Realistic expectations are key to realising the benefits of polygenic scores.

We must not let enthusiasm around polygenic scores allow us to forget other factors that are bigger, more modifiable, and relevant for everyone, argue Amit Sud, Rachel Horton, and colleague

Realistic expectations are key to realising the benefits of polygenic scores

We must not let enthusiasm around polygenic scores allow us to forget other factors that are bigger, more modifiable, and relevant for everyone, argue Amit Sud, Rachel Horton, and colleague

Improving the use of research evidence in guideline development: introduction

In 2005 the World Health Organisation (WHO) asked its Advisory Committee on Health Research (ACHR) for advice on ways in which WHO can improve the use of research evidence in the development of recommendations, including guidelines and policies. The ACHR established the Subcommittee on the Use of Research Evidence (SURE) to collect background documentation and consult widely among WHO staff, international experts and end users of WHO recommendations to inform its advice to WHO. We have prepared a series of reviews of methods that are used in the development of guidelines as part of this background documentation. We describe here the background and methods of these reviews, which are being published in Health Research Policy and Systems together with this introduction

Utility of salt-marsh foraminifera, testate amoebae and bulk-sediment δ13C values as sea-level indicators in Newfoundland, Canada

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this record.We investigated the utility of foraminifera, testate amoebae and bulk-sediment δ 13 C measurements for reconstructing Holocene relative sea level from sequences of salt-marsh sediment in Newfoundland, Canada. Modern, surface sediment was collected along transects from low to supra-tidal elevations in eastern (at Placentia) and western (at Hynes Brook and Big River) Newfoundland. Consistent with previous work, low-diversity assemblages of foraminifera display an almost binary division into a higher salt-marsh assemblage dominated by Jadammina macrescens and Balticammina pseudomacrescens and a lower salt-marsh assemblage comprised of Miliammina fusca. This pattern and composition resembles those identified at other high latitude sites with cool climates and confirms that foraminifera are sea-level indicators. The lowest occurrence of testate amoebae was at approximately mean higher high water. The composition of high salt-marsh testate amoebae assemblages (Centropyxis cassis type, Trinema spp., Tracheleuglypha dentata type, and Euglypha spp.) in Newfoundland was similar to elsewhere in the North Atlantic, but preservation bias favors removal of species with idiosomic tests over those with xenosomic tests. The mixed high salt-marsh plant community in Newfoundland results in bulk surface-sediment δ 13 C values that are typical of C 3 plants, making them indistinguishable from freshwater sediment. Therefore we propose that the utility of this proxy for reconstructing RSL in eastern North America is restricted to the coastline between Chesapeake Bay and southern Nova Scotia. Using a simple, multi-proxy approach to establish that samples in three radiocarbon-dated sediment cores formed between the lowest occurrence of testate amoebae and the highest occurrence of foraminifera, we generated three example late Holocene sea-level index points at Hynes Brook.This work was supported by NSF awards OCE-1458921, OCE-1458904 and EAR-1402017 and the Robert L. Nichols student research fund of the Department of Earth and Ocean Sciences at Tufts University. Foraminiferal data from Hynes Brook and Big River were collected as part of a series of projects including “Ocean-climate variability and sea level in the North Atlantic region since AD 0” funded by the Dutch National Research Programme (NRP) on Global air pollution and Climate Change; “Coastal Records” funded by the Vrije Universiteit Amsterdam and “Simulations, Observations & Palaeoclimatic data: climate variability over the last 500 years” funded by the European Union

Mesenteric panniculitis with pedal edema in a 33-year-old Pakistani man: a case report and literature review

<p>Abstract</p> <p>Introduction</p> <p>Mesenteric panniculitis is a rare pathology of unknown etiology characterized by inflammation and fibrosis in the mesentery. Its protean clinical and radiological manifestations make it a diagnostic challenge. There is no established treatment available for its management. The clinical outcome is inconsistent, with the prognosis ranging from complete resolution without any treatment to rapid progression culminating in death.</p> <p>Case presentation</p> <p>A 33-year-old Pakistani man presented with vague abdominal pain, an ill-defined epigastric mass and bilateral pedal edema. A detailed review of his history and laboratory investigations did not point to any diagnosis. The patient underwent an exploratory laparotomy based on the finding of mesenteric soft-tissue density on computed tomography. The laparotomy did not prove to be of any diagnostic or therapeutic value. Upon review of the pre-operative computed tomographic scan at our institution, a diagnosis of mesenteric panniculitis was made. An acceptable resolution of abdominal pain and pedal edema was attained after a 4-week trial of immunosuppressive therapy. This is the first reported case of mesenteric panniculitis with pedal edema as part of its presentation.</p> <p>Conclusion</p> <p>An increased awareness may lead to the development of a less invasive diagnostic approach and optimal treatment for this rarely recognized condition.</p

Evidence-informed health policy 1 – Synthesis of findings from a multi-method study of organizations that support the use of research evidence

