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Objective Tuberculosis (TB) poses a huge socioeconomic burden and remains listed among the top ten causes of deaths across the globe, despite enormous efforts of health agencies and researchers. The primary concern in a relatively slower pace of curbing TB is the emergence of multi-drug resistance and difficulty in tracking antibiotic consumption. Methods We propose here a biometric-linked digital means of antibiotic prescription data collection and its utility for various epidemiological assessments. Results In this short communication, we propose here, a visionary workflow to explore the use of biometric identification system to gather the antibiotic prescription information for tuberculosis cases and real-time monitoring over a global scale. Our proposal is mainly aimed at collection of antibiotic prescription data at clinician level and point of sales level using a simple fingerprint-based biometric approach and its linkage to unique biometric IDs such as Aadhar in India and related systems in other countries. Conclusion The online server and web-interface are aimed at facilitating the health organizations and medical councils to monitor the antibiotic prescription and their consumption in real time. This will not only augment the existing policy-making regarding drug-resistance programs but also promote the collection and downstream exploratory analysis of huge amount of data to get a deeper insight into the epidemiology of tuberculosis and related diseases.

MicroRNAs constitute a class of noncoding small RNAs involved in the posttranscriptional regulation of many biological pathways. In recent years, microRNAs have also been associated with regulation across kingdoms, demonstrating that exogenous miRNAs can function in mammals in a fashion similar to mammalian miRNAs. The growing interest in microRNAs and the increasing amount of literature and molecular and biomedical data available make it difficult to identify records of interest and keep up to date with novel findings. For these reasons, we developed the microRNA Analysis Portal (MAP). MAP selects relevant miRNA-focused articles from PubMed, links biomedical and molecular data and applies bioinformatics modules. At the time of this writing, MAP represents the richest, most complete and integrated database focused on microRNAs. MAP also integrates an updated version of MirCompare (2.0), a computational platform used for selecting plant microRNAs on the basis of their ability to regulate mammalian genes. Both MAP and MirCompare functionalities were used to predict that microRNAs from Moringa oleifera have putative roles across kingdoms by regulating human genes coding for proteins of the immune system. Starting from a selection of 94 human microRNAs, MirCompare selected 6 Moringa oleifera functional homologs. The subsequent prediction of human targets and areas of functional enrichment highlighted the central involvement of these genes in regulating immune system processes, particularly the host-virus interaction processes in hepatitis B, cytomegalovirus, papillomavirus and coronavirus. This case of use showed how MAP can help to perform complex queries without any computational background. MAP is available at http://stablab.uniroma2.it/MAP.

ObjectivesWorkers can be exposed to a range of different carcinogenic agents in the workplace. However, previous studies have often focused on prevalence of exposure to a single carcinogen, resulting in substantial knowledge gaps regarding the extent of multiple exposures in the workplace. This study aims to investigate the current prevalence of occupational exposure to multiple carcinogens among exposed workers in Australia.MethodsThe data for this study come from the Australian Work Exposures Study, a nationwide cross-sectional telephone survey of Australian workers aged between 18 and 65. Information was collected about the respondents’ current employment and numerous demographic factors using a web-based application (Occupational Integrated Database Exposure Assessment System) to conduct the interview, with predefined algorithms used to automatically assign exposures to carcinogens based on the respondents’ job tasks.ResultsThe majority (81%) of exposed respondents were assessed as being probably exposed to more than one carcinogen, and 26% reported exposure to five or more carcinogens. We found that after adjusting for occupation, exposure to multiple carcinogens was more likely among male respondents, while older workers (aged between 55 and 65) were less likely to be exposed to multiple carcinogens.ConclusionsThis study provides information on the prevalence of exposure to multiple carcinogens in the general population that has not previously been reported. This information could be useful for the intervention and control of occupational exposures to the prioritised carcinogens identified in this study.

Background and Objective: Patients who receive cochlear implants (CIs) constitutes a significant population in Iran. This population needs regular monitor on long-term outcomes, educational placement and quality of life. Currently, there is no national or regional registry on the long term outcomes of CI users in Iran. The present study aims to introduce the design and implementation of a national patient-outcomes registry on CI recipients for Iran. This Iranian CI registry (ICIR) provides an integrated framework for data collection and sharing, scientific communication and collaboration in CI research. Methods: The national ICIR is a prospective patient-outcomes registry for patients who are implanted in one of Iranian centers. The registry is based on an integrated database that utilizes a secure web-based platform to collect response data from clinicians and patient’s proxy via electronic case report forms (e-CRFs) at predefined intervals. The CI candidates are evaluated with a set of standardized and non-standardized questionnaires prior to initial device activation (as baseline variables) and at three-monthly interval follow-up intervals up to 24 months and annually thereafter. Results: The software application of the ICIR registry is designed in a user-friendly graphical interface with different entry fields. The collected data are categorized into four subsets including personal information, clinical data, surgery data and commission results. The main parameters include audiometric performance of patient, device use, patient comorbidities, device use, quality of life and health-related utilities, across different types of CI devices from different manufacturers. Conclusion: The ICIR database could be used by the increasingly growing network of CI centers in Iran. Clinicians, academic and industrial researchers as well as healthcare policy makers could use this database to develop more effective CI devices and better management of the recipients as well as to develop national guidelines

Background The analysis of cancer diversity based on a logical framework of hallmarks has greatly improved our understanding of the occurrence, development and metastasis of various cancers. Methods We designed Cancer Hallmark Genes (CHG) database which focuses on integrating hallmark genes in a systematic, standard way and annotates the potential roles of the hallmark genes in cancer processes. Following the conceptual criteria description of hallmark function the keywords for each hallmark were manually selected from the literature. Candidate hallmark genes collected were derived from 301 pathways of KEGG database by Lucene and manually corrected. Results Based on the variation data, we finally identified the hallmark genes of various types of cancer and constructed CHG. And we also analyzed the relationships among hallmarks and potential characteristics and relationships of hallmark genes based on the topological structures of their networks. We manually confirm the hallmark gene identified by CHG based on literature and database. We also predicted the prognosis of breast cancer, glioblastoma multiforme and kidney papillary cell carcinoma patients based on CHG data. Conclusions In summary, CHG, which was constructed based on a hallmark feature set, provides a new perspective for analyzing the diversity and development of cancers.

