Cost-Effectiveness of Total Hip and Knee Replacements for the Australian Population with Osteoarthritis: Discrete-Event Simulation Model

Background: Osteoarthritis constitutes a major musculoskeletal burden for the aged Australians. Hip and knee replacement surgeries are effective interventions once all conservative therapies to manage the symptoms have been exhausted. This study aims to evaluate the cost-effectiveness of hip and knee replacements in Australia. To our best knowledge, the study is the first attempt to account for the dual nature of hip and knee osteoarthritis in modelling the severities of right and left joints separately

Population-level approaches to universal health coverage in resource-poor settings: Lessons from tobacco control policy in Vietnam

Population-based health promotion and disease prevention approaches are essential elements in achieving universal health coverage; yet they frequently do not appear on national policy agendas. This paper suggests that resource-poor countries should take greater advantage of such approaches to reach all segments of the population to positively affect health outcomes and equity, especially considering the epidemic of chronic non-communicable diseases and associated modifiable risk factors. Tobacco control policy development and implementation in Vietnam provides a case study to discuss opportunities and challenges associated with such strategies

The development of Tobacco Harm Prevention Law in Vietnam: stakeholder tensions over tobacco control legislation in a state owned industry

Background: Building on its National Tobacco Control Policy initiated in 2000, Vietnam is currently considering introducing a comprehensive law to strengthen the implementation of tobacco control policy. This study analyses the positions of key stakeholders in the development of tobacco control legislation in the context of a largely state-owned industry, and discusses their implications for the policy process

A single consumption of curry improved postprandial endothelial function in healthy male subjects: a randomized, controlled crossover trial

BACKGROUND: Curry, one of the most popular foods in Japan, contains spices that are rich in potentially antioxidative compounds, such as curcumin and eugenol. Oxidative stress is thought to impair endothelial function associated with atherosclerosis, a leading cause of cardiovascular events. The aim of this study was to determine whether a single consumption of curry meal would improve endothelial function in healthy men. METHODS: Fourteen healthy male subjects (BMI 23.7 ± 2.7 kg/m(2); age 45 ± 9 years) were given a single serving of curry meal or spice-free control meal (180 g of curry or control and 200 g of cooked rice; approximately 500 kcal in total) in a randomized, controlled crossover design. Before and 1 hr after the consumption, fasting and postprandial flow-mediated vasodilation (FMD) responses and other parameters were measured. RESULTS: The consumption of the control meal decreased FMD from 5.8 ± 2.4% to 5.1 ± 2.3% (P = 0.039). On the other hand, the consumption of the curry meal increased FMD from 5.2 ± 2.5% to 6.6 ± 2.0% (P = 0.001), and the postprandial FMD after the curry meal was higher than that after the control meal (P = 0.002). Presence of spices in the curry did not alter significantly the systemic and forearm hemodynamics, or any biochemical parameters including oxidative stress markers measured. CONCLUSIONS: These findings suggest that the consumption of curry ameliorates postprandial endothelial function in healthy male subjects and may be beneficial for improving cardiovascular health. TRIAL REGISTRATION: UMIN Clinical Trials Registry 000012012

Cost-effectiveness analysis of population-based tobacco control strategies in the prevention of cardiovascular diseases in Tanzania

Background: Tobacco consumption contributes significantly to the global burden of disease. The prevalence of smoking is estimated to be increasing in many low-income countries, including Tanzania, especially among women and youth. Even so, the implementation of tobacco control measures has been discouraging in the country. Efforts to foster investment in tobacco control are hindered by lack of evidence on what works and at what cost. Aims: We aim to estimate the cost and cost-effectiveness of population-based tobacco control strategies in the prevention of cardiovascular diseases (CVD) in Tanzania. Materials and methods: A cost-effectiveness analysis was performed using an Excel-based Markov model, from a governmental perspective. We employed an ingredient approach and step-down methodologies in the costing exercise following a government perspective. Epidemiological data and efficacy inputs were derived from the literature. We used disability-adjusted life years (DALYs) averted as the outcome measure. A probabilistic sensitivity analysis was carried out with Ersatz to incorporate uncertainties in the model parameters. Results: Our model results showed that all five tobacco control strategies were very cost-effective since they fell below the ceiling ratio of one GDP per capita suggested by the WHO. Increase in tobacco taxes was the most cost-effective strategy, while a workplace smoking ban was the least cost-effective option, with a cost-effectiveness ratio of USD 5 and USD 267, respectively. Conclusions: Even though all five interventions are deemed very cost-effective in the prevention of CVD in Tanzania, more research on budget impact analysis is required to further assess the government’s ability to implement these interventions.publishedVersio

Universality and superiority in preference for chromatic composition of art paintings

Color composition in paintings is a critical factor affecting observers' aesthetic judgments. We examined observers' preferences for the color composition of Japanese and Occidental paintings when their color gamut was rotated. In the experiment, observers were asked to select their preferred image from original and three hue-rotated images in a four-alternative forced choice paradigm. Despite observers' being unfamiliar with the presented artwork, the original paintings (0 degrees) were preferred more frequently than the hue-rotated ones. Furthermore, the original paintings' superiority was observed when the images were divided into small square pieces and their positions randomized (Scrambled condition), and when the images were composed of square pieces collected from different art paintings and composed as patchwork images (Patchwork condition). Therefore, the original paintings' superiority regarding preference was quite robust, and the specific objects in the paintings associated with a particular color played only a limited role. Rather, the original paintings' general trend in color statistics influenced hue-angle preference. Art paintings likely share common statistical regulations in color distributions, which may be the basis for the universality and superiority of the preference for original paintings.- We thank Dr. Yukinori Misaki at Kagawa National Institute of Technology, Japan and Ms. Nobuyo Okada and Ms. Kanako Maruchi at Toyohashi City Museum of Art and History, Japan for assisting in the measurement of art paintings. This work was supported by JSPS KAKENHI Grant Number JP19H01119 and 20H05956, and by the Portuguese Foundation for Science and Technology (FCT) in the framework of the Strategic Funding UIDB/04650/2020

