Epilepsy in veterinary patients: perspectives of Dutch veterinarians in first-line practice

2020 ◽  
Vol 187 (6) ◽  
pp. e44-e44
Author(s):  
Koen Maurits Santifort ◽  
Maud Hamers ◽  
Paul Mandigers
Keyword(s):  
Diagnostic Imaging ◽  
Diagnostic Tests ◽  
Postgraduate Education ◽  
Care Giver ◽  
First Line ◽  
Treatment Results ◽  
Web Based ◽  
General Aspects ◽  
Patients With Epilepsy ◽  
Insight Into

BackgroundThis study aims to investigate the perspectives of veterinarians in first-line practice on confidence and satisfaction regarding several important aspects of the description, diagnosis and treatment of canine patients with epilepsy.MethodsA web-based questionnaire was used, focussing on general aspects of canine epilepsy, diagnostic tests, treatment and communication with owners.ResultsOne hundred and two questionnaires were evaluated. No less than 73 per cent of veterinarians had performed euthanasia on one or more patients with epilepsy as the main reason. First-line veterinarians scored confidence on general aspects of epilepsy as 6 or 7 out of 10. Confidence regarding communication with owners was scored 7 or 8 out of 10.ConclusionsThis study provides insight into perspectives of Dutch veterinarians in first-line practice regarding canine epilepsy. Several results may provide reasons to adjust (pregraduate or postgraduate) education of veterinarians with regard to management of canine patients with epilepsy. Several factors (such as the importance of diagnostic imaging) may help specialists in the field communicate better with referring veterinarians so that first-line practitioners become better equipped in managing patients with epilepsy. These steps may then positively influence treatment results as well as care-giver burden for the first-line practitioner.

PubChem and ChEMBL Beyond Lipinski

2019 ◽  
Author(s):  
Jean-Louis Reymond ◽  
Mahendra Awale ◽  
Daniel Probst ◽  
Alice Capecchi
Keyword(s):  
Nearest Neighbor ◽  
Molecular Shape ◽  
Biological Properties ◽  
Web Based ◽  
Large Molecules ◽  
Interactive Tools ◽  
Small Molecule Drugs ◽  
Pubchem Database ◽  
Nearest Neighbor Searches ◽  
Insight Into

<p>Seven million of the currently 94 million entries in the PubChem database break at least one of the four Lipinski constraints for oral bioavailability, 183,185 of which are also found in the ChEMBL database. These non-Lipinski PubChem (NLP) and ChEMBL (NLC) subsets are interesting because they contain new modalities that can display biological properties not accessible to small molecule drugs. Unfortunately, the current search tools in PubChem and ChEMBL are designed for small molecules and are not well suited to explore these subsets, which therefore remain poorly appreciated. Herein we report MXFP (macromolecule extended atom-pair fingerprint), a 217-D fingerprint tailored to analyze large molecules in terms of molecular shape and pharmacophores. We implement MXFP in two web-based applications, the first one to visualize NLP and NLC interactively using Faerun (http://faerun.gdb.tools/), the second one to perform MXFP nearest neighbor searches in NLP (http://similaritysearch.gdb.tools/). We show that these tools provide a meaningful insight into the diversity of large molecules in NLP and NLC. The interactive tools presented here are publicly available at http://gdb.unibe.ch and can be used freely to explore and better understand the diversity of non-Lipinski molecules in PubChem and ChEMBL.</p>

scholarly journals Real world cost and health outcomes of patients presented with chest pain in England: which is the most cost-effective first-line test?

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Tsiachristas ◽  
H West ◽  
E.K Oikonomou ◽  
B Mihaylova ◽  
N Sabharwall ◽  
...  
Keyword(s):  
Chest Pain ◽  
Health Outcomes ◽  
Diagnostic Tests ◽  
Clinical Presentation ◽  
Cost Effective ◽  
Funding Source ◽  
First Line ◽  
Nice Guidelines ◽  
Exercise Ecg ◽  
Stable Chest Pain

