Culture: Not just Burns – what about the poet Robert Fergusson?

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Impact of 2018 EU Risk Minimisation Measures and Revised Pregnancy Prevention Programme on Utilisation and Prescribing Trends of Medicinal Products Containing Valproate: An Interrupted Time Series Study

Pregnancy prevention programme; Prescribing medicinal products; ValproatePrograma de prevenció de l'embaràs; Prescripció de medicaments; ValproatPrograma de prevención de embarazo; Prescripción de medicamentos; ValproatoIntroduction Due to established teratogenicity of valproates, the EU risk minimisation measures (RMMs) with a pregnancy prevention programme (PPP) for valproate were updated in March 2018. Objectives To investigate the effectiveness of the 2018 EU RMMs on valproate utilisation in five European countries/regions. Methods A multi-database, times series study of females of childbearing potential (12–55 years) was conducted using electronic medical records from five countries/regions (01.01.2010–31.12.2020): Denmark, Tuscany (Italy), Spain, the Netherlands, and the UK. Clinical and demographic information from each database was transformed to the ConcePTION Common Data Model, quality checks were conducted and a distributed analysis was performed using common scripts. Incident and prevalent use of valproate, proportion of discontinuers and switchers to alternative medicine, frequency of contraception coverage during valproate use, and occurrence of pregnancies during valproate exposure were estimated per month. Interrupted time series analyses were conducted to estimate the level or trend change in the outcome measures. Results We included 69,533 valproate users from 9,699,371 females of childbearing potential from the five participating centres. A significant decline in prevalent use of valproates was observed in Tuscany, Italy (mean difference post-intervention −7.7%), Spain (−11.3%), and UK (−5.9%) and a non-significant decline in the Netherlands (−3.3%), but no decline in incident use after the 2018 RMMs compared to the period before. The monthly proportion of compliant valproate prescriptions/dispensings with a contraceptive coverage was low (<25%), with an increase after the 2018 RMMs only in the Netherlands (mean difference post-intervention 12%). There was no significant increase in switching rates from valproates to alternative medicine after the 2018 intervention in any of the countries/regions. We observed a substantial number of concurrent pregnancies during valproate exposure, but with a declining rate after the 2018 RMMs in Tuscany, Italy (0.70 per 1000 valproate users pre- and 0.27 post-intervention), Spain (0.48 and 0.13), the Netherlands (0.34 and 0.00), and an increasing rate in UK (1.13 and 5.07). Conclusion There was a small impact of the 2018 RMMs on valproate use in the studied European countries/regions. The substantial number of concurrent pregnancies with valproate exposure warrants a careful monitoring of implementation of the existing PPP for valproate in clinical practice in Europe, to see if there is any need for additional measures in the future

Procedimiento de obtención de partículas de ZnO con morfología acicular

Referencia OEPM: P200001597.-- Fecha de solicitud: 27/06/2000.-- Titular: Consejo Superior de Investigaciones Científicas (CSIC).Procedimiento de obtención de partículas de ZnO con morfología acicular. La presente invención utiliza el método de precipitación controlada para obtener partículas de ZnO con morfología acicular. A través del control de los parámetros de formación de precursores intermedios de compuestos de cinc y la evolución de dichos precursores intermedios mediante el lavado con agua destilada de la suspensión coloidal se obtiene hidróxido de cinc. La destilación entre 100-150°C de una suspensión acuosa del hidróxido de zinc produce la formación de partículas de óxido de cinc con morfología acicular. El tamaño de las partículas varía con las condiciones de obtención, siendo el tamaño estándar de 0.5 μm de diámetro y 5-8 μm de longitud. La eficacia del procedimiento es superior al 90%.Peer reviewe

Impact of the 2018 revised Pregnancy Prevention Programme by the European Medicines Agency on the use of oral retinoids in females of childbearing age in Denmark, Italy, Netherlands, and Spain: an interrupted time series analysis

