Views of healthcare professionals to linkage of routinely collected healthcare data : a systematic review

Peer reviewedPublisher PD

Linked health data for pharmacovigilance in children : Perceived legal and ethical issues for stakeholders and data guardians

Peer reviewedPublisher PD

Core requirements for successful data linkage: an example of a triangulation method

OBJECTIVES: The aim was to explore the views of professional stakeholders and healthcare professionals (HCPs) on the linkage of UK National Health Service (NHS) data for paediatric pharmacovigilance purposes and to make recommendations for such a system. METHODS: A mixed methods approach including a literature review, interviews, focus groups and a three-round Delphi survey with HCPs in Scotland was followed by a triangulation process using a systematic protocol. The survey was structured using the Theoretical Domains Framework of behaviour change. Items retained after applying the matrix-based triangulation process were thematically coded. Ethical approval was granted by the North of Scotland Research Ethics Service. RESULTS: Results from 18 papers, 23 interviewees, 23 participants of focus groups and 61 completed questionnaires in the Delphi survey contributed to the triangulation process. A total of 25 key findings from all four studies were identified during triangulation. There was good convergence; 21 key findings were agreed and remained to inform recommendations. The items were coded as practical/technical (eg, decision about the unique patient identifier to use), mandatory (eg, governed by statute), essential (consistently mentioned in all studies and therefore needed to ensure professional support) or preferable. CONCLUSIONS: The development of a paediatric linked database has support from professional stakeholders and HCPs in Scotland. The triangulation identified three sets of core requirements for a new system of data linkage. An additional fourth set of 'preferable' requirements might increase engagement of HCPs and their support for the new system

High-field fMRI reveals brain activation patterns underlying saccade execution in the human superior colliculus

Background The superior colliculus (SC) has been shown to play a crucial role in the initiation and coordination of eye- and head-movements. The knowledge about the function of this structure is mainly based on single-unit recordings in animals with relatively few neuroimaging studies investigating eye-movement related brain activity in humans. Methodology/Principal Findings The present study employed high-field (7 Tesla) functional magnetic resonance imaging (fMRI) to investigate SC responses during endogenously cued saccades in humans. In response to centrally presented instructional cues, subjects either performed saccades away from (centrifugal) or towards (centripetal) the center of straight gaze or maintained fixation at the center position. Compared to central fixation, the execution of saccades elicited hemodynamic activity within a network of cortical and subcortical areas that included the SC, lateral geniculate nucleus (LGN), occipital cortex, striatum, and the pulvinar. Conclusions/Significance Activity in the SC was enhanced contralateral to the direction of the saccade (i.e., greater activity in the right as compared to left SC during leftward saccades and vice versa) during both centrifugal and centripetal saccades, thereby demonstrating that the contralateral predominance for saccade execution that has been shown to exist in animals is also present in the human SC. In addition, centrifugal saccades elicited greater activity in the SC than did centripetal saccades, while also being accompanied by an enhanced deactivation within the prefrontal default-mode network. This pattern of brain activity might reflect the reduced processing effort required to move the eyes toward as compared to away from the center of straight gaze, a position that might serve as a spatial baseline in which the retinotopic and craniotopic reference frames are aligned

Hematological variations in healthy participants exposed 2 h to propylene glycol ethers under controlled conditions.

Glycol ethers are solvents used in a plethora of occupational and household products exposing the users to potential toxic effects. Several glycol ethers derived from ethylene glycol induce hematological toxicity, such as anemia in workers. The exposure effects on blood cells of glycol ethers derived from propylene glycol are unknown in humans. The aim of our study was to evaluate blood parameters indicative of red blood cell (RBC) hemolysis and oxidative stress in participants exposed to propylene glycol (propylene glycol monobutyl ether (PGBE) and propylene glycol monomethyl ether (PGME)), two extensively used propylene glycol derivatives worldwide. Seventeen participants were exposed 2 h in a control inhalation exposure chamber to low PGME (35 ppm) and PGBE (15 ppm) air concentrations. Blood was regularly collected before, during (15, 30, 60, and 120 min), and 60 min after exposure for RBC and oxidative stress analyses. Urine was also collected for clinical effects related to hemolysis. Under the study conditions, our results showed that the blood parameters such as RBCs, hemoglobin concentration, and white blood cells tended to increase in response to PGME and PGBE exposures. These results raise questions about the possible effects in people regularly exposed to higher concentrations, such as workers

Cohomogeneity one manifolds and selfmaps of nontrivial degree

We construct natural selfmaps of compact cohomgeneity one manifolds with finite Weyl group and compute their degrees and Lefschetz numbers. On manifolds with simple cohomology rings this yields in certain cases relations between the order of the Weyl group and the Euler characteristic of a principal orbit. We apply our construction to the compact Lie group SU(3) where we extend identity and transposition to an infinite family of selfmaps of every odd degree. The compositions of these selfmaps with the power maps realize all possible degrees of selfmaps of SU(3).Comment: v2, v3: minor improvement

