Global, regional, and national burden of colorectal cancer and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Funding: F Carvalho and E Fernandes acknowledge support from Fundação para a Ciência e a Tecnologia, I.P. (FCT), in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of the Research Unit on Applied Molecular Biosciences UCIBIO and the project LA/P/0140/2020 of the Associate Laboratory Institute for Health and Bioeconomy i4HB; FCT/MCTES through the project UIDB/50006/2020. J Conde acknowledges the European Research Council Starting Grant (ERC-StG-2019-848325). V M Costa acknowledges the grant SFRH/BHD/110001/2015, received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006.proofepub_ahead_of_prin

The global burden of adolescent and young adult cancer in 2019 : a systematic analysis for the Global Burden of Disease Study 2019

Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults. Findings There were 1.19 million (95% UI 1.11-1.28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59.6 [54.5-65.7] per 100 000 person-years) and high-middle SDI countries (53.2 [48.8-57.9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14.2 [12.9-15.6] per 100 000 person-years) and middle SDI (13.6 [12.6-14.8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23.5 million (21.9-25.2) DALYs to the global burden of disease, of which 2.7% (1.9-3.6) came from YLDs and 97.3% (96.4-98.1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Integrating Blockchain Technology for Air Purifier Production System at FIM Learning Factory

This paper focuses on the use of blockchain technology in the production process of the air purifier through a learning factory collaboration concept, which emphasizes more on the academic and industrial liaisons for innovation and development among partners. The partners agreed to use learning factory concepts through collaboration between academia and industry for the production planning and design, plant automation, execution, maintenance, services, and quality enhancement. Moreover, it has also described the rationale for using blockchain technology for the production of air purifiers and the strategies of the supply chain activities incumbent for the manufacturing processes of the air purifier. Furthermore, for supply chain activities were integrated with the blockchain technology in order to identify the blocks and data during the process flow. This paper also explains a synchronization process flow and integration for the smoother operation of the manufacturing processes of the Air purifier using blockchain technology. Potential industrial challenges of the Air purifier construction and development have been highlighted. The review results indicate the significance of using blockchain technology to meet energy needs around the globe; it will give new directions and philosophies to the industrial processes of manufacturing high-quality cost-effective Air purifiers efficiently and effectively, fulfilling the needs and expectations of the customers

مقایسه تأثیر آموزش حضوری و مجازی به شیوه روایتگری اخلاقی بر رعایت حریم خصوصی بیمار توسط پرستاران

