A pilot Internet "Value of Health" Panel: recruitment, participation and compliance

Objectives To pilot using a panel of members of the public to provide preference data via the Internet Methods A stratified random sample of members of the general public was recruited and familiarised with the standard gamble procedure using an Internet based tool. Health states were perdiodically presented in "sets" corresponding to different conditions, during the study. The following were described: Recruitment (proportion of people approached who were trained); Participation (a) the proportion of people trained who provided any preferences and (b) the proportion of panel members who contributed to each "set" of values; and Compliance (the proportion, per participant, of preference tasks which were completed). The influence of covariates on these outcomes was investigated using univariate and multivariate analyses. Results A panel of 112 people was recruited. 23% of those approached (n = 5,320) responded to the invitation, and 24% of respondents (n = 1,215) were willing to participate (net = 5.5%). However, eventual recruitment rates, following training, were low (2.1% of those approached). Recruitment from areas of high socioeconomic deprivation and among ethnic minority communities was low. Eighteen sets of health state descriptions were considered over 14 months. 74% of panel members carried out at least one valuation task. People from areas of higher socioeconomic deprivation and unmarried people were less likely to participate. An average of 41% of panel members expressed preferences on each set of descriptions. Compliance ranged from 3% to 100%. Conclusion It is feasible to establish a panel of members of the general public to express preferences on a wide range of health state descriptions using the Internet, although differential recruitment and attrition are important challenges. Particular attention to recruitment and retention in areas of high socioeconomic deprivation and among ethnic minority communities is necessary. Nevertheless, the panel approach to preference measurement using the Internet offers the potential to provide specific utility data in a responsive manner for use in economic evaluations and to address some of the outstanding methodological uncertainties in this field

Adaptiveness in proactive control engagement in children and adults.

Age-related progress in cognitive control reflects more frequent engagement of proactive control during childhood. As proactive preparation for an upcoming task is adaptive only when the task can be reliably predicted, progress in proactive control engagement may rely on more efficient use of contextual cue reliability. Developmental progress may also reflect increasing efficiency in how proactive control is engaged, making this control mode more advantageous with age. To address these possibilities, 6-year-olds, 9-year-olds, and adults completed three versions of a cued task-switching paradigm in which contextual cue reliability was manipulated. When contextual cues were reliable (but not unreliable or uninformative), all age groups showed greater pupil dilation and a more pronounced (pre)cue-locked posterior positivity associated with faster response times, suggesting adaptive engagement of proactive task selection. However, adults additionally showed a larger contingent negative variation (CNV) predicting a further reduction in response times with reliable cues, suggesting motor preparation in adults but not children. Thus, early developing use of contextual cue reliability promotes adaptiveness in proactive control engagement from early childhood; yet, less efficient motor preparation in children makes this control mode overall less advantageous in childhood than adulthood

Composition and functional comparison of vetiver root endophytic microbiota originating from different geographic locations that show antagonistic activity towards Fusarium graminearum

International audienceGiven the current trend towards reducing the use of chemical controls in agriculture, microbial resources such as plant endophytes are being intensively investigated for traits that are conducive to plant protection. Among the various important target pathogens, Fusarium graminearum is a fungal pathogen of cereal crops that is responsible for severe yield losses and mycotoxin contamination in grains. In the present study, we investigated the bacterial endophytic communities from vetiver (Chrysopogon zizanioides (L.) Roberty) roots originating from 5 different geographic locations across Europe and Africa. This study relies on a global 16S metabarcoding approach and the isolation/functional characterization of bacterial isolates. The results we obtained showed that geographical location is a factor that influences the composition and relative abundance of root endophyte communities in vetiver. Three hundred eighty-one bacterial endophytes were isolated and assessed for their in vitro antagonistic activities towards F. graminearum mycelium growth. In total, 46 % of the isolates showed at least 50 % inhibitory activity against F. graminearum. The taxonomic identification of the bioactive isolates revealed that the composition of these functional culturable endophytic communities was influenced by the geographic origins of the roots. The selected communities consisted of 15 genera. Some endophytes in Bacillus, Janthinobacterium, Kosakonia, Microbacterium, Pseudomonas, and Serratia showed strong growth inhibition activity (>= 70 %) against F. graminearum and could be candidates for further development as biocontrol agents

Screening of Endophytic Bacteria of Leucojum aestivum ‘Gravety Giant’ as a Potential Source of Alkaloids and as Antagonist to Some Plant Fungal Pathogens

