PP Analysis Research Articles

Reverse hybrid therapy for Helicobacter pylori eradication: A systematic review and meta-analysis.

The efficacy and safety of reverse hybrid therapy in the treatment of Helicobacter pylori (H.pylori) infection remained unclear. This systematic review was performed in accordance with the PRISMA 2009 guidelines. A systematic search of the Pubmed, Embase, and Cochrane database was conducted using the combination of "Helicobacter pylori or H.pylori or Hp" and "hybrid". The primary endpoint of this meta-analysis was to evaluate the efficacy of reverse hybrid therapy; the second endpoint was to evaluate the efficacy of reverse hybrid therapy among the strains with antibiotic resistance and the compliance, safety of reverse hybrid therapy. Four studies with 1530 participants were included. The crude H.pylori eradication rate of reverse hybrid therapy was 95.5% (737/772) and 96.2% (701/729) by ITT and PP analysis, respectively. There is no statistical significance of efficacy between reverse hybrid therapy and control according to ITT (pooled rate: 96% vs. 94%, RR=1.02, 95% CI, 0.95-1.05, p=.28) and PP (pooled rate: 96% vs. 94%, RR=1.02, 95% CI, 0.99-1.06, p=.23) analysis. The effect of reverse hybrid therapy in strains with isolated clarithromycin resistance (pooled rate: 89% vs. 65%, RR=1.13, 95% CI, 0.77-1.66, p=.53), metronidazole resistance (pooled rate: 91% vs. 81%, RR=1.00, 95% CI, 0.96-1.05, p=.85), and dual clarithromycin-metronidazole resistance (pooled rate: 86% vs. 83%, RR=0.94, 95% CI, 0.69-1.27, p=.69) showed no superior to that of control. The compliance of reverse hybrid therapy is 96%, and side effect is slightly lower to that of control group. Reverse hybrid therapy shows good efficacy, safety, and compliance in the treatment of H.pylori infection. However, its application for H.pylori treatment in regions with high antibiotic resistance need to be further explored.

Application of a semi-automatic, intensive follow-up for improving efficacy and adherence of Helicobacter pylori eradication therapy: A randomized controlled trial.

A complete understanding and good adherence are crucial for successful Helicobacter pylori eradication. Proper frequency of reminders might be helpful to both doctors and patients to maintain adherence during treatment. The study was to evaluate the influence of an intensive follow‐up system based on a clinical database on H. pylori eradication therapy. A total of 196 eligible patients were equally and randomly divided into an intensive follow‐up group and a control group. Both groups were administered bismuth‐containing quadruple therapy for 14 days. Patients in the intensive follow‐up group were informed of pre‐treatment, including the duration and potential adverse events. Subsequently, they received telephone follow‐ups on days 3 and 14 and 3 days before the urea breath test (UBT). The time points were automatically reminded by a follow‐up system in the established clinical database. The control group was only informed of pre‐treatment information. UBT was performed 4 weeks after treatment in both groups to assess the presence of H. pylori. The eradication rate, patient compliance, and adverse events were calculated and compared. The H. pylori eradication rates of the intensive follow‐up and control groups were 94.7% (90/95, 95% CI: 90%–99%) and 92.9% (78/84, 95% CI: 87%–98%), respectively, by PP analysis (p = 0.601), and 91.8% (90/98, 95% CI: 86%–97%) and 81.6% (80/98, 95% CI: 74%–89%) by ITT analysis (p = 0.035). Adverse events occurred in 9 intensive follow‐up group patients and 12 in the control group. Adherence was 96.9% (95/98) in the intensive follow‐up group and 85.7% (84/98) in the control group. Semi‐automatic intensive follow‐up contributed to a higher eradication rate and adherence to H. pylori treatment.

