. The T-sigma relation implies a nearly constant mass-to-light ratio within six half-light radii: M/L_V ~ 25h_80 M_sun/L_V_sun. This conflicts with the simplest extension of CDM theories of large scale structure formation to galactic scales; we consider a couple of modifications which can better account for the observed T-sigma relation.Comment: 27 pages AASTeX; 15 PostScript figures; to appear in Ap

Successional dynamics of a 35 year old freshwater mitigation wetland in southeastern New Hampshire

The long-term ecological success of compensatory freshwater wetland projects has come into question based on follow-up monitoring studies over the past few decades. Given that wetland restoration may require many years to decades to converge to desired outcomes, long-term monitoring of successional patterns may increase our ability to fully evaluate success of wetland mitigation projects or guide adaptive management when needed. In Portsmouth, New Hampshire a 4 ha wetland was constructed in an abandoned gravel quarry as off-site compensatory mitigation for impacts to a scrub-shrub swamp associated with property expansion. Building upon prior evaluations from 1992 and 2002, we conducted a floral survey in 2020 to compare results with prior surveys to document vegetation successional trends over time. In addition, we monitored the avian community throughout the growing season as a measure of habitat quality. The plant community mirrored documented successional trends of freshwater wetland restoration projects as native hydrophytes dominated species composition. Plant species composition stabilized as the rate of turnover, the measurement of succession, declined by nearly half after 17 years. Researchers should consider long-term monitoring of specific sites to better understand successional patterns of created wetlands as we documented long time frames required for the development of scrub-shrub swamps, red maple swamps, and sedge meadows. High species richness was attributed to beaver activity, topographic heterogeneity from Carex stricta tussocks, and the seed bank from the application of peat from the original wetland. Habitat heterogeneity of open water, herbaceous cover, and woody vegetation supports a diverse avian community including 11 wetland dependent species. Although the mitigation project has not created the full area of lost scrub-shrub swamp after 35 years, it has developed a structurally complex habitat and diverse avian community that effectively provides the functions and values of the impacted system

Constraints on Type Ia Supernova Models from X-ray Spectra of Galaxy Clusters

We present constraints on theoretical models of Type Ia supernovae using spatially resolved ASCA X-ray spectroscopy of three galaxy clusters: Abell 496, Abell 2199 and Abell 3571. All three clusters have central iron abundance enhancements; an ensemble of abundance ratios are used to show that most of the iron in the central regions of the clusters comes from SN Ia. These observations are consistent with the suppressed galactic wind scenario proposed by Dupke and White (1999). At the center of each cluster, simultaneous analysis of spectra from all ASCA instruments shows that the nickel to iron abundance ratio (normalized by the solar ratio) is Ni/Fe ~ 4. We use the nickel to iron ratio as a discriminator between SN Ia explosion models: the Ni/Fe ratio of ejecta from the "Convective Deflagration" model W7 is consistent with the observations, while those of "delayed detonation" models are not consistent at the 90% confidence level.Comment: 20 pages, 2 figures, accepted by The Astrophysical Journa

Polarimetric Properties of Flux-Ropes and Sheared Arcades in Coronal Prominence Cavities

The coronal magnetic field is the primary driver of solar dynamic events. Linear and circular polarization signals of certain infrared coronal emission lines contain information about the magnetic field, and to access this information, either a forward or an inversion method must be used. We study three coronal magnetic configurations that are applicable to polar-crown filament cavities by doing forward calculations to produce synthetic polarization data. We analyze these forward data to determine the distinguishing characteristics of each model. We conclude that it is possible to distinguish between cylindrical flux ropes, spheromak flux ropes, and sheared arcades using coronal polarization measurements. If one of these models is found to be consistent with observational measurements, it will mean positive identification of the magnetic morphology that surrounds certain quiescent filaments, which will lead to a greater understanding of how they form and why they erupt.Comment: 22 pages, 8 figures, Solar Physics topical issue: Coronal Magnetis