https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(13)62296-5.pdf

Increasing value and reducing waste: addressing inaccessible research.

Rapid advances in artificial intelligence (AI) and automation technologies have the potential to significantly disrupt labor markets. While AI and automation can augment the productivity of some workers, they can replace the work done by others and will likely transform almost all occupations at least to some degree. Rising automation is happening in a period of growing economic inequality, raising fears of mass technological unemployment and a renewed call for policy efforts to address the consequences of technological change. In this paper we discuss the barriers that inhibit scientists from measuring the effects of AI and automation on the future of work. These barriers include the lack of high-quality data about the nature of work (e.g., the dynamic requirements of occupations), lack of empirically informed models of key microlevel processes (e.g., skill substitution and human–machine complementarity), and insufficient understanding of how cognitive technologies interact with broader economic dynamics and institutional mechanisms (e.g., urban migration and international trade policy). Overcoming these barriers requires improvements in the longitudinal and spatial resolution of data, as well as refinements to data on workplace skills. These improvements will enable multidisciplinary research to quantitatively monitor and predict the complex evolution of work in tandem with technological progress. Finally, given the fundamental uncertainty in predicting technological change, we recommend developing a decision framework that focuses on resilience to unexpected scenarios in addition to general equilibrium behavior.

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Toward understanding the impact of artificial intelligence on labor

Objective Self-reports of physical activity (PA) have been the mainstay of measurement in most non-communicable disease (NCD) surveillance systems. To these, other measures are added to summate to a comprehensive PA surveillance system. Recently, some national NCD surveillance systems have started using accelerometers as a measure of PA. The purpose of this paper was specifically to appraise the suitability and role of accelerometers for population-level PA surveillance. Methods A thorough literature search was conducted to examine aspects of the generalisability, reliability, validity, comprehensiveness and between-study comparability of accelerometer estimates, and to gauge the simplicity, cost-effectiveness, adaptability and sustainability of their use in NCD surveillance. Conclusions Accelerometer data collected in PA surveillance systems may not provide estimates that are generalisable to the target population. Accelerometer-based estimates have adequate reliability for PA surveillance, but there are still several issues associated with their validity. Accelerometer-based prevalence estimates are largely dependent on the investigators’ choice of intensity cut-off points. Maintaining standardised accelerometer data collections in long-term PA surveillance systems is difficult, which may cause discontinuity in time-trend data. The use of accelerometers does not necessarily produce useful between-study and international comparisons due to lack of standardisation of data collection and processing methods. To conclude, it appears that accelerometers still have limitations regarding generalisability, validity, comprehensiveness, simplicity, affordability, adaptability, between-study comparability and sustainability. Therefore, given the current evidence, it seems that the widespread adoption of accelerometers specifically for large-scale PA surveillance systems may be premature.

https://bjsm.bmj.com/content/bjsports/49/4/219.full.pdf

Accelerometer-based measures in physical activity surveillance: current practices and issues

Improvements in healthcare and nutrition have generated remarkable increases in life expectancy worldwide. This is one of the greatest achievements of the modern world yet it also presents a grave challenge: as more people survive into later life, more also experience the diseases of old age, including type 2 diabetes (T2D), cardiovascular disease (CVD) and cancer. Developing new ways to improve health in the elderly is therefore a top priority for biomedical research. Although our understanding of the molecular basis of these morbidities has advanced rapidly, effective novel treatments are still lacking. Alternative drug development strategies are now being explored, such as the repurposing of existing drugs used to treat other diseases. This can save a considerable amount of time and money since the pharmacokinetics, pharmacodynamics and safety profiles of these drugs are already established, effectively enabling preclinical studies to be bypassed. Metformin is one such drug currently being investigated for novel applications. The present review provides a thorough and detailed account of our current understanding of the molecular pharmacology and signalling mechanisms underlying biguanide–protein interactions. It also focuses on the key role of the microbiota in regulating age-associated morbidities and a potential role for metformin to modulate its function. Research in this area holds the key to solving many of the mysteries of our current understanding of drug action and concerted effects to provide sustained and long-life health.

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Repurposing metformin: an old drug with new tricks in its binding pockets.

Objective The rapid scale up of antiretroviral treatment (ART) in sub-Saharan Africa (SSA) has resulted in an increased focus on patient adherence. Non-adherence can lead to drug-resistant HIV caused by failure to achieve maximal viral suppression. Optimal treatment requires the identification of patients at high risk of suboptimal adherence and targeted interventions. The aim of this review was to identify and summarise determinants of adherence to ART among HIV-positive adults. Design Systematic review of adherence to ART in SSA from January 2002 to October 2014. Methods A systematic search was performed in 6 databases (PubMed, Cochrane Library, EMBASE, Web of Science, Popline, Global Health Library) for qualitative and quantitative articles. Risk of bias was assessed. A meta-analysis was conducted for pooled estimates of effect size on adherence determinants. Results Of the 4052 articles screened, 146 were included for final analysis, reporting on determinants of 161 922 HIV patients with an average adherence score of 72.9%. Main determinants of non-adherence were use of alcohol, male gender, use of traditional/herbal medicine, dissatisfaction with healthcare facility and healthcare workers, depression, discrimination and stigmatisation, and poor social support. Promoters of adherence included counselling and education interventions, memory aids, and active disclosure among people living with HIV. Determinants of health status had conflicting influence on adherence. Conclusions The sociodemographic, psychosocial, health status, treatment-related and intervention-related determinants are interlinked and contribute to optimal adherence. Clinics providing ART in SSA should therefore design targeted interventions addressing these determinants to optimise health outcomes.

