Health Data Linkage for Public Interest Research in the UK: Key Obstacles and Solutions

Introduction: Analysis of linked health data can generate important, even life-saving, insights into population health. Yet obstacles both legal and organisational in nature can impede this work. Approach: We focus on three UK infrastructures set up to link and share data for research: the Administrative Data Research Network, NHS Digital, and the Secure Anonymised Information Linkage Databank. Bringing an interdisciplinary perspective, we identify key issues underpinning their challenges and successes in linking health data for research. Results: We identify examples of uncertainty surrounding legal powers to share and link data, and around data protection obligations, as well as systemic delays and historic public backlash. These issues require updated official guidance on the relevant law, approaches to linkage which are planned for impact and ongoing utility, greater transparency between data providers and researchers, and engagement with the patient population which is both high-profile and carefully considered. Conclusions: Health data linkage for research presents varied challenges, to which there can be no single solution. Our recommendations would require action from a number of data providers and regulators to be meaningfully advanced. This illustrates the scale and complexity of the challenge of health data linkage, in the UK and beyond: a challenge which our case studies suggest no single organisation can combat alone. Planned programmes of linkage are critical because they allow time for organisations to address these challenges without adversely affecting the feasibility of individual research projects.</p

Health Data Linkage for Public Interest Research in the UK: Key Obstacles and Solutions

ntroduction: Analysis of linked health data can generate important, even life-saving, insights into populationhealth. Yet obstacles both legal and organisational in nature can impede this work. Approach: We focus on three UK infrastructures set up to link and share data for research: the AdministrativeData Research Network, NHS Digital, and the Secure Anonymised Information Linkage Databank.Bringing an interdisciplinary perspective, we identify key issues underpinning their challenges andsuccesses in linking health data for research. Results:We identify examples of uncertainty surrounding legal powers to share and link data, and around dataprotection obligations, as well as systemic delays and historic public backlash. These issues requireupdated official guidance on the relevant law, approaches to linkage which are planned for impactand ongoing utility, greater transparency between data providers and researchers, and engagementwith the patient population which is both high-profile and carefully considered.ConclusionsHealth data linkage for research presents varied challenges, to which there can be no single solution.Our recommendations would require action from a number of data providers and regulators tobe meaningfully advanced. This illustrates the scale and complexity of the challenge of health datalinkage, in the UK and beyond: a challenge which our case studies suggest no single organisation cancombat alone. Planned programmes of linkage are critical because they allow time for organisationsto address these challenges without adversely affecting the feasibility of individual research project

Imaging and tuning polarity at SrTiO3 domain walls.

Electrostatic fields tune the ground state of interfaces between complex oxide materials. Electronic properties, such as conductivity and superconductivity, can be tuned and then used to create and control circuit elements and gate-defined devices. Here we show that naturally occurring twin boundaries, with properties that are different from their surrounding bulk, can tune the LaAlO3/SrTiO3 interface 2DEG at the nanoscale. In particular, SrTiO3 domain boundaries have the unusual distinction of remaining highly mobile down to low temperatures, and were recently suggested to be polar. Here we apply localized pressure to an individual SrTiO3 twin boundary and detect a change in LaAlO3/SrTiO3 interface current distribution. Our data directly confirm the existence of polarity at the twin boundaries, and demonstrate that they can serve as effective tunable gates. As the location of SrTiO3 domain walls can be controlled using external field stimuli, our findings suggest a novel approach to manipulate SrTiO3-based devices on the nanoscale

Characterization of Fine Particulate Matter and Associations between Particulate Chemical Constituents and Mortality in Seoul, Korea

Background: Numerous studies have linked fine particles [≤ 2.5 µm in aerodynamic diameter (PM2.5)] and health. Most studies focused on the total mass of the particles, although the chemical composition of the particles varies substantially. Which chemical components of fine particles that are the most harmful is not well understood, and research on the chemical composition of PM2.5 and the components that are the most harmful is particularly limited in Asia

The Hall Technique 10 years on: its effect and influence

Dental caries in early childhood can have a very significant effect not only on the oral health of young children but on their quality of life and that of their families. Added to this are the long-term infective risks to the host of untreated caries in primary teeth but also the risk of damage to successor permanent teeth. Traditional restoration of damaged primary teeth has been shown to have only moderate outcomes depending on the techniques and materials used and the ability of children to cooperate because of age or other factors. The Hall technique has outperformed other techniques in randomised clinical trials. In this Opinion Article I will take a look back at the Innes et al. paper, first published in this Journal in 2006, that introduced the Hall Technique and the subsequent scientific literature which provided us with high quality scientific evidence of the efficacy of the technique. I will evaluate how this new technique has affected the management of early childhood caries and hence its influence on wider oral and general health

A pilot dose-response study of the acute effects of haskap berry extract (Lonicera caerulea L.) on cognition, mood and blood pressure in older adults