OBJECTIVES: We aimed to determine the characteristics of the deceased victims of deaths caused by exposure to humidifier disinfectants, and present the distribution of the victims’ data submitted for damage application, demographic characteristics, imaging findings, characteristics of humidifier disinfectant exposure, and distribution of the causes of death.METHODS: An integrated database of victims was established using the medical records data of 1,413 victims submitted during the application for death damage caused by exposure to humidifier disinfectants, and the demographic characteristics, medical records, imaging findings, exposure characteristics, and cause of death were examined.RESULTS: The average numbers of data submissions of each applicant for death damage were 3.0 medical use records. A total of 608 (43.0%) victims had more than one finding of acute, subacute, or chronic interstitial lung diseases. The average daily and cumulative use times of the victims were 14.40 and 24,645.81 hours, respectively, indicating greater exposure in this group than in the survivors. The humidifier disinfectants’ components comprised polyhexamethylene guanidine (72.8%), chloromethylisothiazolinone/methylisothiazolinone (10.5%), other components (15.0%), and oligo-[2-(2-ethoxy)-ethoxyethyl] guanidine chloride (1.5%). The components’ distribution was 67.8% for single-component use, which was higher than that in the survivors (59.8%). The distribution of the causes of death were: respiratory diseases (54.4%), neoplasms (16.8%), and circulatory diseases (6.3%). Other interstitial lung diseases (65.5%) were the most common cause of death among those who died due to respiratory diseases.CONCLUSIONS: Careful discussions of appropriate remedies should be conducted based on a comprehensive understanding of the characteristics of the deceased victims, considering their specificities and limitations.

Objective\ud \ud To assess the hypothesis that patients receiving placebo in overactive bladder (OAB) trials who experience less benefit from “treatment” continue with behavioral modifications such as fluid restriction, whereas those on active treatment adopt more normal drinking patterns. This may manifest itself as a reduction in micturition frequency (MF).\ud \ud Materials and Methods\ud \ud We interrogated a large integrated database containing pooled patient data from 4 randomized, placebo-controlled phase III OAB solifenacin studies. A statistical correction was applied to MF to remove the influence of fluid intake.\ud \ud Results\ud \ud Pooled analysis using patient-level data from 3011 patients and accounting for the studies within the models showed that all patients voided progressively less total urine per 24 hours during treatment than at baseline. However, reduction in total urine volume voided per 24 hours was larger in patients receiving placebo vs those on solifenacin; with a substantial decrease in 24-hour urine output in the placebo group from baseline to week 4, which was not the case in active groups. After correcting MF for volume voided for each patient using the statistical correction and averaging the corrected MF per treatment arm, the placebo effect almost disappeared. Patients on solifenacin voided less often, with a statistically significant increase in volume voided each time they voided, vs placebo.\ud \ud Conclusion\ud \ud Assuming volume voided is a good surrogate measure for fluid intake, this analysis shows that fluid restriction almost completely explains the reduction in MF in the placebo group. In contrast, patients receiving active treatment adopt more normal drinking patterns once they start to perceive improvement in their OAB symptoms.

Background Treatment for chronic immune thrombocytopenia (cITP) in children is largely limited to immunosuppressive agents. Thrombopoietin receptor agonists (TRAs) have been used to treat cITP in adults for over a decade. The objective of this integrated analysis was to examine the safety and efficacy of the TRA romiplostim in children with ITP. Methods We examined efficacy and safety in children with ITP across five romiplostim trials: final data from two double-blind placebo-controlled trials and two open-label extensions, and interim data from an ongoing single-arm trial. Results Patients (n = 24 initially placebo; n = 262 initially romiplostim) had a median age of 10.0 years (Q1: 6.0, Q3: 13.0), ITP duration of 1.9 years (Q1: 1.0, Q3: 4.0), and baseline platelet count of 14.3 × 109 /L (Q1: 7.5, Q3: 23.0). Among 282 patients receiving romiplostim, median treatment duration was 65 weeks (range 8-471 weeks) and median weekly dose was 6.6 μg/kg (range 0.1-9.7 μg/kg). Overall, 89% of romiplostim-treated patients had platelet responses. Nineteen patients (7%) maintained treatment-free responses for ≥6 months while withholding all ITP therapy. Grade 3 and 4 adverse events of bleeding occurred in 10% and 12 months at baseline. Conclusions Across five pediatric clinical trials, romiplostim was well tolerated. Most patients had a platelet response; some maintained responses for at least 6 months while withholding all ITP therapy.

Objectives To identify and assess the evidence showing the efficacy of auricular acupressure alone for myopia in children and adolescents. Methods Randomized controlled trials (RCTs) that were published until March 2019 in Pubmed, Web of Science, OVID, Foreign Medical Literature Retrieval Service, China Knowledge Resource Integrated Database, The Chinese Biological Medicine Database, Wanfang Database, and Chongqing VIP Information were searched. The quality of RCTs was assessed using the Cochrane risk of bias assessment tool. Results Ten RCTs were included to be qualitatively summarized, of which 5 studies qualified for the meta-analysis of the efficacy rate in treating myopia. This review demonstrated that auricular acupressure alone was more effective than eye-drops treatment, eye exercise, and was the just as effective as needle acupuncture. Conclusions Auricular acupressure could slow the progression of myopia in children and adolescents. However, there is a need for further studies with higher methodological quality and sufficient follow-up.

