Valuing Health Gain from Composite Response Endpoints for Multisystem Diseases

Objectives: This study aimed to demonstrate how to estimate the value of health gain after patients with a multisystem disease achieve a condition-specific composite response endpoint. Methods: Data from patients treated in routine practice with an exemplar multisystem disease (systemic lupus erythematosus) were extracted from a national register (British Isles Lupus Assessment Group Biologics Register). Two bespoke composite response endpoints (Major Clinical Response and Improvement) were developed in advance of this study. Difference-in-differences regression compared health utility values (3-level version of EQ-5D; UK tariff) over 6 months for responders and nonresponders. Bootstrapped regression estimated the incremental quality-adjusted life-years (QALYs), probability of QALY gain after achieving the response criteria, and population monetary benefit of response. Results: Within the sample (n = 171), 18.2% achieved Major Clinical Response and 49.1% achieved Improvement at 6 months. Incremental health utility values were 0.0923 for Major Clinical Response and 0.0454 for Improvement. Expected incremental QALY gain at 6 months was 0.020 for Major Clinical Response and 0.012 for Improvement. Probability of QALY gain after achieving the response criteria was 77.6% for Major Clinical Response and 72.7% for Improvement. Population monetary benefit of response was £1 106 458 for Major Clinical Response and £649 134 for Improvement. Conclusions: Bespoke composite response endpoints are becoming more common to measure treatment response for multisystem diseases in trials and observational studies. Health technology assessment agencies face a growing challenge to establish whether these endpoints correspond with improved health gain. Health utility values can generate this evidence to enhance the usefulness of composite response endpoints for health technology assessment, decision making, and economic evaluation

Long-term impacts of prenatal synthetic glucocorticoids exposure on functional brain correlates of cognitive monitoring in adolescence

The fetus is highly responsive to the level of glucocorticoids in the gestational environment. Perturbing glucocorticoids during fetal development could yield long-term consequences. Extending prior research about effects of prenatally exposed synthetic glucocorticoids (sGC) on brain structural development during childhood, we investigated functional brain correlates of cognitive conflict monitoring in term-born adolescents, who were prenatally exposed to sGC. Relative to the comparison group, behavioral response consistency (indexed by lower reaction time variability) and a brain correlate of conflict monitoring (the N2 event-related potential) were reduced in the sGC exposed group. Relatedly, source localization analyses showed that activations in the fronto-parietal network, most notably in the cingulate cortex and precuneus, were also attenuated in these adolescents. These regions are known to subserve conflict detection and response inhibition as well as top-down regulation of stress responses. Moreover, source activation in the anterior cingulate cortex correlated negatively with reaction time variability, whereas activation in the precuneus correlated positively with salivary cortisol reactivity to social stress in the sGC exposed group. Taken together, findings of this study indicate that prenatal exposure to sGC yields lasting impacts on the development of fronto-parietal brain functions during adolescence, affecting multiple facets of adaptive cognitive and behavioral control

Comparative investigation of personality traits in migraine patients and sound people by personality MMPI questionaire.

Aim of this study was to investigate the relationship between migraine attacks and mental disorders.mental disorders is that disorders which assessed by Minnesota multiphasic personality inventory (MMPI), and migrain predicated to transient ischemic attacks. The investigation hypothesis was: tendency to mental disorders assessed by MMPI in migraine patients is mor than normal population.fortesting hypothesis 66 persons diagnosed as migraine patient selected on medicine dosiers and compared with 66 sound person.in this study MMPI and a qustionaire related to history of migraine administered and Multivariate Analysis Of Variance (MANOVA) is used for analysis of data.results confirmed our hypothesis.migraine patients had mor tendency to mental disorders in comparative with sound persons.thisdisorders were depression,hysteria,psychopath,paranoia,psychasthenia,chizophrenia,hypomania and hypochondria.totally results similar to former studies supported our hypothesis and this differences are significant in statistical viewpoint

Intolerance of Uncertainty, Emotional Dysregulation, and Health Anxiety: The Moderating Role of Coronavirus-Related Stress

Background: Health anxiety is a psychological problem the behavioral consequences of which can lead to increased referrals to the health care system. This problem can be even more important during the coronavirus pandemic. This study was conducted with the aim to investigate the moderating role of coronavirus-related stress in the relationship of intolerance of uncertainty (IU) and emotional dysregulation (ED) with health anxiety. Methods: This web-based, cross-sectional study was conducted on 403 individuals (54.8 women) with a mean age of 36.3 years. The data collection tools included the Intolerance of Uncertainty Scale (IUS), Difficulties in Emotion Regulation Scale (DERS), COVID Stress Scale (CSS), and Whitley Index (WI). Hierarchical regression and the Pearson correlation were used to analyze the data. Results: The findings revealed that IU and ED explained 32 of the variance in health anxiety. The moderating role of coronavirus-related stress in the relationship of IU and ED with health anxiety was 12 (p < 0.01). In total, the research variables predicted large proportions of variance (R2 ≥ 0.45) in health anxiety. Conclusion: Regarding the specific complicated characteristics of the Covid-19 pandemic and the resulting injuries, coronavirus-related stress (especially its 3 dimensions of danger and contamination fears, traumatic stress symptoms, and compulsive checking) appear to play an important role in health anxiety. In addition, the interaction of coronavirus-related stress with IU and ED significantly predicts an increase in health anxiety. Therefore, to reduce the burden of health anxiety, coronavirus-related stress interventions are required. © 2021, Int J Body Mind Culture. All rights reserved

Photoelectrochemical Water‐Splitting Using CuO‐Based Electrodes for Hydrogen Production: A Review

The cost-effective, robust, and efficient electrocatalysts for photoelectrochemical (PEC) water-splitting has been extensively studied over the past decade to address a solution for the energy crisis. The interesting physicochemical properties of CuO have introduced this promising photocathodic material among the few photocatalysts with a narrow bandgap. This photocatalyst has a high activity for the PEC hydrogen evolution reaction (HER) under simulated sunlight irradiation. Here, the recent advancements of CuO-based photoelectrodes, including undoped CuO, doped CuO, and CuO composites, in the PEC water-splitting field, are comprehensively studied. Moreover, the synthesis methods, characterization, and fundamental factors of each classification are discussed in detail. Apart from the exclusive characteristics of CuO-based photoelectrodes, the PEC properties of CuO/2D materials, as groups of the growing nanocomposites in photocurrent-generating devices, are discussed in separate sections. Regarding the particular attention paid to the CuO heterostructure photocathodes, the PEC water splitting application is reviewed and the properties of each group such as electronic structures, defects, bandgap, and hierarchical structures are critically assessed