Comparison of algorithms that detect drug side effects using electronic healthcare databases

The electronic healthcare databases are starting to become more readily available and are thought to have excellent potential for generating adverse drug reaction signals. The Health Improvement Network (THIN) database is an electronic healthcare database containing medical information on over 11 million patients that has excellent potential for detecting ADRs. In this paper we apply four existing electronic healthcare database signal detecting algorithms (MUTARA, HUNT, Temporal Pattern Discovery and modified ROR) on the THIN database for a selection of drugs from six chosen drug families. This is the first comparison of ADR signalling algorithms that includes MUTARA and HUNT and enabled us to set a benchmark for the adverse drug reaction signalling ability of the THIN database. The drugs were selectively chosen to enable a comparison with previous work and for variety. It was found that no algorithm was generally superior and the algorithms’ natural thresholds act at variable stringencies. Furthermore, none of the algorithms perform well at detecting rare ADRs

Women’s responses to changes in U.S. preventive task force’s mammography screening guidelines: results of focus groups with ethnically diverse women

Background: The 2009 U.S. Preventive Services Task Force (USPSTF) changed mammography guidelines to recommend routine biennial screening starting at age 50. This study describes women’s awareness of, attitudes toward, and intention to comply with these new guidelines. Methods: Women ages 40–50 years old were recruited from the Boston area to participate in focus groups (k = 8; n = 77). Groups were segmented by race/ethnicity (Caucasian = 39%; African American = 35%; Latina = 26%), audio-taped, and transcribed. Thematic content analysis was used. Results: Participants were largely unaware of the revised guidelines and suspicious that it was a cost-savings measure by insurers and/or providers. Most did not intend to comply with the change, viewing screening as obligatory. Few felt prepared to participate in shared decision-making or advocate for their preferences with respect to screening. Conclusions: Communication about the rationale for mammography guideline changes has left many women unconvinced about potential disadvantages or limitations of screening. Since further guideline changes are likely to occur with advances in technology and science, it is important to help women become informed consumers of health information and active participants in shared decision-making with providers. Additional research is needed to determine the impact of the USPSTF change on women’s screening behaviors and on breast cancer outcomes

Avaliação de programa de prevenção de obesidade em adolescentes de escolas públicas

OBJETIVO: Avaliar os efeitos de um programa de prevenção de obesidade sobre práticas alimentares de adolescentes de escolas públicas. MÉTODOS: Intervenção com 331 estudantes de 11 a 17 anos de 5º e 6º anos de duas escolas públicas estaduais de Niterói, RJ, em 2005. As escolas foram classificadas em escola de intervenção (EI) e escola de controle (EC) para comparação. Práticas alimentares foram abordadas em questionários auto-respondidos antes e após o período de intervenção: consumo de fast food, consumo de refrigerantes, substituição de refeições por lanches, consumo de frutas, verduras e legumes e tipo de alimentação consumida nos intervalos das aulas. Testes qui-quadrado e McNemar foram aplicados para comparar proporções, considerando valor de p < 0,05. RESULTADOS: Na linha de base participaram 185 estudantes da EI (82,2% dos elegíveis) e 146 estudantes da EC (70,5% dos elegíveis). Na fase pós-intervenção houve perda de 10,3% dos adolescentes da EI e 27,4% da EC. Não se observaram mudanças significativas nas práticas alimentares na EC. Na EI aumentou a proporção de estudantes que relataram não consumir lanches vendidos por ambulantes (de 36,7% para 50,6%; p = 0,02) e dos jovens que relataram não substituir almoço (de 44,5% para 65,2%; p < 0,01) e jantar (de 38,4% para 54,3%; p < 0,01) por lanches. A principal mudança favorável foi a redução na freqüência de consumo de lanches fast food na EI comparada à EC (72,7% vs 54,4%; p = 0,001). CONCLUSÕES: Mudanças favoráveis nas práticas alimentares dos adolescentes foram encontradas e estimulam a implantação de programas dessa natureza; contudo, intervenções de maior duração precisam ser implementadas e avaliadas quanto a sua efetividade

Characterization of the Rabbit Neonatal Fc Receptor (FcRn) and Analyzing the Immunophenotype of the Transgenic Rabbits That Overexpresses FcRn

