Optimal Duration of Imatinib Mesylate Therapy in Metastatic Gastrointestinal Stromal Tumours

While current literature provides evidence that imatinib mesylate has significant activity in patients with advanced and metastatic gastrointestinal stromal tumour (GIST), and highlights the potential for the development of anticancer drugs based on specific molecular abnormalities present in cancers, specific recommendations concerning the optimal duration of therapy remain controversial. This case presents the favourable outcome of a patient who originally presented almost 9 years ago with widespread, bulky, metastatic GIST involving the abdomen and pelvis. A sustained, complete response was achieved with imatinib and prompted an interruption in treatment 7 years after initial presentation. The disease reoccurred extensively within 9 months of treatment interruption, but once again rapidly completely responded to the recommencement of imatinib, with that response being now maintained for over 9 months. This report suggests that dramatic and durable responses to imatinib can be achieved in individual cases despite the lack of specific guidelines in the literature with respect to defining how long treatment with imatinib should be continued in the absence of evidence of tumour progression

Tobacco habits : attitudes and beliefs among the Maltese medical and dental profession

Health professionals, particularly doctors and dentists are the vanguard of any society’s battle against tobacco. They are knowledgeable on the impact of tobacco smoking on health and generally receive updated scientific information on this relationship. Doctors and dentists both witness the effects of smoking on their patients, often on a daily basis. They are inevitably viewed as role-models for health related behaviour, influencing that of their patients as well as their families. In their turn patients are quick to point out particular doctors who smoke as a justification for their own habits. It is, therefore, of particular interest to study the habits of doctors and dentists, as well as their attitudes to this particular form of risk behaviour and to assess their collective views.peer-reviewe

Seven star pharmacists

The seven star pharmacist is care-giver, decision-maker, communicator, manager, life-long-learner, teacher and leader.1 Implicit in these roles is that of health promoter. The pharmacist’s continuing relationship with the client, the community-based practice, and multiple entry points for counselling make the pharmacist a leader in health care.peer-reviewe

Nutritional determinants of worldwide diabetes: an econometric study of food markets and diabetes prevalence in 173 countries.

OBJECTIVE: Ageing and urbanization leading to sedentary lifestyles have been the major explanations proposed for a dramatic rise in diabetes worldwide and have been the variables used to predict future diabetes rates. However, a transition to Western diets has been suggested as an alternative driver. We sought to determine what socio-economic and dietary factors are the most significant population-level contributors to diabetes prevalence rates internationally. DESIGN: Multivariate regression models were used to study how market sizes of major food products (sugars, cereals, vegetable oils, meats, total joules) corresponded to diabetes prevalence, incorporating lagged and cumulative effects. The underlying social determinants of food market sizes and diabetes prevalence rates were also studied, including ageing, income, urbanization, overweight prevalence and imports of foodstuffs. SETTING: Data were obtained from 173 countries. SUBJECTS: Population-based survey recipients were the basis for diabetes prevalence and food market data. RESULTS: We found that increased income tends to increase overall food market size among low- and middle-income countries, but the level of food importation significantly shifts the content of markets such that a greater proportion of available joules is composed of sugar and related sweeteners. Sugar exposure statistically explained why urbanization and income have been correlated with diabetes rates. CONCLUSIONS: Current diabetes projection methods may estimate future diabetes rates poorly if they fail to incorporate the impact of nutritional factors. Imported sugars deserve further investigation as a potential population-level driver of global diabetes

Equilibrium Clusters in Concentrated Lysozyme Protein Solutions

We have studied the structure of salt-free lysozyme at 293 K and pH 7.8 using molecular simulations and experimental SAXS effective potentials between proteins at three volume fractions, 0.012, 0.033, and 0.12. We found that the structure of lysozyme near physiological conditions strongly depends on the volume fraction of proteins. The studied lysozyme solutions are dominated by monomers only for <0.012; for the strong dilution 70% of proteins are in a form of monomers. For 0.033 only 20% of proteins do not belong to a cluster. The clusters are mainly elongated. For 0.12 almost no individual particles exits, and branched, irregular clusters of large extent appear. Our simulation study provides new insight into the formation of equilibrium clusters in charged protein solutions near physiological conditions