https://gh.bmj.com/content/bmjgh/1/4/e000125.full.pdf

Determinants of adherence to antiretroviral therapy among HIV-positive adults in sub-Saharan Africa: a systematic review

Objectives 
Publication bias may affect the validity of evidence based medical decisions. The aim of this study is to assess whether research outcomes affect the dissemination of clinical trial findings, in terms of rate, time to publication, and impact factor of journal publications.


Methods and Findings 
All drug-evaluating clinical trials submitted to and approved by a general hospital ethics committee between 1997 and 2004 were prospectively followed to analyze their fate and publication. Published articles were identified by searching Pubmed and other electronic databases. Clinical study final reports submitted to the ethics committee, final reports synopses available online and meeting abstracts were also considered as sources of study results. Study outcomes were classified as positive (when statistical significance favoring experimental drug was achieved), negative (when no statistical significance was achieved or it favored control drug) and descriptive (for non-controlled studies). Time to publication was defined as time from study closure to publication. A survival analysis was performed using a Cox regression model to analyze time to publication. Journal impact factors of identified publications were recorded. Publication rate was 48·4% (380/785). Study results were identified for 68·9% of all completed clinical trials (541/785). Publication rate was 84·9% (180/212) for studies with results classified as positive and 68·9% (128/186) for studies with results classified as negative (p<0·001). Median time to publication was 2·09 years (IC95 1·61–2·56) for studies with results classified as positive and 3·21 years (IC95 2·69–3·70) for studies with results classified as negative (hazard ratio 1·99 (IC95 1·55–2·55). No differences were found in publication impact factor between positive (median 6·308, interquartile range: 3·141–28·409) and negative result studies (median 8·266, interquartile range: 4·135–17·157).


Conclusions 
Clinical trials with positive outcomes have significantly higher rates and shorter times to publication than those with negative results. However, no differences have been found in terms of impact factor.

http://diposit.ub.edu/dspace/bitstream/2445/36344/1/619791.pdf

Positive Outcomes Influence the Rate and Time to Publication, but Not the Impact Factor of Publications of Clinical Trial Results

Chitosan nanoparticles as non-viral gene delivery systems: determination of loading efficiency.

Objective To consolidate and assess information on counterfeit medicines subject to pharmaceutical alerts issued by the Peruvian Medicines Regulatory Authority over 18 years (1997–2014) of health monitoring and enforcement.

Design A retrospective review of drug alerts.

Setting A search of the website of the General Directorate of Medicines, Supplies and Drugs (DIGEMID) of the Ministry of Health of Peru for drug alerts issued between 1997 and 2014.

Eligibility criteria Drug alerts related to counterfeit medicines.

Results A total of 669 DIGEMID alerts were issued during the study period, 354 (52.91%) of which cover 1738 cases of counterfeit medicines (many alerts deal with several cases at a time). 1010 cases (58.11%) involved pharmaceutical establishments and 349 (20.08%) involved non-pharmaceutical commercial outlets. In 126 cases (7.25%), counterfeit medicines were seized in an unauthorised trade (without any marketing authorisation); in 253 cases (14.56%) the type of establishment or business associated with the seized product was not identified.

Conclusions Counterfeit medicines are a serious public health problem in Peru. A review of the data cannot determine whether counterfeit medicines in Peru increased during the study period, or if monitoring by different government health agencies highlighted the magnitude of the problem by providing more evidence. The problem is clearly structural, since the majority of cases (58.11% of the total) were detected in legitimate supply chains. Most counterfeit medicines involve staple pharmaceutical products and common dosage forms. Considerable work remains to be done to control the serious problem of counterfeit medicines in Peru.

https://bmjopen.bmj.com/content/bmjopen/6/4/e010387.full.pdf

Counterfeit medicines in Peru: a retrospective review (1997–2014)

This work focuses on analysing the changes in the territorial control of Tortosa during the Umayyad period through three main lines of approach: the administrative organisation of its domains, the implementation of efficient tax policies and tribute collection mechanisms, and military activity regarding fortress construction and troop mobilisation. In this way, this text presents a critical analysis of written and archaeological sources in order to undertake a historical interpretation of the process under study within this territory.

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Territorio, fiscalidad y actividad militar en la formación de un espacio fronterizo. La consolidación de Tortosa como límite extremo del al-Andalus omeya

Josep Maria Suñé

Papers

Positive Outcomes Influence the Rate and Time to Publication, but Not the Impact Factor of Publications of Clinical Trial Results

Chitosan nanoparticles as non-viral gene delivery systems: determination of loading efficiency.

Counterfeit medicines in Peru: a retrospective review (1997–2014)

Territorio, fiscalidad y actividad militar en la formación de un espacio fronterizo. La consolidación de Tortosa como límite extremo del al-Andalus omeya