Economic evaluation of osteoporosis screening strategy conducted in the Province of Liège with the cooperation of Liège Province Santé

peer reviewedThe Province of Liege has conducted an osteoporosis screening strategy for women aged 50 to 69 years. The objective of this study is to investigate the economic characteristics of the screening strategy and to assess its cost-effectiveness, using a Markov microsimulation model. Our analyses suggest that the osteoporosis screening strategy is efficient if the medical community and the patients fulfill the recommendations of the Province of Liege health authorities and if persistence is optimized. Therefore, bone mineral density (BMD) measurement should be performed in all individuals with positive ultrasound screening; individuals having a positive BMD diagnosis should be treated and adherence to therapy should be increased. Furthermore, to improve the efficiency of the screening strategy, we suggest to target screening on women with one or more clinical risk factors, or on women aged 65 years and older

Influence of pH and stirring on the hydrogen production by a pure Clostridium strain.

info:eu-repo/semantics/publishe

Anti-fracture efficacy of intravenous ibandronate: how to translate epidemiological studies into daily clinical practice

peer reviewedNumerous epidemiological approaches are used to demonstrate the efficacy of a new chemical entity. In postmenopausal osteoporosis, anti-fracture efficacy can be assessed through prospective, randomized controlled trials, meta-analyses or real-life setting studies. Intravenous ibandronate was recently marketed, with the aim of optimizing drug absorption and adherence to treatment. Furthermore, this new formulation avoids gastrointestinal side effects and constrains linked to the oral intake of the medication. Spinal anti-fracture efficacy of IV ibandronate derives from a non-inferiority bridging study, using surrogate endpoints, i.e., bone mineral density and biochemical markers of bone turnover, compared to the oral daily formulation, previously registered for the treatment of osteoporosis in Europe. Coherent results from two separate meta-analyses have suggested that the non-vertebral anti-fracture efficacy of IV ibandronate is similar to that observed with oral, daily and weekly bisphosphonates. Similarly, a recent real-life setting study, based on claims from an US database, suggests that hip fractures are reduced, with IV ibandronate, to the same extend as they are with oral bisphosphonates. Notwithstanding, those results should probably be confirmed in an European setting, before being extrapolated, in daily practice, to the Belgian population

CLIL, an elitist language learning approach?:A background analysis of English and Dutch CLIL pupils in French-speaking Belgium

Content and language integrated learning (CLIL) programmes are increasingly popular throughout Europe, but are sometimes accused of inducing a selection bias in the pupil population, both through selection mechanisms of the schools themselves and self- selection of the pupils (and/or their parents). As a result, the outcomes of the CLIL approach may be artificially promoted, and, at the same time, such a selection bias can contribute to an elitist education model, which arguably runs counter to the aims of the approach. This paper looks into a number of background variables of both English and Dutch CLIL learners in Francophone Belgium and compares them to their non-CLIL counterparts. Results from a logistic regression indicate that there is indeed evidence of selection: the socio-economic status of the pupils appears as the main predictor of whether a pupil is in a CLIL or a non-CLIL track, whereas other, more personal, variables such as non-verbal intelligence play a minor (or additional) role. Moreover, Dutch CLIL programmes appear to be more selective than English CLIL programmes in this context. We conclude that CLIL (and particularly Dutch CLIL) in French-speaking Belgium, although a priori open to anyone, is particularly attractive to a socially privileged public

Optimisation of culture conditions for biological hydrogen production by Citrobacter freundii CWBI952 in batch, sequenced-batch and semicontinuous operating mode

