Analyzing Adherence to Prenatal Supplement: Does Pill Count Measure Up?

Objective. To determine if adherence as measured by pill count would show a significant association with serum-based measures of adherence. Methods. Data were obtained from a prenatal vitamin D supplementation trial where subjects were stratified by race and randomized into three dosing groups: 400 (control), 2000, or 4000 IU vitamin D3/day. One measurement of adherence was obtained via pill counts remaining compared to a novel definition for adherence using serum 25-hydroxy-vitamin D (25-OH-D) levels (absolute change in 25(OH)D over the study period and the subject's steady-state variation in their 25(OH)D levels). A multivariate logistic regression model examined whether mean percent adherence by pill count was significantly associated with the adherence measure by serum metabolite levels. Results. Subjects' mean percentage of adherence by pill count was not a significant predictor of adherence by serum metabolite levels. This finding was robust across a series of sensitivity analyses. Conclusions. Based on our novel definition of adherence, pill count was not a reliable predictor of adherence to protocol, and calls into question how adherence is measured in clinical research. Our findings have implications regarding the determination of efficacy of medications under study and offer an alternative approach to measuring adherence of long half-life supplements/medications

Maximizing realized yield by breeding for disease tolerance: A case study for Septoria tritici blotch

Disease-tolerant cultivars maintain yield in the presence of disease. When disease intensity is high, they can improve a grower's net return compared to less tolerant cultivars. Many authors report a trade-off, whereby higher fully protected yields are correlated with a lower disease tolerance. We analyse the question for breeders: to what extent should they breed for tolerance when it compromises maximizing fully protected yield? Field trials with 147 progeny from five parental crosses of wheat were used to measure yield and tolerance under a range of disease intensities from Septoria tritici blotch (STB; causal organism Zymoseptoria tritici) at a range of sites and seasons. The data define the variation for these traits from which breeders can select. A simple data-driven descriptive model was used to calculate the combination of tolerance and fully protected yield that maximizes actual yield for any given level of disease—quantified by loss of healthy canopy area duration (HAD-loss). This model was combined with data on the year-to-year variability of HAD-loss in the UK to calculate the tolerance and fully protected yield that maximizes the mean actual yield. We found that even when an effective fungicide treatment programme is applied, breeding for tolerance increases the mean actual yield. Some commercially available cultivars were found to have a level of tolerance that leads to yields close to the maximum yield in the presence of disease, others had a lower tolerance leading to suboptimal yields

Interaction Between Solid Copper Jets and Powerful Electrical Current Pulses

The interaction between a solid copper jet and an electric current pulse is studied. Coppe

Vaccino antinfluenzale stagionale in Italia: misurare l’efficacia sul campo e la sicurezza : Stagione 2015-2016

