Challenges and opportunities of sharing animal health data for research and disease management: a case study of bovine tuberculosis.

The sharing of animal disease data should be encouraged. The analysis of such data will broaden our knowledge of animal diseases and potentially provide insights into their management. However, the need to conform to data protection rules in the sharing of such data for analysis purposes often poses practical difficulties. This paper sets out the challenges and the methods used for the sharing of animal health data in England, Scotland and Wales - Great Britain - using bovine tuberculosis (bTB) data as a case study. The data sharing described is undertaken by the Animal and Plant Health Agency on behalf of the Department for Environment, Food and Rural Affairs and the Welsh and Scottish Governments. It should be noted that animal health data are held at the level of Great Britain (rather than the United Kingdom - which includes Northern Ireland), as Northern Ireland's Department of Agriculture, Environment and Rural Affairs has its own separate data systems. Bovine tuberculosis is the most significant and costly animal health problem facing cattle farmers in England and Wales. It can be devastating for farmers and farming communities and the control costs for taxpayers in Great Britain are over £150 million a year. The authors describe two methods of data sharing - first, where data are requested by, and delivered to, an academic institution for epidemiological or scientific analysis, and second, where data are proactively published in an accessible and meaningful way. They provide details of an example of the second method, namely, the free-to-access website â€Ëœinformation bovine TB' (https://ibtb.co.uk), which publishes bTB data for the benefit of the farming community and veterinary health professionals.

L'échange et le partage de données sur les maladies animales sont des pratiques à encourager. En effet, l'analyse de ces données permet d'étoffer les connaissances sur les maladies animales et peut aussi apporter un nouvel éclairage sur leur gestion. Néanmoins, la nécessité de se conformer aux règles sur la protection des données pose souvent des difficultés pratiques lors des échanges de ce type de données à des fins d'analyse. Les auteurs expliquent les difficultés rencontrées en matière d'échange de données de santé animale en Angleterre, en écosse et au Pays de Galles (Grande-Bretagne), ainsi que les méthodes utilisées, à partir de l'exemple concret des données relatives à la tuberculose bovine. L'échange et le partage de données sont réalisés par l'Agence britannique de santé animale et végétale, pour le compte du ministère britannique de l'Environnement, de l'Alimentation et des Affaires rurales et des gouvernements gallois et écossais. Il convient de préciser que les données de santé animale dont il s'agit sont celles conservées au niveau de la Grande-Bretagne seulement (et non du Royaume-Uni, qui inclut l'Irlande du Nord), étant donné que le ministère de l'Agriculture, de l'Environnement et des Affaires rurales de l'Irlande du Nord possède ses propres systèmes de données. La tuberculose bovine est le principal problème de santé animale auquel sont confrontés les éleveurs de bovins en Angleterre et au Pays de Galles, et le plus coûteux à traiter. La survenue de la tuberculose bovine est une catastrophe pour les éleveurs affectés et leur communauté. En outre, le coût annuel de son contrôle s'élève à plus de 150 millions de livres pour le contribuable britannique. Les auteurs décrivent deux méthodes d'échange et de partage de données : la première est celle où une institution de recherche demande et obtient l'accès à des données particulières afin de réaliser une étude épidémiologique ou scientifique ; la deuxième consiste à publier les données de manière proactive et constructive, en les rendant facilement accessibles. Un exemple concret de cette deuxième méthode est décrit en détail : il s'agit du site web d'information sur la tuberculose bovine (https://ibtb.co.uk), d'accès libre, qui diffuse des informations sur cette maladie à l'intention des éleveurs et des professionnels de la santé animale.

