103 research outputs found

    An Overview of Research and Evaluation Designs for Dissemination and Implementation

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    The wide variety of dissemination and implementation designs now being used to evaluate and improve health systems and outcomes warrants review of the scope, features, and limitations of these designs

    A research agenda to support the development and implementation of genomics-based clinical informatics tools and resources.

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    OBJECTIVE: The Genomic Medicine Working Group of the National Advisory Council for Human Genome Research virtually hosted its 13th genomic medicine meeting titled Developing a Clinical Genomic Informatics Research Agenda . The meeting\u27s goal was to articulate a research strategy to develop Genomics-based Clinical Informatics Tools and Resources (GCIT) to improve the detection, treatment, and reporting of genetic disorders in clinical settings. MATERIALS AND METHODS: Experts from government agencies, the private sector, and academia in genomic medicine and clinical informatics were invited to address the meeting\u27s goals. Invitees were also asked to complete a survey to assess important considerations needed to develop a genomic-based clinical informatics research strategy. RESULTS: Outcomes from the meeting included identifying short-term research needs, such as designing and implementing standards-based interfaces between laboratory information systems and electronic health records, as well as long-term projects, such as identifying and addressing barriers related to the establishment and implementation of genomic data exchange systems that, in turn, the research community could help address. DISCUSSION: Discussions centered on identifying gaps and barriers that impede the use of GCIT in genomic medicine. Emergent themes from the meeting included developing an implementation science framework, defining a value proposition for all stakeholders, fostering engagement with patients and partners to develop applications under patient control, promoting the use of relevant clinical workflows in research, and lowering related barriers to regulatory processes. Another key theme was recognizing pervasive biases in data and information systems, algorithms, access, value, and knowledge repositories and identifying ways to resolve them

    Crop Updates 2010 - Farming Systems

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    This session covers twenty papers from different authors: Pests and Disease 1. Preserving phosphine for use in Grain Storage Industry, Christopher R Newman, Department of Agriculture and Food Farming Systems Research 2. Demonstrating the benefits of grazing canola in Western Australia, Jonathan England, Stephen Gherardi and Mohammad Amjad, Department of Agriculture and Food 3. Buloke barley yield when pasture-cropped across subtropical perennial pastures, David Ferris, Department of Agriculture and Food, Phil Ward and Roger Lawes, CSIRO 4. Is pasture cropping viable in WA? Grower perceptions and EverCrop initiatives to evaluate, David Ferris, Tim Wiley, Perry Dolling, Department of Agriculture and Food, Philip Barrett-Lennard, Evergreen farming 5. Best-bet management for dual-purpose canola, John Kirkegaard, Susan Sprague, Hugh Dove and Walter Kelman, CSIRO, Canberra, Peter Hamblin, Agritech Research, Young, NSW 6. Pasture in cropping systems – with and without sheep, Brad Nutt and Angelo Loi, Department of Agriculture and Food 7. Can technology substitute for a lupin break? Wayne Parker, Department of Agriculture and Food 8. Canola row spacing with and without long term stubble retention on a sandy clay loam at Merredin, Glen Riethmuller, Department of Agriculture and Food 9. Impact of stubble retention on water balance and crop yield, Phil Ward1, Ken Flower2,3, Neil Cordingley2 and Shayne Micin1, 1CSIRO, Wembley, Western Australia, 2Western Australian No-Till Farmers Association, 3University of Western Australia Analysis and Modelling 10. Using POAMA rainfall forecasts for crop management in South-West WA, Senthold Asseng1, Peter McIntosh2,3, Mike Pook2,3, James Risbey2,3, Guomin Wang3, Oscar Alves3, Ian Foster4, Imma Farre4 and Nirav Khimashia1, 1CSIRO Plant Industry, Perth, 2CSIRO Marine and Atmospheric Research, Hobart, 3Centre for Australian Weather and Climate Research (CAWCR), A partnership between the Australian Bureau of Meteorology and CSIRO, Melbourne, 4Department of Agriculture and Food 11. Adaption to changing climates and variability – results of the Agribusiness Changing Climates regional workshop, Anderson W3, Beard D3, Blake J3, Grieve R1, Lang M3, Lemon J3, McTaggart R3, Gray D3, Price M2 and Stephens D3, 1Roderick Grieve Farm Management Consultants, 2Coffey International P/L, 3Department of Agriculture and Food 12. Farmers’ management of seasonal variability and climate change in WA, DA Beard, DM Gray, P Carmody, Department of Agriculture and Food 13. Is there a value in having a frost forecast for wheat in South-West WA? Imma Farre1, Senthold Asseng2, Ian Foster1 and Doug Abrecht3, 1Department of Agriculture and Food, CSIRO, Floreat, 2CSIRO Plant Industry, Perth 3Department of Agriculture and Food, Centre for Cropping Systems 14. Does buying rainfall pay? Greg Kirk, Planfarm Agricultural Consultants 15. Which region in the WA wheatbelt makes best use of rainfall? Peter Rowe, Bankwest Agribusiness 16. POAMA – the Predictive Ocean-Atmosphere Model for Australia, Guomin Wang and Oscar Alves, Centre for Australian Weather and Climate Research (CAWCR), A partnership between the Australian Bureau of Meteorology and CSIRO, Melbourne 17. Exploring the link between water use efficiency and farm profitability, Cameron Weeks, Planfarm and Peter Tozer, PRT Consulting Precision Agriculture 18. A plethora of paddock information is available – how does it stack up? Derk Bakker, Department of Agriculture and Food 18. Variable rate prescription mapping for lime inputs based on electromagnetic surveying and deep soil testing, Frank D’Emden, Quenten Knight and Luke Marquis, Precision Agronomics, Australia 19. Trial design and analysis using precision agriculture and farmer’s equipment, Roger Lawes, CSIRO Sustainable Ecosystems, Centre for Environment and Life Sciences, Floreat 20. Farmer perspectives of precision agriculture in Western Australia: Issues and the way forward, Dr Roger Mandel, Curtin Universit

