The distribution of sales revenues from pharmaceutical innovation.

OBJECTIVE: This report updates our earlier work on the returns to pharmaceutical research and development (R&D) in the US (1980 to 1984), which showed that the returns distributions are highly skewed. It evaluates a more recent cohort of new drug introductions in the US (1988 to 1992) and examines how the returns distribution is emerging for drugs with life cycles concentrated in the 1990s versus the 1980s. DESIGN AND SETTING: Methods were described in detail in our earlier reports. The current sample included 110 new drug entities (including 28 orphan drugs), and sales data were obtained for the period 1988 to 1998, which represented between 7 and 11 years of sales for the drugs included. 20 years was chosen as the expected market life for this cohort, and a 2-step procedure was used to project future sales for the drugs--during the period until patent expiry and then beyond patent expiry until the 20-year time-horizon was completed. Thus, the values in the first half of the life cycle are essentially based on realised sales, while those in the second half are projected using information on patent expiry and other inputs. MAIN OUTCOME MEASURES AND RESULTS: Peak annual sales for the top decile of drugs introduced between 1988 and 1992 in the US amounted to almost $US1.1 billion compared with peak sales of less than $US175 million (1992 values) for the mean compound. In particular, the top decile accounted for 56% of overall sales revenue. Although the sales distributions were skewed in both our earlier and current analysis, the top decile in the later time-period exhibited more rapid rates of growth after launch, a peak that was more than 50% greater in real terms than for the 1980 to 1984 cohort, and a faster rate of expected decline in sales after patent expiry. One factor contributing to the distribution of sales revenues becoming more skewed over time is the orphan drug phenomenon (i.e. most of the orphan drugs are concentrated at the bottom of the distribution). CONCLUSION: The distribution of sales revenues for new drug compounds is highly skewed in nature. In this regard, the top decile of new drugs accounts for more than half of the total sales generated by the 1988 to 1992 cohort analysed. Furthermore, the distribution of sales revenues for this cohort is more skewed than that of the 1980 to 1984 cohort we analysed in previous research.

Assessment of the Spatial and Temporal Distribution of Functional Connectivity in Resting-State BOLD fMRI

Recent research into resting-state functional magnetic resonance imaging (fMRI) has shown that the brain is very active during rest. This thesis work utilizes blood oxygenation level dependent (BOLD) signals to investigate the spatial and temporal functional network information found within resting-state data, and aims to investigate the feasibility of extracting functional connectivity networks using different methods as well as the dynamic variability within some of the methods. Furthermore, this work looks into producing valid networks using a sparsely-sampled sub-set of the original data.

In this work we utilize four main methods: independent component analysis (ICA), principal component analysis (PCA), correlation, and a point-processing technique. Each method comes with unique assumptions, as well as strengths and limitations into exploring how the resting state components interact in space and time.

Correlation is perhaps the simplest technique. Using this technique, resting-state patterns can be identified based on how similar the time profile is to a seed region’s time profile. However, this method requires a seed region and can only identify one resting state network at a time. This simple correlation technique is able to reproduce the resting state network using subject data from one subject’s scan session as well as with 16 subjects.

Independent component analysis, the second technique, has established software programs that can be used to implement this technique. ICA can extract multiple components from a data set in a single analysis. The disadvantage is that the resting state networks it produces are all independent of each other, making the assumption that the spatial pattern of functional connectivity is the same across all the time points. ICA is successfully able to reproduce resting state connectivity patterns for both one subject and a 16 subject concatenated data set.

Using principal component analysis, the dimensionality of the data is compressed to find the directions in which the variance of the data is most significant. This method utilizes the same basic matrix math as ICA with a few important differences that will be outlined later in this text. Using this method, sometimes different functional connectivity patterns are identifiable but with a large amount of noise and variability.

To begin to investigate the dynamics of the functional connectivity, the correlation technique is used to compare the first and second halves of a scan session. Minor differences are discernable between the correlation results of the scan session halves. Further, a sliding window technique is implemented to study the correlation coefficients through different sizes of correlation windows throughout time. From this technique it is apparent that the correlation level with the seed region is not static throughout the scan length.