Purpose Haskap (Lonicera caerulea L. or blue honeysuckle) is a plant native to the low-lying wet areas and mountains of Siberia and northeastern Asia, but is now cultivated in Canada. The dark blue berries are rich in anthocyanins, particularly cyanidin-3-O-glucoside. Previously, anthocyanin-rich fruits have been observed to benefit cognitive performance during the immediate postprandial period following a single acute dose. However, no study has currently examined the potential for haskap berries to influence cognitive performance. Here, we investigate the acute cognitive benefits of an anthocyanin-rich haskap berry extract. Methods A double-blind, counterbalanced, crossover intervention study compared the acute effects of three separate haskap berry extract doses, containing 100mg, 200mg, and 400mg anthocyanins, with a sugar-matched placebo. Participants were an opportunity sample of 20 older adults, aged 62-81 years. Measures of cognition, mood, and blood pressure were recorded at baseline and 1.5 hours postprandially. Results Compared to placebo, the 400mg dose elicited significantly lower diastolic blood pressure and heart rate. Both 200mg and 400mg doses elicited significantly higher word recall, with the 400mg dose also significantly improving word recognition scores, on an episodic memory task. However, mood, working memory and executive function task results were more equivocal. Conclusions The findings provide evidence for improvements in episodic memory and blood pressure following acute supplementation with haskap berry extract, with higher doses appearing most effective. The cognitive findings concur with previous literature that suggests episodic memory effects, and not executive function effects, are most prevalent in older adults following anthocyanin-rich berry supplementation. The blood pressure outcome is consistent with a vasodilatory mechanism of action

The relationship between ocean surface turbulence and air-sea gas transfer velocity: An in-situ evaluation

Although the air-sea gas transfer velocity k is usually parameterized with wind speed, the so-called small-eddy model suggests a relationship between k and ocean surface dissipation of turbulent kinetic energy . Laboratory and field measurements of k and have shown that this model holds in various ecosystems. Here, field observations are presented supporting the theoretical model in the open ocean. These observations are based on measurements from the Air-Sea Interaction Profiler and eddy covariance CO2 and DMS air-sea flux data collected during the Knorr11 cruise. We show that the model results can be improved when applying a variable Schmidt number exponent compared to a commonly used constant value of 1/2. Scaling to the viscous sublayer allows us to investigate the model at different depths and to expand its applicability for more extensive data sets

Associations of Body Mass and Fat Indexes With Cardiometabolic Traits

Background Body mass index (BMI) is criticized for not distinguishing fat from lean mass and ignoring fat distribution, leaving its ability to detect health effects unclear. Objectives The aim of this study was to compare BMI with total and regional fat indexes from dual-energy x-ray absorptiometry in their associations with cardiometabolic traits. Duration of exposure to and change in each index across adolescence were examined in relation to detailed traits in young adulthood. Methods BMI was examined alongside total, trunk, arm, and leg fat indexes (each in kilograms per square meter) from dual-energy x-ray absorptiometry at ages 10 and 18 years in relation to 230 traits from targeted metabolomics at age 18 years in 2,840 offspring from the Avon Longitudinal Study of Parents and Children. Results Higher total fat mass index and BMI at age 10 years were similarly associated with cardiometabolic traits at age 18 years, including higher systolic and diastolic blood pressure, higher very low-density lipoprotein and low-density lipoprotein cholesterol, lower high-density lipoprotein cholesterol, higher triglycerides, and higher insulin and glycoprotein acetyls. Associations were stronger for both indexes measured at age 18 years and for gains in each index from age 10 to 18 years (e.g., 0.45 SDs [95% confidence interval: 0.38 to 0.53] in glycoprotein acetyls per SD unit gain in fat mass index vs. 0.38 SDs [95% confidence interval: 0.27 to 0.48] per SD unit gain in BMI). Associations resembled those for trunk fat index. Higher lean mass index was weakly associated with traits and was not protective against higher fat mass index. Conclusions The results of this study support abdominal fatness as a primary driver of cardiometabolic dysfunction and BMI as a useful tool for detecting its effects

Multi-modality curative treatment of salivary gland cancer liver metastases with drug-eluting bead chemoembolization, radiofrequency ablation, and surgical resection: a case report

<p>Abstract</p> <p>Introduction</p> <p>Liver metastases are rare in salivary gland tumors and have been reported only once to be the first manifestation of the disease. They are usually treated with surgical resection of the primary tumor and systemic chemotherapy. Drug-eluting bead chemoembolization has an evolving role in the treatment of hepatocellular carcinoma, as well as in the treatment of metastatic disease of the liver. Nevertheless, it has never been used in a patient with salivary gland liver metastases.</p> <p>Case presentation</p> <p>We report a case of a 51-year-old Caucasian Greek woman who presented to our hospital with liver metastases as the first manifestation of an adenoid cystic carcinoma of the left submandibular gland. The liver lesions were deemed inoperable because of their size and multi-focality and proved resistant to systemic chemotherapy. She was curatively treated with a combination of doxorubicin eluting bead (DC Beads) chemoembolization, intra-operative and percutaneous radiofrequency ablation, and radiofrequency-assisted surgical resection. The patient remained disease-free one year after the surgical resection.</p> <p>Conclusion</p> <p>In conclusion, this complex case is an example of inoperable liver metastatic disease from the salivary glands that was refractory to systemic chemotherapy but was curatively treated with a combination of locoregional therapies and surgery. A multi-disciplinary approach and the adoption of modern radiological techniques produced good results after conventional therapies failed and there were no other available treatment modalities.</p

Implications of mirror neutrinos for early universe cosmology

The Exact Parity Model (EPM) is, in part, a theory of neutrino mass and mixing that can solve the atmospheric, solar and LSND anomalies. The central feature of the neutrino sector is three pairs of maximally mixed ordinary and mirror neutrinos. It has been shown that ordinary-mirror neutrino oscillations can generate large neutrino asymmetries in the epoch of the early universe immediately prior to Big Bang Nucleosynthesis (BBN). The large neutrino asymmetries generically suppress the production of mirror neutrinos, and a sufficiently large $\nu_e$ asymmetry can directly affect light element synthesis through nuclear reaction rates. In this paper we present a detailed calculation of neutrino asymmetry evolution driven by the six-flavour EPM neutrino sector, focusing on implications for BBN.Comment: Latex, about 55 pages long with some figure