Convendría alentar la puesta en común de datos zoosanitarios, pues el análisis de estos datos nos ayudará a conocer más y mejor las enfermedades animales y, a la postre, puede darnos pistas sobre la mejor manera de afrontarlas. Ocurre a menudo, sin embargo, que el prescriptivo cumplimiento de las reglas de protección de datos plantee dificultades prácticas para poner estos datos en común con fines de análisis. Los autores, empleando como ejemplo un estudio sobre la tuberculosis bovina, describen esas dificultades y los métodos utilizados para compartir datos zoosanitarios en Inglaterra, Escocia y Gales (Gran Bretaña). En el ejemplo descrito, la Agencia de Sanidad Animal y Vegetal del Reino Unido fue la instancia que impulsó la puesta en común de los datos en nombre del Departamento de Medio Ambiente, Alimentación y Asuntos Rurales del Reino Unido y de los gobiernos galés y escocés. Conviene puntualizar que los datos zoosanitarios cubren el territorio de Gran Bretaña (y no de todo el Reino Unido, que incluye Irlanda del Norte), ya que el Departamento de Medio Ambiente, Alimentación y Asuntos Rurales norirlandés dispone de su propio sistema de datos independiente. La tuberculosis bovina es el problema zoosanitario más importante y oneroso al que hacen frente las explotaciones de vacuno en Inglaterra y Gales. Esta enfermedad no solo puede ser devastadora para los productores y profesionales del sector, sino que la lucha contra ella cuesta al contribuyente británico más de 150 millones de libras al año. Los autores describen dos métodos para compartir de datos: en el primero de ellos, un establecimiento universitario solicita y recibe los datos con fines de análisis científico o epidemiológico; en el segundo, una entidad toma la iniciativa de hacer públicos los datos de forma accesible y coherente. Los autores exponen en detalle un ejemplo del segundo procedimiento, a saber, el sitio web de información sobre la tuberculosis bovina (https://ibtb.co.uk) en libre acceso, en el cual se publican datos sobre la enfermedad dirigidos a los profesionales del sector pecuario y la sanidad animal.

An unusual lightning flash at kennedy space center.

A lightning flash that struck the 150-meter weather tower at Kennedy Space Center was studied by several research groups using varioul techniques. The flash had unusually large peak currents and a stepped leader of relatively short duration. The charged regions neutralized by the three return strokes were located within a horizontal layer between heights of about 6 and 8 kilometers, where environmental temperatures were about -10 degrees to -20 degrees C. The charge source for the first return stroke coincided with a vertical shaft of precipitation inferred to have been graupel or hail. Charge sources for subsequent strokes were near the edge of the detectable precipitation echo. The overall channel length was about 10 kilometers. A Vertically oriented intracloud discharge occurred after the three return strokes.

Amphiphilic conetworks as regenerative controlled releasing antimicrobial coatings.

Bitelechelic polydimethylsiloxanes (PDMS) and 2-hydroxyethylacrylate (HEA)/acrylic acid(AA) were photopolymerized to give nanophase separated amphiphilic 20-mum-thin coatings covalently attached to glass. The coatings quickly take up the antimicrobial surfactant cetyltrimethylammonium chloride (CTAC). After a 30 min loading period the release of CTAC in water was followed by simultaneously measuring both the antimicrobial activity of the coating's surface against Staphylococcus aureus and the release of the structurally related dye Rhodamine B. Depending on the composition the antimicrobial activity remained up to 3 weeks. The influence of different pH, varying sodium chloride concentrations, and the surfactant Pluronic was investigated. However, even in the cases of 160 mM NaCl and 1 wt.% Pluronic as release medium, the antimicrobial activity remained more than 6 days in case of a coating consisting of 45 wt.% PDMS, 31 wt.% PHEA, and 25 wt.% PAA. Mechanistic investigations revealed that the CTAC-loaded coatings act like contact-active surfaces, i.e., they do not kill microbes in the surrounding solution but only on their surface. This supports our hypothesis that the antimicrobial action is due to a concentration gradient of CTAC on the surface, allowing it to be antimicrobial on contact and to release only very low concentration of the biocide into the surrounding.

