The global impact of non-communicable diseases on macro-economic productivity: a systematic review

© 2015, The Author(s). Non-communicable diseases (NCDs) have large economic impact at multiple levels. To systematically review the literature investigating the economic impact of NCDs [including coronary heart disease (CHD), stroke, type 2 diabetes mellitus (DM), cancer (lung, colon, cervical and breast), chronic obstructive pulmonary disease (COPD) and chronic kidney disease (CKD)] on macro-economic productivity. Systematic search, up to November 6th 2014, of medical databases (Medline, Embase and Google Scholar) without language restrictions. To identify additional publications, we searched the reference lists of retrieved studies and contacted authors in the field. Randomized controlled trials, cohort, case–control, cross-sectional, ecological studies and modelling studies carried out in adults (>18 years old) were included. Two independent reviewers performed all abstract and full text selection. Disagreements were resolved through consensus or consulting a third reviewer. Two independent reviewers extracted data using a predesigned data collection form. Main outcome measure was the impact of the selected NCDs on productivity, measured in DALYs, productivity costs, and labor market participation, including unemployment, return to work and sick leave. From 4542 references, 126 studies met the inclusion criteria, many of which focused on the impact of more than one NCD on productivity. Breast cancer was the most common (n = 45), followed by stroke (n = 31), COPD (n = 24), colon cancer (n = 24), DM (n = 22), lung cancer (n = 16), CVD (n = 15), cervical cancer (n = 7) and CKD (n = 2). Four studies were from the WHO African Region, 52 from the European Region, 53 from the Region of the Americas and 16 from the Western Pacific Region, one from the Eastern Mediterranean Region and none from South East Asia. We found large regional differences in DALYs attributable to NCDs but especially for cervical and lung cancer. Productivity losses in the USA ranged from 88 million US dollars (USD) for COPD to 20.9 billion USD for colon cancer. CHD costs the Australian economy 13.2 billion USD per year. People with DM, COPD and survivors of breast and especially lung cancer are at a higher risk of reduced labor market participation. Overall NCDs generate a large impact on macro-economic productivity in most WHO regions irrespective of continent and income. The absolute global impact in terms of dollars and DALYs remains an elusive challenge due to the wide heterogeneity in the included studies as well as limited information from low- and middle-income countries.WHO; Nestle´ Nutrition (Nestec Ltd.); Metagenics Inc.; and AX

OpenStreetMap building data quality: the Siedleckie county study

Jakość danych OpenStreetMap (OSM), a w szczególności takie jej elementy ilościowe jak kompletność oraz dokładność położenia, wzbudza szerokie zainteresowanie naukowców na świecie. W artykule przedstawiono potencjalne okoliczności powszechnie obserwowanej heterogenicznej charakterystyki OSM, zwracając uwagę na aspekt niedoskonałości ustaleń semantycznych i założeń jakościowych inicjatywy oddolnej jaką jest OpenStreetMap. Część praktyczną badań stanowi ocena kompletności i dokładności lokalizacji danych o budynkach i budowlach OSM w stosunku do krajowych danych urzędowych, bazy danych obiektów topograficznych BDOT10k. Analizy zostały przeprowadzone dla peryferyjnie położonego, powiatu siedleckiego i miasta Siedlce. Opracowanie dopełnia dotychczasowe rezultaty badawcze w zakresie analiz ilościowych jakości OSM, a otrzymane wyniki potwierdzają zróżnicowaną jakość danych o budynkach, w sensie ich kompletności i wypełnienia wartościami ich atrybutów oraz dokładności lokalizacji, także na terenie Polski. Niemniej jednak, wyniki analizy dokładności geometrycznej są zaskakująco dobre. W dyskusji autorzy zwracają uwagę na fakt, że mimo niedoskonałości danych wolnych i otwartych są one powszechnie wykorzystywane przez użytkowników, do których należy także administracja publiczna.Researchers all over the world are interested in OpenStreetMap data and its quality including completeness and geometric accuracy. This article looks into the commonly observed heterogeneous characteristics of OpenStreetMap geospatial data and draws attention to the vague semantic and quality foundations of this important grass-roots initiative. The experiment is an assessment of the completeness and positional accuracy of OSM building data compared to the national data: the Database of Topographic Objects in Poland (BDOT10k). The analysis was performed for the county and city of Siedlce. This study complements previous research results in the quantitative analysis of OpenStreet- Map data quality. The results confirm the variable quality of OSM data in terms of completeness and updating of building information found in their attribute's, and the positional accuracy of building corners even for the Polish territory. Nevertheless, the analysis did find that the positional accuracy of the OpenStreetMap building data was very good in comparison to the BDOT10K database. The authors draw attention to the fact that Free and Open geospatial data, despite its imperfections, is widely adopted by users including public administrations