Chinese pediatric Tuina on children with acute diarrhea: a randomized sham-controlled trial

BackgroundPediatric Tuina has been widely used in children with acute diarrhea in China. However, due to the lack of high-quality clinical evidence, the benefit of Tuina as a therapy is not clear. We aimed to assess the effect of pediatric Tuina compared with sham Tuina as an add-on therapy in addition to usual care for 0–6-year-old children with acute diarrhea.MethodsEighty-six participants aged 0–6 years with acute diarrhea were randomized to receive pediatric Tuina plus usual care (n = 43) or sham Tuina plus usual care (n = 43). The primary outcomes were days of diarrhea from baseline and times of diarrhea on day 3. Secondary outcomes included a global change rating (GCR) and the number of days when the stool characteristics returned to normal. Adverse events were assessed.ResultsPediatric Tuina was associated with a reduction in times of diarrhea on day 3 compared with sham Tuina in both ITT (crude RR, 0.73 [95% CI, 0.59–0.91]) and PP analyses (crude RR, 0.66 [95% CI, 0.53–0.83]). However, the results were not significant when we adjusted for social demographic and clinical characteristics. No significant difference was found between groups in days of diarrhea, global change rating, or number of days when the stool characteristics returned to normal.ConclusionsIn children aged 0–6 years with acute diarrhea, pediatric Tuina showed significant effects in terms of reducing times of diarrhea compared with sham Tuina. Studies with larger sample sizes and adjusted trial designs are warranted to further evaluate the effect of pediatric Tuina therapy.Trial registrationClinicaltrials.gov, Identifier: NCT03005821, Data of registration: 2016-12-29.

Non-Bismuth Quadruple Therapy, Sequential Therapy or High-Dose Esomeprazole and Amoxicillin Dual Therapy for First-Line Helicobacter pylori Eradication: A Prospective Randomized Study.

Aim: The study aims were to evaluate and compare the effectiveness and safety of non-bismuth quadruple therapy with sequential therapy and dual therapy with high dose esomeprazole and amoxicillin as an empirical first-line approach to eradicate Helicobacter pylori infection.Patients and methods: Prospective randomized trial included 393 patients infected with H. pylori naïve to eradication therapy, randomized to receive a 10-day non-bismuth quadruple or concomitant (CT) therapy, 10-day sequential therapy (SQ), or 14-day high-dose esomeprazole and amoxicillin (BT). Treatment outcome was assessed by C13-urea breath test at least six weeks after therapy. Adverse events and compliance were assessed with questionnaires and residual medication count.Results: The baseline demographic clinical and endoscopic characteristics were similar among the three groups. The intention to treat (ITT) analysis was performed in 130, 132, and 131 patients in the BT, SQ, and CT groups, respectively. The eradication rates in ITT were 64.6%, 83.1%, and 92.3%, respectively, in the BT, SQ and CT groups (p = 0.0001). The eradication rates per protocol were 67.7%, 88.5%, and 95.3% (p = 0.0001), respectively, in the BT, SQ, and CT groups. The CT and SQ groups were higher than the BT group (p = 0,0001) but no significant results were seen in the eradication rate between CT and SQ, both in PP analysis and in ITT analysis (p = 0.09). The prevalence of the side effects following the non-bismuth quadruple therapy was 38.2%, significantly higher (p = 0.001) than the BT group (13.80%) and SQ group (22%). There were no significant differences in compliance among the three therapies (p = 0.16).Conclusion: This study found that non-bismuth quadruple therapy yielded a higher H. pylori eradication rate over sequential regimen as a first-line treatment in Morocco, with no statistical difference between the two protocols studied, while the eradication rate of dual high-dose of esomeprazole and amoxicillin did not exceed 60%. All three therapy schemes showed excellent compliance. However, the prevalence of side events was more important and significantly higher with non-bismuth quadruple therapy.

The efficacy and safety of Clostridium butyricum and Bacillus coagulans in Helicobacter pylori eradication treatment: An open-label, single-arm pilot study.

