Direct to Consumer or Direct to All: Home DNA Tests and Lack of Privacy Regulations in the United States

Although the U.S. has some measures of privacy protection for genetic data, the lack of a comprehensive approach to protecting direct-to-consumer genetic testing results in privacy violations for both consumers and their relatives. This essay explores the critical need for the U.S. government to address these privacy violations and argues that the U.S. should approach the problem and strategize a solution similar to the European Union’s (EU) General Data Protection Regulation (GDPR). Part I identifies current United States law, both federal and state regulations that address DTC-GT and genetic privacy. Part II examines the lack of regulation surrounding current DTC-GT companies and the potential to abuse individuals’ privacy. Finally, Part III explores various solutions to resolve genetic privacy issues in the U.S. and advocates for the federal government to adopt a comprehensive regulatory framework like the EU or California

Role of combined prenatal and postnatal paracetamol exposure on asthma development: the Czech ELSPAC study

Background: Prenatal and postnatal paracetamol exposure has been previously associated with asthma development in childhood in Western populations. We explore the association between prenatal and postnatal paracetamol exposure and asthma development in a Central European sample of Czech children, suggesting possible additive effect of the both exposures. Furthermore, since aspirin had been used more widely during study data collection in Central Europe, we also compared asthma development for those exposed to paracetamol and aspirin. Methods: We used data from 3329 children born in the 1990s as members of the prospective Czech European Longitudinal Study of Pregnancy and Childhood. Data about prenatal and postnatal paracetamol and aspirin exposure, and potential covariates were obtained from questionnaires completed by mothers. Data about incident asthma were obtained from paediatrician health records. Results: 60.9% of children received paracetamol only postnatally, 1.5% only prenatally and 4.9% of children were exposed both during pregnancy and infancy. Prevalence of asthma in following population was 5% at 11 years. Being exposed to paracetamol both in prenatal and postnatal period was associated with asthma development (unadjusted OR 1.98, 95% CI 1.02 to 3.87). Being exposed only in the postnatal period was also significantly associated with increased risk of asthma. No association between prenatal exposure only and outcome was found. A higher but non-significant risk of asthma was observed for those whose mothers used paracetamol during pregnancy compared with those who used aspirin. Conclusions: The main findings of this prospective birth cohort study add to previous observations linking prenatal and early postnatal paracetamol exposure to asthma development. However, the magnitude of effect is relatively modest, and therefore, we recommend paracetamol to remain the analgesic and antipyretic of choice throughout pregnancy and early childhood

How Do Patients with Chronic Pain Benefit from a Peer-Supported Pain Self-Management Intervention? A Qualitative Investigation

Objective. Peer support is a novel and under-studied approach to the management of chronic pain. This study’s purpose was to uncover the elements of a peer-supported self-management intervention that are perceived by participants as essential to achieving positive changes. Design. Qualitative, semi-structured interviews. Methods. Veterans and veteran peer coaches who participated in a pilot study of peer support Improving Pain using Peer-Reinforced Self-Management Strategies (IMPPRESS, NCT01748227) took part in qualitative semi-structured interviews after completing the 4-month intervention. Questions were designed to facilitate understanding of how participants experienced the intervention. An immersion/crystallization approach was used to analyze data. Results. All 26 peer coaches and patients who completed the intervention were interviewed. Qualitative analysis revealed three elements of IMPPRESS that peer coaches and patients believed conferred benefit: 1) making interpersonal connections; 2) providing/receiving encouragement and support; and 3) facilitating the use of pain self-management strategies. Conclusions. Peer support represents a promising approach to chronic pain management that merits further study. The current study helps to identify intervention elements perceived by participants to be important in achieving positive results. Understanding how peer support may benefit patients is essential to optimize the effectiveness of peer support interventions and increase the implementation potential of peer-supported pain self-management into clinical practice

p-species integrable reaction-diffusion processes

We consider a process in which there are p-species of particles, i.e. A_1,A_2,...,A_p, on an infinite one-dimensional lattice. Each particle $A_i$ can diffuse to its right neighboring site with rate $D_i$, if this site is not already occupied. Also they have the exchange interaction A_j+A_i --> A_i+A_j with rate $r_{ij}.$ We study the range of parameters (interactions) for which the model is integrable. The wavefunctions of this multi--parameter family of integrable models are found. We also extend the 2--species model to the case in which the particles are able to diffuse to their right or left neighboring sites.Comment: 16 pages, LaTe

A Brief Peer Support Intervention for Veterans with Chronic Musculoskeletal Pain: A Pilot Study of Feasibility and Effectiveness