Acne; Oral retinoids; Pregnancy preventionAcné; Retinoides orales; Prevención del embarazoAcné; Retinoides orals; Prevenció de l'embaràsBackground: In March 2018, the European pregnancy prevention programme for oral retinoids was updated as part of risk minimisation measures (RMM), emphasising their contraindication in pregnant women. Objective: To measure the impact of the 2018 revision of the RMMs in Europe by assessing the utilisation patterns of isotretinoin, alitretinoin and acitretin, contraceptive measures, pregnancy testing, discontinuation, and pregnancy occurrence concomitantly with a retinoid prescription. Methods: An interrupted time series (ITS) analysis to compare level and trend changes after the risk minimisation measures implementation was conducted on a cohort of females of childbearing age (12–55 years of age) from January 2010 to December 2020, derived from six electronic health data sources in four countries: Denmark, Netherlands, Spain, and Italy. Monthly utilisation figures (incidence rates [IR], prevalence rates [PR] and proportions) of oral retinoids were calculated, as well as discontinuation rates, contraception coverage, pregnancy testing, and rates of exposed pregnancies to oral retinoids, before and after the 2018 RMMs. Results: From 10,714,182 females of child-bearing age, 88,992 used an oral retinoid at any point during the study period (mean age 18.9–22.2 years old). We found non-significant level and trend changes in incidence or prevalence of retinoid use in females of child-bearing age after the 2018 RMMs. The reason of discontinuation was unknown in >95% of cases. Contraception use showed a significant increase trend in Spain; for other databases this information was limited. Pregnancy testing was hardly recorded thus was not possible to model ITS analyses. After the 2018 RMM, rates of pregnancy occurrence during retinoid use, and start of a retinoid during a pregnancy varied from 0.0 to 0.4, and from 0.2 to 0.8, respectively. Conclusion: This study shows a limited impact of the 2018 RMMs on oral retinoids utilisation patterns among females of child-bearing age in four European countries. Pregnancies still occur during retinoid use, and oral retinoids are still prescribed to pregnant women. Contraception and pregnancy testing information was limited in most databases. Regulators, policymakers, prescribers, and researchers must rethink implementation strategies to avoid any pregnancy becoming temporarily related to retinoid use.The research leading to these results was conducted as part of the activities of the EU PE&PV (Pharmacoepidemiology and Pharmacovigilance) Research Network which is a public academic partnership coordinated by the Utrecht University, Netherlands. The project has received support from the European Medicines Agency under the Framework service contract nr EMA/2017/09/PE (Lot 4). The content of this manuscript expresses the opinion of the authors and may not be understood or quoted as being made on behalf of or reflecting the position of the European Medicines Agency or one of its committees or working parties

Friedreich’s Ataxia: Phenotype and Genotype in Eleven Patients

Introducción: La ataxia de Friedreich (FRDA) es una enfermedad autosómica recesiva debida a una mutación en el gen X25. Dicho gen está localizado en el cromosoma 9 y codifica para la proteína frataxina. La enfermedad es causada por la repetición del trinucleótido GAA. En individuos normales la secuencia GAA se encuentra repetida entre siete y veintidós veces, mientras que, en pacientes con ataxia de Friedreich GAA puede estar repetida cientos o miles de veces.Objetivos: Evaluar si existe correlación entre el tamaño de la expansión, la edad de inicio de FRDA y su severidad en la muestra seleccionada.Métodos:- Se estudiaron once pacientes con fenotipo típico de ataxia de Friedreich. El análisis molecular por PCR determinó la expansión del trinucleótido GAA. Se analizó la correlación entre la edad de inicio de FRDA y su progresión con el número de repeticiones GAA.Resultados y conclusiones:- El análisis molecular por PCR mostró ocho pacientes homocigotos para la expansión, y tres negativos. El promedio del tamaño de las expansiones en los alelos es 622±5 con un promedio correspondiente de la edad inicio de FRDA 13±8. Para el tamaño de la muestra no se observó una correlación estadística significativa entre la edad de inicio de la enfermedad y el número de repeticiones, pero sí una tendencia a correlacionarse de forma inversa (p<0.11). El diagnóstico molecular de FRDA, sumado a la comprensión de su fisiología y a la utilización de los criterios de inclusión de Harding, constituye un paso importante en el logro de un tratamiento óptimo de la enfermedad.Introduction:- Friedreich’s ataxia is an autosomal recessive disease due to a mutation in gene X25. This gene codes for frataxin and it is located on chromosome 9. The disease is caused by a triplet particular sequence of bases (GAA). Normally, the GAA sequence is repeated 7 to 22 times, but in people with Friedreich’s ataxia, it can be repeated hundreds or even over thousand times. Objectives:To determine if there is a correlation between clinical and molecular findings in our FRDA patients. Methods: Eleven patients with the typical Friedreich´s ataxia phenotype were studied by PCR we determined the size of the GAA expansions, and analyzed the correlation of age at onset and rate of disease progression with the number of GAA repetitions. Results and conclusions: Molecular analysis by PCR showed eight homozygous patients for the expansion and three negative. The average of the size of the expansions in the allele was of 622±5 with an average in the age of beginning of 13±8. For the sample size, there was no significant statistical correlation between the age of beginning of the disease and the number of repetitions, although there was like an inverse correlation. Besides understanding of FRDA physiology and the Harding clinical inclusion criteria, molecular diagnosis is an important step in the achievement of an optimal therapeutic treatment

Preprints in times of COVID19: The time is ripe for agreeing on terminology and good practices

Over recent years, the research community has been increasingly using preprint servers to share manuscripts that are not yet peer-reviewed. Even if it enables quick dissemination of research findings, this practice raises several challenges in publication ethics and integrity. In particular, preprints have become an important source of information for stakeholders interested in COVID19 research developments, including traditional media, social media, and policy makers. Despite caveats about their nature, many users can still confuse pre-prints with peer-reviewed manuscripts. If unconfirmed but already widely shared first-draft results later prove wrong or misinterpreted, it can be very difficult to unlearn what we thought was true. Complexity further increases if unconfirmed findings have been used to inform guidelines. To help achieve a balance between early access to research findings and its negative consequences, we formulated five recommendations: (a) consensus should be sought on a term clearer than \u27pre-print\u27, such as \u27Unrefereed manuscript\u27, Manuscript awaiting peer review or \u27\u27Non-reviewed manuscript ; (b) Caveats about unrefereed manuscripts should be prominent on their first page, and each page should include a red watermark stating \u27Caution-Not Peer Reviewed\u27; (c) pre-print authors should certify that their manuscript will be submitted to a peer-review journal, and should regularly update the manuscript status; (d) high level consultations should be convened, to formulate clear principles and policies for the publication and dissemination of non-peer reviewed research results; (e) in the longer term, an international initiative to certify servers that comply with good practices could be envisaged