Background Ixekizumab (IXE) is a high-affinity monoclonal antibody that selectively targets interleukin-17A. During 24 weeks (wks) of treatment, IXE resulted in significantly greater improvements versus placebo (PBO) in the signs and symptoms of active psoriatic arthritis (PsA) in two randomized Phase 3 studies.1,2 Objectives To evaluate the consistency of clinical response with IXE in demographic subsets of patients (pts) with active PsA. Methods Clinical response to IXE was analyzed from an integrated database of 2 randomized, double-blind, Phase 3 studies in biologic Disease Modifying Anti-Rheumatic Drug (bDMARD)-naive (SPIRIT-P1) pts or in pts with prior inadequate response or intolerance to TNF inhibitors (SPIRIT-P2). Analyses were conducted on subgroups defined by sex, body mass index (BMI), and duration of disease ( Results Response rates at Wk 24 (Table) were significantly (p Conclusion IXE was superior to PBO in the treatment of pts with active PsA at Wk 24 regardless of sex or disease duration, as well as in normal, overweight, and obese BMI subgroups. References [1] Mease, et al. Ann Rheum Dis. 2017 [2] Nash, et al. Lancet. 2017 Disclosure of Interests Lihi Eder Grant/research support from: AbbVie, Eli Lilly and Company, Amgen, Celgene, UCB, Janssen, Novartis, and Pfizer, Consultant for: AbbVie, Eli Lilly and Company, Amgen, Celgene, UCB, Janssen, Novartis, and Pfizer, Satish Odhav Grant/research support from: AbbVie, Ardea Biosciences, AstraZeneca, BMS, Celgene Corporation, Centocor, Eli Lilly and Company, Galapagos, Genentech, GSK, Human Genome Sciences, Janssen, Merck, Mesoblast, Novartis, Novo Nordisk, Pfizer, Roche, Sanofi-Aventis, Takeda Pharmaceuticals, UCB, and Vertex Pharmaceuticals, Consultant for: AbbVie, Ardea Biosciences, AstraZeneca, BMS, Celgene Corporation, Centocor, Eli Lilly and Company, Galapagos, Genentech, GSK, Human Genome Sciences, Janssen, Merck, Mesoblast, Novartis, Novo Nordisk, Pfizer, Roche, Sanofi-Aventis, Takeda Pharmaceuticals, UCB, and Vertex Pharmaceuticals, Speakers bureau: AbbVie, Ardea Biosciences, AstraZeneca, BMS, Celgene Corporation, Centocor, Eli Lilly and Company, Galapagos, Genentech, GSK, Human Genome Sciences, Janssen, Merck, Mesoblast, Novartis, Novo Nordisk, Pfizer, Roche, Sanofi-Aventis, Takeda Pharmaceuticals, UCB, and Vertex Pharmaceuticals, Mariusz Korkosz Consultant for: Eli Lilly and Company, Novartis, Roche, MSD, UCB, and AbbVie, Speakers bureau: Eli Lilly and Company, Novartis, Roche, MSD, UCB, and AbbVie, Aubrey Trevelin Sprabery Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Amanda M. Gellett Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Chen-Yen Lin Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, So Young Park Employee of: Eli Lilly and Company, Clinton C Bertram Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Alexis Ogdie Grant/research support from: (To my university) Novartis, Pfizer, Grant/research support from: Novartis, Pfizer, Grant/research support from: Novartis, Pfizer, Grant/research support from: Novartis, Pfizer, Consultant for: AbbVie, Bristol-Myers Squibb, Celgene, Corrona, Eli Lilly and Company, Novartis, Pfizer, and Takeda, Consultant for: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Corrona, Eli Lilly, Novartis, Pfizer Inc, Takeda, Consultant for: Abbvie, Amgen, BMS, Celgene, Corrona, Lilly, Novartis, Pfizer, Takeda, Consultant for: Abbvie, Amgen, BMS, Celgene, Corrona, Lilly, Novartis, Pfizer, Takeda

Background Ixekizumab (IXE), a high-affinity monoclonal antibody that selectively targets interleukin-17A, was superior to placebo (PBO) in two randomized Phase 3 studies in patients (pts) with active psoriatic arthritis (PsA).1,2 Objectives To assess the consistency of response of IXE across subgroups of pts defined by specific baseline disease characteristics. Methods Data were analyzed from an integrated database of 2 randomized, double-blind, Phase 3 studies in pts who were either biologic Disease Modifying Anti-Rheumatic Drug (bDMARD)-naive (SPIRIT-P1) or who had prior inadequate response or intolerance to TNF inhibitors (SPIRIT-P2). Analyses included pts randomly assigned to the approved dosing regimen of IXE (80 mg IXE every 4 wks [IXE Q4W] with a starting dose of 160 mg IXE) or to PBO through Wk 24. Efficacy was measured as the percentage of pts achieving ≥20%, 50%, or 70% improvement from baseline in the American College of Rheumatology criteria (ACR20/50/70) or minimal disease activity (MDA) in subgroups of pts defined by baseline presence of enthesitis, dactylitis, psoriasis body surface area (BSA) involvement ( 6 or ≤6 mg/L). Missing data were imputed by nonresponder imputation. Results Clinical response rates at Wk 24 in each subgroup are summarized (Table). Significantly (p Conclusion At Wk 24, IXE was superior to placebo for the treatment of PsA signs and symptoms regardless of baseline presence of dactylitis or enthesitis, BSA involvement, or CRP levels. References [1] Mease, et al. Ann Rheum Dis. 2017 [2] Nash, et al. Lancet. 2017 Disclosure of Interests Hans-Peter Tony Consultant for: Eli Lilly and Company, Speakers bureau: Eli Lilly and Company, Eva Galindez: None declared, Aubrey Trevelin Sprabery Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Amanda M. Gellett Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Chen-Yen Lin Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, So Young Park Employee of: Eli Lilly and Company, Clinton C Bertram Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Alexis Ogdie Grant/research support from: (To my university) Novartis, Pfizer, Grant/research support from: Novartis, Pfizer, Grant/research support from: Novartis, Pfizer, Grant/research support from: Novartis, Pfizer, Consultant for: AbbVie, Bristol-Myers Squibb, Celgene, Corrona, Eli Lilly and Company, Novartis, Pfizer, and Takeda, Consultant for: AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Corrona, Eli Lilly, Novartis, Pfizer Inc, Takeda, Consultant for: Abbvie, Amgen, BMS, Celgene, Corrona, Lilly, Novartis, Pfizer, Takeda, Consultant for: Abbvie, Amgen, BMS, Celgene, Corrona, Lilly, Novartis, Pfizer, Takeda

Background Osteosarcoma (OS) is the most frequent primary malignancy of bone with a high incidence in adolescence. This study aimed to construct a publicly available, integrated database of human OS, named HOsDb. Methods Microarray data, current databases, and a literature search of PubMed were used to extract information relevant to human OS-related genes and their transcription factors (TFs) and single nucleotide polymorphisms (SNPs), as well as methylation sites and microRNAs (miRNAs). This information was collated for constructing the HOsDb. Results In total, we identified 7191 OS tumor-related genes, 763 OS metastasis-related genes, and 1589 OS drug-related genes, corresponding to 190,362, 21,131, and 41,135 gene-TF pairs, respectively, 3,749,490, 358,361, and 767,674 gene-miRNA pairs, respectively; and 28,386, 2532, and 3943 SNPs, respectively. Additionally, 240 OS-related miRNAs, 1695 genes with copy number variations in OS, and 18 genes with methylation sites in OS were identified. These data were collated to construct the HOsDb, which is available at www.hosdatabase.com. Users can search OS-related molecules using this database. Conclusion The HOsDb provides a platform that is comprehensive, quick, and easily accessible, and it will enrich our current knowledge of OS.

