3,995 research outputs found

    A Dual Read-Out Assay to Evaluate the Potency of Compounds Active against Mycobacterium tuberculosis

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    PMCID: PMC3617142This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

    Immune Checkpoint Blockade in Lung Carcinoids with Aggressive Behaviour: One More Arrow in Our Quiver?

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    Lung carcinoids are well-differentiated and low-/intermediate-grade neuroendocrine neoplasms of the lung. Given their relative rarity, and the paucity of data available from prospective studies, no global consensus exists on the systemic treatment of these tumours. In recent years, immune checkpoint inhibitors have revolutionized cancer management and are under evaluation in patients with diverse types of neuroendocrine neoplasms. The aim of this narrative review is to analyse all available data for the use of approved immune checkpoint inhibitors in patients with lung carcinoids. We performed an extensive search for relevant data sources and found five published articles, one meeting abstract, and nine registered clinical trials indicating a growing interest of researchers in this field, and providing preliminary evidence of efficacy for combined nivolumab plus ipilimumab and durvalumab plus tremelimumab regimens in the treatment of advanced and/or metastatic lung carcinoids

    Large-Scale Investment in Science: Economic Impact and Social Justice

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    Abstract Science is not a free lunch. Worldwide, R&D expenditures per year, from basic research to product development by firms, are about USD1.7 trillion (according to UNESCO estimates for 2017). There are perhaps 7.8 million professional researchers globally, around one researcher out of one thousand inhabitants of the planet. In the OECD area, which includes the most developed economies, government R&D spending is worth about USD 315 billion per year and the share of government of the total R&D expenditures is 28%. Hence, citizens support research in two ways: firstly, as consumers by paying a price for goods and services which in turn include in their production costs such expenditures; secondly, by paying taxes which support government R&D expenditures, mostly for basic science. In this short essay, I discuss two questions: What is the economic impact of basic research? What are the implications for social justice of the interplay between -on one side- government funded science and -on the other side- R&D supported by business? I will argue that the ultimate economic impact of large-scale investment in basic research is often (but not always) positive (i.e. benefits are greater than costs). There is, however, a potential concern for social justice arising from the private appropriation by business of rents arising from knowledge as a public good

    Perinatal psychiatric episodes: a population-based study on treatment incidence and prevalence

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    Perinatal psychiatric episodes comprise various disorders and symptom severity, which are diagnosed and treated in multiple treatment settings. To date, no studies have quantified the incidence and prevalence of perinatal psychiatric episodes treated in primary and secondary care, which we aimed to do in the present study. We designed a descriptive prospective study and included information from Danish population registers to study first-time ever and recurrent psychiatric episodes during the perinatal period, including treatment at psychiatric facilities and general practitioners (GPs). This was done for all women who had records of one or more singleton births from 1998 until 2012. In total, we had information on 822 439 children born to 491 242 unique mothers. Results showed first-time psychiatric episodes treated at inpatient facilities were rare during pregnancy, but increased significantly shortly following childbirth (0.02 vs 0.25 per 1000 births). In comparison, first-time psychiatric episodes treated at outpatient facilities were more common, and showed little variation across pregnancy and postpartum. For every single birth resulting in postpartum episodes treated at inpatient psychiatric facilities, 2.5 births were followed by an episode treated at outpatient psychiatric facility and 12 births by GP-provided pharmacological treatment. We interpret our results the following way: treated severe and moderate psychiatric disorders have different risk patterns in relation to pregnancy and childbirth, which suggests differences in the underlying etiology. We further speculate varying treatment incidence and prevalence in pregnancy vs postpartum may indicate that the current Diagnostic and Statistical Manual of Mental Disorders-5 peripartum specifier not adequately describes at-risk periods across moderate and severe perinatal psychiatric episodes

