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simulation and health

Lauren E Griffith, Edwin van den Heuvel, Parminder Raina, Isabel Fortier, Nazmul Sohel, Scott M Hofer, Hélène Payette, Christina Wolfson, Sylvie Belleville, Meghan Kenny, Dany Doiron
Standardization procedures are commonly used to combine phenotype data that were measured using different instruments, but there is little information on how the choice of standardization method influences pooled estimates and heterogeneity. Heterogeneity is of key importance in meta-analyses of observational studies because it affects the statistical models used and the decision of whether or not it is appropriate to calculate a pooled estimate of effect. Using 2-stage individual participant data analyses, we compared 2 common methods of standardization, T-scores and category-centered scores, to create combinable memory scores using cross-sectional data from 3 Canadian population-based studies (the Canadian Study on Health and Aging (1991-1992), the Canadian Community Health Survey on Healthy Aging (2008-2009), and the Quebec Longitudinal Study on Nutrition and Aging (2004-2005))...
October 21, 2016: American Journal of Epidemiology
Katherine A Guthrie, Hilary S Gammill, Mads Kamper-Jørgensen, Anne Tjønneland, Vijayakrishna K Gadi, J Lee Nelson, Wendy Leisenring
Natural acquisition of small amounts of foreign cells or DNA, referred to as microchimerism, occurs primarily through maternal-fetal exchange during pregnancy. Microchimerism can persist long-term and has been associated with both beneficial and adverse human health outcomes. Quantitative microchimerism data present challenges for statistical analysis, including a skewed distribution, excess zero values, and occasional large values. Methods for comparing microchimerism levels across groups while controlling for covariates are not well established...
October 21, 2016: American Journal of Epidemiology
Alexis K Huynh, Martin L Lee, Melissa M Farmer, Lisa V Rubenstein
BACKGROUND: Stepped wedge designs have gained recognition as a method for rigorously assessing implementation of evidence-based quality improvement interventions (QIIs) across multiple healthcare sites. In theory, this design uses random assignment of sites to successive QII implementation start dates based on a timeline determined by evaluators. However, in practice, QII timing is often controlled more by site readiness. We propose an alternate version of the stepped wedge design that does not assume the randomized timing of implementation while retaining the method's analytic advantages and applying to a broader set of evaluations...
October 21, 2016: BMC Medical Research Methodology
Lanfang Tian, Siyuan Chen, Haiyan Liu, Mingzhang Guo, Wentao Xu, Xiaoyun He, Yunbo Luo, Xiaozhe Qi, Hongxia Luo, Kunlun Huang
Hepcidin, one kind of antimicrobial peptides, is one of the promising alternatives to antibiotics with broad spectrum of antimicrobial activity. Hepcidins cloned from different kinds of fishes have been produced using exogenous expression systems, and their in vitro antimicrobial effects have been verified. However their in vivo effects on gut microbiota and gut health of hosts remain unclear. Here we performed a safety study of hepcidin so that it can be used to reduce microbial contaminations in the food and feed...
2016: PloS One
Blake T Riley, Olga Ilyichova, Mauricio G S Costa, Benjamin T Porebski, Simon J de Veer, Joakim E Swedberg, Itamar Kass, Jonathan M Harris, David E Hoke, Ashley M Buckle
The kallikrein-related peptidase (KLK) family of proteases is involved in many aspects of human health and disease. One member of this family, KLK4, has been implicated in cancer development and metastasis. Understanding mechanisms of inactivation are critical to developing selective KLK4 inhibitors. We have determined the X-ray crystal structures of KLK4 in complex with both sunflower trypsin inhibitor-1 (SFTI-1) and a rationally designed SFTI-1 derivative to atomic (~1 Å) resolution, as well as with bound nickel...
October 21, 2016: Scientific Reports
M Bryant Howren, Jeffrey S Gonzalez
The current issue is devoted broadly to research on treatment adherence and chronic illness self-management behavior. As the prevalence of chronic illness increases, the pervasive problem of treatment nonadherence is increasingly viewed as having a major impact on treatment outcomes, public health and healthcare costs, making this issue particularly timely. Sixteen articles spanning an array of topics are presented; articles include empirical studies, statistical simulations, systematic reviews, and theoretical commentaries...
October 20, 2016: Journal of Behavioral Medicine
James Weatherall, Lisa Bloudek, Sarah Buchs
OBJECTIVE: To quantify the annual budget impact if all United States (US) commercially insured type 1 diabetes mellitus patients on basal-bolus therapy (T1DMBBT), type 2 diabetes mellitus patients on basal-oral therapy (T2DMBOT), and type 2 diabetes mellitus patients on basal-bolus therapy (T2DMBBT) switched from insulin glargine (IGlar) to insulin degludec (IDeg). METHODS: A short-term (1-year) budget impact model was developed to evaluate the costs of IDeg vs...
