Search

Mafalda Ramos,1 Mark Lamotte,1 Laetitia Gerlier,1 Per Svangren,2 Anna Miquel-Cases,3 John Haughney4 1Real World Evidence Solutions, IQVIA, 1930 Zaventem, Belgium; 2Core Respiratory, Global Product and Portfolio Strategy – Global Payer Evidence and Pricing, AstraZeneca Gothenburg R&D, SE-431 83 Mölndal, Sweden; 3Global Price and Reimbursement, Global Payer Evidence and Pricing, AstraZeneca Gothenburg R&D, Cambridge CB2 8PA, UK; 4Academic Primary Care Division of Applied Health Sciences, University of Aberdeen, Aberdeen AB25 2ZD, UK Background: While the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines advise exercise to reduce disease progression, little investment in promoting physical activity (PA) is made by health care authorities. The purpose of this study was to estimate the cost-effectiveness of regular PA vs sedentary lifestyle in people with COPD in the UK.Methods: Efficacy, quality of life, and economic evidence on the PA effects in COPD patients were retrieved from literature to serve as input for a Markov microsimulation model comparing a COPD population performing PA vs a COPD population with sedentary lifestyle. The GOLD classification defined the model health states. For the base case, the cost of PA was estimated at zero, a lifetime horizon was used, and costs and effects were discounted at 3.5%. Analyses were performed from the UK National Health Service (NHS) perspective. Uncertainty around inputs and assumptions were explored via scenario and sensitivity analyses, including a cost threshold analysis. Outcomes were cost/quality-adjusted life year (QALY) gained and cost/year gained.Results: Based on our model, the effects of PA in the UK COPD population would be lower mortality (-6%), fewer hospitalizations (-2%), gains in years (+0.82) and QALYs (+0.66), and total cost savings of £2,568. The cost/QALY and cost/year gained were dominant. PA was cost-saving at costs

Mafalda Ramos,1 John Haughney,2 Nathaniel Henry,3 Leandro Lindner,4 Mark Lamotte1 1Real World Evidence, IMS Health, Zaventem, Belgium; 2Academic Primary Care Division of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, 3Health Economics and Outcomes Research, Real World Evidence, IMS Health, London, UK; 4AstraZeneca, Barcelona, Spain Purpose: Aclidinium–formoterol 400/12 µg is a long-acting muscarinic antagonist (LAMA) and a long-acting β2-agonist in a fixed-dose combination used in the management of patients with COPD. This study aimed to assess the cost-effectiveness of aclidinium–formoterol 400/12 µg against the long-acting muscarinic antagonist aclidinium bromide 400 µg.Materials and methods: A five-health-state Markov transition model with monthly cycles was developed using MS Excel to simulate patients with moderate-to-severe COPD and their initial lung-function improvement following treatment with aclidinium–formoterol 400/12 µg or aclidinium 400 µg. Health states were based on severity levels defined by Global Initiative for Chronic Obstructive Lung Disease 2010 criteria. The analysis was a head-to-head comparison without step-up therapy, from the NHS Scotland perspective, over a 5-year time horizon. Clinical data on initial lung-function improvement were provided by a pooled analysis of the ACLIFORM and AUGMENT trials. Management, event costs, and utilities were health state-specific. Costs and effects were discounted at an annual rate of 3.5%. The outcome of the analysis was expressed as cost (UK£) per quality-adjusted life-year (QALY) gained. The analysis included one way and probabilistic sensitivity analyses to investigate the impact of parameter uncertainty on model outputs.Results: Aclidinium–formoterol 400/12 µg provided marginally higher costs (£41) and more QALYs (0.014), resulting in an incremental cost-effectiveness ratio of £2,976/QALY. Sensitivity analyses indicated that results were robust to key parameter variations, and the main drivers were: mean baseline forced expiratory volume in 1 second (FEV1), risk of exacerbation, FEV1 improvement from aclidinium–formoterol 400/12 µg, and lung-function decline. The probability of aclidinium–formoterol 400/12 µg being cost-effective (using a willingness-to-pay threshold of £20,000/QALY) versus aclidinium 400 µg was 79%.Conclusion: In Scotland, aclidinium–formoterol 400/12 µg can be considered a cost-effective treatment option compared to aclidinium 400 µg alone in patients with moderate-to-severe COPD. Keywords: cost-effectiveness, Scotland, Markov model, lung-function improvement, LABA, LAMA

