Assessing the potential utility of commercial 'big data' for health research: Enhancing small-area deprivation measures with Experian™ Mosaic groups.

In contrast to area-based deprivation measures, commercial datasets remain infrequently used in health research and policy. Experian collates numerous commercial and administrative data sources to produce Mosaic groups which stratify households into 15 groups for marketing purposes. We assessed the potential utility of Mosaic groups for health research purposes by investigating their relationships with Indices of Multiple Deprivation (IMD) for the British population. Mosaic groups showed significant associations with IMD quintiles. Correspondence Analysis revealed variations in patterns of association, with Mosaic groups either showing increasing, decreasing, or some mixed trends with deprivation quintiles. These results suggest that Experian's Mosaics additionally measure other aspects of socioeconomic circumstances to those captured by deprivation measures. These commercial data may provide new insights into the social determinants of health at a small area level.

Comparative Assessment of Health Benefits of Praziquantel Treatment of Urogenital Schistosomiasis in Preschool and Primary School-Aged Children.

Schistosomiasis is a major public health problem in Africa. However, it is only recently that its burden has become recognised as a significant component impacting on the health and development of preschool-aged children. A longitudinal study was conducted in Zimbabwean children to determine the effect of single praziquantel treatment on Schistosoma haematobium-related morbidity markers: microhaematuria, proteinuria, and albuminuria. Changes in these indicators were compared in 1-5 years versus 6-10 years age groups to determine if treatment outcomes differed by age. Praziquantel was efficacious at reducing infection 12 weeks after treatment: cure rate = 94.6% (95% CI: 87.9-97.7%). Infection rates remained lower at 12 months after treatment compared to baseline in both age groups. Among treated children, the odds of morbidity at 12 weeks were significantly lower compared to baseline for proteinuria: odds ratio (OR) = 0.54 (95% CI: 0.31-0.95) and albuminuria: OR = 0.05 (95% CI: 0.02-0.14). Microhaematuria significantly reduced 12 months after treatment, and the effect of treatment did not differ by age group: OR = 0.97 (95% CI: 0.50-1.87). In conclusion, praziquantel treatment has health benefits in preschool-aged children exposed to S. haematobium and its efficacy on infection and morbidity is not age-dependent.

Identifying and evaluating field indicators of urogenital schistosomiasis-related morbidity in preschool-aged children.

BACKGROUND: Several studies have been conducted quantifying the impact of schistosome infections on health and development in school-aged children. In contrast, relatively little is known about morbidity levels in preschool-aged children (≤ 5 years) who have been neglected in terms of schistosome research and control. The aim of this study was to compare the utility of available point-of-care (POC) morbidity diagnostic tools in preschool versus primary school-aged children (6-10 years) and determine markers which can be used in the field to identify and quantify Schistosoma haematobium-related morbidity. METHODS/PRINCIPAL FINDINGS: A comparative cross-sectional study was conducted to evaluate the performance of currently available POC morbidity diagnostic tools on Zimbabwean children aged 1-5 years (n=104) and 6-10 years (n=194). Morbidity was determined using the POC diagnostics questionnaire-based reporting of haematuria and dysuria, clinical examination, urinalysis by dipsticks, and urine albumin-to-creatinine ratio (UACR). Attributable fractions were used to quantify the proportion of morbidity attributable to S. haematobium infection. Based on results of attributable fractions, UACR was identified as the most reliable tool for detecting schistosome-related morbidity, followed by dipsticks, visual urine inspection, questionnaires, and lastly clinical examination. The results of urine dipstick attributes showed that proteinuria and microhaematuria accounted for most differences between schistosome egg-positive and negative children (T=-50.1; p<0.001). These observations were consistent in preschool vs. primary school-aged children. CONCLUSIONS/SIGNIFICANCE: Preschool-aged children in endemic areas can be effectively screened for schistosome-related morbidity using the same currently available diagnostic tools applicable to older children. UACR for detecting albuminuria is recommended as the best choice for rapid assessment of morbidity attributed to S. haematobium infection in children in the field. The use of dipstick microhaematuria and proteinuria as additional indicators of schistosome-related morbidity would improve the estimation of disease burden in young children.

Comparing parasitological vs serological determination of Schistosoma haematobium infection prevalence in preschool and primary school-aged children: implications for control programmes.

To combat schistosomiasis, the World Health Organization (WHO) recommends that infection levels are determined prior to designing and implementing control programmes, as the treatment regimens depend on the population infection prevalence. However, the sensitivity of the parasitological infection diagnostic method is less reliable when infection levels are low. The aim of this study was to compare levels of Schistosoma haematobium infection obtained by the parasitological method vs serological technique. Infection levels in preschool and primary school-aged children and their implications for control programmes were also investigated. Infection prevalence based on serology was significantly higher compared with that based on parasitology for both age groups. The difference between infection levels obtained using the two methods increased with age. Consequentially, in line with the WHO guidelines, the serological method suggested a more frequent treatment regimen for this population compared with that implied by the parasitological method. These findings highlighted the presence of infection in children aged ⩽5 years, further reiterating the need for their inclusion in control programmes. Furthermore, this study demonstrated the importance of using sensitive diagnostic methods as this has implications on the required intervention controls for the population.