In Italia, nella stagione influenzale 2015-2016 sono stati condotti dall\u2019Istituto Superiore di Sanit\ue0 (ISS), con il supporto dell\u2019Agenzia Italiana del Farmaco (AIFA), due studi al fine di stimare l\u2019efficacia sul campo (I-MOVE, Influenza - Monitoring Vaccine Effectiveness) e valutare la sicurezza (SVEVA, Studio sulla Valutazione degli Eventi dopo Vaccinazione Antinfluenzale) del vaccino antinfluenzale. Nel complesso hanno aderito 8 Regioni che corrispondono a oltre met\ue0 della popolazione italiana nel 2015 (non tutte le Regioni hanno aderito a entrambi gli obiettivi di studio). Nello studio I-MOVE sono stati reclutati 1.094 casi di ILI (Influenza-Like Illness), dai 64 medici di medicina generale e pediatri di libera scelta partecipanti (506 casi e 498 controlli). I risultati suggeriscono che il vaccino ha conferito una protezione moderata nei confronti del tipo virale A(H1N1)pdm09 e molto bassa per A(H3N2) e B a causa del sostanziale grado di mismatch antigenico osservato, rispetto al ceppo vaccinale. Nello studio SVEVA sono stati monitorati 3.213 soggetti vaccinati e rilevati 854 (26%) eventi dopo 7 giorni dalla vaccinazione, la maggior parte dei quali di lieve entit\ue0. Al fine di ottenere stime di efficacia pi\uf9 solide e descrivere eventi avversi rari, \ue8 necessario tuttavia raggiungere una numerosit\ue0 campionaria maggiore.In Italy, during the 2015/2016 flu season, the National Institute of Health (ISS), with the support of the Italian Drug Agency (AIFA), conducted two studies to estimate vaccine effectiveness (I-MOVE) and evaluate safety (SVEVA) of the flu vaccine. A total of 8 regions, among 21, participated to the study which can correspond to more than 50% of the Italian population in 2015 (not all regions participated to both objectives of the study). For the I-MOVE study, 1094 cases of ILI (506 cases and 498 controls) were recruited by 64 general practitioners and pediatricians. The results indicate that the vaccine gave moderate protection against the virus type A (H1N1) pdm09 and very low protection for A (H3N2) and B due to the antigenic mismatch that was observed, compared to the vaccine strain. For SVEVA study, 3213 vaccinated cases were monitored and 854 (26%) side effects were notified after 7 days of vaccination, the major part were mild. In order to obtain more solid data regarding vaccine effectiveness, and to describe rare adverse events, it is necessary to increase the sample size of both studies

Gram Negative Wound Infection in Hospitalised Adult Burn Patients-Systematic Review and Metanalysis-

BACKGROUND: Gram negative infection is a major determinant of morbidity and survival. Traditional teaching suggests that burn wound infections in different centres are caused by differing sets of causative organisms. This study established whether Gram-negative burn wound isolates associated to clinical wound infection differ between burn centres. METHODS: Studies investigating adult hospitalised patients (2000-2010) were critically appraised and qualified to a levels of evidence hierarchy. The contribution of bacterial pathogen type, and burn centre to the variance in standardised incidence of Gram-negative burn wound infection was analysed using two-way analysis of variance. PRIMARY FINDINGS: Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumanni, Enterobacter spp., Proteus spp. and Escherichia coli emerged as the commonest Gram-negative burn wound pathogens. Individual pathogens' incidence did not differ significantly between burn centres (F (4, 20) = 1.1, p = 0.3797; r2 = 9.84). INTERPRETATION: Gram-negative infections predominate in burn surgery. This study is the first to establish that burn wound infections do not differ significantly between burn centres. It is the first study to report the pathogens responsible for the majority of Gram-negative infections in these patients. Whilst burn wound infection is not exclusive to these bacteria, it is hoped that reporting the presence of this group of common Gram-negative "target organisms" facilitate clinical practice and target research towards a defined clinical demand.peer-reviewe

Persistence of single species of symbionts across multiple closelyrelated host species

Some symbiont species are highly host-specific, inhabiting only one or a very few host species, and typically have limited dispersal abilities. When they do occur on multiple host species, populations of such symbionts are expected to become genetically structured across these different host species, and this may eventually lead to new symbiont species over evolutionary timescales. However, a low number of dispersal events of symbionts between host species across time might be enough to prevent population structure and species divergence. Overall, processes of evolutionary divergence and the species status of most putative multi-host symbiont systems are yet to be investigated. Here, we used DNA metabarcoding data of 6,023 feather mites (a total of 2,225 OTU representative sequences) from 147 infracommunities (i.e., the assemblage consisting of all mites of different species collected from the same bird host individual) to investigate patterns of population genetic structure and species status of three different putative multi-host feather mite species Proctophyllodes macedo Vitzthum, 1922, Proctophyllodes motacillae Gaud, 1953, and Trouessartia jedliczkai (Zimmerman, 1894), each of which inhabits a variable number of different closely related wagtail host species (genus Motacilla). We show that mite populations from different host species represent a single species. This pattern was found in all the mite species, suggesting that each of these species is a multi-host species in which dispersal of mites among host species prevents species divergence. Also, we found evidence of limited evolutionary divergence manifested by a low but significant level of population genetic structure among symbiont populations inhabiting different host species. Our study agrees with previous studies showing a higher than expected colonization opportunities in host-specific symbionts. Indeed, our results support that these dispersal events would allow the persistence of multi-host species even in symbionts with limited dispersal capabilities, though additional factors such as the geographical structure of some bird populations may also play a role.This work was supported by the MINECO CGL2011-24466 to RJ and CGL2015-69650-P to RJ and DS