The dexamethasone suppression test and plasma dexamethasone in generalized anxiety disorder.

A Dexamethasone Suppression Test nonsuppression rate of 27% was found in a group of 30 generalized anxiety disorder patients before treatment. The dexamethasone concentrations in the eight nonsuppressors were significantly lower than in eight suppressors matched by sex and age, but were similar to those in five nonsuppressors from a matched normal control group. The dexamethasone concentrations in the generalized anxiety disorder suppressors and a matched group of eight normal control suppressors were similar. After successful nondrug behavioral treatment, all generalized anxiety disorder patients were suppressors. Posttreatment dexamethasone concentrations in the initial nonsuppressor patients remained significantly lower than in the initial suppressors. The results suggest that low plasma dexamethasone concentrations after 1 mg oral dexamethasone may confer a vulnerability to nonsuppression that may be expressed in the presence of high state anxiety.

The dexamethasone suppression test: importance of dexamethasone concentrations.

Plasma dexamethasone concentrations and cortisol response to dexamethasone were measured in 29 normal healthy volunteers, 23 depressed patients, and 10 patients with anorexia nervosa at 4:00 PM postdexamethasone. In each of the 3 groups, nonsuppressors had lower dexamethasone concentrations than suppressors. Of the subjects with plasma dexamethasone at or below 0.7 ng/ml, a significantly higher proportion (48%) were nonsuppressors compared to the proportion above 0.7 ng/ml (14%), all of whom were patients. Plasma dexamethasone concentrations in a subgroup of depressed nonsuppressors were high (mean 1.35 ng/ml), whereas the remainder were low (0.42 ng/ml) and were similar to the normal nonsuppressors (0.35 ng/ml), suggesting different mechanisms for nonsuppression in the subgroups. Plasma dexamethasone concentrations were similar in nonendogenous and endogenous depressives, in men and women, and in medicated and drug-free patients. None of the variables of age, weight, history of weight loss, Hamilton depression rating score, predexamethasone cortisol, or postdexamethasone cortisol were significantly correlated with plasma dexamethasone, except for body weight and a history of weight loss in the depressed group only. Mean plasma dexamethasone concentrations increased significantly from week 1 to week 2 in 7 depressed patients, whereas plasma cortisol decreased; however, the relationship between dexamethasone and cortisol varied considerably for individual patients.

Dexamethasone kinetics in depressed patients before and after clinical response.

Dexamethasone pharmacokinetics were measured in 19 depressed patients, 10 dexamethasone suppression test (DST) nonsuppressors and nine suppressors, following a 1 mg oral dose in tablet form at 2300 h. Median dexamethasone concentrations were significantly lower in the nonsuppressors from 3-16 hr post-administration. Nonsuppressors had a significantly lower area under the curve than suppressors, and plasma clearance was significantly faster in the nonsuppressors than in the suppressors. Eleven patients, six nonsuppressors and five suppressors, agreed to a repeat DST after clinical improvement when all six nonsuppressors had normal DST responses. There were no significant differences between the median dexamethasone concentrations, or any of the pharmacokinetic parameters measured, of the "normalising" nonsuppressors and the suppressors. Dexamethasone kinetics were altered in depressed nonsuppressors but became normal with remission of depressive symptoms and normalisation of the DST response.

Plasma cortisol and 11-deoxycortisol activity in depressed patients and normal volunteers.

Plasma cortisol and 11-deoxycortisol were measured in 30 depressed patients and 110 normal volunteers before and after a 1.0 mg dexamethasone suppression test (DST). Post-dexamethasone plasma cortisol, 11-deoxycortisol and the cortisol/11-deoxycortisol ratio were significantly higher in the depressives compared to the controls, even when age and sex were taken into account. Pre-dexamethasone plasma cortisol, post-dexamethasone cortisol, 11-deoxycortisol and their ratio were significantly higher in the cortisol nonsuppressors than in the suppressors. The measurement of post-dexamethasone 11-deoxycortisol and the ratio did not differentiate between endogenous and reactive depression. Using the normative data, we explored several methods for determining a criterion value to define abnormal post-dexamethasone plasma 11-deoxycortisol and the cortisol/11-deoxycortisol ratio in depressed patients. All showed poor sensitivity and a low positive predictive value for depression. The measurement of 11-deoxycortisol thus does not enhance the clinical utility of the DST.