Mortality among 24,865 workers exposed to polychlorinated biphenyls (PCBs) in three electrical capacitor manufacturing plants: a ten-year update

The objective of this analysis was to evaluate mortality among a cohort of 24,865 capacitor-manufacturing workers exposed to polychlorinated biphenyls (PCBs) at plants in Indiana, Massachusetts, and New York and followed for mortality through 2008. Cumulative PCB exposure was estimated using plant-specific job-exposure matrices. External comparisons to US and state-specific populations used standardized mortality ratios, adjusted for gender, race, age and calendar year. Among long-term workers employed 3 months or longer, within-cohort comparisons used standardized rate ratios and multivariable Poisson regression modeling. Through 2008, more than one million person-years at risk and 8749 deaths were accrued. Among long-term employees, all-cause and all-cancer mortality were not elevated; of the a priori outcomes assessed only melanoma mortality was elevated. Mortality was elevated for some outcomes of a priori interest among subgroups of long-term workers: all cancer, intestinal cancer and amyotrophic lateral sclerosis (women); melanoma (men); melanoma and brain and nervous system cancer (Indiana plant); and melanoma and multiple myeloma (New York plant). Standardized rates of stomach and uterine cancer and multiple myeloma mortality increased with estimated cumulative PCB exposure. Poisson regression modeling showed significant associations with estimated cumulative PCB exposure for prostate and stomach cancer mortality. For other outcomes of a priori interest--rectal, liver, ovarian, breast, and thyroid cancer, non-Hodgkin lymphoma, Alzheimer disease, and Parkinson disease--neither elevated mortality nor positive associations with PCB exposure were observed. Associations between estimated cumulative PCB exposure and stomach, uterine, and prostate cancer and myeloma mortality confirmed our previous positive findings

Classification of integrable Weingarten surfaces possessing an sl(2)-valued zero curvature representation

In this paper we classify Weingarten surfaces integrable in the sense of soliton theory. The criterion is that the associated Gauss equation possesses an sl(2)-valued zero curvature representation with a nonremovable parameter. Under certain restrictions on the jet order, the answer is given by a third order ordinary differential equation to govern the functional dependence of the principal curvatures. Employing the scaling and translation (offsetting) symmetry, we give a general solution of the governing equation in terms of elliptic integrals. We show that the instances when the elliptic integrals degenerate to elementary functions were known to nineteenth century geometers. Finally, we characterize the associated normal congruences

Aquifer thermal energy storage : A well doublet experiment at increased temperatures

This is the published version. Copyright 1983 American Geophysical UnionThe two main objectives of this communication are to present a study of potential advantages and disadvantages of the doublet supply-injection well configuration in an aquifer thermal energy storage (ATES) system and to report on aquifer storage problems with injection temperatures in the 80°C range. A 3-month injection-storage-recovery cycle followed by a 7.3-month cycle constituted the main experiment. The injection volumes were 25,402 m3 and 58,063 m3 at average temperatures of 58.5°C and 81°C respectively. Unlikely previous experiments at the Mobile site, no clogging of the injection well due to clay particle swelling, dispersion, and migration was observed. This is attributed to the fact that the supply water used for injection contained a cation concentration equal to or slightly greater than that in the native groundwater. For cycles I and II, the fraction of injected energy recovered in a volume of water equal to the injection volume was 0.56 and 0.45 respectively. Both groundwater temperature and tracer data support the conclusion that this relatively low recovery was due to the detrimental effects of free thermal convection, possibly augmented by longitudinal zones of high permeability. Construction of a partially penetrating recovery well improved recovery efficiency but is not thought to be an adequate solution to thermal stratification. A maximum increase of 1.24 cm in relative land surface elevation was recorded near the end of second cycle injection. The engineering implications of such an elevation change would have to be considered, especially if an ATES system were being designed in an urban environment. A third cycle was started at the Mobile site on April 7, 1982. This final experiment contains a partially penetrating, dual-recovery well system which is expected to maximize energy recovery from a thermally stratified storage aquifer

Universalities in One-electron Properties of Limit Quasi-periodic Lattices

We investigate one-electron properties of one-dimensional self-similar structures called limit quasi-periodic lattices. The trace map of such a lattice is nonconservative in contrast to the quasi-periodic case, and we can determine the structure of its attractor. It allows us to obtain the three new features of the present system: 1) The multi-fractal characters of the energy spectra are {\it universal}. 2) The supports of the $f(\alpha)$-spectra extend over the whole unit interval, $[0, 1]$. 3) There exist marginal critical states.Comment: 4 pages, 2figure