October 21, 2016: Current Medical Research and Opinion
Edna Ruiz Magpantay-Monroe
The military and veteran populations in the U. S. state of Hawaii have a strong presence in the local communities. It was this substantial presence that provided the impetus to integrate military and veteran health into a Bachelor's of Science in Nursing (BSN) curriculum. This exploratory study investigated the relationship between the integration of military and veteran health into a psychiatric mental health BSN curriculum and nursing students' understanding of the many facets of military veterans' health...
October 6, 2016: Nurse Education Today
Lawrence C Ku, Huali Wu, Rachel G Greenberg, Kevin D Hill, Daniel Gonzalez, Christoph P Hornik, Alysha Berezny, Jeffrey T Guptill, Wenlei Jiang, Nan Zheng, Michael Cohen-Wolkowiez, Chiara Melloni
BACKGROUND: Defining a drug's therapeutic index (TI) is important for patient safety and regulating the development of generic drugs. For many drugs, the TI is unknown. A systematic approach was developed to characterize the TI of a drug using therapeutic drug monitoring and electronic health record (EHR) data with pharmacokinetic (PK) modeling. This approach was first tested on phenytoin, which has a known TI, and then applied to lamotrigine, which lacks a defined TI. METHODS: Retrospective EHR data from patients in a tertiary hospital were used to develop phenytoin and lamotrigine population PK models and to identify adverse events (anemia, thrombocytopenia, and leukopenia) and efficacy outcomes (seizure-free)...
October 19, 2016: Therapeutic Drug Monitoring
Sytske Anne Bergstra, Pedro M M C Machado, Rosaline van den Berg, Robert B M Landewé, Tom W J Huizinga
OBJECTIVES: Ten years ago, the METEOR tool was developed to simulate treatment-to-target and create an international research database. The development of the METEOR tool and database, research opportunities and future perspectives are described. METHODS: The METEOR tool is a free, online, internationally available tool in which daily practice visits of all rheumatoid arthritis patients visiting a rheumatologist can be registered. In the tool, disease characteristics, patient- and physician-reported outcomes and prescribed treatment could be entered...
September 2016: Clinical and Experimental Rheumatology
Francesco Siano, Francesco Addeo, Maria Grazia Volpe, Marina Paolucci, Gianluca Picariello
Fatty acid composition of pomegranate (Punica granatum L.) seed oil (PSO) is dominated by punicic acid, a conjugated linolenic acid (18:3, ω-5). As a free fatty acid, punicic acid is rapidly oxidized in air and extensively isomerizes upon acid-catalyzed methylation at 90 °C. In contrast, triacylglycerol-bound punicic acid in PSO was unchanged by simulated gastric conditions and was degraded for 5-7% by severe heating (up to 170 °C for 4 h), as herein assessed by gas chromatography, attenuated total reflectance-Fourier transform infrared spectroscopy, 1H and 13C NMR and high-resolution electrospray ionization mass spectrometry...
October 20, 2016: Journal of Agricultural and Food Chemistry
Priyanka Dutta, Ahnaf Siddiqui, Mohsen Botlani, Sameer Varma
Nipah is an emerging paramyxovirus that is of serious concern to human health. It invades host cells using two of its membrane proteins-G and F. G binds to host ephrins and this stimulates G to activate F. Upon activation, F mediates virus-host membrane fusion. Here we focus on mechanisms that underlie the stimulation of G by ephrins. Experiments show that G interacts with ephrin and F through separate sites located on two different domains, the receptor binding domain (RBD) and the F activation domain (FAD)...
October 18, 2016: Biophysical Journal
S Negin Mortazavi, Donna Geddes, Fatemeh Hassanipour
This work presents a fluid dynamic study of milk flow in lactating human breast. The motivation for this study is in part to improve the fundamental understanding of transport processes in an important but insufficiently studied human organ, and in part to produce a new methodology for the understanding of the pathologies of lactation, which can have a huge impact on the health and well-being of a significant proportion of the population. This collaborative effort among lactation specialists and fluid dynamic engineers starts with a careful, statistically representative measurement of infant suckling patterns...
