What research agenda could be generated from the European General Practice Research Network concept of Multimorbidity in Family Practice?

This is the final version of the article. Available from the publisher via the DOI in this record.BACKGROUND: Multimorbidity is an intuitively appealing, yet challenging, concept for Family Medicine (FM). An EGPRN working group has published a comprehensive definition of the concept based on a systematic review of the literature which is closely linked to patient complexity and to the biopsychosocial model. This concept was identified by European Family Physicians (FPs) throughout Europe using 13 qualitative surveys. To further our understanding of the issues around multimorbidity, we needed to do innovative research to clarify this concept. The research question for this survey was: what research agenda could be generated for Family Medicine from the EGPRN concept of Multimorbidity? METHODS: Nominal group design with a purposive panel of experts in the field of multimorbidity. The nominal group worked through four phases: ideas generation phase, ideas recording phase, evaluation and analysis phase and a prioritization phase. RESULTS: Fifteen international experts participated. A research agenda was established, featuring 6 topics and 11 themes with their corresponding study designs. The highest priorities were given to the following topics: measuring multimorbidity and the impact of multimorbidity. In addition the experts stressed that the concept should be simplified. This would be best achieved by working in reverse: starting with the outcomes and working back to find the useful variables within the concept. CONCLUSION: The highest priority for future research on multimorbidity should be given to measuring multimorbidity and to simplifying the EGPRN model, using a pragmatic approach to determine the useful variables within the concept from its outcomes.The study had a Grant of 8000 Euros from the EGPRN

A study protocol for the evaluation of occupational mutagenic/carcinogenic risks in subjects exposed to antineoplastic drugs: a multicentric project

<p>Abstract</p> <p>Background</p> <p>Some industrial hygiene studies have assessed occupational exposure to antineoplastic drugs; other epidemiological investigations have detected various toxicological effects in exposure groups labeled with the job title. In no research has the same population been studied both environmentally and epidemiologically. The protocol of the epidemiological study presented here uses an integrated environmental and biological monitoring approach. The aim is to assess in hospital nurses preparing and/or administering therapy to cancer patients the current level of occupational exposure to antineoplastic drugs, DNA and chromosome damage as cancer predictive effects, and the association between the two.</p> <p>Methods/Design</p> <p>About 80 healthy non-smoking female nurses, who job it is to prepare or handle antineoplastic drugs, and a reference group of about 80 healthy non-smoking female nurses not occupationally exposed to chemicals will be examined simultaneously in a cross-sectional study. All the workers will be recruited from five hospitals in northern and central Italy after their informed consent has been obtained.</p> <p>Evaluation of surface contamination and dermal exposure to antineoplastic drugs will be assessed by determining cyclophosphamide on selected surfaces (wipes) and on the exposed nurses' clothes (pads). The concentration of unmetabolized cyclophosphamide as a biomarker of internal dose will be measured in end-shift urine samples from exposed nurses.</p> <p>Biomarkers of effect and susceptibility will be assessed in exposed and unexposed nurses: urinary concentration of 8-hydroxy-2-deoxyguanosine; DNA damage detected using the single-cell microgel electrophoresis (comet) assay in peripheral white blood cells; micronuclei and chromosome aberrations in peripheral blood lymphocytes. Genetic polymorphisms for enzymes involved in metabolic detoxification (i.e. glutathione <it>S</it>-transferases) will also be analysed.</p> <p>Using standardized questionnaires, occupational exposure will be determined in exposed nurses only, whereas potential confounders (medicine consumption, lifestyle habits, diet and other non-occupational exposures) will be assessed in both groups of hospital workers.</p> <p>Statistical analysis will be performed to ascertain the association between occupational exposure to antineoplastic drugs and biomarkers of DNA and chromosome damage, after taking into account the effects of individual genetic susceptibility, and the presence of confounding exposures.</p> <p>Discussion</p> <p>The findings of the study will be useful in updating prevention procedures for handling antineoplastic drugs.</p

One second vector and scalar magnetic measurements at the low-latitude Choutuppal (CPL) magnetic observatory

One second measurements of the geomagnetic field variations, which meet INTERMAGNET quality and transmission specifications, require very special conditions to be maintained at the observatories over sustained periods of time, which pose serious challenges for the operators, particularly when infrastructural and environmental conditions are far from ideal. This work presents the progressive steps, which led to the successful setup of such measurements at the new magnetic observatory of the Council of Scientific and Industrial Research (CSIR)-National Geophysical Research Institute (NGRI) in the Choutuppal (CPL) campus, Hyderabad (HYB), India. The 1 s magnetic measurements in trial mode commenced in 2015 using the newly developed observatory-grade 1 s fluxgate magnetometer, GEOMAG-02MO, from Research Centre GEOMAGNET (GM), Ukraine, and the Overhauser proton precession magnetometer, GSM-90F1, along with the data acquisition system, Magrec-4B from Mingeo, Hungary. Iterative tuning of the setup led to the generation of good quality data from 2016 onward. The processes of commissioning this setup in low-latitude conditions, with the aim of producing 1 s definitive data, and the characteristics of the data from this new instrument are presented here

Neural network classification of late gamma band electroencephalogram features

This paper investigates the feasibility of using neural network (NN) and late gamma band (LGB) electroencephalogram (EEG) features extracted from the brain to identify the individuality of subjects. The EEG signals were recorded using 61 active electrodes located on the scalp while the subjects perceived a single picture. LGB EEG signals occur with jittering latency of above 280 ins and are not time-locked to the triggering stimuli. Therefore, LGB EEG could only be computed from single trials of EEG signals and the common method of averaging across trials to remove undesired background EEG (i.e. noise) is not possible. Here, principal component analysis has been used to extract single trials of EEG signals. Zero phase Butterworth filter and Parseval's time-frequency equivalence theorem were used to compute the LGB EEG features. These features were then classified by backpropagation and simplified fuzzy ARTMAP NNs into different categories that represent the individuality of the subjects. The results using a tenfold cross validation scheme gave a maximum classification of 97.33% when tested on 800 unseen LGB EEG features from 40 subjects. This pilot investigation showed that the method of identifying the individuality of subjects using NN classification of LGB EEG features is worth further study

What research agenda could be generated from the European General Practice Research Network concept of Multimorbidity in Family Practice?

BACKGROUND: Multimorbidity is an intuitively appealing, yet challenging, concept for Family Medicine (FM). An EGPRN working group has published a comprehensive definition of the concept based on a systematic review of the literature which is closely linked to patient complexity and to the biopsychosocial model. This concept was identified by European Family Physicians (FPs) throughout Europe using 13 qualitative surveys. To further our understanding of the issues around multimorbidity, we needed to do innovative research to clarify this concept. The research question for this survey was: what research agenda could be generated for Family Medicine from the EGPRN concept of Multimorbidity? METHODS: Nominal group design with a purposive panel of experts in the field of multimorbidity. The nominal group worked through four phases: ideas generation phase, ideas recording phase, evaluation and analysis phase and a prioritization phase. RESULTS: Fifteen international experts participated. A research agenda was established, featuring 6 topics and 11 themes with their corresponding study designs. The highest priorities were given to the following topics: measuring multimorbidity and the impact of multimorbidity. In addition the experts stressed that the concept should be simplified. This would be best achieved by working in reverse: starting with the outcomes and working back to find the useful variables within the concept. CONCLUSION: The highest priority for future research on multimorbidity should be given to measuring multimorbidity and to simplifying the EGPRN model, using a pragmatic approach to determine the useful variables within the concept from its outcomes