Analysis, design, and test of acoustic treatment in a laboratory inlet duct

A suppression prediction program based on the method of modal analysis for spinning mode propagation in a circular duct was used in the analytical design of optimized, multielement, Kevlar bulk-absorber treatment configurations for an inlet duct. The NASA-Langley ANRL anechoic chamber using the spinning mode synthesizer as a sound source was used to obtain in-duct spinning mode measurements, radial mode measurements, and far-field traverses, as well as aerodynamic measurements. The measured suppression values were compared to predicted values, using the in-duct, forward-traveling, radial-mode content as the source for the prediction. The performance of the treatment panels was evaluated from the predicted and measured data. Although experimental difficulties were encountered at the design condition, sufficient information was obtained to confirm the expectation that it is the panel impedance components which are critical to suppression at a single frequency, not the particular construction materials. The agreement obtained between measurement and prediction indicates that the analytical program can be used as an accurate, reliable, and useful design tool

Interview : reflections on wellbeing

Interview with Dr. Gauden Galea, public health physician, currently working as the WHO Representative in China, based in Beijing since April 2018. He has been coordinating the collaboration between WHO and China across all health concerns, with a primary focus on: the COVID-19 response, the review of a decade of health sector reform, advocacy for tobacco and alcohol control, and exploring the digital health landscape of China. On behalf of the Western Pacific Region of WHO, he has been coordinating an effort promoting innovation in public health within the "For the Future" vision of the Region.peer-reviewe

Time-discounting and tobacco smoking: a systematic review and network analysis.

BACKGROUND: Tobacco smoking harms health, so why do people smoke and fail to quit? An explanation originating in behavioural economics suggests a role for time-discounting, which describes how the value of a reward, such as better health, decreases with delay to its receipt. A large number of studies test the relationship of time-discounting with tobacco outcomes but the temporal pattern of this relationship and its variation according to measurement methods remain unclear. We review the association between time-discounting and smoking across (i) the life course, from initiation to cessation, and (ii) diverse discount measures. METHODS: We identified 69 relevant studies in Web of Science and PubMed. We synthesized findings across methodologies and evaluated discount measures, study quality and cross-disciplinary fertilization. RESULTS: In 44 out of 54 studies, smokers more greatly discounted the future than non-smokers and, in longitudinal studies, higher discounting predicted future smoking. Smokers with lower time-discount rates achieved higher quit rates. Findings were consistent across studies measuring discount rates using hypothetical monetary or cigarette reward scenarios. The methodological quality of the majority of studies was rated as 'moderate' and co-citation analysis revealed an isolation of economics journals and a dearth of studies in public health. CONCLUSION: There is moderate yet consistent evidence that high time-discounting is a risk factor for smoking and unsuccessful cessation. Policy scenarios assuming a flat rate of population discounting may inadequately capture smokers' perceptions of costs and benefits

Unhealthy diets, obesity and time discounting: a systematic literature review and network analysis

There is an increasing policy commitment to address the avoidable burdens ofunhealthy diet, overweight and obesity. However, to design effective policies, it isimportant to understand why people make unhealthy dietary choices. Researchfrom behavioural economics suggests a critical role for time discounting, whichdescribes how people’s value of a reward, such as better health, decreases with delayto its receipt. We systematically reviewed the literature on the relationship of timediscounting with unhealthy diets, overweight and obesity in Web of Science andPubMed. We identified 41 studies that met our inclusion criteria as they examinedthe association between time discount rates and (i) unhealthy food consumption;(ii) overweight and (iii) response to dietary and weight loss interventions. Nineteenout of 25 cross-sectional studies found time discount rates positively associated withoverweight, obesity and unhealthy diets. Experimental studies indicated that lowertime discounting was associated with greater weight loss. Findings varied by howtime discount rates were measured; stronger results were observed for food thanmonetary-based measurements. Network co-citation analysis revealed a concentra-tion of research in nutrition journals. Overall, there is moderate evidence that hightime discounting is a significant risk factor for unhealthy diets, overweight and obe-sity and may serve as an important target for intervention

Influence of activated carbon surface oxygen functionalities on SO2 physisorption – Simulation and experiment

The influence of the gradual oxidation of carbons on SO2 physisorption was studied, by comparison of experimental and simulated SO2 adsorption isotherms. The results confirmed a significant impact of surface groups on the SO2 adsorption. The simulations also revealed a similar, to that observed experimentally, effect of the increase in the percentage of the smallest micropores on adsorption isotherms. The isotherms were analysed using the CMMS model. The conclusion is that this model seems to be a good and sensitive tool for studying SO2 physisorption mechanism since a very good qualitative agreement between the experimental and simulated data was observed