Pyramiding of Meloidogyne hapla resistance genes in potato does not result in an increase of resistance

High levels of resistance against Meloidogyne hapla have been identified in wild species of tuber-bearing potatoes, but only QTL with partial effects have been identified so far in back crosses with cultivated potato. This study was designed to test if pyramiding of two previously identified resistance genes, R Mh-tar and R Mh-chc A, will result in improved or even an absolute level of resistance. R Mh-tar and R Mh-chc A introgressed from the wild tuber-bearing potato species Solanum tarijense and Solanum chacoense were combined in a segregating diploid Solanum tuberosum population. With the aid of AFLP markers, descendants from this segregating population were classified into four groups, carrying no R gene, with only R Mh-tar , with only R Mh-chc A and a group with the pyramided R Mh-tar and R Mh-chc A. Upon inoculation with M. hapla isolate Bovensmilde, the group containing only R Mh-chc A showed a decline of 88% in average number of developed egg masses compared to the group without R Mh-chc A and R Mh-tar . The group of genotypes containing only R Mh-tar , but not R Mh-chc A, showed a decline of 55% in the number of developed egg masses compared to the group without R Mh-chc A and R Mh-tar . Unfortunately, the latter effect of R Mh-tar was not significant. The effect of both loci, R Mh-tar and R Mh-chc A combined, did not further reduce the number of egg masses compared to the level of R Mh-chc A alon

Seven Years after the Manifesto: Literature Review and Research Directions for Technologies in Animal Computer Interaction

As technologies diversify and become embedded in everyday lives, the technologies we expose to animals, and the new technologies being developed for animals within the field of Animal Computer Interaction (ACI) are increasing. As we approach seven years since the ACI manifesto, which grounded the field within Human Computer Interaction and Computer Science, this thematic literature review looks at the technologies developed for (non-human) animals. Technologies that are analysed include tangible and physical, haptic and wearable, olfactory, screen technology and tracking systems. The conversation explores what exactly ACI is whilst questioning what it means to be animal by considering the impact and loop between machine and animal interactivity. The findings of this review are expected to form the first grounding foundation of ACI technologies informing future research in animal computing as well as suggesting future areas for exploratio

Costs and Cost-Effectiveness of Hypertension Screening and Treatment in Adults with Hypertension in Rural Nigeria in the Context of a Health Insurance Program.

BACKGROUND: High blood pressure is a leading risk factor for death and disability in sub-Saharan Africa (SSA). We evaluated the costs and cost-effectiveness of hypertension care provided within the Kwara State Health Insurance (KSHI) program in rural Nigeria. METHODS: A Markov model was developed to assess the costs and cost-effectiveness of population-level hypertension screening and subsequent antihypertensive treatment for the population at-risk of cardiovascular disease (CVD) within the KSHI program. The primary outcome was the incremental cost per disability-adjusted life year (DALY) averted in the KSHI scenario compared to no access to hypertension care. We used setting-specific and empirically-collected data to inform the model. We defined two strategies to assess eligibility for antihypertensive treatment based on 1) presence of hypertension grade 1 and 10-year CVD risk of >20%, or grade 2 hypertension irrespective of 10-year CVD risk (hypertension and risk based strategy) and 2) presence of hypertension in combination with a CVD risk of >20% (risk based strategy). We generated 95% confidence intervals around the primary outcome through probabilistic sensitivity analysis. We conducted one-way sensitivity analyses across key model parameters and assessed the sensitivity of our results to the performance of the reference scenario. RESULTS: Screening and treatment for hypertension was potentially cost-effective but the results were sensitive to changes in underlying assumptions with a wide range of uncertainty. The incremental cost-effectiveness ratio for the first and second strategy respectively ranged from US$1,406 to US$ 7,815 and US$732 to US$ 2,959 per DALY averted, depending on the assumptions on risk reduction after treatment and compared to no access to antihypertensive treatment. CONCLUSIONS: Hypertension care within a subsidized private health insurance program may be cost-effective in rural Nigeria and public-private partnerships such as the KSHI program may provide opportunities to finance CVD prevention care in SSA

Maritime Aerosol Network as a Component of AERONET - First Results and Comparison with Global Aerosol Models and Satellite Retrievals

The Maritime Aerosol Network (MAN) has been collecting data over the oceans since November 2006. Over 80 cruises were completed through early 2010 with deployments continuing. Measurement areas included various parts of the Atlantic Ocean, the Northern and Southern Pacific Ocean, the South Indian Ocean, the Southern Ocean, the Arctic Ocean and inland seas. MAN deploys Microtops handheld sunphotometers and utilizes a calibration procedure and data processing traceable to AERONET. Data collection included areas that previously had no aerosol optical depth (AOD) coverage at all, particularly vast areas of the Southern Ocean. The MAN data archive provides a valuable resource for aerosol studies in maritime environments. In the current paper we present results of AOD measurements over the oceans, and make a comparison with satellite AOD retrievals and model simulations

Deprescribing interventions and their impact on medication adherence in community-dwelling older adults with polypharmacy: a systematic review

