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Data sharing: not as simple as it seems
Neil Pearce, Allan H Smith
Environmental Health , 2011, DOI: 10.1186/1476-069x-10-107
Abstract: In recent years there has been a major change on the part of funders, particularly in North America, so that data sharing is now considered to be the norm rather than the exception. Data sharing is clearly, in general, a good idea. However, it is not as simple as it seems. The devil is in the detail, and the detail is highly specific to each study, and each potential data recipient. In this paper, we will therefore discuss some of the concerns and caveats which should be taken into account in any data sharing policy, or any individual decision about data sharing.More than twenty years ago, one of us (NP) was involved in a series of studies that identified a beta agonist asthma drug (fenoterol) as the cause of an epidemic of asthma deaths in New Zealand [1]. The accuracy of the data was disputed by other researchers, so prior to publication we organised several reviews, conducted blind, where they sat down with us and reviewed the general practitioner questionnaires and the hospital records (which were the basis for the drug prescribing data); this found that the classification of the data had been accurate [2]. However, following publication, the study findings were strongly disputed by the pharmaceutical company involved [2], and by an 'expert panel' which was assembled by the company [3]. The company requested the raw data for the studies, using the New Zealand Official Information Act, which applies to universities.We checked with the regulations of the New Zealand Medical Research Council, our main funder, and these stated that data could be shared with other 'bona fide researchers', but the decision was to be left up to the researchers who had originally collected the data - it was they who should decide who were 'bona fide researchers' who the data could be shared with. Since we did not consider the company, or its hired consultants, to be 'bona fide researchers' - in fact, we felt they had a vested interest in the issue, and had seriously misrepresented the p
Does comorbidity explain the ethnic inequalities in cervical cancer survival in New Zealand? A retrospective cohort study
Naomi Brewer, Barry Borman, Diana Sarfati, Mona Jeffreys, Steven T Fleming, Soo Cheng, Neil Pearce
BMC Cancer , 2011, DOI: 10.1186/1471-2407-11-132
Abstract: The study involved 1,594 cervical cancer cases registered during 1994-2005. Comorbidity was measured using hospital events data and was classified using the Elixhauser instrument; effects on survival of individual comorbid conditions from the Elixhauser instrument were also assessed. Cox regression was used to estimate adjusted cervical cancer mortality hazard ratios (HRs).Comorbidity during the year before diagnosis was associated with cervical cancer-specific survival: those with an Elixhauser count of ≥3 (compared with a count of zero) had a HR of 2.17 (1.32-3.56). The HR per unit of Elixhauser count was 1.25 (1.11-1.40). However, adjustment for the Elixhauser instrument made no difference to the mortality HRs for Māori and Asian women (compared to 'Other' women), and made only a trivial difference to that for Pacific women. In contrast, concurrent adjustment for 12 individual comorbid conditions from the Elixhauser instrument reduced the Māori HR from 1.56 (1.19-2.05) to 1.44 (1.09-1.89), i.e. a reduction in the excess risk of 21%; and reduced the Pacific HR from 1.95 (1.21-3.13) to 1.62 (0.98-2.68), i.e. a reduction in the excess risk of 35%.Comorbidity is associated with cervical cancer-specific survival in New Zealand, but accounts for only a moderate proportion of the ethnic differences in survival.In 2005, cervical cancer was the ninth most common site of cancer registration for New Zealand females [1], and the incidence and mortality rates were moderately high compared with the rest of the developed world [2]. Incidence and mortality rates are not the same across ethnic groups within New Zealand. For example, in 2005, Māori women had an incidence rate of 9.0, Pacific women 16.3 and 'Other' (predominantly European) women 5.6 per 100,000 women; Māori women had a mortality rate of 6.5, Pacific women 7.1 and 'Other' women 1.4 per 100,000 women [1].We have previously reported demographic differences in cervical cancer survival in New Zealand [3]. Māori and Paci
Tackling Non-Communicable Diseases In Low- and Middle-Income Countries: Is the Evidence from High-Income Countries All We Need?