Objective The aim of this study was to pilot test a peer support intervention, involving peer delivery of pain self-management strategies, for veterans with chronic musculoskeletal pain. Design Pretest/posttest with 4-month intervention period. Methods Ten peer coaches were each assigned 2 patients (N = 20 patients). All had chronic musculoskeletal pain. Guided by a study manual, peer coach–patient pairs were instructed to talk biweekly for 4 months. Pain was the primary outcome and was assessed with the PEG, a three-item version of the Brief Pain Inventory, and the PROMIS Pain Interference Questionnaire. Several secondary outcomes were also assessed. To assess change in outcomes, a linear mixed model with a random effect for peer coaches was applied. Results Nine peer coaches and 17 patients completed the study. All were male veterans. Patients' pain improved at 4 months compared with baseline but did not reach statistical significance (PEG: P = 0.33, ICC [intra-class correlation] = 0.28, Cohen's d = −0.25; PROMIS: P = 0.17, d = −0.35). Of secondary outcomes, self-efficacy (P = 0.16, ICC = 0.56, d = 0.60) and pain centrality (P = 0.06, ICC = 0.32, d = −0.62) showed greatest improvement, with moderate effect sizes. Conclusions This study suggests that peers can effectively deliver pain self-management strategies to other veterans with pain. Although this was a pilot study with a relatively short intervention period, patients improved on several outcomes

An interacting spin flip model for one-dimensional proton conduction

A discrete asymmetric exclusion process (ASEP) is developed to model proton conduction along one-dimensional water wires. Each lattice site represents a water molecule that can be in only one of three states; protonated, left-pointing, and right-pointing. Only a right(left)-pointing water can accept a proton from its left(right). Results of asymptotic mean field analysis and Monte-Carlo simulations for the three-species, open boundary exclusion model are presented and compared. The mean field results for the steady-state proton current suggest a number of regimes analogous to the low and maximal current phases found in the single species ASEP [B. Derrida, Physics Reports, {\bf 301}, 65-83, (1998)]. We find that the mean field results are accurate (compared with lattice Monte-Carlo simulations) only in the certain regimes. Refinements and extensions including more elaborate forces and pore defects are also discussed.Comment: 13pp, 6 fig

Genetically discrete populations of Trypanosoma congolense from livestock on the Kenyan coast

Twenty-seven stocks of Nannomonas trypanosomes isolated from livestock in 1982 on a ranch at Kilifi on the Kenyan coast were characterized by isoenzyme electrophoresis and by the abilities of the parasite's DNA to hybridize to two repetitive sequence DNA probes. Allthe Kilifi stocks which were examined had isoenzyme patterns which were markedly different from the 75 patterns previously described from 78 stocks of Trypanosoma congolense. On average only 15% of the enzyme bands present in the Kilifi stocks were present in those stocks of T. congolense which had previously been surveyed for isoenzymes. The DNA from all the Kilifi stocks which had been examined for isoenzymes hybridized with only the repetitive sequence probe isolated from a clone of a Kilifi stock. In contrast, the DNA from all 27 Kilifi stocks failed to hybridize with a repetitive sequence probe isolated from a clone from a different stock of T. congolense. Thus, the trypanosomes in all the Kilifi stocks examined were both phenotypically and genotypically discrete. These genetically discrete trypanosomes have also been detected in 2 stocks isolated from livestock from another location on the Kenyan coast. The results show that there is a wide range of genetic heterogeneity within the trypanosomes currently classified as T. congolense. We suggest that the limits of this genetic heterogeneity could represent incipient speciatio

Facilitators and Barriers to Participation in a Peer Support Intervention for Veterans With Chronic Pain

OBJECTIVE: To understand facilitators and barriers to participation in a peer support intervention for self-management of chronic pain. METHODS: After completing a pilot intervention study, peer coaches and their veteran patients took part in a qualitative, semistructured interview to explore their experiences with the intervention. Data were analyzed using an immersion/crystallization approach. RESULTS: Three facilitators and 2 barriers to patient participation in a peer support intervention for veterans with chronic pain emerged. Facilitators were (1) having a shared identity as veterans, (2) being partnered with a person who also has chronic pain, and (3) support from the study staff. Barriers were (1) logistical challenges, and (2) challenges to motivation and engagement in the intervention. DISCUSSION: Awareness of facilitators and barriers to participation in a peer-supported self-management program for chronic pain, as well as strategies to capitalize on facilitators and mitigate barriers, are essential for further study and ultimate clinical implementation of such a program