Background:Helicobacter pylori (H pylori) infection plays a critical role in gastritis-associated diseases, gastroduodenal ulcers, and even gastric cancer. Studies have shown that probiotics may exhibit antagonistic activity against H pylori.Methods:This study aimed to assess the efficacy and safety of monotherapy with Clostridium butyricum (C butyricum) and Bacillus coagulans (B coagulans) for H pylori treatment. Our research was an open-label, single-arm pilot study of H pylori eradication. Subjects diagnosed with H pylori infection as outpatients at Xijing Hospital were randomized (1:1:1) to receive 8 weeks of therapy with C butyricum (group A), B coagulans (group B), or C butyricum plus B coagulans (group C). H pylori status was assessed 1 to 2 weeks after treatment. The H pylori eradication rate according to intention-to-treat and per-protocol analyses was the primary outcome of study, and the delta over baseline score, adverse events, and compliance were the secondary outcomes. This study was registered at ClinicalTrials.gov (NCT 03857425).Results:A total of 150 subjects were consecutively enrolled from February 2019 to August 2019. The ITT analysis demonstrated that the 3 groups achieved similar eradication rates (18%, 20%, and 26%, respectively, P = .597). The PP analysis yielded a similar result (24.3%, 26.3%, and 32.5%, respectively, P = .703). None of the subjects reported adverse events during treatment. The 3 groups had comparable compliance rates (74% vs 76% vs 80%, P > .05).Conclusion:C butyricum and B coagulans may effectively inhibit H pylori to some extent, with rare adverse events, and thus may reduce the burden of antibiotic resistance.

Fixed-order and merged parton-shower predictions for WW and WWj production at the LHC including NLO QCD and EW corrections

First, we present a combined analysis of pp to {mu}^{+}{v}_{mu }{mathrm{e}}^{-}{overline{v}}_{mathrm{e}} and pp to {mu}^{+}{v}_{mu }{mathrm{e}}^{-}{overline{v}}_{mathrm{e}}mathrm{j} at next-to-leading order, including both QCD and electroweak corrections. Second, we provide all-order predictions for pp to {mu}^{+}{v}_{mu }{mathrm{e}}^{-}{overline{v}}_{mathrm{e}}+ jets using merged parton-shower simulations that also include approximate EW effects. A fully inclusive sample for WW production is compared to the fixed-order computations for exclusive zero- and one-jet selections. The various higher-order effects are studied in detail at the level of cross sections and differential distributions for realistic experimental set-ups. Our study confirms that merged predictions are significantly more stable than the fixed-order ones in particular regarding ratios between the two processes.

Postpartum long-acting contraception uptake and service delivery outcomes after a multilevel intervention in Kigali, Rwanda

IntroductionPostpartum family planning (PPFP) is critical to reduce maternal–child mortality, abortion and unintended pregnancy. As in most countries, the majority of PP women in Rwanda have an unmet need for...

Enhancing the performance of TEG system coupled with PCMs by regulating the interfacial thermal conduction

Heat storage with phase change materials (PCMs) is promising to enhance the performance of thermoelectric generator (TEG) systems. Optimizing the thermal management in practical application is crucial to improve the performance of these TEG-PCM coupling systems. In this study, a TEG system coupled with PCMs has been fabricated and thermal interface materials (TIMs) with different thermal conductivities were used to regulate the interfacial thermal conduction between heat storage unit, TEG and heat exchanger. The experimental results revealed that the interfacial thermal conduction has substantial effects on the temperatures and performance of the TEG system coupled with PCMs. With the improvement of the interfacial thermal conduction, the time of the temperature of PCMs maintaining stable during cooling (tp) was shortened, while the average of output power of TEG system within this period (Pp) was increased. It indicates that the excess energy generated with the coupled PCMs would not increase monotonously with the enhancement of interfacial thermal conduction. We proposed a method to explore the optimal interfacial thermal conduction for the largest excess energy by performing polynomial fitting analysis of tp and Pp, respectively. This study provided a feasible means to improve the performance of TEG-PCM coupling systems by regulating the interfacial thermal conduction.

