The advantages of UK Biobank's open access strategy for health research

Ready access to health research studies is becoming more important as researchers, and their funders, seek to maximize the opportunities for scientific innovation and health improvements. Large‐scale population‐based prospective studies are particularly useful for multidisciplinary research into the causes, treatment and prevention of many different diseases. UK Biobank has been established as an open‐access resource for public health research, with the intention of making the data as widely available as possible in an equitable and transparent manner. Access to UK Biobank's unique breadth of phenotypic and genetic data has attracted researchers worldwide from across academia and industry. As a consequence, it has enabled scientists to perform world‐leading collaborative research. Moreover, open access to an already deeply characterized cohort has encouraged both public and private sector investment in further enhancements to make UK Biobank an unparalleled resource for public health research and an exemplar for the development of open‐access approaches for other studies

Mental health in UK Biobank - development, implementation and results from an online questionnaire completed by 157 366 participants: a reanalysis

Background UK Biobank is a well-characterised cohort of over 500 000 participants including genetics, environmental data and imaging. An online mental health questionnaire was designed for UK Biobank participants to expand its potential. Aims Describe the development, implementation and results of this questionnaire. Method An expert working group designed the questionnaire, using established measures where possible, and consulting a patient group. Operational criteria were agreed for defining likely disorder and risk states, including lifetime depression, mania/hypomania, generalised anxiety disorder, unusual experiences and self-harm, and current post-traumatic stress and hazardous/harmful alcohol use. Results A total of 157 366 completed online questionnaires were available by August 2017. Participants were aged 45–82 (53% were ≥65 years) and 57% women. Comparison of self-reported diagnosed mental disorder with a contemporary study shows a similar prevalence, despite respondents being of higher average socioeconomic status. Lifetime depression was a common finding, with 24% (37 434) of participants meeting criteria and current hazardous/harmful alcohol use criteria were met by 21% (32 602), whereas other criteria were met by less than 8% of the participants. There was extensive comorbidity among the syndromes. Mental disorders were associated with a high neuroticism score, adverse life events and long-term illness; addiction and bipolar affective disorder in particular were associated with measures of deprivation. Conclusions The UK Biobank questionnaire represents a very large mental health survey in itself, and the results presented here show high face validity, although caution is needed because of selection bias. Built into UK Biobank, these data intersect with other health data to offer unparalleled potential for crosscutting biomedical research involving mental health

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events

Excited State Interactions in Flurbiprofen-Tryptophan dyads

This document is the Accepted Manuscript version of a Published Work that appeared in final form in The Journal of Physical Chemistry B, copyright © American Chemical Society after peer review and technical editing by the publisher. To access the final edited and published work see http://doi.org/10.1021/jp071301z[EN] Fluorescence and laser-flash photolysis measurements have been performed on two pairs of diastereomeric dyads that contain the nonsteroidal anti-inflammatory drug (S)- or (R)-flurbiprofen (FBP) and (S)-tryptophan (Trp), which is a relevant amino acid present in site I of human serum albumin. The fluorescence spectra were obtained when subjected to excitation at 266 nm, where similar to 60% of the light is absorbed by FBP and similar to 40% is absorbed by Trp; the most remarkable feature observed in all dyads was a dramatic fluorescence quenching, and the residual emission was assigned to the Trp chromophore. In addition, an exciplex emission was observed as a broad band between 380 and 500 nm, especially in the case of the (R,S) diastereomers. The fluorescence lifetimes (tau(F)) at lambda(em) = 340 nm were clearly shorter in the dyads than in Trp-derived model compounds; in contrast, the values of tau(F) at lambda(em) = 440 nm (exciplex) were much longer. On the other hand, the typical FBP triplet-triplet transient absorption spectrum was obtained when subjected to laser-flash photolysis, although the signals were less intense than when FBP was directly excited under the same conditions. The main photophysical events in FBP-Trp dyads can be summarized as follows: (1) most of the energy provided by the incident radiation at 266 nm reaches the excited singlet state of Trp ((1)Trp*), either via direct absorption by this chromophore or by singlet singlet energy transfer from excited FBP ((FBP)-F-1*); (2) a minor, yet stereoselective deactivation of (FBP)-F-1* leads to detectable exciplexes and/or radical ion pairs; (3) the main process observed is intramolecular (1)Trp* quenching; and (4) the first triplet excited-state of FBP can be populated by triplet-triplet energy transfer from excited Trp or by back-electron transfer within the charge-separated states.Financial support from the MCYT (CTQ2004-03811) and the Generalitat Valenciana (GV06/099) is gratefully acknowledged. Author I.V. thanks MEC for a fellowship.Vayá Pérez, I.; Jiménez Molero, MC.; Miranda Alonso, MÁ. (2007). Excited State Interactions in Flurbiprofen-Tryptophan dyads. The Journal of Physical Chemistry B. 111(31):9363-9371. https://doi.org/10.1021/jp071301zS936393711113

Image-level harmonization of multi-site data using image-and-spatial transformer networks

We investigate the use of image-and-spatial transformer networks (ISTNs) to tackle domain shift in multi-site medical imaging data. Commonly, domain adaptation (DA) is performed with little regard for explainability of the inter-domain transformation and is often conducted at the feature-level in the latent space. We employ ISTNs for DA at the image-level which constrains transformations to explainable appearance and shape changes. As proof-of-concept we demonstrate that ISTNs can be trained adversarially on a classification problem with simulated 2D data. For real-data validation, we construct two 3D brain MRI datasets from the Cam-CAN and UK Biobank studies to investigate domain shift due to acquisition and population differences. We show that age regression and sex classification models trained on ISTN output improve generalization when training on data from one and testing on the other site

A randomized trial to assess the impact of an antithrombotic decision aid in patients with nonvalvular atrial fibrillation: the DAAFI trial protocol [ISRCTN14429643]

BACKGROUND: Decision aids are often advocated as a means to assist patient and health care provider decision making when faced with complicated treatment or screening decisions. Despite an exponential growth in the availability of decision aids in recent years, their impact on long-term treatment decisions and patient adherence is uncertain due to a paucity of rigorous studies. The choice of antithrombotic therapy for nonvalvular atrial fibrillation (NVAF) is one condition for which a trade-off exists between the potential risks and benefits of competing therapies, and the need to involve patients in decision making has been clearly identified. This study will evaluate whether an evidence-based patient decision aid for patients with NVAF can improve the appropriateness of antithrombotic therapy use by patients and their family physicians. DESIGN: A multi-center, two-armed cluster randomized trial based in community family practices in which patients with NVAF will be randomized to decision aid or usual care. Patients will receive one of four decision aids depending on their baseline stroke risk. The primary outcome is the provision of "appropriate antithrombotic therapy" at 3 months to study participants (appropriateness defined as per the 2001 American College of Chest Physicians recommendations for NVAF). In addition, the impact of this decision aid on patient knowledge, decisional conflict, well-being, and adherence will be assessed after 3 months, 6 months, and 12 months