زمینه و هدف: حریم خصوصی یکی از نیازهای ضروری انسان بوده و احترام به قلمرو بیماران یکی از وظایف مهم پرستاران است. بیشتر بیماران از حقوق خود آگاهی ندارند و آگاهی و عملکرد پرستاران در مورد حریم خصوصی بیمار، در بیمارستان‌های مختلف در سطح متوسط می‌باشد از طرفی ارائه برنامه‌های آموزشی برای پرستاران منجر به ارتقای رعایت حریم خصوصی بیمار و رضایت بیمار می‌شود، لذا مطالعه حاضر با هدف مقایسه تأثیر آموزش حضوری و مجازی به شیوه روایتگری اخلاقی بر رعایت حریم خصوصی بیمار توسط پرستاران انجام شده است. روش: این مطالعه نیمه‌تجربی سه گروهه، در سه بخش داخلی بیمارستان امام رضا (ع) مشهد که به صورت تصادفی با قرعه‌کشی انتخاب گردیدند بر روی 93 پرستار شاغل در آن‌ها انجام شد. پرستاران هر بخش براساس معیارهای ورود به مطالعه و به روش در دسترس به شرکت در مطالعه دعوت شدند. ابزارهای مورد استفاده در پژوهش شامل پرسشنامه حریم بیمار و فرم اطلاعات دموگرافیک بود. برای گروه مداخله یک ، پرستاران به پنج گروه تقسیم شده و سه جلسه یک‌ساعته به صورت حضوری برای هر یک از گروه‌ها برگزار شد. در این جلسات روایت‌هایی از ابعاد حریم خصوصی ارائه گردید. در گروه مداخله دو، پرستاران در گروه‌هایی از طریق یک شبکه پیام‌رسان مجازی آموزش حریم خصوصی را دریافت کردند. در گروه کنترل آموزشی ارائه نشد. پرسشنامه حریم خصوصی بیمار، قبل و یک ماه بعد از مداخله در هر سه گروه تکمیل و داده‌ها با SPSS 25 و آزمون‌های آماری توصیفی، ویلکاکسون و تی زوجی تجزیه و تحلیل شدند. ملاحظات اخلاقی: تحقیق حاضر از سوی کمیته اخلاق دانشگاه علوم پزشکی مشهد (کد کمیته اخلاق: IR.MUMS.REC.1398.079) به تأیید رسیده است. یافته‌ها: قبل از مداخله میانگین و انحراف معیار رعایت حریم خصوصی در سه گروه تفاوت معنی‌داری نداشت (952/0=P). بعد از مداخله میانگین و انحراف معیار رعایت حریم خصوصی در هر دو گروه آموزش حضوری و مجازی نسبت به گروه کنترل افزایش یافته بود (001/0>P). اختلاف آماری معناداری میان آموزش حضوری و آموزش مجازی وجود نداشت (256/0=P). نتیجه‌گیری: یافته‌های مطالعه حاضر نشان دادند که آموزش حضوری و مجازی روایتگری اخلاقی تأثیراتی مشابه بر رعایت حریم خصوصی بیماران داشته و می‌توان در شرایطی که امکان برگزاری جلسات حضوری نباشد، از طریق مجازی آموزش‌های لازم در زمینه حریم خصوصی بیمار را ارائه نمود.Background and Aim: Privacy is one of the essential human needs and respecting the patient' territory is one of the important duties of nurses. Most patients are not aware of their rights and nurses’ awareness and performance regarding the patient's privacy is at a moderate level in different hospitals. On the other hand, providing training programs for nurses leads to the promotion of respect for patients' privacy and their satisfaction. Therefore, the present study was conducted with the aim of comparing the effects of in-person and virtual narrative ethics training on nurses’ respect for the patient’s privacy. Methods: This quasi-experimental three-group study was conducted on 93 nurses working at three internal wards of Imam Reza Hospital in Mashhad. The samples were selected using the random sampling method, through a lottery. Nurses of each ward were invited to participate in the study based on the inclusion criteria and using convenience sampling method. The instruments used in the study included a patient privacy questionnaire and a demographic information form. In the first intervention group, the nurses were divided into five groups and three one-hour in-person sessions were held for each group. In these sessions, standard narratives of the dimensions of privacy were presented. In the second intervention group, the nurses received training on privacy through a virtual messaging network. No training was provided to the control