Hypertension management in Canada: good news, but important challenges remain.
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ABSTRACT:
SUBMITTER: Mohan S
PROVIDER: S-EPMC2374867 | biostudies-literature | 2008 May
REPOSITORIES: biostudies-literature
Publications
Hypertension management in Canada: good news, but important challenges remain.
Mohan Sailesh S Campbell Norm R C NR
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne 20080501 11
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Project description:BackgroundOverviews of reviews (overviews) provide an invaluable resource for healthcare decision-making by combining large volumes of systematic review (SR) data into a single synthesis. The production of high-quality overviews hinges on the availability of practical evidence-based guidance for conduct and reporting.ObjectivesWithin the broad purpose of informing the development of a reporting guideline for overviews, we aimed to provide an up-to-date map of existing guidance related to the conduct of overviews, and to identify common challenges that authors face when undertaking overviews.MethodsWe updated a scoping review published in 2016 using the search methods that had produced the highest yield: ongoing reference tracking (2014 to March 2020 in PubMed, Scopus, and Google Scholar), hand-searching conference proceedings and websites, and contacting authors of published overviews. Using a qualitative meta-summary approach, one reviewer extracted, organized, and summarized the guidance and challenges presented within the included documents. A second reviewer verified the data and synthesis.ResultsWe located 28 new guidance documents, for a total of 77 documents produced by 34 research groups. The new guidance helps to resolve some earlier identified challenges in the production of overviews. Important developments include strengthened guidance on handling primary study overlap at the study selection and analysis stages. Despite marked progress, several areas continue to be hampered by inconsistent or lacking guidance. There is ongoing debate about whether, when, and how supplemental primary studies should be included in overviews. Guidance remains scant on how to extract and use appraisals of quality of the primary studies within the included SRs and how to adapt GRADE methodology to overviews. The challenges that overview authors face are often related to the above-described steps in the process where evidence-based guidance is lacking or conflicting.ConclusionThe rising popularity of overviews has been accompanied by a steady accumulation of new, and sometimes conflicting, guidance. While recent guidance has helped to address some of the challenges that overview authors face, areas of uncertainty remain. Practical tools supported by empirical evidence are needed to assist authors with the many methodological decision points that are encountered in the production of overviews.
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Project description:Recent research has explored the possibility of building attitudinal resistance against online misinformation through psychological inoculation. The inoculation metaphor relies on a medical analogy: by pre-emptively exposing people to weakened doses of misinformation cognitive immunity can be conferred. A recent example is the Bad News game, an online fake news game in which players learn about six common misinformation techniques. We present a replication and extension into the effectiveness of Bad News as an anti-misinformation intervention. We address three shortcomings identified in the original study: the lack of a control group, the relatively low number of test items, and the absence of attitudinal certainty measurements. Using a 2 (treatment vs. control) × 2 (pre vs. post) mixed design (N = 196) we measure participants' ability to spot misinformation techniques in 18 fake headlines before and after playing Bad News. We find that playing Bad News significantly improves people's ability to spot misinformation techniques compared to a gamified control group, and crucially, also increases people's level of confidence in their own judgments. Importantly, this confidence boost only occurred for those who updated their reliability assessments in the correct direction. This study offers further evidence for the effectiveness of psychological inoculation against not only specific instances of fake news, but the very strategies used in its production. Implications are discussed for inoculation theory and cognitive science research on fake news.
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Project description:We examine whether investor mood, driven by World Health Organization (WHO) alerts and media news on dangerous infectious diseases, is priced in pharmaceutical companies' stocks in the United States. We argue that disease-related news (DRNs) should not trigger rational trading. We find that DRNs have a positive and significant sentiment effect among investors (on Wall Street). The effect is stronger (weaker) for small (large) companies, who are less (more) likely to engage in the development of new vaccines. A potential negative investor climate (on Main Street) – induced by disease-related fear – does not alter the positive sentiment effect. Highlights • We examine whether investor mood, driven by World Health Organization alerts on infectious diseases, is priced in pharmaceutical stocks in the U.S.• Disease-related fear has a negative and significant effect on returns on pharmaceutical stocks.• Disease-related news (DRN) has a positive and significant effect on returns on pharmaceutical stocks.• The effect of DRN persists over several days following a WHO alert on infectious diseases.• The effect of DRN is stronger for smaller companies and is weaker for larger companies.• Our findings give rise to profitable trading strategies.
