Penbactam for Helicobacter pylori eradication: A randomised comparison of quadruple and triple treatment schedules in an Iranian population

Background & study aims: Selection of the best drug regimens for eradication of Helicobacter pylori infection especially in patients at risk of peptic ulcer relapses and the development of complications is challenging. This study assessed and compared the efficacy of the two common PPI based triple therapies to a quadruple therapy including PPI, metronidazole, amoxicillin and a bismuth compound in Iranian population. Patients & Methods: Three hundred and thirty patients with peptic ulcer and H. pylori infection were included in the study. Patients were randomly assigned to one of the three treatment protocols all given twice daily: (a) A 14-day quadruple therapy (OMAB group) comprising omeprazole 20. mg, metronicazole 500. mg, amoxicillin 1. g, and bismuth subcitrate 240. mg; (b) A 14-day triple regimen (OCP group) comprising omeprazole 20. mg plus clarithromycine 500. mg and penbactam 750. mg and (c) A 14-day triple regimen (OCA group) comprising omeprazole 20. mg plus clarithromycine 500. mg and amoxicillin 1. g. Cure was defined as a negative urea breath test at least six weeks after treatment. Results: The per-protocol eradication rates achieved with both OCP regimen (87.0%) and OCA treatment (90.8%) were significantly higher than the OMAB treatment protocol (56.0%); however, no significant difference emerged in eradication rates between the two triple treatment schedules. No significant differences between the groups were found in most side-effects. Conclusion: Two-week quadruple therapy showed a lower eradication rate compared to common triple treatment schedules when used as first-line eradication treatment for H. pylori infection in Iranian population. © 2012 Arab Journal of Gastroenterology

Overview on Patient Centricity in Cancer Care

Successful implementation of treatment in cancer care partially depends on how patients’ perspectives are taken into account, as preferences of health care professionals and patients may differ. Objectives of this exploratory research were I) to identify patient preferences and values (PPVs) in cancer care as indicated by patient organizations (POs), II) to determine how these PPVs are captured in cancer care guidelines and III) to review how guidelines take into account these PPVs. Based on a survey developed and completed by 19 POs, a literature review was conducted to analyse how patient perspectives are incorporated in oncology treatment guidelines. Based on survey results traditional health technology assessment value propositions of oncology care, such as extended life, treatment-free remission and pain reduction, were also highly rated by POs. However, the heterogeneity of cancer PPVs were clearly reflected in the survey results. PPVs in cancer care guidelines were mostly limited to those micro-level aspects that are strictly related to health care provision, such as side-effects and comorbidities. Patient experience, emotional support and convenience of care were relatively neglected fields in the reviewed guidelines. Patient engagement was rarely presented in the guideline development phase. POs believe that patients should be encouraged to take an active role in their own care due to the heterogeneity of cancer patients and PPVs. Even if patient-centricity is a leading paradigm in cancer policy, based on our research it is not yet standard practice to include patients or POs at all appropriate levels of decision-making processes that are related to their health and well-being. Patient engagement should be an integral part of cancer care decision-making. This complexity must be reflected throughout policy making, avoiding a population level ‘one-size-fits-all’ solution

Investigation of the Effects of Hydrodynamic and Parasitic Electrostatic Forces on the Dynamics of a High Aspect Ratio MEMS Accelerometer

AbstractWe present the results of an extensive characterization of physical and electrostatic effects influencing the dynamical behavior of a micro-electromechanical (MEMS) accelerometer based on commercial technology. A similar device has been utilized recently to demonstrate the effect of Casimir and other nano-scale interactions on the pull-in distance [Ardito et. al., Microelectron. Reliab., 52 (2012) 271]. In the present work, we focus on the influence of pressure, plate separation, and electric surface potentials on the spectral mechanical response. We finally find evidence for the presence of non-viscous damping due to compressibility of the ambient gas, and demonstrate a strong dependence of the sensitivity on the parameters of the operating point

