Rofecoxib and cardiovascular adverse events in adjuvant treatment of colorectal cancer

Background Selective cyclooxygenase inhibitors may retard the progression of cancer, but they have enhanced thrombotic potential. We report on cardiovascular adverse events in patients receiving rofecoxib to reduce rates of recurrence of colorectal cancer. Methods All serious adverse events that were cardiovascular thrombotic events were reviewed in 2434 patients with stage II or III colorectal cancer participating in a randomized, placebo-controlled trial of rofecoxib, 25 mg daily, started after potentially curative tumor resection and chemotherapy or radiotherapy as indicated. The trial was terminated prematurely owing to worldwide withdrawal of rofecoxib. To examine possible persistent risks, we examined cardiovascular thrombotic events reported up to 24 months after the trial was closed. Results The median duration of active treatment was 7.4 months. The 1167 patients receiving rofecoxib and the 1160 patients receiving placebo were well matched, with a median follow-up period of 33.0 months (interquartile range, 27.6 to 40.1) and 33.4 months (27.7 to 40.4), respectively. Of the 23 confirmed cardiovascular thrombotic events, 16 occurred in the rofecoxib group during or within 14 days after the treatment period, with an estimated relative risk of 2.66 (from the Cox proportional-hazards model; 95% confidence interval [CI], 1.03 to 6.86; P = 0.04). Analysis of the Antiplatelet Trialists’ Collaboration end point (the combined incidence of death from cardiovascular, hemorrhagic, and unknown causes; of nonfatal myocardial infarction; and of nonfatal ischemic and hemorrhagic stroke) gave an unadjusted relative risk of 1.60 (95% CI, 0.57 to 4.51; P = 0.37). Fourteen more cardiovascular thrombotic events, six in the rofecoxib group, were reported within the 2 years after trial closure, with an overall unadjusted relative risk of 1.50 (95% CI, 0.76 to 2.94; P = 0.24). Four patients in the rofecoxib group and two in the placebo group died from thrombotic causes during or within 14 days after the treatment period, and during the follow-up period, one patient in the rofecoxib group and five patients in the placebo group died from cardiovascular causes. Conclusions Rofecoxib therapy was associated with an increased frequency of adverse cardiovascular events among patients with a median study treatment of 7.4 months’ duration. (Current Controlled Trials number, ISRCTN98278138.

Goal neglect, fluid intelligence and processing speed:Manipulating instruction load and inter-stimulus interval

Goal maintenance is the process where task rules and instructions are kept active to exert their control on behavior. When this process fails, an individual may ignore a rule while performing the task, despite being able to describe it after task completion. Previous research has suggested that the goal maintenance system is limited by the number of concurrent rules which can be maintained during a task, and that this limit is dependent on an individual's level of fluid intelligence. However, the speed at which an individual can process information may also limit their ability to use task rules when the task demands them. In the present study, four experiments manipulated the number of instructions to be maintained by younger and older adults and examined whether performance on a rapid letter-monitoring task was predicted by individual differences in fluid intelligence or processing speed. Fluid intelligence played little role in determining how frequently rules were ignored during the task, regardless of the number of rules to be maintained. In contrast, processing speed predicted the rate of goal neglect in older adults, where increasing the presentation rate of the letter-monitoring task increased goal neglect. These findings suggest that goal maintenance may be limited by the speed at which it can operate

Experience of clinical services shapes attitudes to mental health data sharing: findings from a UK-wide survey