Background: Polypharmacy, and the associated adverse drug events such as non-adherence to prescriptions, is a common problem for elderly people living with multiple comorbidities. Deprescribing, i.e. the gradual withdrawal from medications with supervision by a healthcare professional, is regarded as a means of reducing adverse effects of multiple medications including non-adherence. This systematic review examines the evidence of deprescribing as an effective strategy for improving medication adherence amongst older, community dwelling adults. Methods: A mixed methods review was undertaken. Eight bibliographic database and two clinical trials registers were searched between May and December 2017. Results were double screened in accordance with pre-defined inclusion/exclusion criteria related to polypharmacy, deprescribing and adherence in older, community dwelling populations. The Mixed Methods Appraisal Tool (MMAT) was used for quality appraisal and an a priori data collection instrument was used. For the quantitative studies, a narrative synthesis approach was taken. The qualitative data was analysed using framework analysis. Findings were integrated using a mixed methods technique. The review was performed in accordance with the PRISMA reporting statement. Results: A total of 22 original studies were included, of which 12 were RCTs. Deprescribing with adherence as an outcome measure was identified in randomised controlled trials (RCTs), observational and cohort studies from 13 countries between 1996 and 2017. There were 17 pharmacy-led interventions; others were led by General Practitioners (GP) and nurses. Four studies demonstrated an overall reduction in medications of which all studies corresponded with improved adherence. A total of thirteen studies reported improved adherence of which 5 were RCTs. Adherence was reported as a secondary outcome in all but one study. Conclusions: There is insufficient evidence to show that deprescribing improves medication adherence. Only 13 studies (of 22) reported adherence of which only 5 were randomised controlled trials. Older people are particularly susceptible to non-adherence due to multi-morbidity associated with polypharmacy. Bio-psycho-social factors including health literacy and multi-disciplinary team interventions influence adherence. The authors recommend further study into the efficacy and outcomes of medicines management interventions. A consensus on priority outcome measurements for prescribed medications is indicated

Prevalence of and Risk Factors for Drug-Related Readmissions in Older Adults: A Systematic Review and Meta-Analysis

Background: Older adults are at an increased risk of drug-related problems, especially following discharge from hospital. Drug-related readmissions place a large burden on the patient and the healthcare system. However, previous studies report inconsistent results on the prevalence and associated risk factors for drug-related hospital readmissions in older adults. Objectives: We aimed to assess the prevalence of drug-related readmissions in older adults aged 65 years and older and investigate the drug classes, preventability and risk factors most associated with these readmissions. Methods: A systematic review and meta-analysis were undertaken to answer our objectives. A search of four databases (MEDLINE, Embase, CINAHL and Scopus) was conducted. Three authors independently performed title and abstract screening, full-text screening and data extraction of all included studies. A meta-analysis was conducted to calculate the pooled prevalence of drug-related readmissions across all studies, and a subgroup analysis was performed to explore heterogeneity among studies reporting on adverse drug reaction-related readmissions. Results: A total of 1978 studies were identified in the initial search, of which four studies were included in the final synthesis. Three studies focused on readmissions due to adverse drug reactions and one study focused on readmissions due to drug-related problems. A pooled prevalence of 9% (95% confidence interval 2–18) was found for drug-related readmissions across all studies, and a pooled prevalence of 6% (95% confidence interval 4–10) was found for adverse drug reaction-related readmissions. Three studies explored the preventability of readmissions and 15.4–22.2% of cases were deemed preventable. The drug classes most associated with adverse drug reaction readmissions included anticoagulants, antibiotics, psychotropics and chemotherapy agents. Polypharmacy (the use of five or more medications) and several comorbidities such as cancer, liver disease, ischaemic heart disease and peptic ulcer disease were identified as risk factors for drug-related readmissions. Conclusions: Almost one in ten older adults discharged from hospital experienced a drug-related hospital readmission, with one fifth of these deemed preventable. Several comorbidities and the use of polypharmacy and high-risk drugs were identified as prominent risk factors for readmission. Further research is needed to explore possible causes of drug-related readmissions in older adults for a more guided approach to the development of effective medication management interventions

Deep learning for healthcare applications based on physiological signals: A review

Background and objective: We have cast the net into the ocean of knowledge to retrieve the latest scientific research on deep learning methods for physiological signals. We found 53 research papers on this topic, published from 01.01.2008 to 31.12.2017. Methods: An initial bibliometric analysis shows that the reviewed papers focused on Electromyogram(EMG), Electroencephalogram(EEG), Electrocardiogram(ECG), and Electrooculogram(EOG). These four categories were used to structure the subsequent content review. Results: During the content review, we understood that deep learning performs better for big and varied datasets than classic analysis and machine classification methods. Deep learning algorithms try to develop the model by using all the available input. Conclusions: This review paper depicts the application of various deep learning algorithms used till recently, but in future it will be used for more healthcare areas to improve the quality of diagnosi

Effectiveness and cost-effectiveness of transmural collaborative care with consultation letter (TCCCL) and duloxetine for major depressive disorder (MDD) and (sub)chronic pain in collaboration with primary care: design of a randomized placebo-controlled multi-Centre trial: TCC:PAINDIP

__Abstract__ Background: The comorbidity of pain and depression is associated with high disease burden for patients in terms of disability, wellbeing, and use of medical care. Patients with major and minor depression often present themselves with pain to a general practitioner and recognition of depression in such cases is low, but evolving. Also, physical symptoms, including pain, in major depressive disorder, predict a poorer response to treatment. A multi-faceted, patient-tailored treatment programme, like collaborative care, is promising. However, treatment of chronic pain conditions in depressive patients has, so far, received limited attention in research. Cost effectiveness of an integrated approach of pain in depressed patients has not been studied. This article describes the aims and design of a study to evaluate effects and costs of collaborative care with the antidepressant duloxetine for patients with pain symptoms and a depressive disorder, compared to collaborative care with placebo and compared to duloxetine alone