Comparative evaluation of efficacy, pharmacodynamics, and safety of Hetero\u2019s adalimumab (Mabura\xae, Hetero Biopharma Ltd.) and reference adalimumab (Humira\xae, Abbvie Inc.) in patients with active rheumatoid arthritis on concomitant methotrexate therapy

BackgroundOur study aimed to compare efficacy and safety of Hetero’s adalimumab (Mabura®, Hetero Biopharma Limited) versus reference adalimumab (Humira®, Abbvie Inc.) in Indian patients with active rheumatoid arthritis (RA) concomitant on methotrexate (MTX) therapy.MethodsPatients (n = 168) were randomized (2:1) to receive either test or reference product for 24 weeks with concomitant MTX. Proportion of patients achieving American College of Rheumatology 20 (ACR20) criteria at week 12 was the primary endpoint. Changes in Disease Activity Score of 28 joints–C-reactive protein (DAS28-CRP), Health Assessment Questionnaire–Disability Index (HAQ-DI), and patients achieving ACR20 at week 24, ACR50/70 at weeks 12 and 24 were secondary endpoints.ResultsPatients achieving ACR20 responses with test (96.43%) were similar to reference (96.43%) in intention-to-treat (ITT) analysis at week 12. Proportional difference (PD) between groups (PD [95% CI] 0.0 [− 6.0, 6.0], p = 1.000) for ACR20 at week 12 for ITT analysis showed lower limit of the two-sided 95% CI was above the pre-specified noninferiority margin of − 15%. Similar trend in PP analysis (PD [95% CI] 0.0 [− 0.03, 0.07], p = 1.000), confirmed therapeutic equivalence. No significant difference was noted between arms for patients attaining ACR20 at week 24 and ACR50/70 at weeks 12 and 24 (all p > 0.05). DAS28-CRP and HAQ-DI were similar between groups. Total of 54 patients reported 88 AEs during the study. Out of these, 60 AEs were reported in 34 patients with Hetero-Adalimumab and 28 AEs were reported in 20 patients with Reference-Adalimumab. Total two patients, one in each group reported two serious adverse events (Sinusitis and Viral infection) during the study and resolved completely. No deaths and no life threatening AEs were reported.ConclusionResults demonstrated Hetero’s adalimumab is as effective and well tolerated as reference adalimumab in patients with active RA concomitantly on MTX therapy.Trial registrationCTRI/2016/04/006884, Registered on 28/04/2016.

Preconception Micronutrient Supplementation Positively Affects Child Development at 6 Years of Age: A Randomized Controlled Trial in Vietnam

Abstract Objectives While there is growing evidence on the role of preconception nutrition for birth outcomes, very few studies have evaluated the effects of nutrition interventions during the preconception period on child development. This study evaluates the impact of preconception weekly multiple micronutrients (MM) or iron and folic acid (IFA) supplementation compared to FA alone on child growth and development at age 6–7y. Methods We followed 1599 offspring born to women who participated in a randomized controlled trial of preconception supplementation in Vietnam. Women received weekly supplements containing either 2800 μg FA only, 60 mg iron and 2800 μg FA, or MM (15 micronutrients including IFA), from baseline until conception; followed by daily prenatal IFA supplements until delivery. Child anthropometry and development were measured at 6–7y. Child development was measured using the Wechsler Intelligence Scale for Children IV®. Group comparisons were done using ANOVA or chi-square tests for both intention-to-treat (ITT) and per-protocol analyses (PP, women consumed supplements ≥26 wk before conception). Results The groups were similar for baseline maternal and offspring birth characteristics and age at follow-up. We found significant differences (P < 0.05) by intervention group for processing speed index for both ITT (n = 1312) and PP analyses (n = 589), and for working memory index in PP analysis. Compared to the offspring in the FA group, those in the MM group had higher processing speed (β = 1.9 for ITT, and β = 3.4 for PP analysis) and working memory indices (β = 1.5 for ITT, and β = 2.2 for PP analysis). Similar trends were found for the offspring in the IFA group compared to the FA group for working memory index (β = 1.6 for ITT, and β = 3.5 for PP analyses). There were no significant differences by treatment group for measures of verbal comprehension, perceptual reasoning index, full-scale IQ or any of the child anthropometry measures. Conclusions Preconception supplementation with MM and IFA improved some components of child development but not child size at age 6–7 y when compared to FA. These findings suggest the potential for preconception micronutrient interventions to have long-term benefits for offspring development. Funding Sources The Nestle Foundation, the Mathile Institute, and the Micronutrient Initiative.