    The genomic landscape of balanced cytogenetic abnormalities associated with human congenital anomalies

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    Despite the clinical significance of balanced chromosomal abnormalities (BCAs), their characterization has largely been restricted to cytogenetic resolution. We explored the landscape of BCAs at nucleotide resolution in 273 subjects with a spectrum of congenital anomalies. Whole-genome sequencing revised 93% of karyotypes and demonstrated complexity that was cryptic to karyotyping in 21% of BCAs, highlighting the limitations of conventional cytogenetic approaches. At least 33.9% of BCAs resulted in gene disruption that likely contributed to the developmental phenotype, 5.2% were associated with pathogenic genomic imbalances, and 7.3% disrupted topologically associated domains (TADs) encompassing known syndromic loci. Remarkably, BCA breakpoints in eight subjects altered a single TAD encompassing MEF2C, a known driver of 5q14.3 microdeletion syndrome, resulting in decreased MEF2C expression. We propose that sequence-level resolution dramatically improves prediction of clinical outcomes for balanced rearrangements and provides insight into new pathogenic mechanisms, such as altered regulation due to changes in chromosome topology

    Inverting the model of genomics data sharing with the NHGRI Genomic Data Science Analysis, Visualization, and Informatics Lab-space

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    The NHGRI Genomic Data Science Analysis, Visualization, and Informatics Lab-space (AnVIL; https://anvilproject.org) was developed to address a widespread community need for a unified computing environment for genomics data storage, management, and analysis. In this perspective, we present AnVIL, describe its ecosystem and interoperability with other platforms, and highlight how this platform and associated initiatives contribute to improved genomic data sharing efforts. The AnVIL is a federated cloud platform designed to manage and store genomics and related data, enable population-scale analysis, and facilitate collaboration through the sharing of data, code, and analysis results. By inverting the traditional model of data sharing, the AnVIL eliminates the need for data movement while also adding security measures for active threat detection and monitoring and provides scalable, shared computing resources for any researcher. We describe the core data management and analysis components of the AnVIL, which currently consists of Terra, Gen3, Galaxy, RStudio/Bioconductor, Dockstore, and Jupyter, and describe several flagship genomics datasets available within the AnVIL. We continue to extend and innovate the AnVIL ecosystem by implementing new capabilities, including mechanisms for interoperability and responsible data sharing, while streamlining access management. The AnVIL opens many new opportunities for analysis, collaboration, and data sharing that are needed to drive research and to make discoveries through the joint analysis of hundreds of thousands to millions of genomes along with associated clinical and molecular data types

    Especiação e seus mecanismos: histórico conceitual e avanços recentes

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    Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

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    IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570
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