BackgroundIn the USA, the epidemiologic features of type 1 diabetes are not well-defined across all 50 states. However, the advent of large nationwide insurance databases enables the investigation of where type 1 diabetes cases occur throughout the country.MethodsAn integrated database from a large nationwide health insurer in the USA (Clinformatics Data Mart Database) was used, from 2001 to 2017. The database contained longitudinal information on approximately 77 million people.ResultsThe incidence of type 1 diabetes was greatest in areas of low population density across the 50 states. Individuals in the lowest population density areas had rates that were 2.28 times (95% CI 2.08 to 2.50) that of persons living in high-density areas. This association was consistent across various measures of rural status (pConclusionsThe predilection of type 1 diabetes in rural areas provides clues to potential factors associated with the onset of this autoimmune disease.

Depression and worse quality of life (QOL) are significantly associated with epilepsy. However, limited descriptive data on depression and quality of life among African Americans with epilepsy are available. This study sought to describe the prevalence of depression among African Americans with epilepsy participating in self-management studies and to examine the relationship between depression and QOL. Using data from the Managing Epilepsy Well (MEW) research network, a subgroup of African Americans with epilepsy were selected for the analytic sample. Descriptive statistics indicated the prevalence of depression (Patient Health Questionnaire-9 [PHQ-9]) and reports of epilepsy-specific QOL (Quality of Life in Epilepsy-10 [QOLIE-10]) in the sample. Multiple linear regression examined the relationship between depression and QOL while controlling for sociodemographic characteristics and seizure frequency. The prevalence of depression (PHQ-9 ≥; 10) was 47.7%. Quality of life was the only variable significantly associated with depressive symptoms in multivariable analyses, suggesting that depressive symptoms have a stronger relationship with QOL than seizure frequency. With the high levels of depression and the significant relationship with QOL, regular screening of depression is needed among African Americans with epilepsy. Self-management programs that improve mood may also play an important role in improving the lives of African Americans with epilepsy.

Background Patient-level data are available for 11 randomized, controlled, Phase III/Phase IV solifenacin clinical trials. Methods Meta-analyses were conducted to interrogate the data, to broaden knowledge about solifenacin and overactive bladder (OAB) in general. Before integrating data, datasets from individual studies were mapped to a single format using methodology developed by the Clinical Data Interchange Standards Consortium (CDISC). Initially, the data structure was harmonized, to ensure identical categorization, using the CDISC Study Data Tabulation Model (SDTM). To allow for patient level meta-analysis, data were integrated and mapped to analysis datasets. Mapping included adding derived and categorical variables and followed standards described as the Analysis Data Model (ADaM). Mapping to both SDTM and ADaM was performed twice by two independent programming teams, results compared, and inconsistencies corrected in the final output. ADaM analysis sets included assignments of patients to the Safety Analysis Set and the Full Analysis Set. Results There were three analysis groupings: Analysis group 1 (placebo-controlled, monotherapy, fixed-dose studies, n = 3011); Analysis group 2 (placebo-controlled, monotherapy, pooled, fixed- and flexible-dose, n = 5379); Analysis group 3 (all solifenacin monotherapy-treated patients, n = 6539). Treatment groups were: solifenacin 5 mg fixed dose, solifenacin 5/10 mg flexible dose, solifenacin 10 mg fixed dose and overall solifenacin. Patient were similar enough for data pooling to be acceptable. Conclusions Creating ADaM datasets provided significant information about individual studies and the derivation decisions made in each study; validated ADaM datasets now exist for medical history, efficacy and AEs. Results from these meta-analyses were similar over time.

The cyclooxygenase-2 (COX-2) 765G>C polymorphism has been extensively investigated for association with Alzheimer's disease (AD). However, results of different studies have been inconsistent. The aim of the present meta-analysis was to evaluate the association between the 765G>C polymorphism of the COX-2 gene and susceptibility to AD. We searched all related subjects in PubMed, Embase, SinoMed, and China Knowledge Resource Integrated Database and identified seven studies that reported a relationship between the COX-2 765G>C polymorphism and AD. A total of 1260 cases and 1112 controls were included in the seven studies. Our data suggest that the COX-2 765G>C polymorphism may decrease the risk of AD in five genetic models. As a result, this meta-analysis suggests the 765G>C polymorphism of the COX-2 gene may be a protective factor for AD. As our sample size was limited, large-scale, well-designed studies are necessary to validate the association between the COX-2 765G>C polymorphism and AD.

Summary Alzheimer's disease (AD) is a progressive neurodegenerative disorder of the brain and the most common form of dementia among the elderly. The single-cell RNA-sequencing (scRNA-Seq) and single-nucleus RNA-sequencing (snRNA-Seq) techniques are extremely useful for dissecting the function/dysfunction of highly heterogeneous cells in the brain at the single-cell level, and the corresponding data analyses can significantly improve our understanding of why particular cells are vulnerable in AD. We developed an integrated database named scREAD (single-cell RNA-Seq database for Alzheimer's disease), which is as far as we know the first database dedicated to the management of all the existing scRNA-Seq and snRNA-Seq data sets from the human postmortem brain tissue with AD and mouse models with AD pathology. scREAD provides comprehensive analysis results for 73 data sets from 10 brain regions, including control atlas construction, cell-type prediction, identification of differentially expressed genes, and identification of cell-type-specific regulons., Graphical Abstract, Highlights • First-of-its-kind database dedicated to Alzheimer's disease sc/snRNA-Seq data sets • Control atlas and disease data sets construction for major cell types in the brain • User-friendly web server to provide comprehensive analysis interpretations, Neuroscience; Bioinformatics; Biological Database

Objectives We aimed to identify the effectiveness of photobiomodulation using low level laser therapy (LLLT), light emitting diode (LED) and others on the growth of the length of the growth plate by reviewing literatures. Methods We searched literatures using PubMed, Science Direct, CINAHL, Korea Traditional Knowledge Portal (KTKP), Oriental Medicine Advanced Searching Integrated System (OASIS), China Knowledge Resource Integrated Database (CNKI), Japan Science and Technology Information Aggregator, Electronic (J STAGE), and Japan National Institute of Informatics Scholarly and Academic Information Navigator (CiNii) using the keywords "Growth plate" "Epiphyseal growth" "Epiphyseal plate" and "Laser", "light emitting diode (LED)", "near-infrared light", and "photobiomodulation". Search range included only original article which provided English abstract were selected. The search strategy contained no language limitation. Results A total 556 studies were found. Then, 551 were excluded by scanning titles and abstracts and finally 5 articles were selected. Five articles were RCTs using rodents. Two of the 5 articles used InGaAlP Laser (630-685 nm), and the other 3 articles used GaAlAs Laser (780, 820, and 870 nm) to investigated the effects of LLLT on the growth of the length of the epiphyseal cartilage and the number of chondrocytes and thickness of each zone of the epiphyseal cartilage. Two articles concluded that LLLT had a beneficial effect on the longitudinal growth of the growth plate. In growth of the epiphyseal plate, there were no significant differences in others. Conclusions It is might that LLLT influenced on the growth of epiphyseal plate by positive affect. However, further rigorous RCTs are warranted.

