Digital Drugs: an anatomy of new medicines

Medicines are digitalized as aspects of their regulation and use are embodied in or draw from interlinked computerized systems and databases. This paper considers how this development changes the delivery of health care, the pharma industry, and regulatory and professional structures, as it reconfigures the material character of drugs themselves. It draws on the concept of assemblage in presenting a theory-based analysis that explores digital drugs’ ontological status including how they embody benefit and value. The paper addresses three interconnected domains – that of use of drugs (practice), of research (epistemology) and of regulation (structures)

Data descriptor: a global multiproxy database for temperature reconstructions of the Common Era

Reproducible climate reconstructions of the Common Era (1 CE to present) are key to placing industrial-era warming into the context of natural climatic variability. Here we present a community-sourced database of temperature-sensitive proxy records from the PAGES2k initiative. The database gathers 692 records from 648 locations, including all continental regions and major ocean basins. The records are from trees, ice, sediment, corals, speleothems, documentary evidence, and other archives. They range in length from 50 to 2000 years, with a median of 547 years, while temporal resolution ranges from biweekly to centennial. Nearly half of the proxy time series are significantly correlated with HadCRUT4.2 surface temperature over the period 1850-2014. Global temperature composites show a remarkable degree of coherence between high-and low-resolution archives, with broadly similar patterns across archive types, terrestrial versus marine locations, and screening criteria. The database is suited to investigations of global and regional temperature variability over the Common Era, and is shared in the Linked Paleo Data (LiPD) format, including serializations in Matlab, R and Python. (TABLE) Since the pioneering work of D'Arrigo and Jacoby1-3, as well as Mann et al. 4,5, temperature reconstructions of the Common Era have become a key component of climate assessments6-9. Such reconstructions depend strongly on the composition of the underlying network of climate proxies10, and it is therefore critical for the climate community to have access to a community-vetted, quality-controlled database of temperature-sensitive records stored in a self-describing format. The Past Global Changes (PAGES) 2k consortium, a self-organized, international group of experts, recently assembled such a database, and used it to reconstruct surface temperature over continental-scale regions11 (hereafter, ` PAGES2k-2013'). This data descriptor presents version 2.0.0 of the PAGES2k proxy temperature database (Data Citation 1). It augments the PAGES2k-2013 collection of terrestrial records with marine records assembled by the Ocean2k working group at centennial12 and annual13 time scales. In addition to these previously published data compilations, this version includes substantially more records, extensive new metadata, and validation. Furthermore, the selection criteria for records included in this version are applied more uniformly and transparently across regions, resulting in a more cohesive data product. This data descriptor describes the contents of the database, the criteria for inclusion, and quantifies the relation of each record with instrumental temperature. In addition, the paleotemperature time series are summarized as composites to highlight the most salient decadal-to centennial-scale behaviour of the dataset and check mutual consistency between paleoclimate archives. We provide extensive Matlab code to probe the database-processing, filtering and aggregating it in various ways to investigate temperature variability over the Common Era. The unique approach to data stewardship and code-sharing employed here is designed to enable an unprecedented scale of investigation of the temperature history of the Common Era, by the scientific community and citizen-scientists alike

Physical activity, sedentary time and breast cancer risk: a Mendelian randomisation study

Objectives: Physical inactivity and sedentary behaviour are associated with higher breast cancer risk in observational studies, but ascribing causality is difficult. Mendelian randomisation (MR) assesses causality by simulating randomised trial groups using genotype. We assessed whether lifelong physical activity or sedentary time, assessed using genotype, may be causally associated with breast cancer risk overall, pre/post-menopause, and by case-groups defined by tumour characteristics. Methods: We performed two-sample inverse-variance-weighted MR using individual-level Breast Cancer Association Consortium case-control data from 130 957 European-ancestry women (69 838 invasive cases), and published UK Biobank data (n=91 105–377 234). Genetic instruments were single nucleotide polymorphisms (SNPs) associated in UK Biobank with wrist-worn accelerometer-measured overall physical activity (nsnps=5) or sedentary time (nsnps=6), or accelerometer-measured (nsnps=1) or self-reported (nsnps=5) vigorous physical activity. Results: Greater genetically-predicted overall activity was associated with lower breast cancer overall risk (OR=0.59; 95% confidence interval (CI) 0.42 to 0.83 per-standard deviation (SD;~8 milligravities acceleration)) and for most case-groups. Genetically-predicted vigorous activity was associated with lower risk of pre/perimenopausal breast cancer (OR=0.62; 95% CI 0.45 to 0.87,≥3 vs. 0 self-reported days/week), with consistent estimates for most case-groups. Greater genetically-predicted sedentary time was associated with higher hormone-receptor-negative tumour risk (OR=1.77; 95% CI 1.07 to 2.92 per-SD (~7% time spent sedentary)), with elevated estimates for most case-groups. Results were robust to sensitivity analyses examining pleiotropy (including weighted-median-MR, MR-Egger). Conclusion: Our study provides strong evidence that greater overall physical activity, greater vigorous activity, and lower sedentary time are likely to reduce breast cancer risk. More widespread adoption of active lifestyles may reduce the burden from the most common cancer in women

Food Instruction Booklet Design For The Nigeria Food Consumption And Nutrition Survey 2001-2003