October 19, 2016: Journal of Biomechanical Engineering
Rossella Letizia Mancusi, Massimo Andreoni, Daniela d'Angela, Cesare Sarrecchia, Federico Spandonaro
Between western European countries, the hepatitis C virus (HCV) endemic is highest in Italy. The main objective of this paper is to estimate the endemic diffusion of hepatitis C at the national level and by geographical area, with an extrapolation at the regional level and by uniform cohorts of subjects (by sex and year of birth). The secondary objective is a stratification by gravity of the estimated statistical figures to provide an overview of possible targets of the new anti-HCV treatments.PubMed and the Cochrane Library were searched for relevant Italian populations studies regarding HCV prevalence...
October 2016: Medicine (Baltimore)
Claudia Baumung, Jürgen Rehm, Heike Franke, Dirk W Lachenmeier
Nicotine was not included in previous efforts to identify the most important toxicants of tobacco smoke. A health risk assessment of nicotine for smokers of cigarettes was conducted using the margin of exposure (MOE) approach and results were compared to literature MOEs of various other tobacco toxicants. The MOE is defined as ratio between toxicological threshold (benchmark dose) and estimated human intake. Dose-response modelling of human and animal data was used to derive the benchmark dose. The MOE was calculated using probabilistic Monte Carlo simulations for daily cigarette smokers...
October 19, 2016: Scientific Reports
Wolfgang G Kunz, M G Myriam Hunink, Wieland H Sommer, Sebastian E Beyer, Felix G Meinel, Franziska Dorn, Stefan Wirth, Maximilian F Reiser, Birgit Ertl-Wagner, Kolja M Thierfelder
BACKGROUND AND PURPOSE: Endovascular therapy in addition to standard care (EVT+SC) has been demonstrated to be more effective than SC in acute ischemic large vessel occlusion stroke. Our aim was to determine the cost-effectiveness of EVT+SC depending on patients' initial National Institutes of Health Stroke Scale (NIHSS) score, time from symptom onset, Alberta Stroke Program Early CT Score (ASPECTS), and occlusion location. METHODS: A decision model based on Markov simulations estimated lifetime costs and quality-adjusted life years (QALYs) associated with both strategies applied in a US setting...
October 6, 2016: Stroke; a Journal of Cerebral Circulation
Michel Debacker, Filip Van Utterbeeck, Christophe Ullrich, Erwin Dhondt, Ives Hubloue
It is recognized that the study of the disaster medical response (DMR) is a relatively new field. To date, there is no evidence-based literature that clearly defines the best medical response principles, concepts, structures and processes in a disaster setting. Much of what is known about the DMR results from descriptive studies and expert opinion. No experimental studies regarding the effects of DMR interventions on the health outcomes of disaster survivors have been carried out. Traditional analytic methods cannot fully capture the flow of disaster victims through a complex disaster medical response system (DMRS)...
December 2016: Journal of Medical Systems
M Hiligsmann, N Burlet, P Fardellone, N Al-Daghri, J-Y Reginster
: The recommended intake of vitamin D-fortified dairy products can substantially decrease the burden of osteoporotic fractures and seems an economically beneficial strategy in the general French population aged over 60 years. INTRODUCTION: This study aims to assess the public health and economic impact of vitamin D-fortified dairy products in the general French population aged over 60 years. METHODS: We estimated the lifetime health impacts expressed in number of fractures prevented, life years gained, and quality-adjusted life years (QALY) gained of the recommended intake of dairy products in the general French population over 60 years for 1 year (2015)...
October 18, 2016: Osteoporosis International
Tomaž Nerat, Igor Locatelli, Mitja Kos
INTRODUCTION: Type 2 diabetes is a major burden for the payer, however, with proper medication adherence, diet and exercise regime, complication occurrence rates, and consequently costs can be altered. AIMS: The aim of this study was to conduct a cost-effectiveness analysis on real patient data and evaluate which medication adherence or lifestyle intervention is less cost demanding for the payer. METHODS: Medline was searched systematically for published type 2 diabetes interventions regarding medication adherence and lifestyle in order to determine their efficacies, that were then used in the cost-effectiveness analysis...
2016: Patient Preference and Adherence
Mark A Otto, Nicholas J Martin, Jennifer S Rous, Michael E Stevens
Dichlorvos is a chemical compound which has been used for decades as a pesticide. Potential inhalational exposure to dichlorvos vapor associated with using commercially-based, dichlorvos-impregnated resin strips in a simulated military guard post was evaluated. A varying number of these pesticide strips, ranging from the manufacturer's guidelines ((3)-16 g strips) up to a full package of strips ((12)-16 g strips), were placed in a small, enclosed space (2.31 m × 2.26 m × 2.44 m, 12.7 m(3)), which was similar in size to a typical military guard post...
October 18, 2016: Journal of Occupational and Environmental Hygiene
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