The goal of this study was to document the relationship between BMI and the components of bariatric surgical operating room (OR) time.The Stanford Translational Research Integrated Database Environment identified all patients who underwent laparoscopic Roux-en-Y gastric bypass procedures at Stanford University Medical Center between May 2008 and November 2013. The 434 patients were divided into 3 groups: group 1 (n = 213) BMI ≥35 to45 kg/m(2), group 2 (n = 188) BMI ≥45.0 to60 kg/m(2), and group 3 (n = 33) BMI ≥60 kg/m(2). The primary variable measured was total operating room time, defined as beginning when the patient entered the OR until the moment the patient physically left the OR. Secondary variables were anesthetic induction time, nursing preparation time, operation time, time for emergence from anesthesia, and total length of hospital stay.Increasing BMI was associated with increased total OR time (group 1 = 202 min, group 2 = 215 min, group 3 = 235 min), mainly due to longer operation time (group 1 = 147 min, group 2 = 154 min, group 3 = 163 min). Anesthetic induction (group 1 = 17 min, group 2 = 18 min, group 3 = 23 min) and emergence times (group 1 = 12 min, group 2 = 12 min, group 3 = 22 min) were also significantly longer in the largest patients.Operating room schedules and plans for resource utilization should recognize that the same bariatric procedure will require more time for patients with BMI60 kg/m(2) than for smaller bariatric patients.

Many insulin-treated patients with type 2 diabetes (T2D) do not reach hemoglobin A1c (HbA1c) 7%, but have clinically relevant HbA1c reductions. Using an integrated database (IDB) of 53 insulin lispro clinical trials and a real-world evidence (RWE) database of T2D patients initiating insulin therapy, an expanded HbA1c measure was used to identify responders to insulin therapy.Analysis included 4,908 patients (IDB) and 1,134 patients (RWE) with T2D treated with any insulin regimen with a baseline and ≥1 post-baseline HbA1c. Responders were defined as patients with endpoint HbA1c 7% (cut point [CP]) and/or either ≥1% absolute (ABS) decrease, and/or ≥10% relative (REL) decrease in HbA1c from baseline. The percentage of responders with CP vs ABS and concordance between ABS and REL were calculated. As the ABS and REL measures were highly correlated (94%), the ABS measure was used to compare characteristics of responders and non-responders by age, diabetes duration, race/ethnicity, baseline HbA1c, and insulin regimen at 24 weeks.In both databases, more responders were identified with ABS or REL (62%) than CP (41%). More ABS responders had a baseline HbA1c ≥ 9% and a shorter diabetes duration than non-responders. Basal insulin-treated patients in the IDB had 78.2% responders at 24 weeks, compared to 69.7% with basal/bolus or pre-mixed insulin (75.4%). Results were similar in the IDB and RWE.Composite HbA1c measures identified more patients with clinically meaningful responses to therapy than the broadly accepted HbA1c 7% and may be useful in assessing clinical trials, clinical care, and quality measures.

Summary Sleep duration has received considerable attention as a potential risk factor of suicidality in youths; however, evidence on the dose–response association between sleep duration and suicidality has not been synthesized. This meta-analysis examined linear and nonlinear dose–response relationships between sleep duration and the risk of suicidality in adolescents and explored potential moderators of the associations. Electronic databases, namely EMBASE, PubMed, PsycINFO, ProQuest Dissertations & Theses A&I Wanfang Data (Chinese database), and the China Knowledge Resource Integrated Database, were searched from their inception to April 18, 2017. Studies examining the association between sleep duration and suicidality in adolescents were included. A random-effects dose–response model was used to estimate the linear and nonlinear dose–response relationships. We identified 13 reports that included a total of 598,281 participants for a systematic review, and 12 reports were further used for a dose–response meta-analysis. Strong curvilinear dose–response associations were obtained for both suicidal ideation and attempts, with the lowest suicidal ideation and attempt risks at sleep durations of 8 h and 8–9 h per day (all Pnonlinearity

// Lin Huang 1,* , Haichang Li 1,* , Duoli Xie 1 , Tieliu Shi 2 and Chengping Wen 1 1 TCM Clinical Basis Institute, Zhejiang University of Chinese Medicine, Hangzhou, China 2 The Center for Bioinformatics and Computational Biology, Shanghai Key Laboratory of Regulatory Biology, The Institute of Biomedical Sciences and School of Life Sciences, East China Normal University, Shanghai, China * These authors have contributed equally to this work Correspondence to: Tieliu Shi, email: // Chengping Wen, email: // Keywords : traditional Chinese medicine (TCM), acute myeloid leukemia(AML), medicine classification, synthetic lethality (SL), drug repurposing Received : January 05, 2017 Accepted : March 06, 2017 Published : April 09, 2017 Abstract Traditional Chinese Medicine (TCM) has been widely used as a complementary medicine in Acute Myeloid Leukemia (AML) treatment. In this study, we proposed a new classification of Chinese Medicines (CMs) by integrating the latest discoveries in disease molecular mechanisms and traditional medicine theory. We screened out a set of chemical compounds on basis of AML differential expression genes and chemical-protein interactions and then mapped them to Traditional Chinese Medicine Integrated Database. 415 CMs contain those compounds and they were categorized into 8 groups according to the Traditional Chinese Pharmacology. Pathway analysis and synthetic lethality gene pairs were applied to analyze the dissimilarity, generality and intergroup relations of different groups. We defined hub CM pairs and alternative CM groups based on the analysis result and finally proposed a formula to form an effective anti-AML prescription which combined the hub CM pairs with alternative CMs according to patients’ molecular features. Our method of formulating CMs based on patients’ stratification provides novel insights into the new usage of conventional CMs and will promote TCM modernization.