In 2001-2003, the International Institute of Tropical Agriculture (IITA), in collaboration with the federal government of Nigeria, USAID and the US Department of Agriculture (USDA), conducted a nationwide food consumption survey. Since the last national survey occurred in 1963, a major objective was to establish national baseline data for women and children under 5 years old. To ensure the accuracy and quality of detailed food intake data, IITA adapted the USDA Food Instruction Booklet (FIB), a compilation of foods consumed in the country, divided into food groups and subgroups. A Nigerian food composition database formed the basis of the Nigerian FIB, whereby, food groups, probes, a food index, and measurement guides with conversion tables were compiled. The Nigerian FIB included 18 major food groups and 79 subgroups compared to 16 food groups and 100 subgroups in the USDA FIB. For both countries, these food groups highlight how food is categorized and consumed. A typical example was how each country grouped grains and cereals. The Nigerian FIB included four separate groups (cereals, cereal products, confectionaries, and pasta). In the USDA FIB, breads and sweet breads were put together as one group. Cereal, pasta and rice were together as a second group. Examples of these food groups and probes are presented. While both FIBs contained measurement guides (cups, spoons, thickness sticks, rulers), the Nigerian FIB also included indigenous guides. These guides allowed for food weight conversions using local utensils, weights of foods cooked at home and purchased away from home, weights of foods with different sizes, and weights of food items with different measuring tools. Another unique element in the Nigerian FIB was the inclusion of scientific names for foods, their English names, and local names in the three Nigerian languages (Hausa, Yoruba, Igbo). The FIB highlights cultural similarities and differences in food consumption and demonstrates how one country′s survey instrument can be adapted to meet the needs of another

Food instruction booklet design for the Nigeria food consumption and nutrition survey 2001-2003

In 2001-2003, the International Institute of Tropical Agriculture (IITA), in collaboration with the federal government of Nigeria, USAID and the US Department of Agriculture (USDA), conducted a nationwide food consumption survey. Since the last national survey occurred in 1963, a major objective was to establish national baseline data for women and children under 5 years old. To ensure the accuracy and quality of detailed food intake data, IITA adapted the USDA Food Instruction Booklet (FIB), a compilation of foods consumed in the country, divided into food groups and subgroups. A Nigerian food composition database formed the basis of the Nigerian FIB, whereby, food groups, probes, a food index, and measurement guides with conversion tables were compiled. The Nigerian FIB included 18 major food groups and 79 subgroups compared to 16 food groups and 100 subgroups in the USDA FIB. For both countries, these food groups highlight how food is categorized and consumed. A typical example was how each country grouped grains and cereals. The Nigerian FIB included four separate groups (cereals, cereal products, confectionaries, and pasta). In the USDA FIB, breads and sweet breads were put together as one group. Cereal, pasta and rice were together as a second group. Examples of these food groups and probes are presented. While both FIBs contained measurement guides (cups, spoons, thickness sticks, rulers), the Nigerian FIB also included indigenous guides. These guides allowed for food weight conversions using local utensils, weights of foods cooked at home and purchased away from home, weights of foods with different sizes, and weights of food items with different measuring tools. Another unique element in the Nigerian FIB was the inclusion of scientific names for foods, their English names, and local names in the three Nigerian languages (Hausa, Yoruba, Igbo). The FIB highlights cultural similarities and differences in food consumption and demonstrates how one country′s survey instrument can be adapted to meet the needs of another

Physical activity, sedentary time and breast cancer risk : a Mendelian randomisation study

Objectives Physical inactivity and sedentary behaviour are associated with higher breast cancer risk in observational studies, but ascribing causality is difficult. Mendelian randomisation (MR) assesses causality by simulating randomised trial groups using genotype. We assessed whether lifelong physical activity or sedentary time, assessed using genotype, may be causally associated with breast cancer risk overall, pre/post-menopause, and by case-groups defined by tumour characteristics.Methods We performed two-sample inverse-variance-weighted MR using individual-level Breast Cancer Association Consortium case-control data from 130 957 European-ancestry women (69 838 invasive cases), and published UK Biobank data (n=91 105–377 234). Genetic instruments were single nucleotide polymorphisms (SNPs) associated in UK Biobank with wrist-worn accelerometer-measured overall physical activity (nsnps=5) or sedentary time (nsnps=6), or accelerometer-measured (nsnps=1) or self-reported (nsnps=5) vigorous physical activity.Results Greater genetically-predicted overall activity was associated with lower breast cancer overall risk (OR=0.59; 95% confidence interval (CI) 0.42 to 0.83 per-standard deviation (SD;~8 milligravities acceleration)) and for most case-groups. Genetically-predicted vigorous activity was associated with lower risk of pre/perimenopausal breast cancer (OR=0.62; 95% CI 0.45 to 0.87,≥3 vs. 0 self-reported days/week), with consistent estimates for most case-groups. Greater genetically-predicted sedentary time was associated with higher hormone-receptor-negative tumour risk (OR=1.77; 95% CI 1.07 to 2.92 per-SD (~7% time spent sedentary)), with elevated estimates for most case-groups. Results were robust to sensitivity analyses examining pleiotropy (including weighted-median-MR, MR-Egger).Conclusion Our study provides strong evidence that greater overall physical activity, greater vigorous activity, and lower sedentary time are likely to reduce breast cancer risk. More widespread adoption of active lifestyles may reduce the burden from the most common cancer in women