The last method introduced, a point processing method, is one of the more novel techniques because it does not require analysis of the continuous time points. Here, network information is extracted based on brief occurrences of high or low amplitude signals within a seed region. Because point processing utilizes less time points from the data, the statistical power of the results is lower. There are also larger variations in DMN patterns between subjects. In addition to boosted computational efficiency, the benefit of using a point-process method is that the patterns produced for different seed regions do not have to be independent of one another.

This work compares four unique methods of identifying functional connectivity patterns. ICA is a technique that is currently used by many scientists studying functional connectivity patterns. The PCA technique is not optimal for the level of noise and the distribution of the data sets. The correlation technique is simple and obtains good results, however a seed region is needed and the method assumes that the DMN regions is correlated throughout the entire scan. Looking at the more dynamic aspects of correlation changing patterns of correlation were evident. The last point-processing method produces a promising results of identifying functional connectivity networks using only low and high amplitude BOLD signals.

Application description and policy model in collaborative environment for sharing of information on epidemiological and clinical research data sets.

BACKGROUND: Sharing of epidemiological and clinical data sets among researchers is poor at best, in detriment of science and community at large. The purpose of this paper is therefore to (1) describe a novel Web application designed to share information on study data sets focusing on epidemiological clinical research in a collaborative environment and (2) create a policy model placing this collaborative environment into the current scientific social context. METHODOLOGY: The Database of Databases application was developed based on feedback from epidemiologists and clinical researchers requiring a Web-based platform that would allow for sharing of information about epidemiological and clinical study data sets in a collaborative environment. This platform should ensure that researchers can modify the information. A Model-based predictions of number of publications and funding resulting from combinations of different policy implementation strategies (for metadata and data sharing) were generated using System Dynamics modeling. PRINCIPAL FINDINGS: The application allows researchers to easily upload information about clinical study data sets, which is searchable and modifiable by other users in a wiki environment. All modifications are filtered by the database principal investigator in order to maintain quality control. The application has been extensively tested and currently contains 130 clinical study data sets from the United States, Australia, China and Singapore. Model results indicated that any policy implementation would be better than the current strategy, that metadata sharing is better than data-sharing, and that combined policies achieve the best results in terms of publications. CONCLUSIONS: Based on our empirical observations and resulting model, the social network environment surrounding the application can assist epidemiologists and clinical researchers contribute and search for metadata in a collaborative environment, thus potentially facilitating collaboration efforts among research communities distributed around the globe.

Distribution of HPV genotypes in cervical intraepithelial lesions and cervical cancer in Tanzanian women.

BACKGROUND: Infection with human papillomavirus (HPV) is associated with uterine cervical intraepithelial neoplasia (CIN) and invasive cancers (ICC). Approximately 80% of ICC cases are diagnosed in under-developed countries. Vaccine development relies on knowledge of HPV genotypes characteristic of LSIL, HSIL and cancer; however, these genotypes remain poorly characterized in many African countries. To contribute to the characterization of HPV genotypes in Northeastern Tanzania, we recruited 215 women from the Reproductive Health Clinic at Kilimanjaro Christian Medical Centre. Cervical scrapes and biopsies were obtained for cytology and HPV DNA detection. RESULTS: 79 out of 215 (36.7%) enrolled participants tested positive for HPV DNA, with a large proportion being multiple infections (74%). The prevalence of HPV infection increased with lesion grade (14% in controls, 67% in CIN1 cases and 88% in CIN2-3). Among ICC cases, 89% had detectable HPV. Overall, 31 HPV genotypes were detected; the three most common HPV genotypes among ICC were HPV16, 35 and 45. In addition to these genotypes, co-infection with HPV18, 31, 33, 52, 58, 68 and 82 was found in 91% of ICC. Among women with CIN2-3, HPV53, 58 and 84/83 were the most common. HPV35, 45, 53/58/59 were the most common among CIN1 cases. CONCLUSIONS: In women with no evidence of cytological abnormalities, the most prevalent genotypes were HPV58 with HPV16, 35, 52, 66 and 73 occurring equally. Although numerical constraints limit inference, findings that 91% of ICC harbor only a small number of HPV genotypes suggests that prevention efforts including vaccine development or adjuvant screening should focus on these genotypes.

Spatial distribution of bednet coverage under routine distribution through the public health sector in a rural district in Kenya.