Asymmetric Organocatalysis in Deep Eutectic Solvents

The recent advances in asymmetric organocatalysis using eutectic mixtures as a reaction medium are revised in this mini‐review. In addition, the first enantioselective transformations using chiral eutectic solvents, which play the role of a green medium and organocatalyst, are described. In this mini‐review we intend to deepen not only in the synthetic aspects of asymmetric organocatalysis in eutectic mixtures, but also in the fundamental issues that seem to be essential for a successful development of this promising, and at the same time challenging, methodology.This work was supported by the Spanish Ministerio de Ciencia, Innovación y Universidades (MICINN, PGC2018-096616-B-I00), the University of Alicante (VIGROB-173 and VIGROB-316FI), and the University of Pisa (PRA_2018_36)

The burden of kidney cancer and its attributable risk factors in 195 countries and territories, 1990�2017

Kidney cancer globally accounts for more than 131,000 deaths each year and has been found to place a large economic burden on society. However, there are no recent articles on the burden of kidney cancer across the world. The aim of this study was to present a status report on the incidence, mortality and disability-adjusted life years (DALYs) associated with kidney cancer in 195 countries, from 1990 to 2017. Vital registration and cancer registry data (total of 23,660 site-years) were used to generate the estimates. Mortality was estimated first and the incidence and DALYs were calculated based on the estimated mortality values. All estimates were presented as counts and age-standardised rates per 100,000 population. The estimated rates were calculated by age, sex and according to the Socio-Demographic Index (SDI). In 2017, kidney cancer accounted for 393.0 thousand (95 UI: 371.0�404.6) incident cases, 138.5 thousand (95 UI: 128.7�142.5) deaths and 3.3 million (95 UI: 3.1�3.4) DALYs globally. The global age-standardised rates for the incidence, deaths and DALY were 4.9 (95 UI: 4.7�5.1), 1.7 (95 UI: 1.6�1.8) and 41.1 (95 UI: 38.7�42.5), respectively. Uruguay 15.8 (95% UI: 13.6�19.0) and Bangladesh 1.5 (95% UI: 1.0�1.8) had highest and lowest age-standardised incidence rates, respectively. The age-standardised death rates varied substantially from 0.47 (95% UI: 0.34�0.58) in Bangladesh to 5.6 (95% UI: 4.6�6.1) in the Czech Republic. Incidence and mortality rates were higher among males, than females, across all age groups, with the highest rates for both sexes being observed in the 95+ age group. Generally, positive associations were found between each country�s age-standardised DALY rate and their corresponding SDI. The considerable burden of kidney cancer was attributable to high body mass index (18.5%) and smoking (16.6%) in both sexes. There are large inter-country differences in the burden of kidney cancer and it is generally higher in countries with a high SDI. The findings from this study provide much needed information for those in each country that are making health-related decisions about priority areas, resource allocation, and the effectiveness of prevention programmes. The results of our study also highlight the need for renewed efforts to reduce exposure to the kidney cancer risk factors and to improve the prevention and the early detection of this disease. © 2020, The Author(s)

