Economic evidence for the prevention and treatment of atopic eczema: a protocol for a systematic review

Background: Eczema, synonymous with atopic eczema or atopic dermatitis, is a chronic skin disease that has a similar impact on health-related quality of life as other chronic diseases. The proposed research aims to provide a comprehensive systematic assessment of the economic evidence base available to inform economic modelling and decision making on interventions to prevent and treat eczema at any stage of the life course. Whilst the Global Resource of Eczema Trials (GREAT) database collects together the effectiveness evidence for eczema there is currently no such systematic resource on the economics of eczema. It is important to gain an overview of the current state of the art of economic methods in the field of eczema in order to strengthen the economic evidence base further. Methods/design: The proposed study is a systematic review of the economic evidence surrounding interventions for the prevention and treatment of eczema. Relevant search terms will be used to search MEDLINE, EMBASE, Database of Abstracts of Reviews of Effects, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, NHS Economic Evaluation Database, Health Technology Assessment, Cumulative Index to Nursing and Allied Health Literature, Econ Lit, Scopus, Cost-Effectiveness Analysis Registry and Web of Science in order to identify relevant evidence. To be eligible for inclusion studies will be primary empirical studies evaluating the cost, utility or full economic evaluation of interventions for preventing or treating eczema. Two reviewers will independently assess studies for eligibility and perform data abstraction. Evidence tables will be produced presenting details of study characteristics, costing methods, outcome methods and quality assessment. The methodological quality of studies will be assessed using accepted checklists. Discussion: The systematic review is being undertaken to identify the type of economic evidence available, summarise the results of the available economic evidence and critically appraise the quality of economic evidence currently available to inform future economic modelling and resource allocation decisions about interventions to prevent or treat eczema. We aim to use the review to offer guidance about how to gather economic evidence in studies of eczema and/or what further research is necessary in order to inform this

Flexible Lipid Bilayers in Implicit Solvent

A minimalist simulation model for lipid bilayers is presented. Each lipid is represented by a flexible chain of beads in implicit solvent. The hydrophobic effect is mimicked through an intermolecular pair potential localized at the ``water''/hydrocarbon tail interface. This potential guarantees realistic interfacial tensions for lipids in a bilayer geometry. Lipids self assemble into bilayer structures that display fluidity and elastic properties consistent with experimental model membrane systems. Varying molecular flexibility allows for tuning of elastic moduli and area/molecule over a range of values seen in experimental systems.Comment: 5 pages, 5 figure

Spatial Patterns and Sequential Sampling Plans for Estimating Densities of Stink Bugs (Hemiptera: Pentatomidae) in Soybean in the North Central Region of the United States

Stink bugs are an emerging threat to soybean (Fabales: Fabaceae) in the North Central Region of the United States. Consequently, region-specific scouting recommendations for stink bugs are needed. The aim of this study was to characterize the spatial pattern and to develop sampling plans to estimate stink bug population density in soybean fields. In 2016 and 2017, 125 fields distributed across nine states were sampled using sweep nets. Regression analyses were used to determine the effects of stink bug species [Chinavia hilaris (Say) (Hemiptera: Pentatomidae) and Euschistus spp. (Hemiptera: Pentatomidae)], life stages (nymphs and adults), and field locations (edge and interior) on spatial pattern as represented by variance–mean relationships. Results showed that stink bugs were aggregated. Sequential sampling plans were developed for each combination of species, life stage, and location and for all the data combined. Results for required sample size showed that an average of 40–42 sample units (sets of 25 sweeps) would be necessary to achieve a precision of 0.25 for stink bug densities commonly encountered across the region. However, based on the observed geographic gradient of stink bug densities, more practical sample sizes (5–10 sample units) may be sufficient in states in the southeastern part of the region, whereas impractical sample sizes (\u3e100 sample units) may be required in the northwestern part of the region. Our findings provide research-based sampling recommendations for estimating densities of these emerging pests in soybean

Anderson Transition in Disordered Graphene

We use the regularized kernel polynomial method (RKPM) to numerically study the effect disorder on a single layer of graphene. This accurate numerical method enables us to study very large lattices with millions of sites, and hence is almost free of finite size errors. Within this approach, both weak and strong disorder regimes are handled on the same footing. We study the tight-binding model with on-site disorder, on the honeycomb lattice. We find that in the weak disorder regime, the Dirac fermions remain extended and their velocities decrease as the disorder strength is increased. However, if the disorder is strong enough, there will be a {\em mobility edge} separating {\em localized states around the Fermi point}, from the remaining extended states. This is in contrast to the scaling theory of localization which predicts that all states are localized in two-dimensions (2D).Comment: 4 page

Foci of Schistosomiasis mekongi, Northern Cambodia: II. Distribution of infection and morbidity.