The Effect of Blood Glucose Concentration on the Error Monitoring and Processing System in Alcohol Users During Intensive Mental Activities

Background:The error monitoring and processing system (EMPS) located in the substantia nigra of the midbrain; basal ganglia and cortex of the forebrain; plays a leading role in error detection and correction. Although recent data show that alcohol disrupts the EMPS; the mechanism of alcohol's effect on this system remains unknown.Aims: To suggest a hypothesis that explains the processes and mechanism of alcohol-related disruption of EMPS. Methods:We critically examined our recent research data; as well as peer-reviewed literature on the effect of alcohol on blood glucose levels; and cognitive functions. The role of blood glucose concentration in the EMPS; including associated theories and hypothesis were also reviewed. Databases utilised were African Journals On Line; Elsevier; Science Direct; Medline from January 1940 to February 2010 . Results: Blood glucose concentration plays a vital role in the EMPS. The effect of blood glucose concentration on the EMPS is realised through the modulation of the activity of the dopaminergic system by proportional changes in the brain glucose level. Based on current literatures and the results of our recent study; here we suggest a hypothesis of alcohol-related glucose-dependent system of error monitoring and processing.The main postulate of this hypothesis holds that the disruption of EMPS by ethanol is related to disorders in glucose metabolism; which in turn may determine the dopamine level the major component of EMPS.Conclusion: Alcohol may disrupt the EMPS indirectly by affecting dopamine level through disorders in glucose homeostasis regulation

The Influence of Hyperbaric Oxygenation Therapy on Recurrent Myocardial Infarction and Two-Year Survival Rate in Acute Myocardial Infarction Patients

Background: Surgical methods of acute myocardial infarction (MI) treatment possess a high clinical effectiveness; but there are limitations; related to the patient's state; medical resources and organizational problems. The development of new medical technologies allows for a better and effective non-surgical treatment and increases long-term prognosis. Aim: To assess the influence of hyperbaric oxygenation (HBO) therapy on mortality rate and recurrent myocardial infarction (rMI) within a two-year monitoring. Methods: The study involved 129 patients who suffered from acute MI; having undergone the standard therapy. The patients were divided at random into 2 groups: Group 1 (reference group; n=65); Group 2 (test group; n=64). Group 2 patients were given the traditional treatment; accompanied with (HBO) standard therapy by BLKS-307 (Russia; Moscow) single-seat apparatus (isopression for 40 minutes at a working pressure of 0.03 MPa). HBO therapy was applied on the 4th- 10th day following MI. The treatment course included 6 cycles; once per day. The clinical assessment was focused on clinical outcome: repeated MI and cardiovascular related mortality. Monitoring duration was two years. Results: The study involved 129 MI patients. No complications were encountered with HBO therapy on post-MI patients. Use of HBO reduced rMI and increased survival especially in the first half year after MI. Conclusion: HBO application that accompanied the acute MI traditional pharmacotherapy proved to reduce rMI within 2 years following inpatient discharge (the rate of rMI was 19in the reference group and 5.3in the test group; ?2=5.0; ?0.05). The joint application of HBO and modern drug regimen in treating acute MI makes it possible to raise the 2-year survival rate from 86.2up to 94.7

Effects of dihydropyridine calcium channel blocking drugs on rat brain muscarinic and alpha-adrenergic receptors.

The dihydropyridine (DHP) Ca2+ channel blocking drugs nicardipine, nitrendipine, nimodipine, felodipine, nifedipine and nisoldipine were examined for activity in inhibiting specific (-)-[3H] QNB and [3H]WB4101 binding to the muscarinic and alpha-adrenergic receptors, respectively, of rat brain. Muscarinic receptor binding was affected most by nicardipine, with felodipine having less activity; the other DHP drugs were essentially inactive at 3 X 10(-5) M. The (+)-stereoisomer nicardipine (KI = 4.07 X 10(-7) M) was 27 times more potent than the (-)-isomer in inhibiting [3H]QNB binding, and this inhibition was found to be competitive. This inhibitory effect of nicardipine was not mediated via interaction with the high-affinity DHP binding site assumed to be associated with a Ca2+ channel. (+)-Nicardipine inhibited the binding of [3H]nitrendipine to this DHP binding site of brain, with a K1 of 9.01 X 10(-11) M, and was 10 times more potent than the (-)-isomer. Thus, the muscarinic receptor was 4200 times less sensitive to (+)-nicardipine than was this DHP binding site. Nicardipine was also the most potent DHP drug inhibiting [3H]WB4104 binding to the alpha-adrenergic receptor, although the other drugs were also somewhat active, in the rank order sequence listed above. This effect of nicardipine on the adrenergic receptor was also stereoselective, with (+)-nicardipine (KI = 3.46 X 10(-7) M) being about 3 times more potent than the (-)-isomer, in producing competitive inhibition of radioligand binding. These data suggest that the effects on brain receptors occur as a result of direct, stereospecific effects of DHP drugs on these receptors and are not due to Ca2+ channel blocking activity of these drugs.