127 research outputs found

    Creating a Model of Cyber Proficiency: Remodeling Law Enforcement Tactics in Pittsburgh to Address the Evolving Nature of Cybersecurity

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    This article summarizes an Interview with The Honorable David J. Hickton, United States Attorney for the Western District of Pennsylvania

    Effect of a test-and-treat approach to vitamin D supplementation on risk of all cause acute respiratory tract infection and covid-19: phase 3 randomised controlled trial (CORONAVIT)

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    Objective To determine the effect of population level implementation of a test-and-treat approach to correction of suboptimal vitamin D status (25-hydroxyvitamin D (25(OH)D) <75 nmol/L) on risk of all cause acute respiratory tract infection and covid 19.Design Phase 3 open label randomised controlled trial.Setting United Kingdom.Participants 6200 people aged ≄16 years who were not taking vitamin D supplements at baseline.Interventions Offer of a postal finger prick test of blood 25(OH)D concentration with provision of a six month supply of lower dose vitamin D (800 IU/day, n=1550) or higher dose vitamin D (3200 IU/day, n=1550) to those with blood 25(OH)D concentration <75 nmol/L, compared with no offer of testing or supplementation (n=3100). Follow-up was for six months.Main outcome measures The primary outcome was the proportion of participants with at least one swab test or doctor confirmed acute respiratory tract infection of any cause. A secondary outcome was the proportion of participants with swab test confirmed covid-19. Logistic regression was used to calculate odds ratios and associated 95% confidence intervals. The primary analysis was conducted by intention to treat.Results Of 3100 participants offered a vitamin D test, 2958 (95.4%) accepted and 2674 (86.3%) had 25(OH)D concentrations <75 nmol/L and received vitamin D supplements (n=1328 lower dose, n=1346 higher dose). Compared with 136/2949 (4.6%) participants in the no offer group, at least one acute respiratory tract infection of any cause occurred in 87/1515 (5.7%) in the lower dose group (odds ratio 1.26, 95% confidence interval 0.96 to 1.66) and 76/1515 (5.0%) in the higher dose group (1.09, 0.82 to 1.46). Compared with 78/2949 (2.6%) participants in the no offer group, 55/1515 (3.6%) developed covid-19 in the lower dose group (1.39, 0.98 to 1.97) and 45/1515 (3.0%) in the higher dose group (1.13, 0.78 to 1.63).Conclusions Among people aged 16 years and older with a high baseline prevalence of suboptimal vitamin D status, implementation of a population level test-and-treat approach to vitamin D supplementation was not associated with a reduction in risk of all cause acute respiratory tract infection or covid-19

    A Harmonised Approach to Curating Research-Ready Datasets for Asthma, Chronic Obstructive Pulmonary Disease (COPD) and Interstitial Lung Disease (ILD) in England, Wales and Scotland Using Clinical Practice Research Datalink (CPRD), Secure Anonymised Information Linkage (SAIL) Databank and DataLoch

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    Background: Electronic healthcare records (EHRs) are an important resource for health research that can be used to improve patient outcomes in chronic respiratory diseases. However, consistent approaches in the analysis of these datasets are needed for coherent messaging, and when undertaking comparative studies across different populations.Methods and results: We developed a harmonised curation approach to generate comparable patient cohorts for asthma, chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) using datasets from within Clinical Practice Research Datalink (CPRD; for England), Secure Anonymised Information Linkage (SAIL; for Wales) and DataLoch (for Scotland) by defining commonly derived variables consistently between the datasets. By working in parallel on the curation methodology used for CPRD, SAIL and DataLoch for asthma, COPD and ILD, we were able to highlight key differences in coding and recording between the databases and identify solutions to enable valid comparisons.Conclusion: Codelists and metadata generated have been made available to help re-create the asthma, COPD and ILD cohorts in CPRD, SAIL and DataLoch for different time periods, and provide a starting point for the curation of respiratory datasets in other EHR databases, expediting further comparable respiratory research

    The Secure Anonymised Information Linkage databank Dementia e-cohort (SAIL-DeC)

