Hip Fracture Risk After Treatment with Tramadol or Codeine: An Observational Study

Introduction: Hip fractures among older people are a major public health issue, which can impact quality of life and increase mortality within the year after they occur. A recent observational study found an increased risk of hip fracture in subjects who were new users of tramadol compared with codeine. These drugs have somewhat different indications. Tramadol is indicated for moderate to severe pain and can be used for an extended period; codeine is indicated for mild to moderate pain and cough suppression. Objective: In this observational study, we compared the risk of hip fracture in new users of tramadol or codeine, using multiple databases and analytical methods. Methods: Using data from the Clinical Practice Research Datalink and three US claims databases, we compared the risk of hip fracture after exposure to tramadol or codeine in subjects aged 50–89 years. To ensure comparability, large-scale propensity scores were used to adjust for confounding. Results: We observed a calibrated hazard ratio of 1.10 (95% calibrated confidence interval 0.99–1.21) in the Clinical Practice Research Datalink database, and a pooled estimate across the US databases yielded a calibrated hazard ratio of 1.06 (95% calibrated confidence interval 0.97–1.16). Conclusions: Our results did not demonstrate a statistically significant difference between subjects treated for pain with tramadol compared with codeine for the outcome of hip fracture risk

A literature review of blockchain technology applications in supply chains:A comprehensive analysis of themes, methodologies and industries

In the past few years, blockchain, the underlying technology of Bitcoin, has received considerable attention from academia and industry. It is widely accepted that blockchain technology causes disruptive changes in supply chain operations that can overcome supply chain difficulties encountered in realizing information sharing, maintaining traceability in the entire process and improving operational efficiency. However, the application of blockchain technology in the supply chain field is still in its infancy, which limits an understanding of its potential. This article uses descriptive and content analysis to review publications related to blockchain-based supply chains between 2017 and 2020 inclusive. To fully explore research on blockchain-based supply chains, four well-designed questions are proposed and addressed, namely, the value of blockchain in supply chains, the attraction of scholars to particular supply chain themes, the development of research methodologies and illustration types in adopting blockchain in supply chains, and the types of industries involved in blockchain-based supply chains. The results reveal that there is growing interest in applying blockchain technology to supply chain operations. A detailed analysis of findings is provided to identify the future opportunities of blockchain-based supply chains, including prospects for tertiary industries and concerted efforts that are necessary to explore sustainability themes. This article provides valuable information to help scholars and practitioners better determine the relevant research topics to accelerate the development of blockchain-based supply chains