Several studies have investigated the relationship between serum and hair nickel (Ni) concentration and breast cancer, but the results were inconsistent. Thus, we conducted a systematic review and meta-analysis to evaluate the association between serum and hair nickel levels and breast cancer. Nine studies determining the serum nickel levels and six studies evaluating the hair nickel levels were identified in a systematic search of PubMed, China Knowledge Resource Integrated Database, Wanfang, and China Biomedical Literature Service System databases. Based on a random-effects model, standard mean differences (SMD) and the corresponding 95% confidence intervals (CI) were pooled to compare the nickel levels between different groups. Compared with healthy controls, the serum nickel levels in breast cancer were significantly higher (SMD (95% CI) 1.76 (0.82, 2.70)), as well as in those post-treated cases (SMD (95% CI) 2.56 (1.18, 3.94)). For breast cancer cases, the treatment made no significant decrease in serum nickel levels (SMD (95% CI) −0.29 (−1.17, 0.59)). In hair, the nickel levels in breast cancer were slightly higher than in controls, but not significant (SMD (95% CI) 0.16 (−1.08, 1.40)). In conclusion, high serum nickel levels were associated with breast cancer, and nickel exposure might be a risk factor for breast cancer.

Within the limits of the regional program «Prevention and treatment of an arterial hypertension for the period of 2004—2008» the electronic register of the patients with hypertensia inTomskRegion has been created. The electronic register is a two-level system where interaction of two kinds of databases is carried out: the first level is the databases of separate medical organization; the second level is the central integrated database. The basic information for the electronic register are documents confirmed by the Health service Ministry of the Russian Federation, that is the coupon of the out-patient patient and a card of dynamic supervision over the patient with hypertensia. All the data about the patients, included in the register are subdivided into unchangeable and changeable ones. The electronic register is an effective control system providing local leading of health service bodies with qualitative and high-grade information in processes of preparation of decision-making and measure taken for prevention and treatment of hypertensia. The electronic register is an effective monitoring system, providing medical authority of important information for taking decisions establishment measures for prevention and treatment of hypertensia.

Secondary use of patient databases is essential in healthcare if clinical trials are to progress efficiently to planned time and target and imperative if the planned UK expansion of research and development (RD) at point of care is to be achieved. Integration of effective databases primarily designed to facilitate patient care with RD requirements is needed but represents a complex challenge. We present a system that achieves an integrated approach with online management of complex datasets for clinical trials within care records using a specific study as an example to show functionality in practice; illustrating how this system provides an ideal resource to meet the needs of both clinicians and researchers.

Background By 2030, the tobacco epidemic will be responsible for over eight million deaths worldwide per year, with 80% of those deaths occurring in low-resource countries. Despite the magnitude of the problem, little is known about the funding for global tobacco control. Methods To estimate the amount of tobacco control funding, we created an integrated database based on information provided by tobacco control donors. We focus on resources available to low-income and middle-income countries provided as Development Assistance to Control Tobacco (DACT). Results Global DACT grew from US$1.2 million in 2000 to US$44.2 million in 2009, primarily due to contributions from private philanthropies. Average annual 2000–2009 funding amounted to about US$0.003 per adult (US$0.0003 per adult in 2000 and US$0.011 per adult in 2009). DACT has been supplemented by domestic public funding that reached US$0.009 per adult in 2008. 28% of emerging and developing countries received zero DACT and 15% of those countries reported no funding at all. Out of US$21.8 billion disbursed in 2007 for health-related development assistance, DACT represented only US$0.02 billion, or 0.09%. Conclusions Since the funding for both infectious and non-communicable diseases in low-resourced countries is inadequate, the solution for global tobacco control is not to shift resources from other public health priorities, but rather to generate additional tobacco control funding. Several mechanisms to achieve this goal are proposed.

International audience

The National Agricultural Biotechnology Information Center (NABIC) reconstructed an AllergenPro database for allergenic proteins analysis and allergenicity prediction. The AllergenPro is an integrated web-based system providing information about allergen in foods, microorganisms, animals and plants. The allergen database has the three main features namely, (1) allergen list with epitopes, (2) searching of allergen using keyword, and (3) methods for allergenicity prediction. This updated AllergenPro outputs the search based allergen information through a user-friendly web interface, and users can run tools for allergenicity prediction using three different methods namely, (1) FAO/WHO, (2) motif-based and (3) epitope-based methods. Availability: The database is available for free at http://nabic.rda.go.kr/allergen/

Biurrun, Idoia/0000-0002-1454-0433; Rojo, Maria Pilar Rodriguez/0000-0001-5449-9386; Ermakov, Nikolai/0000-0001-7550-990X; De Sanctis, Michele/0000-0002-7280-6199; Svenning, Jens-Christian/0000-0002-3415-0862; Virtanen, Risto/0000-0002-8295-8217; Agrillo, Emiliano/0000-0003-2346-8346; Onyshchenko, Viktor/0000-0001-9079-7241; Marceno, Corrado/0000-0003-4361-5200; Willner, Wolfgang/0000-0003-1591-8386; Fernandez-Gonzalez, Federico/0000-0003-1234-4065; Jansen, Florian/0000-0002-0331-5185; Swacha, Grzegorz/0000-0002-6380-2954; Dengler, Jurgen/0000-0003-3221-660X; Guarino, Riccardo/0000-0003-0106-9416; Sopotlieva, Desislava/0000-0002-9281-7039; Venanzoni, Roberto/0000-0002-7768-0468; Chytry, Milan/0000-0002-8122-3075; Kuzemko, Anna/0000-0002-9425-2756; Danihelka, Jiri/0000-0002-2640-7867; Kuzemko, Anna/0000-0002-9425-2756; Venanzoni, Roberto/0000-0002-7768-0468; Gavilan, Rosario G./0000-0002-1022-445X; Jansen, Florian/0000-0002-0331-5185; Wohlgemuth, Thomas/0000-0002-4623-0894; Svenning, Jens-Christian/0000-0002-3415-0862; Sibik, Jozef/0000-0002-5949-862X; Casella, Laura/0000-0003-2550-3010; Lenoir, Jonathan/0000-0003-0638-9582; Attorre, Fabio/0000-0002-7744-2195; Kacki, Zygmunt/0000-0002-2241-1631; Jandt, Ute/0000-0002-3177-3669; Carni, Andraz/0000-0002-8909-4298; Jirousek, Martin/0000-0002-4293-478X; GARCIA-MIJANGOS, ITZIAR/0000-0002-6642-7782; Campos, Juan Antonio/0000-0001-5992-2753; Fanelli, Giuliano/0000-0002-3143-1212; Haveman, Rense/0000-0001-9127-4549; Acic, Svetlana/0000-0001-6553-3797; De Bie, Els/0000-0001-7679-743X; Font, Xavier/0000-0002-7253-8905; Moeslund, Jesper Erenskjold/0000-0001-8591-7149; Martynenko, Vasiliy/0000-0002-9071-3789; Jimenez-Alfaro, Borja/0000-0001-6601-9597; Ejrnaes, Rasmus/0000-0003-2538-8606; Carlon Ruiz, Luis/0000-0003-3442-8710; Angelini, Pierangela/0000-0002-5321-9757; Silc, Urban/0000-0002-3052-699X; Landucci, Flavia/0000-0002-6848-0384; Ewald, Jorg/0000-0002-2758-9324; Dziuba, Tetiana/0000-0001-8621-0890 WOS: 000368074600018 The European Vegetation Archive (EVA) is a centralized database of European vegetation plots developed by the IAVS Working Group European Vegetation Survey. It has been in development since 2012 and first made available for use in research projects in 2014. It stores copies of national and regional vegetation-plot databases on a single software platform. Data storage in EVA does not affect on-going independent development of the contributing databases, which remain the property of the data contributors. EVA uses a prototype of the database management software TURBOVEG 3 developed for joint management of multiple databases that use different species lists. This is facilitated by the SynBioSys Taxon Database, a system of taxon names and concepts used in the individual European databases and their corresponding names on a unified list of European flora. TURBOVEG 3 also includes procedures for handling data requests, selections and provisions according to the approved EVA Data Property and Governance Rules. By 30 June 2015, 61 databases from all European regions have joined EVA, contributing in total 1 027 376 vegetation plots, 82% of them with geographic coordinates, from 57 countries. EVA provides a unique data source for large-scale analyses of European vegetation diversity both for fundamental research and nature conservation applications. Updated information on EVA is available online at http://euroveg.org/eva-database. Czech Science Foundation (Centre of Excellence PLADIAS) [14-36079G] Our major thanks go to thousands of European vegetation scientists of several generations who collected the original vegetation-plot data in the field, published them or made their unpublished data available to others, and to those who spent myriad hours digitizing data and managing the contributing databases. EVA data management has been partly funded by the Czech Science Foundation (Centre of Excellence PLADIAS, 14-36079G).