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Project description:BackgroundUterine leiomyosarcomas are rare malignant mesenchymal tumors. The systemic treatment of these tumors includes chemotherapy and radiotherapy. However, there are still a lot of unanswered questions regarding the ideal therapeutic approach.MethodsWe have conducted a systematic review of the treatment strategies of uterine leiomyosarcomas for the last ten years.ResultsAdjuvant chemotherapy is still a matter of dilemma. Doxorubicin based chemotherapy or the combination of Gemcitabine-Docetaxel are the regimens of choice for the first line setting. Beyond the first line, there are several options;, including chemotherapy, targeted therapy, and recently efforts of introducing immunotherapy to the therapeutic armamentarium of clinicians treating uterine leiomyosarcomas.ConclusionsDespite the efforts of the clinicians dealing with uterine leiomyosarcomas, the optimal therapeutic algorithm is yet to be described.
| S-EPMC8021365 | biostudies-literature
Project description:In contrast to adults where hypertension is a leading cause of chronic kidney disease, in pediatrics, hypertension is predominantly a sequela, however, an important one that, like in adults, is likely associated with a more rapid decline in kidney function or progression of chronic kidney disease to end stage. There is a significant issue with unrecognized, or masked, hypertension in childhood chronic kidney disease. Recent evidence and, therefore, guidelines now suggest targeting a blood pressure of <50th percentile for age, sex, and height in children with proteinuria and chronic kidney disease. This often cannot be achieved by monotherapy and additional agents need to be added. Blockade of the renin angiotensin aldosterone system represents the mainstay of therapy, although often limited by the side effect of hyperkalemia. The addition of a diuretic, at least in the earlier stages of chronic kidney disease, might help mitigate this problem.
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| S-EPMC10304213 | biostudies-literature
Project description:BackgroundThe main goal of the whole transcriptome analysis is to correctly identify all expressed transcripts within a specific cell/tissue--at a particular stage and condition--to determine their structures and to measure their abundances. RNA-seq data promise to allow identification and quantification of transcriptome at unprecedented level of resolution, accuracy and low cost. Several computational methods have been proposed to achieve such purposes. However, it is still not clear which promises are already met and which challenges are still open and require further methodological developments.ResultsWe carried out a simulation study to assess the performance of 5 widely used tools, such as: CEM, Cufflinks, iReckon, RSEM, and SLIDE. All of them have been used with default parameters. In particular, we considered the effect of the following three different scenarios: the availability of complete annotation, incomplete annotation, and no annotation at all. Moreover, comparisons were carried out using the methods in three different modes of action. In the first mode, the methods were forced to only deal with those isoforms that are present in the annotation; in the second mode, they were allowed to detect novel isoforms using the annotation as guide; in the third mode, they were operating in fully data driven way (although with the support of the alignment on the reference genome). In the latter modality, precision and recall are quite poor. On the contrary, results are better with the support of the annotation, even though it is not complete. Finally, abundance estimation error often shows a very skewed distribution. The performance strongly depends on the true real abundance of the isoforms. Lowly (and sometimes also moderately) expressed isoforms are poorly detected and estimated. In particular, lowly expressed isoforms are identified mainly if they are provided in the original annotation as potential isoforms.ConclusionsBoth detection and quantification of all isoforms from RNA-seq data are still hard problems and they are affected by many factors. Overall, the performance significantly changes since it depends on the modes of action and on the type of available annotation. Results obtained using complete or partial annotation are able to detect most of the expressed isoforms, even though the number of false positives is often high. Fully data driven approaches require more attention, at least for complex eucaryotic genomes. Improvements are desirable especially for isoform quantification and for isoform detection with low abundance.
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