Monoclonal gammopathy of renal significance (MGRS)-related AL amyloidosis complicated by amyloid myopathy: a case report

BACKGROUND: Lately, monoclonal gammopathy of renal significance (MGRS) has been defined as a group of renal disorders that are strongly associated with monoclonal protein, including amyloid immunoglobulin light chain (AL) amyloidosis. Amyloid myopathy is rare (1.5% of all patients with amyloidosis) and the prognosis is poor. Furthermore, only approximately 20% of patients with amyloid myopathy are reported to have renal involvement, indicating a lack of data in the literature. CASE PRESENTATION: Here, we report a rare case of MGRS-related AL amyloidosis complicated by amyloid myopathy that presented with muscle weakness in the upper and lower limbs, neck and fingers, and nephrotic syndrome. Blood, urine, and bone marrow examination revealed monoclonal gammopathy of undetermined significance (MGUS) (Bence Jones protein-lambda). Muscle biopsy of the vastus lateralis muscle demonstrated amyloid proteins in the sarcolemma and in the blood vessel walls on Congo red staining, suggesting amyloid myopathy, and tiny inclusions in fibers on modified Gomori trichrome stain. Although we thought they were reminiscent of nemaline bodies, we could not confirm the nature of this structure. Renal biopsy demonstrated amyloid proteins in the mesangial region, part of the capillary walls, and the blood vessel walls on direct fast scarlet staining. As these amyloid proteins were positive for p-component staining and negative for amyloid A staining, β2-microglobulin, and pre-albumin, and as lambda light chains were positive in the mesangial region, we diagnosed the patient with MGRS-related AL amyloidosis. Although he was treated with melphalan and dexamethasone, his symptoms did not improve. CONCLUSIONS: AL amyloidosis involving the kidneys and muscles has a poor prognosis, and a delayed diagnosis of amyloid myopathy is common because of its rarity and frequent misdiagnosis, which increases organ function deterioration. Therefore, early detection, therapeutic intervention, and careful follow-up are crucial

Musculoskeletal injuries in young handball players: a cross-sectional study

O objetivo deste estudo foi descrever a população, as características do treinamento e o histórico de lesões musculoesqueléticas em atletas de handebol do gênero feminino e investigar possíveis associações entre as características de treinamento com lesões musculoesqueléticas relacionadas ao handebol. Participaram deste estudo transversal 220 atletas, que responderam a um questionário autorreportado que abordava dados pessoais, características do treinamento e lesões prévias relacionadas ao handebol nos últimos 12 meses. Os dados foram analisados por estatística descritiva e modelos de regressão logística. Os resultados demonstram que a maioria era constituída de atletas com idade aproximada de 15 anos, com índice de massa corpórea classificado como normal, que realizavam 3 treinos por semana, com carga horária semanal de aproximadamente 8 horas e 30 minutos. As principais lesões encontradas foram as entorses e as tendinopatias, sendo o tornozelo e o joelho as regiões mais acometidas. Somente a experiência no esporte acima de 6 anos mostrou relação estatística com lesões prévias (p=0,032). A prevalência de lesões nos últimos 12 meses nesta população foi de 53,60%.This study aimed to describe the population, training features and history of musculoskeletal injuries in young female handball players and to investigate possible associations between these features and previous musculoskeletal injuries related to handball. The subjects of this cross-sectional study were 220 athletes who completed a self-reported questionnaire about personal data, training features and previous injuries related to handball in the last 12 months. Data were analyzed using descriptive statistics and logistic regression models. The results showed that most of the athletes were approximately 15 years old, had a body mass index was classified as normal, worked out at an average of 3 times a week and their weekly workload was approximately 8 hours and 30 minutes. The main injuries found were sprains and tendinopathies, with the ankle and knee being the most affected regions. Only the sport practice of over 6 years showed statistical relationship with previous injuries (p=0.032). The prevalence of injuries in the last 12 months in this population was 53.60%.Este estudio tuvo los propósitos de describir la población, las características de entrenamiento y el historial de lesiones musculo esqueléticas en atletas de balonmano del género femenino y de investigar posibles asociaciones entre las características del entrenamiento a este tipo de lesiones relacionadas con la práctica del balonmano. Han participado de este estudio transversal 220 atletas, que contestaron a un cuestionario auto reportado que contenían datos personales, características del entrenamiento y lesiones previas relacionadas con la práctica del balonmano en los últimos 12 meses. Se han evaluados los datos por estadística descriptiva y modelos de regresión logística. Los resultados muestran que la mayoría se constituía por atletas de edad cercana a los 15 años, con índice de masa corporal clasificado como normal, que hacían entrenamiento 3 veces por semana, con carga horaria semanal de cerca de 8 horas y 30 minutos. Se han encontrado las principales lesiones: esguinces y tendinopatías, en que el tobillo y la rodilla eran los más afectados. Se ha mostrado relación estadística con lesiones previas (p=0,032) solamente la experiencia de más de 6 años en la práctica del deporte. El 53,60% fue la prevalencia de lesiones en los últimos 12 meses en la población investigada