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    Introduction: The rising burden of dementia is a global concern, and there is a need to study its causes, natural history and outcomes. The Secure Anonymised Information Linkage (SAIL) Databank contains anonymised, routinely-collected healthcare data for the population of Wales, UK. It has potential to be a valuable resource for dementia research owing to its size, long follow-up time and prospective collection of data during clinical care. Objectives:We aimed to apply reproducible methods to create the SAIL dementia e-cohort (SAIL-DeC). We created SAIL-DeC with a view to maximising its utility for a broad range of research questions whilst minimising duplication of effort for researchers. Methods:SAIL contains individual-level, linked primary care, hospital admission, mortality and demographic data. Data are currently available until 2018 and future updates will extend participant follow-up time. We included participants who were born between 1st January 1900 and 1st January 1958 and for whom primary care data were available. We applied algorithms consisting of International Classification of Diseases (versions 9 and 10) and Read (version 2) codes to identify participants with and without all-cause dementia and dementia subtypes. We also created derived variables for comorbidities and risk factors. Results:From 4.4 million unique participants in SAIL, 1.2 million met the cohort inclusion criteria, resulting in 18.8 million person-years of follow-up. Of these, 129,650 (10%) developed all-cause dementia, with 77,978 (60%) having dementia subtype codes. Alzheimer's disease was the most common subtype diagnosis (62%). Among the dementia cases, the median duration of observation time was 14 years. Conclusion:We have created a generalisable, national dementia e-cohort, aimed at facilitating epidemiological dementia research

    BREATHE: The Health Data Research Hub for Respiratory Health.

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    Objectives The BREATHE Health Data Research Hub for Respiratory Health was formed in October 2019 as a multi-site academic consortium with multiple industrial partners via an Industry Forum and across its wider network. BREATHE’s main mission is enhancing data services within respiratory science, funded by the UKRI Industrial Strategy Challenge Fund. Approach BREATHE leveraged expertise across its founding sites and industrial partners to create data services which could be used by multiple sectors of collaborator. Across the founding sites, BREATHE was able to mobilise datasets housed within national TREs to form real-world evidence eCohorts for rapid and efficient respiratory study (Asthma, COPD, ILD), and has worked with specialists in cohort study and genomic data to house and supply these from within our partner TRE, SAIL Databank. As well as data assets, BREATHE is able to provide clinical and data expertise to collaborators for grant submissions and on bespoke respiratory science projects. Results Including a significant period of work during the pandemic supporting COVID-19 research and also focusing on other respiratory disease science support, BREATHE is now well-placed to move towards a sustainable operating plan post-grant from March 2023. Due to the approach taken in maximising data services for multiple sectors, BREATHE is positioned to provide data linkage and sharing services (making use of its TRE, SAIL Databank), providing analytic and clinical support to respiratory research projects for customers in multiple sectors (Pharma, SMEs, Academia, NHS, Charities), and advancing synthetic data and software development, again in partnership with SAIL and our wider industry partners. Conclusion As of March 2022, BREATHE has established a portfolio of data services and projects interfacing with multiple sectors of collaborator in enhancing respiratory science projects across the UK. With population-level data assets representing Wales, Scotland, and England and the ability to work with the Northern Ireland infrastructure housed at Swansea University, BREATHE supports 4-nation respiratory science in RWE data, and provides clinical and data linkage expertise to studies such as longitudinal cohorts, pharma companies, and contract research organisations

    A silent cry for leadership : organizing for leading (in) clusters

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    Leadership research so far has neglected clusters as a particular context for leadership, while research on networks and clusters has hardly studied leadership issues. This paper fills this dual gap in the abundant research on leadership on the one hand and on networks/clusters on the other by investigating leadership in photonics clusters from a structuration perspective. Apart from giving an insight into the variety and patterns of leadership practices observed, the paper addresses the dilemma that regional innovation systems such as clusters usually have a critical need of some kind of leadership, but that neither individual nor organizational actors wish to be led. This dilemma can only be ‘managed’ by organizing for leading (in) clusters in a certain way