    Applications of MCMC methods on function spaces

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    In the course of this thesis, several different applications of data assimilation will be looked at. In each case, a rigorous mathematical framework will be constructed, in a Bayesian context, to enable the use of various types of data to infer on various infinite dimensional parameters of the system that has been observed. After careful consideration of the forward problem, well-defined posterior distributions on function space are constructed. Using MCMC methods which are defined on these function spaces themselves, we can construct Markov chains whose invariant measures are the posterior of interest. From this point, we can implement these methods on a computer, having finally discretised the problem. The philosophy that we adhere to throughout, is the idea that numerical methods formulated on function space are robust under discretisation, and do not suffer from the curse of dimensionality typically suffered by sampling methods formulated after disretisation. The first few chapters (after the introductory chapter) will focus on various aspects of data assimilation of observations of Stokes ow dynamics. Chapter 2 will focus on Eulerian data where direct observations of the velocity of the fluid at various points in time and space will be made. Chapter 3 will concentrate on data assimilation of indirect observations of the field, in the form of the positions of passive tracers in the flow. In these two chapters we will assume that the forcing of the system is known and that we are merely trying to recover the initial condition of the flow field. In chapter 4 we will consider both Eulerian and Lagrangian data assimilation, with the added complexity of trying to use the data to not only infer on the initial condition but also on the space-time dependant forcing of the system. In chapter 5 we will try to show how these smoothing methods could be adapted into a filtering algorithm, and a simple example will be presented. In the final chapter, 6, this Bayesian framework on function space will be applied to a shape matching problem with applications in the biomedical sciences.EThOS - Electronic Theses Online ServiceEngineering and Physical Sciences Research Council (EPSRC)GBUnited Kingdo

    Cohort Profile:Health and Wellbeing of People with Intellectual Disability in New South Wales, Australia – A data linkage cohort

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    Purpose People with intellectual disability (ID) experience high rates of physical and mental health problems, while access to appropriate healthcare is often poor. This cohort was established to develop an epidemiological profile related to the health, health service use, disability services, mortality and corrective services records of people with ID. Participants The cohort contains 92 542 people with ID (40% females) with a median age of 23 years (IQR: 12–43 years) and 2 004 475 people with a neuropsychiatric or developmental disorder diagnosis (50% females) with a median age of 51 years (IQR: 29–73 years) from New South Wales, Australia. The whole sample contains records for 2 097 017 individuals with most data sets spanning financial years 1 July 2001 to 30 June 2016. A wide range of data from linked population data sets are included in the areas of disability, health, corrective services and targeted specialist support services in public schools, Public Guardian and Ombudsman services. Findings to date This study includes one of the largest cohorts of people with ID internationally. Our data have shown that the presence of ID is significantly associated with emergency department presentations and psychiatric readmissions after the first psychiatric admission based on a subcohort of people with a psychiatric admission. Adults with ID experience premature mortality and over-representation of potentially avoidable deaths compared with the general population. Future plans Within the health service system, we will examine different components, that is, inpatient, emergency adult services, children and younger people services and costs associated with healthcare as well as mortality, cause and predictors of death. The neuropsychiatric and developmental disorders comparison cohort allows comparisons of the physical health, mental health and service use profiles of people with ID and those with other neuropsychiatric disorders

    L-levothyroxine therapeutic dosage evaluation in dogs with primary hypothyroidism

