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Objective: Evaluation of ophthalmologic safety with focus on retinal safety in patients with spinal muscular atrophy (SMA) treated with risdiplam (EVRYSDI®), a survival of motor neuron 2 splicing modifier associated with retinal toxicity in monkeys. Risdiplam was approved recently for the treatment of patients with SMA, aged ≥ 2 months in the United States, and is currently under Health Authority review in the EU. Methods: Subjects included patients with SMA aged 2 months–60 years enrolled in the FIREFISH, SUNFISH, and JEWELFISH clinical trials for risdiplam. Ophthalmologic assessments, including functional assessments (age‐appropriate visual acuity and visual field) and imaging (spectral domain optical coherence tomography [SD‐OCT], fundus photography, and fundus autofluorescence [FAF]), were conducted at baseline and every 2–6 months depending on study and assessment. SD‐OCT, FAF, fundus photography, and threshold perimetry were evaluated by an independent, masked reading center. Adverse events (AEs) were reported throughout the study. Results: A total of 245 patients receiving risdiplam were assessed. Comprehensive, high‐quality, ophthalmologic monitoring assessing retinal structure and visual function showed no retinal structural or functional changes. In the youngest patients, SD‐OCT findings of normal retinal maturation were observed. AEs involving eye disorders were not suggestive of risdiplam‐induced toxicity and resolved with ongoing treatment. Interpretation: Extensive ophthalmologic monitoring conducted in studies in patients with SMA confirmed that risdiplam does not induce ophthalmologic toxicity in pediatric or adult patients with SMA at the therapeutic dose. These results suggest that safety ophthalmologic monitoring is not needed in patients receiving risdiplam, as also reflected in the United States Prescribing Information for risdiplam. [ABSTRACT FROM AUTHOR]

Background: Funding models influence provision and development of palliative care services. As palliative care integrates into mainstream health care provision, opportunities to develop funding mechanisms arise. However, little has been reported on what funding models exist or how we can learn from them. Aim: To assess national models and methods for financing and reimbursing palliative care. Design: Initial literature scoping yielded limited evidence on the subject as national policy documents are difficult to identify, access and interpret. We undertook expert consultations to appraise national models of palliative care financing in England, Germany, Hungary, Republic of Ireland, New Zealand, The Netherlands, Norway, Poland, Spain, Sweden, Switzerland, the United States and Wales. These represent different levels of service development and a variety of funding mechanisms. Results: Funding mechanisms reflect country-specific context and local variations in care provision. Patterns emerging include the following: • Provider payment is rarely linked to population need and often perpetuates existing inequitable patterns in service provision. • Funding is frequently characterised as a mixed system of charitable, public and private payers. • The basis on which providers are paid for services rarely reflects individual care input or patient needs. Conclusion: Funding mechanisms need to be well understood and used with caution to ensure best practice and minimise perverse incentives. Before we can conduct cross-national comparisons of costs and impact of palliative care, we need to understand the funding and policy context for palliative care in each country of interest. [ABSTRACT FROM AUTHOR]

The checkerplot is a new type of graphical display that combines geographical information and statistical plots. Hereby, the traditional plots like barplots or polygon lines are visualized in geographical order on a grid. The checkerplots can be seen as a mixture between thematic maps and the grid representation in trellis plots. In a checkerplot, any complex statistical graphics that are produced for geographical areas are placed in a grid. An interpretable checkerplot requires an arrangement of areas on the grid that reflects the underlying geography. A loss function is proposed that represents the distortion of the underlying geography needed in order to place the areas onto a grid. It is demonstrated that the minimization of the loss function does indeed produce interpretable checkerplots. Moreover, the optimization problem can be formulated as a linear programming problem that can be solved using standard linear programming solvers. The proposed checkerplot is applied to US health insurance data to analyze the development of the coverage rate in the health system per state with respect to the different health care programs. Moreover, an example related to the EU-member states is also given. Additional information like the national flags of countries are placed in each grid to allow better visibility and recognition of the countries. The checkerplot is implemented in the R-package sparkTable (Kowarik, Meindl, and Templ, 2012.sparkTable: sparklines and graphical tables for tex and html[online]. R package version 0.9.3 [Accessed 7 February 2012]) and can be freely downloaded from the CRAN repository. It is implemented in a flexible manner and not restricted to the examples given in this contribution. [ABSTRACT FROM PUBLISHER]