Shah Ebrahim ,Neil Pearce,Liam Smeeth,Juan P. Casas,Shabbar Jaffar,Peter Piot
PLOS Medicine , 2013, DOI: 10.1371/journal.pmed.1001377
Cigarette Smoking and Risk of Breast Cancer in a New Zealand Multi-Ethnic Case-Control Study
Fiona McKenzie, Lis Ellison-Loschmann, Mona Jeffreys, Ridvan Firestone, Neil Pearce, Isabelle Romieu
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0063132
Abstract: Background The association between breast cancer and tobacco smoke is currently unclear. The aim of this study was to assess the effect of smoking behaviours on the risk of breast cancer among three ethnic groups of New Zealand women. Methods A population-based case-control study was conducted including breast cancer cases registered on the New Zealand Cancer Registry between 2005 and 2007. Controls were matched by ethnicity and 5-year age-group. Logistic regression was used to estimate the association between breast cancer and smoking at different time points across the lifecourse, for each ethnic group. Estimated odds ratios (OR) were adjusted for established risk factors. Results The study comprised 1,799 cases (302 Māori, 70 Pacific, 1,427 non-Māori/non-Pacific) and 2,540 controls (746 Māori, 191 Pacific, 1,603 non-Māori/non-Pacific). There was no clear association between smoking and breast cancer for non-Māori/non-Pacific women, although non-Māori/non-Pacific ex-smokers had statistically significant increased risk of breast cancer when smoking duration was 20 years or more, and this remained significant in the fully adjusted model (OR 1.31, 95% CI 1.03 to 1.66). Māori showed more consistent increased risk of breast cancer with increasing duration among current smokers (<20 years OR 1.61, 95% CI 0.55 to 4.74; 20+ years OR 2.03, 95% CI 1.29 to 3.22). There was a clear pattern of shorter duration since smoking cessation being associated with increased likelihood of breast cancer, and this was apparent for all ethnic groups. Conclusion There was no clear pattern for cigarette smoking and breast cancer incidence in non-Māori/non-Pacific women, but increased risks were observed for Māori and Pacific women. These findings suggest that lowering the prevalence of smoking, especially among Māori and Pacific women, could be important for reducing breast cancer incidence.
Quantifying the Value of Open Source Hard-ware Development  [PDF]
Joshua M. Pearce
Modern Economy (ME) , 2015, DOI: 10.4236/me.2015.61001
Abstract: With the maturation of digital manufacturing technologies like 3-D printing, a new paradigm is emerging of distributed manufacturing in both scientific equipment and consumer goods. Hardware released under free licenses is known as free and open source hardware (FOSH). The availability of these FOSH designs has a large value to those with access to digital manufacturing methods and particularly for scientists with needs for highly-customized low-volume production products. It is challenging to use traditional funding models to support the necessary investment of resources in FOSH development because of the difficulty in quantifying the value of the result. In order to overcome that challenge and harvest the current opportunity in both low-cost scientific equipment and consumer products, this article evaluates the following methods to quantify the value of FOSH design including: 1) downloaded substitution valuation; 2) avoided reproduction valuation and 3) market savings valuation along with additional benefits related to market expansion, scientific innovation acceleration, educational enhancement and medical care improvement. The strengths and weaknesses of these methods are analyzed and the results show that the methods are relatively straight-forward to institute, based on reliable freely-available data, and that they minimize assumptions. A case study of a syringe pump with numerous scientific and medical applications is presented. The results found millions of dollars of economic value from a relatively simple scientific device being released under open-licenses representing orders of magnitude increase in value from conventional proprietary development. The inescapable conclusion of this study is that FOSH development should be funded by organizations interested in maximizing return on public investments particularly in technologies associated with science, medicine and education.