Vorapaxar in the secondary prevention of atherothrombotic events

Item does not contain fulltextBACKGROUND: Thrombin potently activates platelets through the protease-activated receptor PAR-1. Vorapaxar is a novel antiplatelet agent that selectively inhibits the cellular actions of thrombin through antagonism of PAR-1. METHODS: We randomly assigned 26,449 patients who had a history of myocardial infarction, ischemic stroke, or peripheral arterial disease to receive vorapaxar (2.5 mg daily) or matching placebo and followed them for a median of 30 months. The primary efficacy end point was the composite of death from cardiovascular causes, myocardial infarction, or stroke. After 2 years, the data and safety monitoring board recommended discontinuation of the study treatment in patients with a history of stroke owing to the risk of intracranial hemorrhage. RESULTS: At 3 years, the primary end point had occurred in 1028 patients (9.3%) in the vorapaxar group and in 1176 patients (10.5%) in the placebo group (hazard ratio for the vorapaxar group, 0.87; 95% confidence interval [CI], 0.80 to 0.94; P<0.001). Cardiovascular death, myocardial infarction, stroke, or recurrent ischemia leading to revascularization occurred in 1259 patients (11.2%) in the vorapaxar group and 1417 patients (12.4%) in the placebo group (hazard ratio, 0.88; 95% CI, 0.82 to 0.95; P=0.001). Moderate or severe bleeding occurred in 4.2% of patients who received vorapaxar and 2.5% of those who received placebo (hazard ratio, 1.66; 95% CI, 1.43 to 1.93; P<0.001). There was an increase in the rate of intracranial hemorrhage in the vorapaxar group (1.0%, vs. 0.5% in the placebo group; P<0.001). CONCLUSIONS: Inhibition of PAR-1 with vorapaxar reduced the risk of cardiovascular death or ischemic events in patients with stable atherosclerosis who were receiving standard therapy. However, it increased the risk of moderate or severe bleeding, including intracranial hemorrhage. (Funded by Merck; TRA 2P-TIMI 50 ClinicalTrials.gov number, NCT00526474.)

Measurement of the prompt J/ψ pair production cross-section in pp collisions at √s = 8 TeV with the ATLAS detector

t The production of two prompt J/ψ mesons, each with transverse momenta pT > 8.5 GeV and rapidity |y| < 2.1, is studied using a sample of proton-proton collisions at √s = 8 TeV, corresponding to an integrated luminosity of 11.4 fb−1 collected in 2012 with the ATLAS detector at the LHC. The differential cross-section, assuming unpolarised J/ψ production, is measured as a function of the transverse momentum of the lower-pT J/ψ meson, di-J/ψ pT and mass, the difference in rapidity between the two J/ψ mesons, and the azimuthal angle between the two J/ψ mesons. The fraction of prompt pair events due to double parton scattering is determined by studying kinematic correlations between the two J/ψ mesons. The total and double parton scattering cross-sections are compared with predictions. The effective cross-section of double parton scattering is measured to be σeff = 6.3 ± 1.6(stat) ± 1.0(syst) mb