Leucojum aestivum is a medicinal plant belonging to the Amaryllidaceae family well known as a producer of alkaloids such as galanthamine and lycorine. However, the endophytic microbes that colonize different plant tissues without causing any damage have not been reported in this plant. Here, we explored the different endophytic bacterial communities isolated from different surface disinfected tissues of L. aestivum ‘Gravety giant’ and screened bacterial isolates producing alkaloids and their potential use as biocontrol agent against wheat pathogens. For that purpose, endophytic bacteria were isolated from bulbs, roots and shoots of L. aestivum. After taxonomical characterization, these microorganisms were screened for their ability to produce alkaloids using high-performance thin-layer chromatography (HPTLC) and untargeted liquid chromatography-Mass Spectrometry/Mass Spectrometry (LC-MS/MS) strategies. We isolated 138 bacteria belonging to four phyla and 42 genera, mainly from roots and shoots. The most abundant genera were Rahnella in shoot, Patulibacter in bulb and Bacillus in roots. Among the different bacterial isolates, the methanolic extracts of Luteibacter rhizovicinus (LaBFB3301) and Commamonas denitrificans (LaBFS2103) slightly delayed the growth of F. graminearum colonies in in vitro dual tests against F. graminearum and M. nivale strains with 15.5% and 19.9% inhibition rates, respectively. These isolates are able to produce an indolic alkaloid tryptophol (C10H11NO, [M + H]+ 162.0913). These endophytic bacteria might be investigated to characterize the plant protection effect and the plant growth promotion effect

Patterns of use of systemic therapies among patients with metastatic melanoma: a retrospective claims database analysis in the United States

Objectives: This retrospective analysis of the IMS PharMetrics Plus claims database aimed to describe the current real-world treatment patterns for metastatic melanoma in the USA. Methods: Included patients (aged ≥18 years) had ≥1 prescription for ipilimumab, vemurafenib, temozolomide or dacarbazine between 1 January 2011 and 31 August 2013; diagnosis of melanoma and metastasis before first use (index date); no index drug use prior to the index date; continuous health plan enrollment for ≥6 months before and ≥3 months after index date. Proportion of days covered (PDC) was defined as days exposed to index therapy divided by continuously enrolled days between index date and last prescription date. Results: Overall, 1043 patients were included (median age 57 years, 63% male), of whom 39% received the index drug ipilimumab, 35% vemurafenib, 19% temozolomide and 7% dacarbazine. Mean treatment duration (days) was 174 (vemurafenib), 100 (temozolomide) and 64 (dacarbazine). Mean PDC was 81% (vemurafenib), 67% (temozolomide) and 51% (dacarbazine). For patients receiving ipilimumab, 58% had the full 4 doses, 20% 3 doses, 14% 2 doses and 9% 1 dose only for the first induction course; 4% received re-induction, and none had a second re-induction. Conclusions: This study provides insights into the treatment patterns for metastatic melanoma, including newer agents, in real-world clinical practice

Comparative treatment-related adverse event cost burden in immune thrombocytopenic purpura

<p><b>Aims:</b> Real-world evidence on the safety profile and costs associated with immune thrombocytopenic purpura (ITP) treatment in adults is lacking. This study quantifies and compares adverse event (AE) crude rates and costs associated with ITP treatments as found in claims data.</p> <p><b>Materials and methods:</b> A retrospective claims-based analysis was conducted using IMS Pharmetrics Plus database. Included patients were ≥18 years old, with a diagnosis of ITP (2007–2012); an ITP-related claim for anti-D, intravenous immunoglobulin (IVIG), rituximab, romiplostim, or eltrombopag; and 1-year continuous enrollment (3-years for rituximab) during follow-up. AEs and event costs were identified during active treatment, defined from the first claim of each drug to a pre-defined treatment gap or end of study period. Descriptive statistics were reported with Wilcoxon rank-sum significance tests.</p> <p><b>Results:</b> A total of 2,518 patients were identified (mean age = 50.8 (±16.3 years); 55.8% male). Of all patients, 22.8% experienced any AE. Significantly fewer anti-D patients had any AE (13.8% vs IVIG: 21.1%, rituximab: 29.4%, romiplostim: 28.1%, eltrombopag: 22.4%). Nausea/vomiting and arthralgia/musculoskeletal pain were most common across treatments, and hemolytic events did not differ significantly across treatments. Most costly AEs were urinary tract infection, aseptic meningitis, and fever ($5000+/case); headache, nasal congestion, and hemolytic event were$4,000–5,000/case. Cost per AE did not differ by treatment.</p> <p><b>Limitations and conclusions:</b> Although lower than trial-based AE rates, claims for ITP treatment-related AEs are common, with higher numbers for rituximab and lower numbers for anti-D. This disparity suggests a possible differential cost burden overall that future analysis should explore.</p