The neonatal Fc receptor (FcRn) regulates IgG and albumin homeostasis, mediates maternal IgG transport, takes an active role in phagocytosis, and delivers antigen for presentation. We have previously shown that overexpression of FcRn in transgenic mice significantly improves the humoral immune response. Because rabbits are an important source of polyclonal and monoclonal antibodies, adaptation of our FcRn overexpression technology in this species would bring significant advantages. We cloned the full length cDNA of the rabbit FcRn alpha-chain and found that it is similar to its orthologous analyzed so far. The rabbit FcRn - IgG contact residues are highly conserved, and based on this we predicted pH dependent interaction, which we confirmed by analyzing the pH dependent binding of FcRn to rabbit IgG using yolk sac lysates of rabbit fetuses by Western blot. Using immunohistochemistry, we detected strong FcRn staining in the endodermal cells of the rabbit yolk sac membrane, while the placental trophoblast cells and amnion showed no FcRn staining. Then, using BAC transgenesis we generated transgenic rabbits carrying and overexpressing a 110 kb rabbit genomic fragment encoding the FcRn. These transgenic rabbits – having one extra copy of the FcRn when hemizygous and two extra copies when homozygous - showed improved IgG protection and an augmented humoral immune response when immunized with a variety of different antigens. Our results in these transgenic rabbits demonstrate an increased immune response, similar to what we described in mice, indicating that FcRn overexpression brings significant advantages for the production of polyclonal and monoclonal antibodies

Pilot parallel randomised controlled trial of protective socks against usual care to reduce skin tears in high risk people: 'STOPCUTS'.

Skin tears are common in older adults and those taking steroids and warfarin. They are traumatic, often blunt injuries caused by oblique knocks to the extremities. The epidermis may separate from the dermis or both layers from underlying tissues leaving a skin flap or total loss of tissue, which is painful and prone to infection. 'Dermatuff™' knee-length socks containing Kevlar fibres (used in stab-proof vests and motorcyclists' clothing) aim to prevent skin tears. The acceptability of the socks and the feasibility of a randomised controlled trial (RCT) had not been explored.Royal Devon & Exeter NHS Foundation TrustThis article is freely available via Open Access. Click on the Additional Link above to access the full-text via the publisher's site.NIHR Research for Patient BenefitEDGE Project ID: 1854

Cosmological lensing ratios with DES Y1, SPT and Planck

International audienceCorrelations between tracers of the matter density field and gravitational lensing are sensitive to the evolution of the matter power spectrum and the expansion rate across cosmic time. Appropriately defined ratios of such correlation functions, on the other hand, depend only on the angular diameter distances to the tracer objects and to the gravitational lensing source planes. Because of their simple cosmological dependence, such ratios can exploit available signal-to-noise ratio down to small angular scales, even where directly modelling the correlation functions is difficult. We present a measurement of lensing ratios using galaxy position and lensing data from the Dark Energy Survey, and CMB lensing data from the South Pole Telescope and Planck, obtaining the highest precision lensing ratio measurements to date. Relative to the concordance ΛCDM model, we find a best-fitting lensing ratio amplitude of A = 1.1 ± 0.1. We use the ratio measurements to generate cosmological constraints, focusing on the curvature parameter. We demonstrate that photometrically selected galaxies can be used to measure lensing ratios, and argue that future lensing ratio measurements with data from a combination of LSST and Stage-4 CMB experiments can be used to place interesting cosmological constraints, even after considering the systematic uncertainties associated with photometric redshift and galaxy shear estimation

Dark Energy Survey Year 1 Results:tomographic cross-correlations between DES galaxies and CMB lensing from SPT+Planck

International audienceWe measure the cross-correlation between redMaGiC galaxies selected from the Dark Energy Survey (DES) year 1 data and gravitational lensing of the cosmic microwave background (CMB) reconstructed from South Pole Telescope (SPT) and Planck data over 1289  deg2. When combining measurements across multiple galaxy redshift bins spanning the redshift range of 0.15<z<0.90, we reject the hypothesis of no correlation at 19.9σ significance. When removing small-scale data points where thermal Sunyaev-Zel’dovich signal and nonlinear galaxy bias could potentially bias our results, the detection significance is reduced to 9.9σ. We perform a joint analysis of galaxy-CMB lensing cross-correlations and galaxy clustering to constrain cosmology, finding Ωm=0.276-0.030+0.029 and S8=σ8Ωm/0.3=0.800-0.094+0.090. We also perform two alternate analyses aimed at constraining only the growth rate of cosmic structure as a function of redshift, finding consistency with predictions from the concordance ΛCDM model. The measurements presented here are part of a joint cosmological analysis that combines galaxy clustering, galaxy lensing and CMB lensing using data from DES, SPT and Planck