Abstract: The evolution of the particle background at an altitude of ~540 km during the time interval between 1996 and 2007 is studied using the particle monitor of the High Energy X-ray Timing Experiment on board NASA''s Rossi X-ray Timing Explorer. A special emphasis of this study is the location and strength of the South Atlantic Anomaly (SAA). The size and strength of the SAA are anti-correlated with the 10.7 cm radio flux of the Sun, which leads the SAA strength by ~1 year reflecting variations in solar heating of the upper atmosphere. The location of the SAA is also found to drift westwards with an average drift rate of about 0.3°/yr following the drift of the geomagnetic-field configuration. Superimposed to this drift rate are irregularities, where the SAA suddenly moves eastwards and where furthermore the speed of the drift changes. The most prominent of these irregularities is found in the second quarter of 2003 and another event took place in 1999. We suggest that these events are previously unrecognized manifestations of the geomagnetic jerks of the Earth''s magnetic field. [Copyright &y& Elsevier]

A new species of the diplogastrid genus Oigolaimella is described in colonies of termites belonging to the genus Reticulitermes from Corsica (France) and USA. Oigolaimella attenuata n. sp. males can be recognised by the conspicuous length of the ventral unkeeled part of the otherwise keeled gubernaculum and, in contrast to the other members of the genus, the fact that the lateral field of both adult stages is marked by a single line. A diagnostic key for the five species of Oigolaimella is presented. Life cycle and development, including spermiogenesis, sperm transfer, sperm competition and fertilisation are described in detail. Some interesting aberrations of the reproductive system are documented. The new species uses the preoral cavities of the termites for internal phoresis and is associated with non-pathogenic gut-inhabiting flagellates of the taxon Kinetoplastida. The heads of 76 of 117 examined termites were infested with dauer juveniles of O. attenuata n. sp. with an average of 6.4 nematodes per termite. Six additional nematode species were isolated from the bodies of the termites, particularly a species of Pristionchus and, for the first time, Halicephalobus sp., Mesorhabditis spiculigera and Rhabditella axei. Rhabpanus ossiculum was isolated from termite-inhabited wood from Corsica, the first such detection in Europe. In the course of our discussion of the literature on termite-associated nematodes, we propose the new combination Pristionchus formosianus (Poinar, Meikle & Mercadier, 2006) n. comb. (=Chroniodiplogaster formosiana). [ABSTRACT FROM AUTHOR]

Over the past several decades, interest in using human milk as a biomonitoring matrix has increased. However, it is not always an easy matter for a new mother to provide a milk sample. In this article, guidance on facilitating collection of human milk is provided. This includes addressing the mother’s ease in expressing a milk sample, and engaging with many audiences to reduce the likelihood of negatively impacting the already low breastfeeding rates in the United States. In addition, this article covers concepts regarding long-term storage and integrity of human milk samples to maximize the utility of those samples, and proposed methods for improving public access to the full spectrum of human milk biomonitoring data, with context to understand the information presented. The environmental chemicals and chemical classes for which robust analytical methods exist are enumerated, and a process for prioritizing the development of analytical methods for additional environmental chemicals is described. [ABSTRACT FROM AUTHOR]

Discusses human milk surveillance and research for environmental chemicals in the U.S. Benefits for both mother and infant associated with breast-feeding; Adverse effects of environmental chemicals in human milk; Potential risks and established benefits of different sources of infant nutrition.

The current medical communication environment is characterised by growing calls for increased data transparency. There are ongoing concerns about the selective publication of trial results and the potential impact on use of medicines by prescribers and patients in both Europe and the US. This article outlines some of the background to current developments and considers the potential impact on those working in the field of medical communications. [ABSTRACT FROM AUTHOR]