group. The patient privacy questionnaire was completed by all three groups both before the intervention and one month after it. The data were analyzed with SPSS2 using descriptive statistical tests, Wilcoxon and paired t-test. Ethical Considerations: The present study was approved by the Ethics Committee of Mashhad University of Medical Sciences (IR.MUMS.REC.1398.079). Results: Before the intervention, there was no significant difference in the mean and the standard deviation of respect for privacy among the three groups (P=0.952). After the intervention, the mean and the standard deviation of respect for privacy had increased in both in-person and virtual training groups compared to the control group (P<0.001). The study findings showed that there was no significant statistical difference between in-person and virtual training (P=0.256). Conclusion: The findings of the present study showed that in-person and virtual narrative ethics training have similar effects on the respect for the patient's privacy. Therefore, in situations where it is not possible to hold in-person sessions, the necessary training on patient privacy can be provided virtually. Please cite this article as: Beyg R, Mohsenpour M, Jamali J, Saleh Moghaddam AR. A Comparison of the Effects of In-Person and Virtual Narrative Ethics Training on Nurses’ Respect for the Patient's Privacy. Faṣlnāmah-i akhlāq-i pizishkī, i.e., Quarterly Journal of Medical Ethics. 2022; 16(47): e22.زمینه و هدف: حریم خصوصی یکی از نیازهای ضروری انسان بوده و احترام به قلمرو بیماران یکی از وظایف مهم پرستاران است. بیشتر بیماران از حقوق خود آگاهی ندارند و آگاهی و عملکرد پرستاران در مورد حریم خصوصی بیمار، در بیمارستان‌های مختلف در سطح متوسط می‌باشد از طرفی ارائه برنامه‌های آموزشی برای پرستاران منجر به ارتقای رعایت حریم خصوصی بیمار و رضایت بیمار می‌شود، لذا مطالعه حاضر با هدف مقایسه تأثیر آموزش حضوری و مجازی به شیوه روایتگری اخلاقی بر رعایت حریم خصوصی بیمار توسط پرستاران انجام شده است. روش: این مطالعه نیمه‌تجربی سه گروهه، در سه بخش داخلی بیمارستان امام رضا (ع) مشهد که به صورت تصادفی با قرعه‌کشی انتخاب گردیدند بر روی 93 پرستار شاغل در آن‌ها انجام شد. پرستاران هر بخش براساس معیارهای ورود به مطالعه و به روش در دسترس به شرکت در مطالعه دعوت شدند. ابزارهای مورد استفاده در پژوهش شامل پرسشنامه حریم بیمار و فرم اطلاعات دموگرافیک بود. برای گروه مداخله یک ، پرستاران به پنج گروه تقسیم شده و سه جلسه یک‌ساعته به صورت حضوری برای هر یک از گروه‌ها برگزار شد. در این جلسات روایت‌هایی از ابعاد حریم خصوصی ارائه گردید. در گروه مداخله دو، پرستاران در گروه‌هایی از طریق یک شبکه پیام‌رسان مجازی آموزش حریم خصوصی را دریافت کردند. در گروه کنترل آموزشی ارائه نشد. پرسشنامه حریم خصوصی بیمار، قبل و یک ماه بعد از مداخله در هر سه گروه تکمیل و داده‌ها با SPSS 25 و آزمون‌های آماری توصیفی، ویلکاکسون و تی زوجی تجزیه و تحلیل شدند. ملاحظات اخلاقی: تحقیق حاضر از سوی کمیته اخلاق دانشگاه علوم پزشکی مشهد (کد کمیته اخلاق: IR.MUMS.REC.1398.079) به تأیید رسیده است. یافته‌ها: قبل از مداخله میانگین و انحراف معیار رعایت حریم خصوصی در سه گروه تفاوت معنی‌داری نداشت (952/0=P). بعد از مداخله میانگین و انحراف معیار رعایت حریم خصوصی در هر دو گروه آموزش حضوری و مجازی نسبت به گروه کنترل افزایش یافته بود (001/0>P). اختلاف آماری معناداری میان آموزش حضوری و آموزش مجازی وجود نداشت (256/0=P). نتیجه‌گیری: یافته‌های مطالعه حاضر نشان دادند که آموزش حضوری و مجازی روایتگری اخلاقی تأثیراتی مشابه بر رعایت حریم خصوصی بیماران داشته و می‌توان در شرایطی که امکان برگزاری جلسات حضوری نباشد، از طریق مجازی آموزش‌های لازم در زمینه حریم خصوصی بیمار را ارائه نمود