In this paper, we looked at clustering coefficient, one of the statistics commonly used to study protein interaction networks. We have calculated clustering coefficient to identify the potential drug targets for Diabetes Mellitus (DM). An integrated database of DM genes has been developed by mining various repositories. Protein-protein interaction (PPI) network for the DM genes was constructed. Various centrality measures for the PPI network were calculated. In this study we considered the top 10 genes from the 15 centrality measures and further we calculated the clustering coefficient to find the potential drug targets.

Ethnopharmacological relevance In the past years, the treatment of rheumatoid arthritis (RA) has undergone remarkable changes in all therapeutic modes. The present newfangled care in clinical research is to determine and to pick a new track for better treatment options for RA. Recent ethnopharmacological investigations revealed that traditional herbal remedies are the most preferred modality of complementary and alternative medicine (CAM). However, several ayurvedic modes of treatments and formulations for RA are not much studied and documented from Indian traditional system of medicine. Therefore, this directed us to develop an integrated database, RAACFDb (acronym: Rheumatoid Arthritis Ayurvedic Classical Formulations Database) by consolidating data from the repository of Vedic Samhita – The Ayurveda to retrieve the available formulations information easily. Materials and methods Literature data was gathered using several search engines and from ayurvedic practitioners for loading information in the database. In order to represent the collected information about classical ayurvedic formulations, an integrated database is constructed and implemented on a MySQL and PHP back-end. Results The database is supported by describing all the ayurvedic classical formulations for the treatment rheumatoid arthritis. It includes composition, usage, plant parts used, active ingredients present in the composition and their structures. Conclusion The prime objective is to locate ayurvedic formulations proven to be quite successful and highly effective among the patients with reduced side effects. The database (freely available at www.beta.vit.ac.in/raacfdb/index.html) hopefully enables easy access for clinical researchers and students to discover novel leads with reduced side effects.

Background Infections such as common colds, influenza, acute upper respiratory infections, bacterial gastroenteritis, and urinary tract infections are usually diagnosed according to patients’ signs and symptoms. This study aims to develop a scale for the diagnosis of infectious diseases based on the six excesses (Liu Yin) etiological theory of Chinese medicine (CM) by the Delphi method. Methods A total of 200 CM-guided diagnostic items measuring signs and symptoms for infectious diseases were compiled from CM literature archives from the Han to Ming dynasties, CM textbooks in both China and Taiwan, and journal articles from the China Knowledge Resource Integrated Database. The items were based on infections and the six excesses (Liu Yin) etiological theory, i.e., Feng Xie (wind excess), Han Xie (coldness excess), Shu Xie (summer heat excess), Shi Xie (dampness excess), Zao Xie (dryness excess), and Huo Xie (fire excess). The items were further classified into the six excess syndromes and reviewed via a Delphi process to reach consensus among CM experts. Results In total, 178 items with a mean or median rating of 7 or above on a scale of 1–9 from a panel of 32 experts were retained. The numbers of diagnostic items in the categories of Feng (wind), Han (coldness), Shu (summer heat), Shi (dampness), Zao (dryness), and Huo (fire) syndromes were 15, 22, 25, 37, 17, and 62, respectively. Conclusions A CM-based six excesses (Liu Yin) evaluation and diagnosis (SEED) scale was developed for the evaluation and diagnosis of infectious diseases based only on signs and symptoms.

We herein present the National NeuroAIDS Tissue Consortium-Data Coordinating Center (NNTC-DCC) database, which is the only available database for neuroAIDS studies that contains data in an integrated, standardized form. This database has been created in conjunction with the NNTC, which provides human tissue and biofluid samples to individual researchers to conduct studies focused on neuroAIDS. The database contains experimental datasets from 1206 subjects for the following categories (which are further broken down into subcategories): gene expression, genotype, proteins, endo-exo-chemicals, morphometrics and other (miscellaneous) data. The database also contains a wide variety of downloadable data and metadata for 95 HIV-related studies covering 170 assays from 61 principal investigators. The data represent 76 tissue types, 25 measurement types, and 38 technology types, and reaches a total of 33 017 407 data points. We used the ISA platform to create the database and develop a searchable web interface for querying the data. A gene search tool is also available, which searches for NCBI GEO datasets associated with selected genes. The database is manually curated with many user-friendly features, and is cross-linked to the NCBI, HUGO and PubMed databases. A free registration is required for qualified users to access the database. Database URL: http://nntc-dcc.unmc.edu

UNLABELLED Bacterial proteases are an important group of enzymes that have very diverse biochemical and cellular functions. Proteases from prokaryotic sources also have a wide range of uses, either in medicine as pathogenic factors or in industry and therapeutics. ProLysED (Prokaryotic Lysis Enzymes Database), our meta-server integrated database of bacterial proteases, is a useful, albeit very niche, resource. The features include protease classification browsing and searching, organism-specific protease browsing, molecular information and visualisation of protease structures from the Protein Data Bank (PDB) as well as predicted protease structures. AVAILABILITY ProLysED is integrated into the ProLysES (Prokaryotic Lysis Enzymes Site) website at http://genome.ukm.my/prolyses/. Access to the ProLysED database is free for academic users upon registration.