The dexamethasone suppression test: a study in a normal population.

One hundred healthy, non-depressed volunteers were given a standard dexamethasone suppression test (DST) to determine the appropriate criterion values of plasma cortisol to define suppression or nonsuppression. By radioimmunoassay (RIA) of cortisol, the criterion value for 5% nonsuppression was plasma cortisol greater than 187 nmol/l, and for suppression less than 153 nmol/l, with an indeterminate range between these values. Use of the widely accepted pre-determined criterion value of 138 nmol/l gave a significantly greater frequency of nonsuppression. Values of cortisol measured by two RIAs in a subset of 43 volunteers were not equivalent. With the experimentally determined criterion value, no significant differences between nonsuppressors and suppressors were found for any measured physical or psychological parameters. Women taking oral contraceptives had significantly higher plasma cortisol pre-dexamethasone and post-dexamethasone. Their exclusion did not alter the calculated criterion value for the remainder, but their separately estimated criterion value was significantly higher. Caution should be exercised when classifying the DST status of women on oral contraceptives, particularly when values are at the lower end of the nonsuppressor range. Determination of a separate normal range for them may be warranted.

Hypomania related to phenelzine and isoetharine interaction in one patient.

A case is reported of a man with apparent unipolar depression that was responsive to treatment with phenelzine who became hypomanic when isoetharine was added to treat his chronic obstructive pulmonary disease. The role of beta-adrenergic receptors in affective illness is reviewed in light of this case.

Anxiety disorder and perception of inspiratory resistive loads.

Sensations of breathlessness in the absence of respiratory disease are common in anxiety disorders. Perceptions of breathlessness in eight patients with anxiety disorder were compared with eight normal control subjects, matched for age and sex, by the application of Steven's law to the magnitude of resistive load test. All subjects estimated the magnitudes of resistive loads to inspiration while peak inspiratory mouth pressures were monitored. Anxious patients' perceptions of the added loads were significantly less sensitive than normal, even though the effort, determined by peak inspiratory mouth pressure, in overcoming each load was normal. Correlations between estimates of resistive loads and peak inspiratory mouth pressure were significantly less for the anxious patients than for normal subjects. Thus, perception of breathlessness in anxiety disorders may be affected by factors not normally associated with breathlessness and may help account for the greater than normal variability in resistive load perception in respiratory disease.

Post-stroke depression.

Depression is present in 25-30% of stroke patients: though associated with physical disability and loss of function, it cannot be explained simply as a response to the disability. The severity of depression correlates with proximity of the lesion to the left anterior frontal pole, while right hemisphere lesions show the reverse trend. Post-stroke depressions may last more than 7-8 months without treatment, and are highly correlated with a failure to resume premorbid social and physical activities. However, this is a group of patients whose recovery could be hastened by appropriate antidepressant treatment, though most antidepressants are of limited value in the treatment of these patients, because of side-effects or possible toxicity. Since moclobemide has few side-effects it may be uniquely well tolerated in this group of patients, having proven efficacy for both endogenous and reactive depressions.

Increased urinary tribulin output in generalised anxiety disorder.

Urinary output of an endogenous monoamine oxidase inhibitor and benzodiazepine receptor binding inhibitor (tribulin) was raised in a group of patients with generalised anxiety disorder compared with controls. Tribulin levels remained relatively constant in individual patients over the 6-week period of observation, mean values remaining high even after reduction of anxiety following non-drug behaviour therapy.