Abstract Background The National Institute for Health and Care Excellence (NICE) updated their guidance for the management of patients with stable chest pain and recommended that all patients undergo computed tomography coronary angiography (CTCA). This update has sparked a great deal of debate, and was followed by upgrade of CTCA into a Class I indication in the recent ESC guidelines. The cost-effectiveness of using CTCA as first line investigation is still unclear. Purpose To describe the current clinical pathway of patients with stable chest pain presented to outpatient clinics, assess the compliance with the updated NICE guideline, and explore the costs and health outcomes of different non-invasive diagnostic tests in real-world clinical setting. Methods We used data of 4,297 patients who attended chest pain clinics in Oxford between 1 January 2014 and 31 July 2018. Data included clinical presentation (e.g. age and previous cardiovascular conditions), diagnostic tests, outpatient visits, hospitalization, and hospital mortality and was compared between 6 alternative first-line diagnostic tests. Multinomial regressions were performed to estimate the probability of receiving each alternative and the associated cost after adjusting for clinical presentation. A decision tree was developed to describe the clinical pathway for each alternative first-line diagnostic in terms of subsequent diagnostic tests and treatments and to estimate the associated costs and life days. Results The proportion of patients who received CTCA as first line diagnostic test increased from 1% in 2014 to 17% in 2018, while the publication of the updated NICE guidelines in 2016 led to a threefold increase in this proportion. CTCA is less likely to be provided as a first-line diagnostic to patients who are younger age, males, smokers, and have angina, PVD, or diabetes. The standardised rate of hospital admission was the lowest in the exercise ECG cohort (0.35 admissions per 1,000 life-days) followed by the CTCA cohort (0.40 admissions per 1,000 life-days) while the latter cohort had the lowest standardised rate of cardiovascular treatment (2.74% per 1,000 life days). Stress echocardiography and MPS were associated with higher costs compared with CTCA, other ECG, and exercise ECG after adjusting for clinical presentation and days of follow-up. CTCA is the pathway most likely to be cost-effective, even compared to exercise ECG, while the other diagnostic alternatives are dominated (i.e. they cost more for less life-days). Conclusions Currently, the updated NICE guidelines for stable chest pain are implemented only to a fifth of the cases in England. Our findings support existing evidence that CTCA is the most-cost effective first-line diagnostic test for this population. Hopefully, this will inform the debate around the implementation of the guidelines and help commissioning and clinical decision processes worldwide. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Institute of Health Research Oxford Biomedical Research Centre

scholarly journals Trends in access to anti‐malarial treatment in the formal private sector in Uganda: an assessment of availability and affordability of first‐line anti‐malarials and diagnostics between 2007 and 2018

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Denis Kibira ◽  
Anthony Ssebagereka ◽  
Hendrika A. van den Ham ◽  
Jimmy Opigo ◽  
Henry Katamba ◽  
...  
Keyword(s):  
Private Sector ◽  
Diagnostic Tests ◽  
Malaria Treatment ◽  
World Health ◽  
First Line ◽  
Cross Sectional ◽  
Malaria Rapid Diagnostic Tests ◽  
Retail Outlets ◽  
Health Action ◽  
Health Organization

Abstract Background Malaria is the single largest cause of illness in Uganda. Since the year 2008, the Global Fund has rolled out several funding streams for malaria control in Uganda. Among these are mechanisms aimed at increasing the availability and affordability of artemisinin-based combination therapy (ACT). This paper examines the availability and affordability of first-line malaria treatment and diagnostics in the private sector, which is the preferred first point of contact for 61% of households in Uganda between 2007 and 2018. Methods Cross-sectional surveys were conducted between 2007 and 2018, based on a standardized World Health Organization/Health Action International (WHO/HAI) methodology adapted to assess availability, patient prices, and affordability of ACT medicines in private retail outlets. A minimum of 30 outlets were surveyed per year as prescribed by the standardized methodology co-developed by the WHO and Health Action International. Availability, patient prices, and affordability of malaria rapid diagnostic tests (RDTs) was also tracked from 2012 following the rollout of the test and treat policy in 2010. The median patient prices for the artemisinin-based combinations and RDTs was calculated in US dollars (USD). Affordability was assessed by computing the number of days’ wages the lowest-paid government worker (LPGW) had to pay to purchase a treatment course for acute malaria. Results Availability of artemether/lumefantrine (A/L), the first-line ACT medicine, increased from 85 to100% in the private sector facilities during the study period. However, there was low availability of diagnostic tests in private sector facilities ranging between 13% (2012) and 37% (2018). There was a large reduction in patient prices for an adult treatment course of A/L from USD 8.8 in 2007 to USD 1.1 in 2018, while the price of diagnostics remained mostly stagnant at USD 0.5. The affordability of ACT medicines and RDTs was below one day’s wages for LPGW. Conclusions Availability of ACT medicines in the private sector medicines retail outlets increased to 100% while the availability of diagnostics remained low. Although malaria treatment was affordable, the price of diagnostics remained stagnant and increased the cumulative cost of malaria management. Malaria stakeholders should consolidate the gains made and consider the inclusion of diagnostic kits in the subsidy programme.