Adenoid cystic carcinoma of the lacrimal gland metastasising to the liver: report of a case
Bashar A Zeidan, Mohammed Abu Hilal, Mohammed Al-Gholmy, Hanan El-Mahallawi, Neil W Pearce, John N Primrose
World Journal of Surgical Oncology , 2006, DOI: 10.1186/1477-7819-4-66
Abstract: We report a rare case of an isolated liver metastasis from a lacrimal gland adenoid cystic carcinoma 20 years after resection of the primary tumour. The patient presented with right upper quadrant pain radiating to the back and shortness of breath of 3 months duration. No local recurrence was detected during a 15 year follow-up with computerized tomography (CT) of the head. Abdominal CT scan demonstrated a solitary liver tumour with no other primary source, and the bone scan was normal. The patient was treated with an extended right hemihepatectomy. The histology revealed a predominantly cribriform tumour with focal areas of basaloid type metastatic lacrimal gland adenoid cystic carcinoma.This case illustrates the unpredictable behaviour of adenoid cystic carcinoma and the need for a life long follow up for these patients after treatment. The possibility of surgical resection for liver metastasis from adenoid cystic carcinoma should always be considered.Adenoid cystic carcinomas (ACC) of the lacrimal gland are rare malignant tumours accounting for 1.6% of all orbital tumours [1-3]. Despite their rarity they are the second most frequent epithelial neoplasms occurring in the lacrimal gland after pleomorphic adenomas [4].They are slow growing tumours, which tend to spread to adjacent structures and occasionally metastasise via haematogenous spread to lungs, brain and bone in decreasing order of frequency [5-8].There are few studies and reports on lacrimal gland ACC describing time interval to presentation of metastases and length of follow-up required [9,10]. The liver is considered a rare site of distant metastasis and when it is involved is usually as part of disseminated disease [7]. To our knowledge, neither solitary liver metastasis, nor metastatic liver resection from a lacrimal gland ACC has been reported.We present a case of an isolated liver metastasis occurring 20 years after initial surgery for lacrimal gland ACC, with no evidence of loco regional, synchrono
Hierarchical Regression for Multiple Comparisons in a Case-Control Study of Occupational Risks for Lung Cancer
Marine Corbin, Lorenzo Richiardi, Roel Vermeulen, Hans Kromhout, Franco Merletti, Susan Peters, Lorenzo Simonato, Kyle Steenland, Neil Pearce, Milena Maule
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0038944
Abstract: Background Occupational studies often involve multiple comparisons and therefore suffer from false positive findings. Semi-Bayes adjustment methods have sometimes been used to address this issue. Hierarchical regression is a more general approach, including Semi-Bayes adjustment as a special case, that aims at improving the validity of standard maximum-likelihood estimates in the presence of multiple comparisons by incorporating similarities between the exposures of interest in a second-stage model. Methodology/Principal Findings We re-analysed data from an occupational case-control study of lung cancer, applying hierarchical regression. In the second-stage model, we included the exposure to three known lung carcinogens (asbestos, chromium and silica) for each occupation, under the assumption that occupations entailing similar carcinogenic exposures are associated with similar risks of lung cancer. Hierarchical regression estimates had smaller confidence intervals than maximum-likelihood estimates. The shrinkage toward the null was stronger for extreme, less stable estimates (e.g., “specialised farmers”: maximum-likelihood OR: 3.44, 95%CI 0.90–13.17; hierarchical regression OR: 1.53, 95%CI 0.63–3.68). Unlike Semi-Bayes adjustment toward the global mean, hierarchical regression did not shrink all the ORs towards the null (e.g., “Metal smelting, converting and refining furnacemen”: maximum-likelihood OR: 1.07, Semi-Bayes OR: 1.06, hierarchical regression OR: 1.26). Conclusions/Significance Hierarchical regression could be a valuable tool in occupational studies in which disease risk is estimated for a large amount of occupations when we have information available on the key carcinogenic exposures involved in each occupation. With the constant progress in exposure assessment methods in occupational settings and the availability of Job Exposure Matrices, it should become easier to apply this approach.