BACKGROUND: Routinely-collected mental health data could deliver novel insights for mental health research. However, patients’ willingness to share their mental health data remains largely unknown. We investigated factors influencing likelihood of sharing these data for research purposes amongst people with and without experience of mental illness. METHODS: We collected responses from a diverse sample of UK National Health Service (NHS) users (n = 2187) of which about half (n = 1087) had lifetime experience of mental illness. Ordinal logistic regression was used to examine the influence of demographic factors, clinical service experience, and primary mental illness on willingness to share mental health data, contrasted against physical health data. RESULTS: There was a high level of willingness to share mental (89.7%) and physical (92.8%) health data for research purposes. Higher levels of satisfaction with the NHS were associated with greater willingness to share mental health data. Furthermore, people with personal experience of mental illness were more willing than those without to share mental health data, once the variable of NHS satisfaction had been controlled for. Of the mental illnesses recorded, people with depression, obsessive-compulsive disorder (OCD), personality disorder or bipolar disorder were significantly more likely to share their mental health data than people without mental illness. CONCLUSIONS: These findings suggest that positive experiences of health services and personal experience of mental illness are associated with greater willingness to share mental health data. NHS satisfaction is a potentially modifiable factor that could foster public support for increased use of NHS mental health data in research. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-022-12694-z

MQ Data Science Report to MRC on building a National Infrastructure for Mental Health Data Science in the UK

At the MQ meeting on 9th September 2019 (Edinburgh), we hosted a discussion session, where we asked participants how they would envision a National Infrastructure for Mental Health Data Science (referred to as “platform” below). Participants were advised that their collected input would be fed back to the MRC to serve as a starting point for their full consultation on this topic. Key findings ● Researchers are particularly interested in using such a platform themselves and recognise its utility to a large number of other organisations. ● The minimum useful requirement for such a platform is a searchable directory of available data with a note about access procedures. Whereas an ideal platform might contain the actual data. Our participants demonstrated a wide interest in the inclusion of different data types and research areas within such a platform. ● Participants were enthusiastic about the possibilities such a platform might enable, mentioning expansion of research topics and conducting more rigorous research. They felt the platform might enable this by maximizing data quality/usage and facilitating data access. ● Participants recognised the positive impact such a platform could have on people affected by mental illness. Patterns of responses arose around patient engagement, policy shaping, open science, and improved research quality. All these elements could help fight the stigma of mental illness in society. ● With regard to the MRC consultation, our participants recognised the need to consult with a range of organisations, including data donors, ethical boards, privacy panels and relevant charities - with an observed less enthusiastic support for political involvement (which may reflect current political circumstances). ● Our participants raised a number of concerns, which the MRC may wish to address during their consultation phase. These included long-term sustainability, governance, and ethical considerations. On a practical note, questions were raised around prioritization, practicalities on data management, platform operation and relevant training and capacity building. Lastly, the participants illustrated the need to raise public awareness of and involvement in this platform in order to ensure the successful implementation

Strangers in the night: nightlife studies and new urban tourism

This paper draws together recent scholarship from the study of urban tourism and nightlife. Though studies of urban tourism do not always specifically address nightlife, and likewise studies of the night and nightlife do not always examine tourism, both bodies of research overlap in important ways. Concerns about commercialisation, gentrification, displacement, and urban change are to be found in both bodies of research. However, while the study of urban tourism typically recognises the erasure of the host / guest binary and seeks to destabilise the notion of who is a tourist or stranger, studies of nightlife often rest on a much clearer distinction between who belongs and who does not. An argument proposed here is that while the host / guest, tourist / non-tourist binary is perhaps reconfiguring, the night and nightlife spaces reinstate these binaries in various ways. This paper thinks through debates about tourists and residents in the night, focusing in particular on questions of belonging, place identification and gentrification through night-time uses

Conching chocolate:A prototypical transition from frictionally jammed solid to flowable suspension with maximal solid content

The mixing of a powder of 10-50{\mu}m primary particles into a liquid to form a dispersion with the highest possible solid content is a common industrial operation. Building on recent advances in the rheology of such 'granular dispersions', we study a paradigmatic example of such powder incorporation: the conching of chocolate, in which a homogeneous, flowing suspension is prepared from an inhomogeneous mixture of particulates, triglyceride oil and dispersants. Studying the rheology of a simplified formulation, we find that the input of mechanical energy and staged addition of surfactants combine to effect a considerable shift in the jamming volume fraction of the system, thus increasing the maximum flowable solid content. We discuss the possible microscopic origins of this shift, and suggest that chocolate conching exemplifies a ubiquitous class of powder-liquid mixing