Impact of Information System and Blockchain on Organizational Learning Effectiveness

The focus of this paper is to investigate the impact of information systems and blockchain technology on organizational learning effectiveness. Data was collected from the information system faculty and administrative staff of two different universities in Pakistan and a qualitative approach was used to achieve the objectives of the study. The paper discovered why and how faculty and administrators show resistance or exert influences or assist information system and blockchain initiatives in organizational learning effectiveness and sustainability. A qualitative approach was used in the study to comprehend the recurring phenomenon. The research finding demands the support of the senior faculty members, administrators, and most importantly, the leadership, in the design, orientation, and implementation of information systems and blockchain for organizational learning effectiveness

Safety and immunogenicity of three dose levels of an investigational, highly purified Vero cell rabies vaccine: A randomized, controlled, observer-blinded, Phase II study with a simulated post-exposure regimen in healthy adults

ABSTRACTA serum-free, highly purified rabies vaccine produced in Vero cells is under development. The initial formulation, PVRV-NG, was evaluated in five Phase II studies and subsequently reformulated (PVRV-NG2). This multicenter, observer-blinded Phase II study investigated the safety and immune response of three different doses (antigen content) of PVRV-NG2 versus a licensed human diploid cell rabies vaccine (HDCV; Imovax rabies®). Healthy adults (N = 320) were randomized to receive PVRV-NG2 (low, medium, or high dose), PVRV-NG, or HDCV (2:2:2:1:1 ratio), according to a five-dose Essen simulated post-exposure regimen (Days [D] 0, 3, 7, 14, and 28). All participants received human rabies immunoglobulin intramuscularly on D0. Immunogenicity was assessed at D0, 14, 28, 42, and 6 months after the final injection using the rapid fluorescent focus inhibition test. Seroconversion rates were calculated as the percentage of participants achieving rabies virus neutralizing antibody titers ≥0.5 IU/mL. All analyses were descriptive. At each timepoint, geometric mean titers (GMTs) increased with antigen content (measured using an enzyme-linked immunosorbent assay). High-dose PVRV-NG2 GMTs were the highest at all timepoints, medium-dose PVRV-NG2 GMTs were similar to those with HDCV, and low-dose PVRV-NG2 GMTs were similar to PVRV-NG. The safety profile of PVRV-NG2 was comparable to PVRV-NG; however, fewer injection site reactions were reported with PVRV-NG2 or PVRV-NG (range 36.7–47.5%) than with HDCV (61.5%). This study demonstrated a dose–effect of antigen content at all timepoints. As post-exposure prophylaxis, the safety and immunogenicity profiles of the high-dose PVRV-NG2 group compared favorably with HDCV. Clinicaltrials.gov number: NCT03145766

Defining the optimal formulation and schedule of a candidate toxoid vaccine against Clostridium difficile infection: A randomized Phase 2 clinical trial

Clostridium difficile, a major cause of nosocomial and antibiotic-associated diarrhea, carries a significant disease and cost burden. This study aimed to select an optimal formulation and schedule for a candidate toxoid vaccine against C. difficile toxins A and B. Randomized, placebo-controlled, two-stage, Phase 2 study in a total of 661 adults aged 40–75 years. Stage I: low (50μg antigen) or high (100μg antigen) dose with or without aluminum hydroxide (AlOH) adjuvant, or placebo, administered on Days 0–7–30. Stage II: Days 0–7–30, 0–7–180, and 0–30–180, using the formulation selected in Stage I through a decision tree defined a priori and based principally on a bootstrap ranking approach. Administration was intramuscular. Blood samples were obtained on Days 0, 7, 14, 30, 60 (Stage I and II), 180, and 210 (Stage II); IgG to toxins A and B was measured by ELISA and in vitro functional activity was measured by toxin neutralizing assay (TNA). Safety data were collected using diary cards. In Stage I the composite immune response against toxins A and B (percentage of participants who seroconverted for both toxins) was highest in the high dose+adjuvant group (97% and 92% for Toxins A and B, respectively) and was chosen for Stage II. In Stage II the immune response profile for this formulation through Day 180 given on Days 0–7–30 ranked above the other two administration schedules. There were no safety issues. The high dose+adjuvant (100μg antigen+AlOH) formulation administered at 0–7–30 days elicited the best immune response profile, including functional antibody responses, through Day 180 and was selected for use in subsequent clinical trials