Myocarditis and pericarditis associated with SARS-CoV-2 vaccines: A population-based descriptive cohort and a nested self-controlled risk interval study using electronic health care data from four European countries

COVID-19 vaccine; Adverse drug reaction; MyocarditisVacuna contra el COVID-19; Reacció adversa a fàrmacs; MiocarditisVacuna contra el COVID-19; Reacción adversa a medicamentos; MiocarditisBackground: Estimates of the association between COVID-19 vaccines and myo-/pericarditis risk vary widely across studies due to scarcity of events, especially in age- and sex-stratified analyses. Methods: Population-based cohort study with nested self-controlled risk interval (SCRI) using healthcare data from five European databases. Individuals were followed from 01/01/2020 until end of data availability (31/12/2021 latest). Outcome was first myo-/pericarditis diagnosis. Exposures were first and second dose of Pfizer, AstraZeneca, Moderna, and Janssen COVID-19 vaccines. Baseline incidence rates (IRs), and vaccine- and dose-specific IRs and rate differences were calculated from the cohort The SCRI calculated calendar time-adjusted IR ratios (IRR), using a 60-day pre-vaccination control period and dose-specific 28-day risk windows. IRRs were pooled using random effects meta-analysis. Findings: Over 35 million individuals (49·2% women, median age 39–49 years) were included, of which 57·4% received at least one COVID-19 vaccine dose. Baseline incidence of myocarditis was low. Myocarditis IRRs were elevated after vaccination in those aged < 30 years, after both Pfizer vaccine doses (IRR = 3·3, 95%CI 1·2-9.4; 7·8, 95%CI 2·6-23·5, respectively) and Moderna vaccine dose 2 (IRR = 6·1, 95%CI 1·1-33·5). An effect of AstraZeneca vaccine dose 2 could not be excluded (IRR = 2·42, 95%CI 0·96-6·07). Pericarditis was not associated with vaccination. Interpretation: mRNA-based COVID-19 vaccines and potentially AstraZeneca are associated with increased myocarditis risk in younger individuals, although absolute incidence remains low. More data on children (≤ 11 years) are needed.The project received support from the European Medicines Agency (EMA/2018/23/PE)

Evaluación de la calidad de la energía en dos casos de estudio: distorsión armónica inyectada por un sistema fotovoltaico de 40 kW y emitida por las cargas de una vivienda unifamiliar

Los posibles efectos de la conexión de sistemas foto voltaicos (FV) a la red eléctrica sobre la calidad del servicio, en particular en lo referente a la inyección de componentes armónicas, suelen ser una preocupación de las empresas distribuidoras y los entes de regulación. A fin de aportar datos cuantitativos en relación con este tema, se analizó la calidad de la energía: (i) en el punto de conexión de un sistema FV de 40 kW instalado en el Polo Científico y Tecnológico, y (ii) en uno de los circuitos eléctricos de una vivienda unifamiliar. Por un lado, las mediciones realizadas en el sistema FV permitieron verificar que las componentes armónicas de corriente inyectadas a la red están claramente por debajo de los límites establecidos por la norma IEC 61000-3-2. Por su parte, las mediciones efectuadas en la vivienda muestran que las componentes armónicas de corriente emitidas por electrodomésticos son significativamente mayores que las armónicas inyectadas por un inversor FV de potencia típica para una vivienda unifamiliar. Los análisis realizados permiten afirmar, en consecuencia, que la conexión de sistemas FV a la red eléctrica no afecta la calidad del servicio en cuanto a la distorsión armónica.The possible effects of the connection of photovoltaic (PV) systems to the power grid on service quality, particularly in relation to the injection of harmonic components, are often a concern of distribution companies and regulatory authorities. In order to provide quantitative data on this subject, the power quality was analyzed: (i) in the connection point of a 40 kW PV system installed in the Scientific and Technological Pole, and (ii) in one of the electrical circuits of a house. On one hand, measurements made in the 40 kW PV system allowed to verify that the current harmonic components injected into the network are clearly below the limits set by IEC 61000-3-2. Meanwhile, measurements performed in the electrical circuit of the house show that current harmonic components emitted by household appliances are significantly higher than the harmonics injected by a typical PV power inverter for a house. Therefore, the results presented in this paper support the conclusion that grid-connected PV systems do not affect the power quality in terms of harmonic distortion.Asociación Argentina de Energías Renovables y Medio Ambiente (ASADES