Global, regional, and national burden of chronic kidney disease, 1990–2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background Health system planning requires careful assessment of chronic kidney disease (CKD) epidemiology, but data for morbidity and mortality of this disease are scarce or non-existent in many countries. We estimated the global, regional, and national burden of CKD, as well as the burden of cardiovascular disease and gout attributable to impaired kidney function, for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We use the term CKD to refer to the morbidity and mortality that can be directly attributed to all stages of CKD, and we use the term impaired kidney function to refer to the additional risk of CKD from cardiovascular disease and gout. Methods The main data sources we used were published literature, vital registration systems, end-stage kidney disease registries, and household surveys. Estimates of CKD burden were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool, and included incidence, prevalence, years lived with disability, mortality, years of life lost, and disability-adjusted life-years (DALYs). A comparative risk assessment approach was used to estimate the proportion of cardiovascular diseases and gout burden attributable to impaired kidney function. Findings Globally, in 2017, 1·2 million (95% uncertainty interval [UI] 1·2 to 1·3) people died from CKD. The global all-age mortality rate from CKD increased 41·5% (95% UI 35·2 to 46·5) between 1990 and 2017, although there was no significant change in the age-standardised mortality rate (2·8%, −1·5 to 6·3). In 2017, 697·5 million (95% UI 649·2 to 752·0) cases of all-stage CKD were recorded, for a global prevalence of 9·1% (8·5 to 9·8). The global all-age prevalence of CKD increased 29·3% (95% UI 26·4 to 32·6) since 1990, whereas the age-standardised prevalence remained stable (1·2%, −1·1 to 3·5). CKD resulted in 35·8 million (95% UI 33·7 to 38·0) DALYs in 2017, with diabetic nephropathy accounting for almost a third of DALYs. Most of the burden of CKD was concentrated in the three lowest quintiles of Socio-demographic Index (SDI). In several regions, particularly Oceania, sub-Saharan Africa, and Latin America, the burden of CKD was much higher than expected for the level of development, whereas the disease burden in western, eastern, and central sub-Saharan Africa, east Asia, south Asia, central and eastern Europe, Australasia, and western Europe was lower than expected. 1·4 million (95% UI 1·2 to 1·6) cardiovascular disease-related deaths and 25·3 million (22·2 to 28·9) cardiovascular disease DALYs were attributable to impaired kidney function. Interpretation Kidney disease has a major effect on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for cardiovascular disease. CKD is largely preventable and treatable and deserves greater attention in global health policy decision making, particularly in locations with low and middle SDI

Applying Contextual integrity to Open Data Publishing

Open data publishing by both corporate and public bodies has increased significantly in recent years and this type of data could soon be developing into a real commodity. However, not all organisations pay sufficient heed to privacy as part of the decision-making process around open data publication, leaving both the organisation and the users whose data they handle vulnerable to privacy breaches. We present a case study in which we applied contextual integrity in practice, working with a UK local authority using real data. This illustrated how privacy can be incorporated into the decision-making process prior to publication taking place. Our results illustrate the application of Nissenbaum's Contextual Integrity Framework (CI) to the open data domain, and shows that CI is usable in practice

Global, regional, and national burden of neck pain in the general population, 1990-2017: Systematic analysis of the Global Burden of Disease Study 2017

Objective: To use data from the Global Burden of Disease Study between 1990 and 2017 to report the rates and trends of point prevalence, annual incidence, and years lived with disability for neck pain in the general population of 195 countries. Design: Systematic analysis. Data source: Global Burden of Diseases, Injuries, and Risk Factors Study 2017. Main outcome measures: Numbers and age standardised rates per 100 000 population of neck pain point prevalence, annual incidence, and years lived with disability were compared across regions and countries by age, sex, and sociodemographic index. Estimates were reported with uncertainty intervals. Results: Globally in 2017 the age standardised rates for point prevalence of neck pain per 100 000 population was 3551.1 (95 uncertainty interval 3139.5 to 3977.9), for incidence of neck pain per 100 000 population was 806.6 (713.7 to 912.5), and for years lived with disability from neck pain per 100 000 population was 352.0 (245.6 to 493.3). These estimates did not change significantly between 1990 and 2017. The global point prevalence of neck pain in 2017 was higher in females compared with males, although this was not significant at the 0.05 level. Prevalence increased with age up to 70-74 years and then decreased. Norway (6151.2 (95 uncertainty interval 5382.3 to 6959.8)), Finland (5750.3 (5058.4 to 6518.3)), and Denmark (5316 (4674 to 6030.1)) had the three highest age standardised point prevalence estimates in 2017. The largest increases in age standardised point prevalence estimates from 1990 to 2017 were in the United Kingdom (14.6 (10.6 to 18.8)), Sweden (10.4 (6.0 to 15.4)), and Kuwait (2.6 (2.0 to 3.2)). In general, positive associations, but with fluctuations, were found between age standardised years lived with disability for neck pain and sociodemographic index at the global level and for all Global Burden of Disease regions, suggesting the burden is higher at higher sociodemographic indices. Conclusions: Neck pain is a serious public health problem in the general population, with the highest burden in Norway, Finland, and Denmark. Increasing population awareness about risk factors and preventive strategies for neck pain is warranted to reduce the future burden of this condition. © 2020 Author(s)