Reversal of diet-induced obesity and diabetes in C57BL/6J mice.

We have previously shown that C57BL/6J (B6) mice develop severe obesity and diabetes if weaned onto high-fat diets, whereas A/J mice tend to be obesity and diabetes-resistant. The purpose of this study was to determine if obesity and diabetes in the B6 mouse could be completely reversed by reducing dietary fat content. After 4 months, both strains consumed more calories on a high-fat diet than on a low-fat diet, and both strains showed a higher feed efficiency (FE=weight gained/calories consumed) on the high-fat diet versus the low-fat diet. However, relative to A/J mice, B6 mice demonstrated a significantly higher FE on the high-fat diet. Hyperglycemia, hyperinsulinemia, and increased adiposity were apparent in B6 mice after 4 months on the high-fat diet regardless of whether the diet was begun at weaning or 4 months later. Correlational analyses showed that adiposity was strongly related to both insulin and glucose levels in B6 mice, but only moderately related to insulin levels in A/J mice. In obese B6 mice that were switched to a low-fat diet, obesity and diabetes were completely reversed. Adiposity, fasting glucose, and fasting insulin values in these mice were equivalent to those in B6 mice of the same age that had spent 8 months on the low-fat diet. In summary, our data show that in the B6 mouse the severity of diabetes is a direct function of obesity and diabetes is completely reversible by reducing dietary fat.

Clinical overview on moclobemide.

1. Moclobemide is a novel benzamide reversible inhibitor of monoamine oxidase A and has clinical efficacy in a wide spectrum of depressive illness including endogenous and non-endogenous depression, in younger adults and in the elderly. 2. Comparisons have shown similar efficacy to all main classes of antidepressants and much greater tolerability and safety in overdose than tricyclic antidepressants. Clinically, it is neither sedative nor alerting. 3. There is no need for dietary restrictions for patients on moclobemide on a normal diet, and drug interactions are few and usually mild. Specific cautions are noted with pethidine and with selective serotonin re-uptake inhibitor antidepressants. 4. Moclobemide is a useful addition to the range of antidepressants in clinical practice.

Comparison of moclobemide with selective serotonin reuptake inhibitors (SSRIs) on sexual function in depressed adults. The Australian and German Study Groups.

OBJECTIVE: To compare the emergent sexual effects of moclobemide and selective serotonin reuptake inhibitors (SSRIs) during acute and maintenance therapy in routine practice. METHOD: 268 patients were evaluated for sexual function at baseline, 6 weeks, 3 and 6 months of treatment using physician ratings and self-rating questionnaires. Patients received moclobemide, an reversible monoamine oxidase A inhibitor (RIMA), or a SSRI (fluoxetine, fluvoxamine, paroxetine, sertraline). RESULTS: Baseline values were similar in all groups. Incidences of impairments of sexual functioning with treatment, whether clinically relevant or not, were 24.3% with moclobemide and 61.5% with SSRIs (physician ratings), with no significant tolerance to these effects. There was a suggestion of differences between the SSRIs in their specific dysfunctions they cause. SSRIs (21.6% of patients) had about ten times the moclobemide rate (1.9%) of sexual dysfunction reported as adverse events. Antidepressant efficacy was comparable between treatments. CONCLUSION: In patients for whom sexual function is important or sexual dysfunction is present, moclobemide should be considered a first line antidepressant.

Reactions of first-year medical students to their initial encounter with a cadaver in the dissecting room.

This study reports the results of a 1986 questionnaire survey of 100 first-year medical students regarding their preparation for and reactions to their first encounter with a human cadaver in the dissecting room. The students were aware of psychological and physical reactions to this experience, and although they felt adequately prepared prior to the class, expressed a desire for greater preparation afterwards, particularly through more discussion of the experience with the anatomy staff. A surprising number of the students (62) had had prior exposure to a dead human body, which was a significant influence upon their reactions. The results of this study suggest a need for improving both the preparation for coping with dissection and the follow-up opportunities for dealing with professional and emotional issues raised during human dissection.