MetLigDB: a web-based database for the identification of chemical groups to design metalloprotein inhibitors

2011 ◽  
Vol 44 (4) ◽  
pp. 878-881 ◽  
Author(s):  
Hwanho Choi ◽  
Hongsuk Kang ◽  
Hwangseo Park
Keyword(s):  
Drug Discovery ◽  
Metal Ions ◽  
Metal Ion ◽  
Central Metal ◽  
Amino Acid Residues ◽  
Web Based ◽  
Additional Information ◽  
Chemical Groups ◽  
Insight Into ◽  
Chelating Groups

MetLigDB (http://silver.sejong.ac.kr/MetLigDB) is a publicly accessible web-based database through which the interactions between a variety of chelating groups and various central metal ions in the active site of metalloproteins can be explored in detail. Additional information can also be retrieved, including protein and inhibitor names, the amino acid residues coordinated to the central metal ion, and the binding affinity of the inhibitor for the target metalloprotein. Although many metalloproteins have been considered promising targets for drug discovery, it is difficult to discover new inhibitors because of the difficulty in designing a suitable chelating moiety to impair the catalytic activity of the central metal ion. Because both common and specific chelating groups can be identified for varying metal ions and the associated coordination environments, MetLigDB is expected to give users insight into designing new inhibitors of metalloproteins for drug discovery.

scholarly journals Interactive Web-Based Resource for Annotation of Genetic Variants Causing Hereditary Angioedema (HADA): Database Development, Implementation, and Validation (Preprint)

2020 ◽  
Author(s):  
Alejandro Mendoza-Alvarez ◽  
Adrián Muñoz-Barrera ◽  
Luis Alberto Rubio-Rodríguez ◽  
Itahisa Marcelino-Rodriguez ◽  
Almudena Corrales ◽  
...  
Keyword(s):  
Hereditary Angioedema ◽  
Genetic Condition ◽  
First Line ◽  
International Consensus ◽  
Web Based ◽  
Genetics And Genomics ◽  
User Friendly ◽  
Current Guidelines ◽  
Generation Sequencing ◽  
Esterase Inhibitor

BACKGROUND Hereditary angioedema is a rare genetic condition caused by C1 esterase inhibitor deficiency, dysfunction, or kinin cascade dysregulation, leading to an increased bradykinin plasma concentration. Hereditary angioedema is a poorly recognized clinical entity and is very often misdiagnosed as a histaminergic angioedema. Despite its genetic nature, first-line genetic screening is not integrated in routine diagnosis. Consequently, a delay in the diagnosis, and inaccurate or incomplete diagnosis and treatment of hereditary angioedema are common. OBJECTIVE In agreement with recent recommendations from the International Consensus on the Use of Genetics in the Management of Hereditary Angioedema, to facilitate the clinical diagnosis and adapt it to the paradigm of precision medicine and next-generation sequencing–based genetic tests, we aimed to develop a genetic annotation tool, termed Hereditary Angioedema Database Annotation (HADA). METHODS HADA is built on top of a database of known variants affecting function, including precomputed pathogenic assessment of each variant and a ranked classification according to the current guidelines from the American College of Medical Genetics and Genomics. RESULTS HADA is provided as a freely accessible, user-friendly web-based interface with versatility for the entry of genetic information. The underlying database can also be incorporated into automated command-line stand-alone annotation tools. CONCLUSIONS HADA can achieve the rapid detection of variants affecting function for different hereditary angioedema types, and further integrates useful information to reduce the diagnosis odyssey and improve its delay.

Insight into interface design of web-based case-based reasoning retrieval systems

2009 ◽  
Vol 36 (3) ◽  
pp. 7280-7287 ◽  
Author(s):  
Wu He ◽  
Feng-Kwei Wang ◽  
Tawnya Means ◽  
Li Da Xu
Keyword(s):  
Interface Design ◽  
Case Based Reasoning ◽  
Web Based ◽  
Retrieval Systems ◽  
Insight Into ◽  
Case Based

Measuring the Conceptual Variables for E-Services Acceptance

2013 ◽  
pp. 302-309
Author(s):  
Kamaljeet Sandhu
Keyword(s):  
User Experience ◽  
Service System ◽  
Descriptive Data ◽  
Web Based ◽  
Electronic Service ◽  
Insight Into ◽  
The Web ◽  
Service Framework

This case study examines the Web Electronic Service framework for a University in Australia. The department is in the process of developing and implementing a Web-based e-service system. The user experience to use e-services requires insight into the attributes that shape the experience variable. The descriptive data about the attributes that form the experience variable is provided in this study.

Web-Based Instructions

2010 ◽  
pp. 302-326
Author(s):  
Mohammed Saleh Al Balawi
Keyword(s):  
Higher Education ◽  
Faculty Attitudes ◽  
Faculty Members ◽  
Current Status ◽  
Critical Factors ◽  
Web Based ◽  
Factors Affecting ◽  
Higher Education System ◽  
Based Instruction ◽  
Insight Into

Factors affecting faculty decisions in the conventional university setup in Saudi Arabia for participating or not participating sin Web-based instruction (WBI) were investigated in this study. Incentives and barriers to WBI, faculty attitudes, and participants’ demographic information were also explored. The study was aimed to investigate the attitudes of the faculty members at three Saudi universities toward WBI in an effort to describe the current status of WBI in the Saudi higher education system. In addition, results of the study could also provide the Saudi universities and the faculty with insight into factors affecting adoption of WBI. Finally, since there have been few implementations of WBI across the country, it was important to explore how WBI is currently used in Saudi universities and to determine critical factors that could affect the implementation of WBI.

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