Novel Predictive Nomogram for Identifying Difficult Guidewire Insertion in Patients With Malignant Colorectal Obstruction and Sphincterotome-Assisted Guidewire Insertion for Improving the Success Rate of Self-Expandable Metal Stent Insertion.

Aims: This study aimed to identify risk factors related to guidewire insertion (GWI) failure and construct a novel predictive nomogram. In addition, sphincterotome-assisted guidewire insertion (SAGWI) in difficult cases was evaluated for efficacy and safety.Methods: We reviewed the data of 509 patients with malignant colorectal obstruction who underwent endoscopic self-expandable metal stent (SEMS) insertion from 2007 to 2018 in our center, retrospectively. We identify risk factors associated with GWI failure by multivariate logistic regression analysis and construct a novel predictive nomogram. Improvements in the GWI and technical and clinical success rates were assessed for the SAGWI technique.Results: A total of 509 patients with malignant colorectal obstruction were included. Increases of 6.9% and 7.0% were found in the GWI success rate by intention-to-treat (ITT; p < 0.001) and per-protocol (PP; p < 0.001) analyses after SAGWI, respectively. Increases of 6.5% and 6.6% in the technical success rate were found by ITT (p < 0.001) and PP (p < 0.001) analyses after SAGWI, respectively. Increases of 5.8% and 6.0% in the clinical success rate were found by ITT (p < 0.001) and PP (p < 0.001) analyses after SAGWI, respectively. Regarding the GWI failure-related factors, a sharply angulated stricture was an independent risk factor, and an experienced colonoscopist was an independent protective factor. A novel effective predictive nomogram was constructed.Conclusion: The novel predictive nomogram can be conveniently used to identify difficult cases. A sharply angulated stricture and an experienced colonoscopist are independent factors related to GWI failure. The SAGWI technique is an effective and safe method for addressing technically difficult cases.

Critical aspects on off-line pyrolysis-based quantification of microplastic in environmental samples

Although pyrolytic analysis of polymers allows a quantitative determination, reports on pyrolysis-based quantifications are very scarce, most probably as the result of some critical aspects that need to be considered. This is valid especially for environmental analysis of microplastics that require a detection at low concentrations in complex matrices.Therefore, an off-line pyrolysis approach to quantify five polymers representing the most relevant constituents of microplastics (polyethylene PE, polypropylene PP, poly(ethylene terephthalate) PET, polystyrene PS, poly(vinyl chloride) PVC) was studied. The analytical approach was critically evaluated and discussed covering the basic analytical parameters specificity, sensitivity, reproducibility and applicability on real samples.Off-line pyrolysis-based analysis of PS and PP provided the best results with a high specificity of pyrolysis products, very good limit of quantification around 1 to 3 μg based on S/N ratios as extrapolated from standard material analyses (without matrix effects) and a recovery from real sample matrix higher than 50%. Hence, for these synthetic polymers the presented analytical method exhibits a high potential for quantification at low concentration levels in real environmental samples. Although for PE a partly lower specificity of pyrolysis products, a little lower sensitivity and reproducibility but a very good recovery from real sample matrix can be summarized, the off-line pyrolysis-based approach seems to be applicable successfully also for PE.Analyses of PVC and PET revealed the highest inconsistencies and drawbacks in particular only minor specificity, less reproducibility and a low recovery. Thus, both polymers can be quantified only with a very low degree of reliance and need complementary analysis to verify the pyrolysis-based quantitative results.Noteworthy, most of the critical aspects revealed by this study are also worth discussing for on-line pyrolysis approaches.