    In-orbit performance of the Herschel/SPIRE imaging Fourier transform spectrometer: lessons learned

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    The Spectral and Photometric Imaging Receiver (SPIRE) is one of three scientific instruments on board the European Space Agency's Herschel Space Observatory which ended its operational phase on 29 April 2013. The low to medium resolution spectroscopic capability of SPIRE is provided by an imaging Fourier transform spectrometer (iFTS) of the Mach-Zehnder configuration. With their high throughput, broad spectral coverage, and variable resolution, coupled with their well-defined instrumental line shape and intrinsic wavelength and intensity calibration, iFTS are becoming increasingly common in far-infrared space astronomy missions. The performance of the SPIRE imaging spectrometer will be reviewed and example results presented. The lessons learned from the measured performance of the spectrometer as they apply to future missions will be discussed

    Investigating the uptake, effectiveness and safety of COVID-19 vaccines : protocol for an observational study using linked UK national data

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    Funding: This research is part of the Data and Connectivity National Core Study, led by Health Data Research UK in partnership with the Office for National Statistics and funded by UK Research and Innovation (HDRUK2020.146). EAVE II is funded by the Medical Research Council (MC_PC_19075) and supported by the Scottish Government. This work is supported by BREATHE - The Health Data Research Hub for Respiratory Health (MC_PC_19004). BREATHE is funded through the UK Research and Innovation Industrial Strategy Challenge Fund and delivered through Health Data Research UK. ConCOV is supported by the Medical Research Council (MR/V028367/1); Health Data Research UK (HDR-9006) which receives its funding from the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF) and the Wellcome Trust; and Administrative Data Research UK which is funded by the Economic and Social Research Council (grant ES/S007393/1).Introduction : The novel coronavirus SARS-CoV-2, which emerged in December 2019, has caused millions of deaths and severe illness worldwide. Numerous vaccines are currently under development of which a few have now been authorised for population-level administration by several countries. As of 20 September 2021, over 48 million people have received their first vaccine dose and over 44 million people have received their second vaccine dose across the UK. We aim to assess the uptake rates, effectiveness, and safety of all currently approved COVID-19 vaccines in the UK. Methods and analysis : We will use prospective cohort study designs to assess vaccine uptake, effectiveness and safety against clinical outcomes and deaths. Test-negative case–control study design will be used to assess vaccine effectiveness (VE) against laboratory confirmed SARS-CoV-2 infection. Self-controlled case series and retrospective cohort study designs will be carried out to assess vaccine safety against mild-to-moderate and severe adverse events, respectively. Individual-level pseudonymised data from primary care, secondary care, laboratory test and death records will be linked and analysed in secure research environments in each UK nation. Univariate and multivariate logistic regression models will be carried out to estimate vaccine uptake levels in relation to various population characteristics. VE estimates against laboratory confirmed SARS-CoV-2 infection will be generated using a generalised additive logistic model. Time-dependent Cox models will be used to estimate the VE against clinical outcomes and deaths. The safety of the vaccines will be assessed using logistic regression models with an offset for the length of the risk period. Where possible, data will be meta-analysed across the UK nations. Ethics and dissemination : We obtained approvals from the National Research Ethics Service Committee, Southeast Scotland 02 (12/SS/0201), the Secure Anonymised Information Linkage independent Information Governance Review Panel project number 0911. Concerning English data, University of Oxford is compliant with the General Data Protection Regulation and the National Health Service (NHS) Digital Data Security and Protection Policy. This is an approved study (Integrated Research Application ID 301740, Health Research Authority (HRA) Research Ethics Committee 21/HRA/2786). The Oxford-Royal College of General Practitioners Clinical Informatics Digital Hub meets NHS Digital’s Data Security and Protection Toolkit requirements. In Northern Ireland, the project was approved by the Honest Broker Governance Board, project number 0064. Findings will be made available to national policy-makers, presented at conferences and published in peer-reviewed journals.Publisher PDFPeer reviewe
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