Since a few years, simulation codes were built at CEA Cadarache to predict the signal of ionisation chambers and taylor detectors for specific applications. It is proposed here to present COSICAF, a tool developed for mainly academic purpose and rapid fission chamber prototyping. This numerical simulation, mostly based on semi-empirical models and Monte-Carlo method will help students to understand how ionisation chambers work. Through the paper, models and their numerical implementation will be discussed. A focus is made on recently implemented features like charge multiplication and correlated source which make the simulation of proportional counter possible. To demonstrate the interest of the code, simulations of a planar fission chamber is proposed.

Keywords: Hyperglycemia in pregnancy; COVID 19 pandemic; Gestational diabetes EN Hyperglycemia in pregnancy COVID 19 pandemic Gestational diabetes 507 510 4 11/23/20 20201101 NES 201101 In 2010, the French-speaking Society of Diabetes (SFD; Société Francophone du Diabète) and French National College of Obstetricians and Gynaecologists (CNGOF) proposed an expert consensus on screening and caring for hyperglycaemia in pregnancy (HIP) in France. 1 French-speaking Society of Diabetes (SFD) recommendations for screening for hyperglycaemia in pregnancy before and during the COVID-19 pandemic: (A) current recommendations; and (B) alternative proposed during the pandemic. [Extracted from the article]

Study Question: Do assisted reproductive technologies alter DNA methylation and/or transcription of transposable elements and imprinted genes in cord blood and placenta?Summary Answer: After ART, DNA methylation and/or transcription changes of some transposable elements and imprinted genes were found in placenta samples while transcription modifications for some transposable elements were also discovered in cord blood.What Is Known Already: Recent studies have confirmed the increased risk of placenta-related adverse pregnancy outcomes and the excess of imprinted disorders with abnormal methylation patterns after ART, which raises the issue of a potential ART-induced epigenetic risk.Study Design, Size, Duration: A total of 51 IVF/ICSI (15 conventional and 36 ICSI) singleton pregnancies were prospectively included from January 2013 to April 2015 and compared to 48 spontaneously conceived singleton pregnancies.Participants/materials, Setting, Methods: The DNA methylation and transcription of three imprinted loci (H19/IGF2, KCNQ1OT1 and SNURF DMRs) and four transposon families (LINE-1, ERVFRD, AluYa5 and ERVW) in cord blood and placenta obtained at birth were assessed by pyrosequencing and quantitative RT-PCR, respectively. All data were adjusted for gestational age at delivery, sex of the newborn, parity and maternal age.Main Results and the Role Of Chance: DNA methylation levels of H19/IGF2, KCNQ1OT1, LINE-1Hs and ERVFRD-1 were significantly lower in IVF/ICSI placentas than in control placentas, while there was no difference for cord blood. Moreover, the expression of ERVFRD-1 and LINE-1 ORF2 in cord blood and ERVFRD-1 in placenta was lower in the IVF/ICSI group than in controls. The expression of ERVFRD-1 in placenta correlated positively with birth weight and placenta weight, but only in the control group, thus pointing to the potential deregulation of syncytin function after ART.Large Scale Data: N/A.Limitations, Reasons For Caution: The control group of fertile couples having conceived within 1 year prevented us from deciphering the distinct roles of ART and infertility.Wider Implications Of the Findings: These novel findings of ERVFRD (syncytin-2) expression correlating with birth weight and placenta weight suggest that more research on syncytins and pregnancy-associated diseases could lead to them being used as biomarkers or even as therapeutic targets. The epigenetic modifications in placenta for sequences involved in foetal development raise the question of their potential effects on pregnancy and future life. These results should encourage us to analyse the exact causes and consequences of epigenetic changes and strive to minimize these variations in the interests of epigenetic safety after ART.Study Funding/competing Interest(s): The study was funded by a grant from Besançon and Dijon University Hospitals. The authors have no conflicts of interest to declare. [ABSTRACT FROM AUTHOR]