Vascular Supply to the Liver: A Report of a Rare Arterial Variant
Peter B. Johnson,Shamir O. Cawich,Sundeep Shah,Michael T. Gardner,Patrick Roberts,Brian Stedman,Neil W. Pearce
Case Reports in Radiology , 2013, DOI: 10.1155/2013/969327
Abstract: In the classic description of hepatic arterial supply, the common hepatic artery originates from the coeliac trunk. However, there are numerous variations to this classic pattern. We report a rare variant pattern of hepatic arterial supply and discuss the clinical significance of this variation. 1. Introduction In the classic description of the arterial supply to the liver, the coeliac trunk trifurcates into left gastric, splenic, and common hepatic arteries [1–5]. The common hepatic then bifurcates at its termination into the proper hepatic artery and gastroduodenal arteries [1–5]. However, there are numerous variations to this classic pattern. Michels [6] first described variants of the classic anatomy of the hepatic arteries in 1953. Based on a series of cadaveric dissections, Michels [7] then proposed a classification system that described ten anatomic variants. The classification is in common use to describe variant hepatic arterial branching patterns and allows standardization of anatomic descriptions [8]. We report a variant that is not described by the Michels’ classification [7]. 2. Case Report A 59-year-old female patient with a diagnosis of locally advanced invasive ductal carcinoma of the left breast was referred for a staging CT scan of the abdomen and pelvis. The scan was done using a Philips Brilliance 64 slice multidetector CT scanner. Nonionic contrast media (Ultravist 300) in a volume of 100?mLs were administered via pressure injector at a rate of 3.5?mL/min. The liver was found to be normal; however, she had evidence of metastases to the spleen, several vertebrae, and the pelvis. An incidental finding of abnormal arterial branching was noted at the upper abdominal aorta (Figures 1 and 2). The left gastric artery originated directly from the anterior surface of the abdominal aorta shortly after it entered the abdomen through the diaphragmatic hiatus. Thereafter, it followed its normal course along the lesser curvature of the stomach. At the level of the first lumbar vertebra, there was a large arterial trunk originating from the anterior surface of the aorta, consistent with the celiacomesenteric trunk described by Ishigami et al. [9]. After coursing 2.5?cm, the celiacomesenteric trunk bifurcated into the superior mesenteric artery and the coeliac trunk that was unusually long and tortuous (Figure 3). The splenic artery coursed to the left over the superior mesenteric artery and vein toward the splenic hilum where it divided into segmental arteries to supply the spleen in normal fashion. The left hepatic took an early origin directly
Stem Cells and Neuroprotection: Understanding the Players
Virginia Pearce
International Journal of Molecular Sciences , 2010, DOI: 10.3390/ijms11093288
Abstract: The use of neuroprotective therapies begs the question of how such therapies could affect preexisting stem cell populations within the host, as well as those introduced through cell-replacement therapy. Multiple mechanisms may mediate stem cell responses to neuroprotectants such as host/donor age and gender, cellular lineage/differentiation status, and mitochondrial dynamics. Current therapeutic sources for stem cells are embryonic, somatic, or induced pluripotent, with very little known about the effects of gender, age, cell type, and mitochondrial dynamics. With the advent of therapies to stimulate and recruit endogenous stem cells or transplant donor cells into damage areas in the hopes of recuperative regeneration of lost neurons, it is important to discuss mechanisms that dictate the winning players in the neuroprotection game. This review will focus on our current understanding of the characteristics of renewing stem cells that may affect neuroprotection.
Lessons for Liberalism: Lord Brougham's Philosophy of Italian Politics
Pearce, Colin
Nordicum-Mediterraneum , 2009,
Abstract: In this paper I attempt to give an historically accurate statement of the fundamentals of Henry Peter Brougham, First Baron Brougham and Vaux's (1778-1867) political philosophy and to show how he seeks guidance in his development of this philosophy from the materials of history in general and Italian history in particular. The article seeks to explain Brougham's view that history should be written in a "non-historicist," "objective," "absolutist" and "judgmental" manner and that this position is linked to his belief that there are rationally demonstrable supreme objects of legitimate government which can be shown to be obligatory on all governments at all times however much the prevailing historical conditions may limit or condition actual practical choices. Brougham will be shown to be a proponent of representative, popular government over an extended territory as the best means to attaining the legitimate objects of government in the form of domestic order and external security. Brougham comes to this conclusion while being aware of the great advantages to be had from the absolute rule of one wise and virtuous monarch and the necessity for a purely democratic constitution when the conditions of public enlightenment and social advancement have reached their apogee. In outlining this portrait the article indicates some of the connecting links between Brougham's thought and that of both ancient and modern political philosophers as it was known to him. We find in Brougham a certain blend or melding of various strands within the tradition of liberal thought which as a central figure in the politics of the British Empire during the first third of the nineteenth century he was able to advance on the practical level. It is the hope of this article to contribute in some small way to the re-discovery of a heretofore undeservedly neglected or at least underestimated historical figure.
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