202 research outputs found
Effectiveness and cost-effectiveness of daily all-over-body application of emollient during the first year of life for preventing atopic eczema in high-risk children (The BEEP trial): protocol for a randomised controlled trial.
BACKGROUND: Atopic eczema (AE) is a common skin problem that impairs quality of life and is associated with the development of other atopic diseases including asthma, food allergy and allergic rhinitis. AE treatment is a significant cost burden for health care providers. The purpose of the trial is to investigate whether daily application of emollients for the first year of life can prevent AE developing in high-risk infants (first-degree relative with asthma, AE or allergic rhinitis). METHODS: This is a protocol for a pragmatic, two-arm, randomised controlled, multicentre trial. Up to 1400 term infants at high risk of developing AE will be recruited through the community, primary and secondary care in England. Participating families will be randomised in a 1:1 ratio to receive general infant skin-care advice, or general skin-care advice plus emollients with advice to apply daily to the infant for the first year of life. Families will not be blinded to treatment allocation. The primary outcome will be a blinded assessment of AE at 24Â months of age using the UK Working Party Diagnostic Criteria for Atopic Eczema. Secondary outcomes are other definitions of AE, time to AE onset, severity of AE (EASI and POEM), presence of other allergic diseases including food allergy, asthma and hay fever, allergic sensitisation, quality of life, cost-effectiveness and safety of the emollients. Subgroup analyses are planned for the primary outcome according to filaggrin genotype and the number of first-degree relatives with AE and other atopic diseases. Families will be followed up by online and postal questionnaire at 3, 6, 12 and 18Â months with a face-to-face visit at 24Â months. Long-term follow-up until 60Â months will be via annual questionnaires. DISCUSSION: This trial will demonstrate whether skin-barrier enhancement through daily emollient for the first year of life can prevent AE from developing in high-risk infants. If effective, this simple and cheap intervention has the potential to result in significant cost savings for health care providers throughout the world by preventing AE and possibly other associated allergic diseases. TRIAL REGISTRATION: ISRCTN registry; ID: ISRCTN21528841 . Registered on 25 July 2014
Emollients for prevention of atopic dermatitis; 5âyear findings from the BEEP randomised trial
Background
The effectiveness of emollients for preventing atopic dermatitis/eczema is controversial. The Barrier Enhancement for Eczema Prevention trial evaluated the effects of daily emollients during the first year of life on atopic dermatitis and atopic conditions to age 5âyears.
Methods
1394 term infants with a family history of atopic disease were randomized (1:1) to daily emollient plus standard skin-care advice (693 emollient group) or standard skin-care advice alone (701 controls). Long-term follow-up at ages 3, 4 and 5âyears was via parental questionnaires. Main outcomes were parental report of a clinical diagnosis of atopic dermatitis and food allergy.
Results
Parents reported more frequent moisturizer application in the emollient group through to 5âyears. A clinical diagnosis of atopic dermatitis between 12 and 60âmonths was reported for 188/608 (31%) in the emollient group and 178/631 (28%) in the control group (adjusted relative risk 1.10, 95% confidence interval 0.93 to 1.30). Although more parents in the emollient group reported food reactions in the previous year at 3 and 4âyears, cumulative incidence of doctor-diagnosed food allergy by 5âyears was similar between groups (92/609 [15%] emollients and 87/632 [14%] controls, adjusted relative risk 1.11, 95% confidence interval 0.84 to 1.45). Findings were similar for cumulative incidence of asthma and hay fever.
Conclusions
Daily emollient application during the first year of life does not prevent atopic dermatitis, food allergy, asthma or hay fever
An economic evaluation of the randomized controlled trial of topical corticosteroid and home-based narrowband ultraviolet B for active and limited vitiligo (the HI-Light Vitiligo Trial)
Background: Economic evidence for vitiligo treatments is absent. Objectives: To determine the cost-effectiveness of (i) handheld narrowband ultraviolet B (NB-UVB) and (ii) a combination of topical corticosteroid (TCS) and NB-UVB compared with TCS alone for localized vitiligo. Methods: Cost-effectiveness analysis alongside a pragmatic, three-arm, placebo-controlled randomized controlled trial with 9 monthsâ treatment. In total 517 adults and children (aged â„ 5 years) with active vitiligo affecting < 10% of skin were recruited from secondary care and the community and were randomized 1: 1: 1 to receive TCS, NB-UVB or both. Cost per successful treatment (measured on the Vitiligo Noticeability Scale) was estimated. Secondary costâutility analyses measured quality-adjusted life-years using the EuroQol 5 Dimensions 5 Levels for those aged â„ 11 years and the Child Health Utility 9D for those aged 5 to < 18 years. The trial was registered with number ISRCTN17160087 on 8 January 2015. Results: The mean ± SD cost per participant was ÂŁ775 ± 83·7 for NB-UVB, ÂŁ813 ± 111.4 for combination treatment and ÂŁ600 ± 96·2 for TCS. In analyses adjusted for age and target patch location, the incremental difference in cost for combination treatment compared with TCS was ÂŁ211 (95% confidence interval 188â235), corresponding to a risk difference of 10·9% (number needed to treat = 9). The incremental cost was ÂŁ1932 per successful treatment. The incremental difference in cost for NB-UVB compared with TCS was ÂŁ173 (95% confidence interval 151â196), with a risk difference of 5·2% (number needed to treat = 19). The incremental cost was ÂŁ3336 per successful treatment. Conclusions: Combination treatment, compared with TCS alone, has a lower incremental cost per additional successful treatment than NB-UVB only. Combination treatment would be considered cost-effective if decision makers are willing to pay ÂŁ1932 per additional treatment success