Background: Organizations have been established in many countries and internationally to support the use of research evidence by producing clinical practice guidelines, undertaking health technology assessments, and/or directly supporting the use of research evidence in developing health policy on an international, national, and state or provincial level. Learning from these organizations can reduce the need to 'reinvent the wheel' and inform decisions about how best to organize support for such organizations, particularly in low- and middle-income countries (LMICs). Methods: We undertook a multi-method study in three phases – a survey, interviews, and case descriptions that drew on site visits – and in each of the second and third phases we focused on a purposive sample of those involved in the previous phase. We used the seven main recommendations that emerged from the advice offered in the interviews to organize much of the synthesis of findings across phases and methods. We used a constant comparative method to identify themes from across phases and methods. Results: Seven recommendations emerged for those involved in establishing or leading organizations that support the use of research evidence in developing health policy: 1) collaborate with other organizations; 2) establish strong links with policymakers and involve stakeholders in the work; 3) be independent and manage conflicts of interest among those involved in the work; 4) build capacity among those working in the organization; 5) use good methods and be transparent in the work; 6) start small, have a clear audience and scope, and address important questions; and 7) be attentive to implementation considerations, even if implementation is not a remit. Four recommendations emerged for the World Health Organization (WHO) and other international organizations and networks: 1) support collaborations among organizations; 2) support local adaptation efforts; 3) mobilize support; and 4) create global public goods. Conclusion: This synthesis of findings from a multi-method study, along with the more detailed findings from each of the three phases of the study (which are reported in the three following articles in the series), provide a strong basis on which researchers, policymakers, international organizations (and networks) like WHO can respond to the growing chorus of voices calling for efforts to support the use of research evidence in developing health policy

Small bowel MRI in adult patients: not just Crohn’s disease—a tutorial

To provide an overview of less well-known small bowel and mesenteric diseases found at small bowel magnetic resonance (MR) enterography/enteroclysis and to review the imaging findings. MR enterography and enteroclysis are important techniques for evaluation of small bowel diseases. In most centres these techniques are primarily used in Crohn's disease, and most radiologists are familiar with these MRI findings. However, the knowledge of findings in other diseases is often sparse, including diseases that may cause similar clinical symptoms to those of Crohn's disease. We present a spectrum of less common and less well-known bowel and mesenteric diseases (e.g. internal hernia, intussusception, neuroendocrine tumour) from our small bowel MR database of over 2,000 cases. These diseases can be found in patients referred for bowel obstruction, abdominal pain or rectal blood loss. Further, in patients with (or suspected to have) Crohn's disease, some of these diseases (e.g. neuroendocrine tumour, familial Mediterranean fever) may mislead radiologists to erroneously diagnose active Crohn's disease. Radiologists should be familiar with diseases affecting the small bowel other than Crohn's disease, including diseases that may mimic Crohn's diseas

The impact of albendazole treatment on the incidence of viral- and bacterial-induced diarrhea in school children in southern Vietnam: study protocol for a randomized controlled trial

Anthelmintics are one of the more commonly available classes of drugs to treat infections by parasitic helminths (especially nematodes) in the human intestinal tract. As a result of their cost-effectiveness, mass school-based deworming programs are becoming routine practice in developing countries. However, experimental and clinical evidence suggests that anthelmintic treatments may increase susceptibility to other gastrointestinal infections caused by bacteria, viruses, or protozoa. Hypothesizing that anthelmintics may increase diarrheal infections in treated children, we aim to evaluate the impact of anthelmintics on the incidence of diarrheal disease caused by viral and bacterial pathogens in school children in southern Vietnam.This is a randomized, double-blinded, placebo-controlled trial to investigate the effects of albendazole treatment versus placebo on the incidence of viral- and bacterial-induced diarrhea in 350 helminth-infected and 350 helminth-uninfected Vietnamese school children aged 6-15 years. Four hundred milligrams of albendazole, or placebo treatment will be administered once every 3 months for 12 months. At the end of 12 months, all participants will receive albendazole treatment. The primary endpoint of this study is the incidence of diarrheal disease assessed by 12 months of weekly active and passive case surveillance. Secondary endpoints include the prevalence and intensities of helminth, viral, and bacterial infections, alterations in host immunity and the gut microbiota with helminth and pathogen clearance, changes in mean z scores of body weight indices over time, and the number and severity of adverse events.In order to reduce helminth burdens, anthelmintics are being routinely administered to children in developing countries. However, the effects of anthelmintic treatment on susceptibility to other diseases, including diarrheal pathogens, remain unknown. It is important to monitor for unintended consequences of drug treatments in co-infected populations. In this trial, we will examine how anthelmintic treatment impacts host susceptibility to diarrheal infections, with the aim of informing deworming programs of any indirect effects of mass anthelmintic administrations on co-infecting enteric pathogens.ClinicalTrials.gov: NCT02597556 . Registered on 3 November 2015

Deformation crossover : from nano- to mesoscale

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