Investigations were carried out to determine the effect of the pH, the nitrogen source, iron and the dilution rate (h 1) on fermentative hydrogen production from glucose by the newly isolated strain Citrobacter freundii CWBI952. The hydrogen production rate (HPR), hydrogen yield, biomass and soluble metabolites were monitored at 30 C in 100 mL serum bottles and in a 2.3 L bioreactor operated in batch, sequenced-batch and semicontinuous mode. The results indicate that hydrogen production activity, formate biosynthesis and glucose intake rates are very sensitive to the culture pH, and that additional formate bioconversion and production of hydrogen with lower biomass yields can be obtained at pH 5.9. In a further series of cultures casein peptone was replaced by (NH4)2SO4, a low cost alternative nitrogen source. The ammonia-based substitute was found to be suitable for H2 production when a concentration of 0.045 g/L FeSO4 was provided. Optimal overall performances (ca. an HPR of 33.2 mL H2/L h and a yield of 0:83 molH2 =molglucose) were obtained in the semicontinuous culture applying the previously optimized parameters for pH, nitrogen, and iron with a dilution rate of 0.012 h 1 and degassing of biogas by N2 at a 28 mL/min flow rate.Micro-H2 : Production microbiologique d’hydrogène : Etude des processus microalgal et bacterie

Classroom anxiety and enjoyment in CLIL and non-CLIL: Does the target language matter?

This study investigates pupils’ anxiety and enjoyment in the classroom when learning a second or foreign language. The particularity of this study lies in the comparison of two target languages (English and Dutch) in two educational contexts (CLIL and non-CLIL) at different instruction levels (primary and secondary education). While most research on content and language integrated learning (CLIL) focuses on English as a target language, the Belgian context calls for a comparison with the language of the “other” community, in this case Dutch. Data were collected from 896 pupils in French-speaking Belgium through a self-report questionnaire measuring pupils’ anxiety and enjoyment in the classroom, along with background characteristics. Results indicate that while CLIL pupils experience significantly less anxiety than their non-CLIL counterparts, English learners report significantly less anxiety and more enjoyment than Dutch learners. This suggests an important role of the target language for emotional engagement in the classroom and calls for further investigation into the role of target language perceptions. Finally, the interactions with instruction level reveal that while primary school pupils report stronger emotions, the effects of CLIL and English are much larger at secondary level

Cost-effectiveness of buffered soluble alendronate 70 mg effervescent tablet for the treatment of postmenopausal women with osteoporosis in Italy

Summary: The use of buffered soluble alendronate 70 mg effervescent tablet, a convenient dosing regimen for bisphosphonate therapy, seems a cost-effective strategy compared with relevant alternative treatments for postmenopausal women with osteoporosis aged 60 years and over in Italy. Introduction: To assess the cost-effectiveness of buffered soluble alendronate (ALN) 70 mg effervescent tablet compared with relevant alternative treatments for postmenopausal osteoporotic women in Italy. Methods: A previously validated Markov microsimulation model was adjusted to the Italian healthcare setting to estimate the lifetime costs (expressed in €2019) per quality-adjusted life-years (QALY) of buffered soluble ALN compared with generic ALN, denosumab, zoledronic acid and no treatment. Pooled efficacy data derived from the NICE network meta-analysis were used for bisphosphonate treatments. Two treatment duration scenarios were assessed: 1 year using persistence data derived from an Italian prospective observational study including 144 and 216 postmenopausal osteoporotic women on buffered soluble ALN and oral ALN, respectively, and 3 years. Analyses were conducted for women 60–80 years of age with a bone mineral density T-score ≤ − 3.0 or with existing vertebral fractures. Results: In all simulated populations, buffered soluble ALN was dominant (more QALYs, lower costs) compared to denosumab. The cost per QALY gained of buffered soluble ALN compared to generic ALN and no treatment always falls below €20,000 per QALY gained. In the 1-year treatment scenario, zoledronic acid was associated with more QALY than buffered soluble ALN but the cost per QALY gained of zoledronic acid compared with buffered soluble ALN was always higher than €70,000, while buffered soluble ALN was dominant in the 3-year treatment scenario. Conclusion: This study suggests that buffered soluble ALN represents a cost-effective strategy compared with relevant alternative treatments for postmenopausal osteoporosis women in Italy aged 60 years and over. © 2021, The Author(s)