UNLABELLED Medicinal plants and plant derived molecules are widely used in traditional cultures all over the world and they are becoming large popular among biomedical researchers and pharmaceutical companies as a natural alternative to synthetic medicine. Information related to medicinal plants and herbal drugs accumulated over the ages are scattered and unstructured which make it prudent to develop a curated database for medicinal plants. The Antidiabetic and Anticancer Medicinal Plants Database (DIACAN) aims to collect and provide an integrated platform for plants and phytochemiclas having antidiabetic or anticancer activity. AVAILABILITY http://www.kaubic.in/diacan.

In spite of the wide prevalence of head, neck and oral cancer, HNOC, there is no integrated database on genes and miRNAs associated with all the carcinoma subtypes of HNOC. The objective is to compile a multilayered and comprehensive database of HNOC as a user-friendly resource for researchers devising novel therapeutic strategies. We present HNOCDB, the head, neck and oral cancer database, with the following key features: (i) it tabulates all the different categories of HNOC separately under appropriate subtype-names, and then puts them together in a table headlined All; (ii) the oncogenes/oncomiRs that cause HNOC are listed; their mutations, methylations and polymorphisms loci are marked, and the variations in their expression profiles relative to the normal are recorded; (iii) HNOCDB contains a chromosomal map of HNOC genes and miRNA; (iv) contains references that experimentally validate the reason for the inclusion of the genes and the miRNAs in HNOCDB. HNOCDB is freely accessible for academic and non-profit users via http://gyanxet.com/hno.html.

In today’s society, the use of Rehabilitation Medical Equipment is rapidly increasing due to the aging population and unexpected incidents. Accordingly, the demand for efficient sharing and use of the rehabilitation medical equipment is becoming higher, but actually its systematic management isn’t properly handled. Consequently, it is extremely difficult for users to grasp the medical clinics where the rehabilitation medical equipment is available. Currently, each hospital is equipped with medical information system and Rehabilitation Medical Equipment system, but not equipped with one integrated system. In this thesis, we established one integrated database by combining the Rehabilitation Medical Equipment which each hospital has, designed and implemented the integrated search system of Rehabilitation medical equipment so that users can easily search the results on the web.

Inpatient care to manage relapse of patients with schizophrenia contributes greatly to the overall financial burden of treatment. The present study explores to what extent this is influenced by duration of illness.Medical and pharmaceutical claims data for patients diagnosed with schizophrenia (ICD-9 295.xx) were obtained from the PharMetrics Integrated Database, a large, regionally representative US insurance claims database, for the period 1998-2007. Recently diagnosed (n = 970) and chronic patients (n = 2996) were distinguished based on ICD-9 295.xx classification, age and claims history relative to the first year (recently diagnosed) and the third year onwards (chronic) after the first index schizophrenia event.The medical resource use and costs during the year following the index schizophrenia event differed significantly between cohorts. A higher proportion of recently diagnosed patients were hospitalised compared with chronic patients (22.3% vs 12.4%; p0.0001), spending a greater mean number of days in hospital (5.1 days vs 3.0 days; p = 0.0065) as well as making more frequent use of emergency room (ER) resources during this time. The mean annual healthcare costs of recently diagnosed patients were also greater ($20,654 vs $15,489; p0.0001) with inpatient costs making up a higher proportion of total costs (62.9%) compared with chronic patients (38.5%).There is a considerably higher overall economic burden in the year following their first schizophrenia event in the treatment of recently diagnosed schizophrenia patients compared with chronic patients. Since hospitalisations and ER visits are the most significant components contributing to this finding, efforts that focus on measures to reduce the risk of relapse, particularly amongst recently diagnosed patients, such as improved adherence programs, may lead to better clinical and economic outcomes in the management of schizophrenia.Only commercially insured patients and direct medical costs were included, therefore, results may underestimate the economic burden of schizophrenia.

Fasciolosis is a serious economic disease of cattle and sheep with a worlwide distribution. In the annual control of the disease, it is vital that the issue of specific veterinary advice on the strategic use of control measures should be based on precise estimates of the levels of risk of the occurrence of the disease. In Northern Ireland, a mathematical model has been developed to forecast accurately the prevalence of the disease in any year. The development of the model has been facilitated by the use of a computerised information retrieval system for an extensive integrated database of abattoir condemnation and meteorological data. The model accounts for 90% of the variation in an 18-year time series of the prevalence of fasciolosis in Northern Ireland. The mathematical model has been used to forecast the level of disease expected in subsequent years in Northern Ireland and has proven to be highly accurate. The forecasting model is now used each year as the basis of an advisory government campaign on the strategic use of veterinary control measures required to reduce the prevalence of this economically important disease. The forecasting model could be adopted for use in any region of the world where relevant abattoir condemnation and meteorological data are available.

The objective of this study is to assess the trends in imaging utilization in adults with diagnosis of appendicitis and the role that imaging plays in the escalating appendicitis hospital charges. Data on demographics, imaging utilization, and charges of all patients discharged after a diagnosis of appendicitis during 6 years (1999–2004) were obtained from the integrated database of a large hospital. The number of discharges from 1999 to 2004 in the institution steadily decreased. An average of 2.34 imaging studies per patient were obtained, increasing from 1.85 in 1999 to 3.07 in 2004 (p = 0.001). Computed tomography (CT) studies represented 65.9% of the total of studies obtained, while plain films and ultrasound represented 19 and 14%, respectively. The percentage of patients who underwent CT increased from 51.4 to 75.7%, with relative decreases of 12 and 54% for plain abdominal films and ultrasound, respectively. Patients older than 65 years had higher rates of imaging utilization, averaging 4.3 compared with 1.86 studies in their younger counterparts (p = 0.001). Imaging utilization rates did not significantly differ among races (p > 0.5), genders (p > 0.8), discharge services (p > 0.1), or payer groups (p > 0.5). Average hospital charges for appendicitis increased by 16.3%, while imaging charges increased as a fraction of hospital charges from 7.89 to 10.87%. Imaging utilization has increased rapidly, but trends show a slowdown that might correspond with achievement of standardization. This suggests that long-term continuous rising is unlikely. Imaging charges correlate with increased hospital charges but cannot explain or accurately predict them.