Measurement of CP observables in B± â D(â)K± and B± â D(â)ϱ decays
Measurements of CP observables in B ± âD (â) K ± and B ± âD (â) Ï Â± decays are presented, where D (â) indicates a neutral D or D â meson that is an admixture of D (â)0 and DÂŻ (â)0 states. Decays of the D â meson to the DÏ 0 and DÎł final states are partially reconstructed without inclusion of the neutral pion or photon, resulting in distinctive shapes in the B candidate invariant mass distribution. Decays of the D meson are fully reconstructed in the K ± Ï â , K + K â and Ï + Ï â final states. The analysis uses a sample of charged B mesons produced in pp collisions collected by the LHCb experiment, corresponding to an integrated luminosity of 2.0, 1.0 and 2.0 fb â1 taken at centre-of-mass energies of s=7, 8 and 13 TeV, respectively. The study of B ± âD â K ± and B ± âD â Ï Â± decays using a partial reconstruction method is the first of its kind, while the measurement of B ± âDK ± and B ± âDÏ Â± decays is an update of previous LHCb measurements. The B ± âDK ± results are the most precise to date
Measurement of the Î<sup>-</sup><sub>b</sub> and Ω<sup>-</sup><sub>b</sub> baryon lifetimes
Using a data sample of pp collisions corresponding to an integrated luminosity of , the and baryons are reconstructed in the and decay modes and their lifetimes measured to be \tau (\Xi_b^-) = 1.55\, ^{+0.10}_{-0.09}~{\rm(stat)} \pm 0.03\,{\rm(syst)} ps, \tau (\Omega_b^-) = 1.54\, ^{+0.26}_{-0.21}~{\rm(stat)} \pm 0.05\,{\rm(syst)} ps. These are the most precise determinations to date. Both measurements are in good agreement with previous experimental results and with theoretical predictions
New insights into the genetic etiology of Alzheimer's disease and related dementias
Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE Δ4 allele
Study of the lineshape of the chi(c1) (3872) state
A study of the lineshape of the chi(c1) (3872) state is made using a data sample corresponding to an integrated luminosity of 3 fb(-1) collected in pp collisions at center-of-mass energies of 7 and 8 TeV with the LHCb detector. Candidate chi(c1)(3872) and psi(2S) mesons from b-hadron decays are selected in the J/psi pi(+)pi(-) decay mode. Describing the lineshape with a Breit-Wigner function, the mass splitting between the chi(c1 )(3872) and psi(2S) states, Delta m, and the width of the chi(c1 )(3872) state, Gamma(Bw), are determined to be (Delta m=185.598 +/- 0.067 +/- 0.068 Mev,)(Gamma BW=1.39 +/- 0.24 +/- 0.10 Mev,) where the first uncertainty is statistical and the second systematic. Using a Flatte-inspired model, the mode and full width at half maximum of the lineshape are determined to be (mode=3871.69+0.00+0.05 MeV.)(FWHM=0.22-0.04+0.13+0.07+0.11-0.06-0.13 MeV, ) An investigation of the analytic structure of the Flatte amplitude reveals a pole structure, which is compatible with a quasibound D-0(D) over bar*(0) state but a quasivirtual state is still allowed at the level of 2 standard deviations
Measurement of the CKM angle in and decays with
A measurement of -violating observables is performed using the decays
and , where the meson is
reconstructed in one of the self-conjugate three-body final states and (commonly denoted ). The decays are analysed in bins of the -decay phase space, leading
to a measurement that is independent of the modelling of the -decay
amplitude. The observables are interpreted in terms of the CKM angle .
Using a data sample corresponding to an integrated luminosity of
collected in proton-proton collisions at centre-of-mass
energies of , , and with the LHCb experiment,
is measured to be . The hadronic
parameters , , , and ,
which are the ratios and strong-phase differences of the suppressed and
favoured decays, are also reported
First observation of forward production in collisions at TeV
The decay ZâbbÂŻ is reconstructed in pp collision data, corresponding to 2 fb â1 of integrated luminosity, collected by the LHCb experiment at a centre-of-mass energy of s=8 TeV. The product of the Z production cross-section and the ZâbbÂŻ branching fraction is measured for candidates in the fiducial region defined by two particle-level b -quark jets with pseudorapidities in the range 2.220 GeV and dijet invariant mass in the range 452045 < m_{jj} < 1655462 \pm 763Z \rightarrow b \bar{b}332 \pm 46 \pm 59Z \rightarrow b \bar{b}pp$ collisions
Measurement of CP asymmetries and branching fraction ratios of Bâ decays to two charm mesons
The asymmetries of seven decays to two charm mesons are measured using data corresponding to an integrated luminosity of of proton-proton collisions collected by the LHCb experiment. Decays involving a or meson are analysed by reconstructing only the or decay products. This paper presents the first measurement of and , and the most precise measurement of the other five asymmetries. There is no evidence of violation in any of the analysed decays. Additionally, two ratios between branching fractions of selected decays are measured.The CP asymmetries of seven B decays to two charm mesons are measured using data corresponding to an integrated luminosity of 9 fb of proton-proton collisions collected by the LHCb experiment. Decays involving a D or meson are analysed by reconstructing only the D or decay products. This paper presents the first measurement of (BâD) and (BâD), and the most precise measurement of the other five CP asymmetries. There is no evidence of CP violation in any of the analysed decays. Additionally, two ratios between branching fractions of selected decays are measured.[graphic not available: see fulltext]The asymmetries of seven decays to two charm mesons are measured using data corresponding to an integrated luminosity of of proton-proton collisions collected by the LHCb experiment. Decays involving a or meson are analysed by reconstructing only the or decay products. This paper presents the first measurement of and , and the most precise measurement of the other five asymmetries. There is no evidence of violation in any of the analysed decays. Additionally, two ratios between branching fractions of selected decays are measured
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