This study examined the difference in the perception of time between young and older adults in a temporal bisection task with four different duration ranges from a few milliseconds (500 ms) to several seconds (30 s). In addition, individual cognitive capacities (short-term memory, working memory, processing speed, attention) were assessed with different neuropsychological tests. The results showed a general effect of age on the variability of time judgment, indicating a lower sensitivity to time in the old than in the younger adults, regardless of the duration range tested. In addition, the results showed that the individual differences in time sensitivity were explained by attention capacities, which decline with aging. [ABSTRACT FROM AUTHOR]

Introduction: Surgery, the cornerstone of most cancer treatments, is associated with considerable postoperative complications1. Adjusting patients' health behavior before surgery may have beneficial effects on postoperative outcomes. The objective of this trial is to investigate the feasibility and safety of, and patient-satisfaction and adherence with, patient-centered teleprehabilitation in patients undergoing breast cancer (BC) surgery. Methods: Women (n = 50) who will undergo breast surgery because of stage I-III BC are eligible. All participants will receive multimodal patient-centered teleprehabilitation comprising of motivational interviewing, education, exercise therapy, and stress management. Feasibility, participation rate, patient satisfaction, intervention safety, and treatment adherence will be monitored as primary outcomes. Fatigue, pain, quality of life (QoL), self-efficacy, and healthcare utilization will be assessed by self-reported questionnaires at baseline, 0-, 2-, and 6-months post-intervention. Results: Proof of concept for using telecommunication and exercise therapy in prehabilitation prior to BC surgery is available2,3. We expect the proposed intervention to be feasible and effective at reducing fatigue, pain, and healthcare use, and at improving treatment adherence, QoL, and self-efficacy. Discussion: Effective prehabilitation interventions can reduce the long-term symptoms that arise/persist beyond treatment completion, improving patients' QoL. By using telecommunication technologies, socio-economic barriers can be reduced, making care accessible to all. Process evaluation: With timely recruitment being the greatest challenge, a thorough mitigation strategy was put in place. Recruitment, drop-out, and loss-to-follow-up will constantly be monitored. Additional study centers confirmed their willingness to participate, and other study centers can easily be contacted through our collaboration with the Belgian Society of Medical Oncology. [ABSTRACT FROM AUTHOR]

The aim of our studies was to design a Metacognitive Questionnaire on Time (MQT) that assesses interindividual variations in the awareness of factors affecting the experience of the passage of time. In the first study, 532 young adults were asked to reply to an initial questionnaire consisting of 106 questions relating to many different factors (e.g., psychostimulant, body temperature, age, attention) that could affect how time is perceived. Factorial analyses allowed us to extract two discriminant factors, one relating to attention and the other to emotion. The second study sought to validate the final 24-item questionnaire by gathering data from 212 university students. Confirmatory Factorial Analyses (AMOS) showed that the MQT has the same two-factor structure. The third study assessed the construct validity of the MQT by measuring the correlation between theMQT scores and the scores with other questionnaires measuring close or different constructs. In sum, these studies enabled us to develop an easy-to-use questionnaire whereby it is possible to distinguish between individuals according to their subjective feeling of the passage of time. In addition, the participants' responses on theMQT showed that they were more aware of attention-related factors than of emotion-related factors that might produce time distortions, and that women were more aware of their own temporal distortions than men. [ABSTRACT FROM AUTHOR]