A sequential double-blind controlled study of moclobemide and diazepam in patients with atypical depression.

A double-blind controlled study comparing moclobemide and diazepam in patients with atypical depression was carried out. Statistical comparison of the 14 pairs completing 4 weeks showed that significant reductions in depressive symptomatology as measured by the Hamilton and Carroll depression rating scales occurred in both drug groups, and that diazepam was significantly better than moclobemide. A separate analysis of the 10 pairs completing 8 weeks treatment showed that significant decreases in depression ratings occurred in both drug groups but that by week 8 there was no significant difference between the two drugs for depression scores. Side-effects were minimal, and the most common side-effects emerging for both drugs were sleep disturbance and physical tiredness.

The psychomotor effects of single and repeated doses of hypnotic benzodiazepines.

Benzodiazepine hypnotics are used for short periods in low doses in healthy people when stressed and in patients with insomnia. This study examined psychomotor impairment in healthy young males and females after 1 and 7 nights of flunitrazepam (1 mg), nitrazepam (2.5 mg) and temazepam (10 mg). There were substantial inter-individual variations. Results showed that no drug significantly affected psychomotor performance at these doses after single or repeated administration. The number and severity of side-effects were significantly greater after the first night with temazepam and 7 nights with nitrazepam, although this may reflect a statistical artefact rather than a significant clinical finding. The difficulties in performing adequately controlled psychopharmacological studies at low doses are highlighted. Given the large intra- and inter-subject variances, small drug effects would necessitate large sample sizes (21 to 600 subjects at the 95% level of chance of detection) depending on the variable. The study suggests there is minimal impairment with low dose hypnotic drugs and a need to individualize treatment.

Moclobemide for anxiety disorders: a focus on moclobemide for panic disorder.

Moclobemide is a reversible selective inhibitor of monoamine oxidase A. It has proven efficacy in a wide range of depressive disorders, including agitated anxious depression. In an international, multicentre, double-blind parallel-group study, the tolerability and efficacy of moclobemide were compared with that of the selective serotonin reuptake inhibitor fluoxetine. The target dose of moclobemide was 450 mg/day in the dose range of 300-600 mg/day, while the target dose for fluoxetine was 20 mg/day in the dose range of 10-30 mg/day. There were two consecutive studies. The first was an 8-week short-term study of acute adverse events, tolerability and efficacy. The efficacy data showed no significant difference between moclobemide and fluoxetine. Evaluation of the tolerability in a long-term study of up to 1 year is still in progress. A review of the moclobemide safety database for panic disorder with 624 patients showed a marginal increase in events with moclobemide compared with placebo for insomnia (11.2%), dizziness (4.5%) and dry mouth (3.7%), with rates for headaches and nausea lower for moclobemide than placebo. These data suggest moclobemide is a well tolerated and effective treatment for panic disorder.

The prevalence of eating disorders in thyroid disease: a pilot study.

The aim of this study was to determine the prevalence of eating disorders and partial syndromes in women with thyroid disease. Female patients between the ages of 18 and 45 who attended a specialist thyroid clinic, in 1990, were asked to complete two self-report questionnaires (Bulimic Investigatory Test, Edinburgh, BITE and General Health Questionnaire, GHQ). High scoring patients were invited to attend for a research interview. The case notes of non-responders were examined. Seventy-three patients were entered into the study and 50 subjects returned their questionnaires (69%). Eleven patients scored highly on the BITE, nine of these patients also scoring highly on the GHQ, as did a further 12 patients. Ten patients were interviewed; of these, three patients (4%) met DSM111R criteria for bulimia nervosa and three patients met criteria for an eating disorder not otherwise specified. These results suggest that there is an increased prevalence of eating disorders in women thyroid patients.