Towards a transparent, credible, evidence-based decision-making process of new drug listing on the Hong Kong Hospital Authority Drug Formulary: challenges and suggestions

The aim of this article is to describe the process, evaluation criteria, and possible outcomes of decision-making for new drugs listed in the Hong Kong Hospital Authority Drug Formulary in comparison to the health technology assessment (HTA) policy overseas. Details of decision-making processes including the new drug listing submission, Drug Advisory Committee (DAC) meeting, and procedures prior to and following the meeting, were extracted from the official Hong Kong Hospital Authority drug formulary management website and manual. Publicly-available information related to the new drug decision-making process for five HTA agencies [the National Institute of Health and Care Excellence (NICE), the Scottish Medicines Consortium (SMC), the Australia Pharmaceutical Benefits Advisory Committee (PBAC), the Canadian Agency for Drugs and Technologies in Health (CADTH), and the New Zealand Pharmaceutical Management Agency (PHARMAC)] were reviewed and retrieved from official documents from public domains. The DAC is in charge of systemically and critically appraising new drugs before they are listed on the formulary, reviewing submitted applications, and making the decision to list the drug based on scientific evidence to which safety, efficacy, and cost-effectiveness are the primary considerations. When compared with other HTA agencies, transparency of the decision-making process of the DAC, the relevance of clinical and health economic evidence, and the lack of health economic and methodological input of submissions are the major challenges to the new-drug listing policy in Hong Kong. Despite these challenges, this review provides suggestions for the establishment of a more transparent, credible, and evidence-based decision-making process in the Hong Kong Hospital Authority Drug Formulary. Proposals for improvement in the listing of new drugs in the formulary should be a priority of healthcare reforms

Mechanical compression to characterize the robustness of liquid marbles

In this work, we have devised a new approach to measure the critical pressure that a liquid marble can withstand. A liquid marble is gradually squeezed under a mechanical compression applied by two parallel plates. It ruptures at a sufficiently large applied pressure. Combining the force measurement and the high-speed imaging, we can determine the critical pressure that ruptures the liquid marble. This critical pressure, which reflects the mechanical robustness of liquid marbles, depends on the type and size of the stabilizing particles as well as the chemical nature of the liquid droplet. By investigating the surface of the liquid marble, we attribute its rupture under the critical pressure to the low surface coverage of particles when highly stretched. Moreover, the applied pressure can be reflected by the inner Laplace pressure of the liquid marble considering the squeezing test is a quasi-static process. By analyzing the Laplace pressure upon rupture of the liquid marble, we predict the dependence of the critical pressure on the size of the liquid marble, which agrees well with experimental results

Coalescence of electrically charged liquid marbles

© The Royal Society of Chemistry. In this work, we investigated the coalescence of liquid water marbles driven by a DC electric field. We have found that two contacting liquid marbles can be forced to coalesce when they are charged by a sufficiently high voltage. The threshold voltage leading to the electro-coalescence sensitively depends on the stabilizing particles as well as the surface tension of the aqueous phase. By evaluating the electric stress and surface tension effect, we attribute such coalescence to the formation of a connecting bridge driven by the electric stress. This liquid bridge subsequently grows and leads to the merging of the marbles. Our interpretation is confirmed by the scaling relation between the electric stress and the restoring capillary pressure. In addition, multiple marbles in a chain can be driven to coalesce by a sufficiently high threshold voltage that increases linearly with the number of the marbles. We have further proposed a simple model to predict the relationship between the threshold voltage and the number of liquid marbles, which agrees well with the experimental results. The concept of electro-coalescence of liquid marbles can be potentially useful in their use as containers for chemical and biomedical reactions involving multiple reagents

Strange-Beauty Meson Production at ppˉp\bar p Colliders

The production rates and transverse momentum distributions of the strange-beauty mesons $B_s$ and $B_s^*$ at $p\bar p$ colliders are calculated assuming fragmentation is the dominant process. Results are given for the Tevatron in the large transverse momentum region, where fragmentation is expected to be most important.Comment: Minor changes in the discussion section. Also available at http://www.ph.utexas.edu/~cheung/paper.htm

Beauty Quark Fragmentation Into Strange B Mesons

Using the recent measurement of the total production rate for $B_s$ and $B_s^*$ mesons in electron-positron annihilation to determine the strange quark mass parameter in the $\bar b\to B_s,\, B_s^*$ fragmentation functions we calculate the momentum distributions of the $B_s$ and $B_s^*$ mesons.Comment: 8 pages, 2 figures (not included but available upon request), standard LaTeX file, Report # NUHEP-TH-94-1

Diabetes and Hypertension: Is There a Common Metabolic Pathway?

Diabetes and hypertension frequently occur together. There is substantial overlap between diabetes and hypertension in etiology and disease mechanisms. Obesity, inflammation, oxidative stress, and insulin resistance are thought to be the common pathways. Recent advances in the understanding of these pathways have provided new insights and perspectives. Physical activity plays an important protective role in the two diseases. Knowing the common causes and disease mechanisms allows a more effective and proactive approach in their prevention and treatment

Urotensin II and the Circulatory System

Urotensin II (UII), first isolated from the spinal cord of teleost fish, is the most potent vasoconstrictor known. It is more potent than endothelin-1 and acts through UT-II, a seven-transmembrane-domain, G-protein-coupled receptor. Human UII is an 11-amino-acid cyclic peptide that is expressed in various tissues, including the central nervous system, heart, kidney, and blood vessels. It circulates in human plasma, and its plasma level is elevated in renal failure, congestive heart failure, diabetes, and portal hypertension. In the kidney, UII has vasodilatory and natriuretic effects, mediated through nitric oxide. The development of UII-receptor antagonists may provide a useful research tool, and a novel treatment for cardiorenal diseases