Insecticide-treated nets (ITNs) are one of the most important and cost-effective tools for malaria control. Maximizing individual and community benefit from ITNs requires high population-based coverage. Several mechanisms are used to distribute ITNs, including health facility-based targeted distribution to high-risk groups; community-based mass distribution; social marketing with or without private sector subsidies; and integrating ITN delivery with other public health interventions. The objective of this analysis is to describe bednet coverage in a district in western Kenya where the primary mechanism for distribution is to pregnant women and infants who attend antenatal and immunization clinics. We use data from a population-based census to examine the extent of, and factors correlated with, ownership of bednets. We use both multivariable logistic regression and spatial techniques to explore the relationship between household bednet ownership and sociodemographic and geographic variables. We show that only 21% of households own any bednets, far lower than the national average, and that ownership is not significantly higher amongst pregnant women attending antenatal clinic. We also show that coverage is spatially heterogeneous with less than 2% of the population residing in zones with adequate coverage to experience indirect effects of ITN protection.

The reminiscence bump in the temporal distribution of the best football players of all time: Pelé, Cruijff or Maradona?

The reminiscence bump is the tendency to recall more autobiographical memories from adolescence and early adulthood than from adjacent lifetime periods. In this online study, the robustness of the reminiscence bump was examined by looking at participants' judgements about the quality of football players. Dutch participants (N = 619) were asked who they thought the five best players of all time were. The participants could select the names from a list or enter the names when their favourite players were not on the list. Johan Cruijff, Pelé, and Diego Maradona were the three most often mentioned players. Participants frequently named football players who reached the midpoint of their career when the participants were adolescents (mode = 17). The results indicate that the reminiscence bump can also be identified outside the autobiographical memory domain.

The temporal distribution of autobiographical memory: changes in reliving and vividness over the life span do not explain the reminiscence bump.

When autobiographical memories are elicited with word cues, personal events from middle childhood to early adulthood are overrepresented compared to events from other periods. It is, however, unclear whether these memories are also associated with greater recollection. In this online study, we examined whether autobiographical memories from adolescence and early adulthood are recollected more than memories from other lifetime periods. Participants rated personal events that were elicited with cue words on reliving or vividness. Consistent with previous studies, most memories came from the period in which the participants were between 6 and 20 years old. The memories from this period were not relived more or recalled more vividly than memories from other lifetime periods, suggesting that they do not involve more recollection. Recent events had higher levels of reliving and vividness than remote events, and older adults reported a stronger recollective experience than younger adults.

The distribution of early childhood memories.

The quantitative distribution of autobiographical memories for the first decade of life is described. The distribution, based on over 11,000 autobiographical memories from age 10 and younger from published studies, is nearly identical for males and females, for participants of different ages, and for different methods of collecting data, including using words to cue memories from anywhere in the lifespan or from just the childhood years, exhaustive listing of all early memories, and interviews.

Knowledge and judgments about events that occurred prior to birth: The measurement of the persistence of information

Data from five laboratories using five different techniques were reanalyzed to measure subjects' knowledge of events that occurred over the past 70 years. Subjects were about 20 years of age, so the measures included events that extended up to 50 years before birth. The functions relating knowledge about the events to age do not decrease precipitously at birth but gradually drop to above-chance levels. Techniques usually used to study retention within the individual can be used to study the persistence of ideas and fashions within an age cohort in a culture.

Distribution of important and word-cued autobiographical memories in 20-, 35-, and 70-year-old adults.

For word-cued autobiographical memories, older adults had an increase, or bump, from the ages 10 to 30. All age groups had fewer memories from childhood than from other years and a power-function retention for memories from the most recent 10 years. There were no consistent differences in reaction times and rating scale responses across decades. Concrete words cued older memories, but no property of the cues predicted which memories would come from the bump. The 5 most important memories given by 20- and 35-year-old participants were distributed similarly to their word-cued memories, but those given by 70-year-old participants came mostly from the single 20-to-30 decade. No theory fully accounts for the bump.

The distribution of autobiographical memories across the lifespan.

Words were used to cue autobiographical memories from 20- and 70-year-old subjects. Both groups showed a decrease in memories from the childhood years and a power-function retention function for their most recent 10 years. Older subjects also had an increase in the number of memories from the ages 10 to 30. These results held for individual subjects as well as grouped data and held when either 124 or 921 memories were cued. Reaction times to produce memories were constant across decades except for childhood where they were longer.