The effect of intra-articular botulinum toxin A on substance P, prostaglandin E-2, and tumor necrosis factor alpha in the canine osteoarthritic joint

Background: Recently, intra-articular botulinum toxin A (IA BoNT A) has been shown to reduce joint pain in osteoarthritic dogs. Similar results have been reported in human patients with arthritis. However, the mechanism of the antinociceptive action of IA BoNT A is currently not known. The aim of this study was to explore this mechanism of action by investigating the effect of IA BoNT A on synovial fluid (SF) and serum substance P (SP), prostaglandin E-2 (PGE(2)), and tumor necrosis factor alpha (TNF-alpha) in osteoarthritic dogs. Additionally, the aim was to compare SF SP and PGE(2) between osteoarthritic and non-osteoarthritic joints, and investigate associations between SP, PGE(2), osteoarthritic pain, and the signalment of dogs. Thirty-five dogs with chronic naturally occurring osteoarthritis and 13 non-osteoarthritic control dogs were included in the study. Osteoarthritic dogs received either IA BoNT A (n = 19) or IA placebo (n = 16). Serum and SF samples were collected and osteoarthritic pain was evaluated before (baseline) and 2 and 8 weeks after treatment. Osteoarthritic pain was assessed with force platform, Helsinki Chronic Pain Index, and joint palpation. Synovial fluid samples were obtained from control dogs after euthanasia. The change from baseline in SP and PGE(2) concentration was compared between the IA BoNT A and placebo groups. The synovial fluid SP and PGE(2) concentration was compared between osteoarthritic and control joints. Associations between SP, PGE(2), osteoarthritic pain, and the signalment of dogs were evaluated. Results: There was no significant change from baseline in SP or PGE(2) after IA BoNT A. Synovial fluid PGE(2) was significantly higher in osteoarthritic compared to control joints. Synovial fluid PGE(2) correlated with osteoarthritic pain. No associations were found between SP or PGE2 and the signalment of dogs. The concentration of TNF-alpha remained under the detection limit of the assay in all samples. Conclusions: The results suggest that the antinociceptive effect of IA BoNT A in the joint might not be related to the inhibition of SP nor PGE(2). Synovial fluid PGE(2,) but not SP, could be a marker for chronic osteoarthritis and pain in dogs.Peer reviewe

Convergence and divergence in media: different perspectives

A current issue in the media industry is coping with the effects of convergence. The concept of convergence is frequently used both in the academic field and within the media industry to denote the ongoing restructuring of media companies as well as to describe the latest developments in media forms, distribution, and consumption. However, there is currently no generally accepted definition of the concept. Depending on the context, the meaning and connotations vary. Some researchers suggest that convergence is a result of a change toward a more modern media society while others treat the concept as denoting the actual process toward a more efficient management of the media value chain. This paper discusses various definitions of convergence, both in a historical perspective and as it is used and understood in contemporary media and communications research, one aim being the evaluation of how the meaning of the concept has evolved during the past decade. The study is based on literature research and one conclusion is that convergence is a process dependent on current circumstances within society. The use of the concept has therefore developed from being mainly connected with digitalization in media technology to also include elements of integration, combination, competition and divergence. This paper suggests that convergence should be seen as an ongoing process of media and media industry development that is dependent on and in continuous interplay with a contrasting and complementary process, that of media divergence