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    O hipotireoidismo primário adquirido é uma endocrinopatia frequentemente diagnosticada na espécie canina. A terapia consiste na suplementação oral com levotiroxina sódica (L-tiroxina), no entanto vários protocolos terapêuticos têm sido propostos pela literatura, com doses variando 11 a 44µg/kg uma a duas vezes ao dia, visto à grande variabilidade de absorção e meia-vida plasmática do fármaco. Foram estudados 30 cães com hipotiroidismo primário adquirido (13 machos e 17 fêmeas, idade média de 7,9±1,9 anos e peso médio de 19,1±12,6 kg) atendidos no Hospital Veterinário da Universidade Guarulhos (UnG) e no Serviço de Endocrinologia de duas clínicas particulares da cidade de São Paulo (2009-2011), com o objetivo de avaliar a posologia e a frequência de administração da L-tiroxina, mais frequentemente utilizada, capaz de garantir um controle terapêutico satisfatório, avaliado através dos sinais clínicos e do teste pós-tiroxina, além de correlacionar a dose de tiroxina empregada com o peso dos animais. A dose média de tiroxina utilizada em nossa casuística foi de 16,9±3,1µg/kg, sendo a frequência de administração a cada 12 horas em 50% dos casos. Para se investigar uma possível correlação entre o peso e a dosagem de tiroxina utilizada, uma vez que cães de pequeno porte apresentam maior taxa metabólica que cães de grande porte, os animais foram agrupados em grupo A, cães com peso <10 Kg (n=12/30; 7,7±2,1 kg) e grupo B, cães com peso >10 kg (n=18/30, 26,8±10,7 kg). A dose média de tiroxina empregada nos grupos A e B não apresentaram diferença estatística e foram, respectivamente, 16±3µg/kg e 17±3µg/kg. A frequência de administração foi 50% a cada 24 horas e 50% a cada 12 horas para ambos os grupos. Dessa forma, a dose de tiroxina não parece se correlacionar com o peso do animal, sendo imprevisível quem deverá receber dose e frequência máxima da medicação. O protocolo deve ser individualizado e o paciente devidamente monitorado.The acquired primary hypothyroidism is a frequently diagnosed endocrinopathy in dogs. The therapy constitutes in oral supplementation with sodium levothyroxine (L-thyroxine), however various therapeutic protocols have been proposed in the literature, with doses ranging from 11 to 44mg/kg once or twice a day, since L-thyroxine has a great variability of absorption and plasma half life. We studied 30 dogs with primary hypothyroidism (13 males and 17 females, mean age 7.9 +/- 1.9 years and mean weight of 19.1 +/- 12.6 kg), in order to evaluate the dose and frequency of administration of L-thyroxine used more often able to secure a satisfactory therapeutic control as measured by clinical signs and test post-pill, and to correlate the amount of thyroxine employed with the animals' weight. The mean dose of thyroxine used in our study was 16.9 +/- 3.1mg/kg, and the frequency of administration every 12 hours in 50% of cases. To investigate a possible correlation between weight and dose of thyroxine used, since small dogs have a higher metabolic rate than large dogs, the animals were grouped in Group A, dogs weighing &lt;= 10 kg (n=12/30, 7.7 +/- 2.1 kg) and group B, dogs weighing&gt; 10 kg (n=18/30, 26.8 +/- 10.7 kg). The mean dose of thyroxine used in groups A and B did not differ significantly and were respectively 16 +/- 3mg/kg and 17 +/- 3mg/kg. The frequency of administration was 50% every 24 hours and 50% every 12 hours for both groups. Thus, the dose of thyroxine does not seem to correlate with the weight of the animal being unpredictable who should receive the highest dose and frequency of the medication. The protocol should be individualized and the patient adequately monitored

    Dynamic expression of genes associated with schizophrenia and bipolar disorder across development

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    Common genetic variation contributes a substantial proportion of risk for both schizophrenia and bipolar disorder. Furthermore, there is evidence of significant, but not complete, overlap in genetic risk between the two disorders. It has been hypothesised that genetic variants conferring risk for these disorders do so by influencing brain development, leading to the later emergence of symptoms. The comparative profile of risk gene expression for schizophrenia and bipolar disorder across development over different brain regions however remains unclear. Using genotypes derived from genome-wide associations studies of the largest available cohorts of patients and control subjects, we investigated whether genes enriched for schizophrenia and bipolar disorder association show a bias for expression across any of 13 developmental stages in prefrontal cortical and subcortical brain regions. We show that genetic association with schizophrenia is positively correlated with expression in the prefrontal cortex during early midfetal development and early infancy, and negatively correlated with expression during late childhood, which stabilises in adolescence. In contrast, risk-associated genes for bipolar disorder did not exhibit a bias towards expression at any prenatal stage, although the pattern of postnatal expression was similar to that of schizophrenia. These results highlight the dynamic expression of genes harbouring risk for schizophrenia and bipolar disorder across prefrontal cortex development and support the hypothesis that prenatal neurodevelopmental events are more strongly associated with schizophrenia than bipolar disorder
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