In the province of Kracheh, in Northern Cambodia, a baseline epidemiological survey on Schistosoma mekongi was conducted along the Mekong River between December 1994 and April 1995. The results of household surveys of highly affected villages of the East and the West bank of the river and of school surveys in 20 primary schools are presented. In household surveys 1396 people were examined. An overall prevalence of infection of 49.3% was detected by a single stool examination with the Kato-Katz technique. The overall intensity of infection was 118.2 eggs per gram of stool (epg). There was no difference between the population of the east and west shore of the Mekong for prevalence (P = 0.3) or intensity (P = 0.9) of infection. Severe morbidity was very frequent. Hepatomegaly of the left lobe was detected in 48.7% of the population. Splenomegaly was seen in 26.8% of the study participants. Visible diverted circulation was found in 7.2% of the population, and ascites in 0.1%. Significantly more hepatomegaly (P = 0.001), splenomegaly (P = 0. 001) and patients with diverted circulation (P = 0.001) were present on the west bank of the Mekong. The age group of 10-14 years was most affected. The prevalence of infection in this group was 71.8% and 71.9% in the population of the West and East of the Mekong, respectively. The intensity of infection was 172.4 and 194.2 epg on the West and the East bank, respectively. In the peak age group hepatomegaly reached a prevalence of 88.1% on the west and 82.8% on the east bank. In the 20 schools 2391 children aged 6-16 years were examined. The overall prevalence of infection was 40.0%, ranging from 7.7% to 72.9% per school. The overalls mean intensity of infection was 110.1 epg (range by school: 26.7-187.5 epg). Both prevalence (P = 0.001) and intensity of infection (P = 0.001) were significantly higher in schools on the east side of the Mekong. Hepatomegaly (55.2%), splenomegaly (23.6%), diverted circulation (4. 1%), ascites (0.5%), reported blood (26.7%) and mucus (24.3%) were very frequent. Hepatomegaly (P = 0.001), splenomegaly (P = 0.001), diverted circulation (P = 0.001) and blood in stool (P = 0.001) were significantly more frequent in schools of the east side of the Mekong. Boys suffered more frequently from splenomegaly (P = 0.05), ascites (P = 0.05) and bloody stools (P = 0.004) than girls. No difference in sex was found for the prevalence and intensity of infection and prevalence of hepatomegaly. On the school level prevalence and intensity of infection were highly associated (r = 0. 93, P = 0.0001). The intensity of infection was significantly associated only with the prevalence of hepatomegaly (r = 0.44, P = 0. 05) and blood in stool (r = 0.40, P = 0.02). This comprehensive epidemiological study documents for the first time the public health importance of schistosomiasis mekongi in the Province of Kracheh, Northern Cambodia and points at key epidemiological features of this schistosome species, in particular the high level of morbidity associated with infection

Anaemia prevalence and nutrient intake among women in peri-urban settlements in Accra, Ghana

Anaemia among women is a major public health concern globally. In developing countries, nutritional anaemia may be due to poor bioavailability of dietary iron, haemoglobinopathies, or intestinal parasites. The study objectives were to determine the prevalence of anaemia and current nutrient intakes essential to erythropoiesis among women of reproductive age (WRA) in peri-urban settlements in the Ga-East Municipality, Accra, Ghana. This cross-sectional study assessed the nutrient intake, sickling and haemoglobin levels of 134 women aged 15-49 years enrolled in a peanut-based field trial at baseline. A pretested semi-quantitative food frequency questionnaire was used to assess energy and nutrient intake using the Food Processor (ESHA) software. Whole blood was used to determine full blood count using the haematology automated analyser. Sickling was determined by blood staining. Anaemia was classified based on recommended cut-offs. Chi-square analysis was used as a test of independence between anaemia and age groups. Linear regression was used to determine predictors of haemoglobin concentration. The mean age of the women was 29 ± 8 years. The mean total caloric intake was 2315 ± 915 kcal, whilst protein and fat intakes were 67 ± 27g and 68± 30g, respectively. Almost three-quarters of the women met the recommended dietary allowance (RDA) for iron and vitamin C. However, only a third met the RDA for fat, and about two-thirds met their needs for energy and protein. None of the women met the RDA for folate which is integral for haem formation. Also 17% (23/134) of the women were sickle cell anaemia positive. Mean haemoglobin concentration was 12.1 ± 1.8 g/dL. Mild, moderate and severe anaemia due to iron deficiency was present in 35.8%, 6.7% and 1.5%, of the women respectively. All categories of anaemia was present in 44% of the women. Anaemia, prevalence increased during the early stages of the reproductive age (15-29 years) and declined towards the end of the reproductive age period (40-49 years). An increase in age of one year was significantly associated with a 0.056 g/dL rise in haemoglobin level (p=0.014). Anaemia due to iron deficiency exists as a public health problem among women in peri-urban settlements in the Ga-East Municipality, Accra, Ghana. Dietary diversity to include green leafy vegetables which are rich in folate and pro-vitamin A may reduce the current level of prevalence.Key words: Anaemia, Nutrients, Peri-urban, Women, RDA, sickling test, Food Processor softwar

Relativistic quantum measurement

Does the measurement of a quantum system necessarily break Lorentz invariance? We present a simple model of a detector that measures the spacetime localization of a relativistic particle in a Lorentz invariant manner. The detector does not select a preferred Lorentz frame as a Newton-Wigner measurement would do. The result indicates that there exists a Lorentz invariant notion of quantum measurement and sheds light on the issue of the localization of a relativistic particle. The framework considered is that of single-particle mechanics as opposed to field theory. The result may be taken as support for the interpretation postulate of the spacetime-states formulation of single-particle quantum theory.Comment: 9 pages, no figures: Revision: references adde