P517 A randomised, placebo-controlled pilot trial of faecal microbiota transplantation for paediatric Crohn’s disease

Abstract Background The role of faecal microbiota transplant (FMT) in Crohn’s disease (CD) remains unclear. Small, open-label case series have shown high rates of clinical remission but protocols have varied across studies, and no randomised controlled trials (RCT) have been performed. We present a protocol for the first pilot RCT of FMT in paediatric CD patients, using a novel colonoscopic + oral capsular intervention that uses fresh-frozen and prepared, lyophilised donor stool. We will measure improvements in clinical disease activity, inflammatory biomarkers, endoscopic markers of mucosal inflammation, as well as, assess key aspects of trial feasibility. Methods Patients 3–17 years with active CD, on stable medication doses for 4 weeks are eligible. Patients will have an initial colonoscopy during which they will receive an infusion into the terminal ileum of normal saline (placebo) or prepared healthy donor stool (RBX2660; Rebiotix, USA) (active). This will be followed by 6-weeks of bi-weekly oral capsular therapy, containing methylcellulose (placebo) or lyophilised healthy adult donor stool (RBX7455; Rebiotix, USA). Randomisation is 2:1 to active and placebo arms (n = 45). Patients will be followed over 24 weeks. (Figure 1) Results Study feasibility will be assessed by: rate of recruitment, completion of sample collections, and frequency and type of adverse events. Clinical outcomes will be measured serially using: Paediatric Crohn’s Disease Activity Index (PCDAI), faecal calprotectin, blood inflammatory markers, and Simple Endoscopic Score for Crohn’s Disease (SES-CD) at baseline and end-of-study. Stool 16s rRNA, metagenomics, and urine metabolomics profiles will be performed on collected stool and urine samples. Patients who complete the placebo arm will be eligible to enter an open-label extension study. Results will be measured through ITT and PP analyses. Proportions and percentages will be reported on feasibility outcomes; odds ratios, mean differences and 95% confidence intervals will be reported on clinical outcomes as preliminary estimates of efficacy. Conclusion This is the first pilot RCT of FMT in the treatment of CD. Recruitment commenced April 2019 and 13 patients have met screening criteria, with 5 enrolled thus far. This study is novel for its focus on paediatric CD patients, and its use of a combined oral + colonoscopic FMT delivery method. The results of this trial will offer preliminary estimates of efficacy for FMT-based therapies in CD, and may support expansion to a future larger multicenter paediatric RCT using our validated study protocol.

Efficacy and safety of glecaprevir and pibrentasvir combination therapy in old-aged patients with chronic hepatitis C virus infection.

Objective: Combination therapy with glecaprevir and pibrentasvir (G/P) has been shown to provide a sustained virologic response (SVR) rate of >97% in patients with chronic hepatitis C virus (HCV) infection in the first published real-world Japanese data. However, a recently published study showed that the treatment was often discontinued in patients ≥75 years old, resulting in low SVR in intention-to-treat (ITT) analysis. Thus, our aim was to evaluate real-world data for G/P therapy in patients ≥75 years of age, the population density of which is high in “rural” regions.Patients and Methods: We conducted a multicenter study to assess the efficacy and safety of G/P therapy for chronic HCV infection, in the North Kanto area in Japan.Results: Of the 308 patients enrolled, 294 (95.5%) completed the treatment according to the protocol. In ITT and per-protocol analyses, the overall SVR12 rate was 97.1% and 99.7%, respectively. The old-aged patients group consisted of 59 participants, 56 of whom (94.9%) completed the scheduled protocol. Although old-aged patients tended to have non-SVR factors such as liver cirrhosis, history of HCC, and prior DAA therapies, the SVR12 rates in old-aged patients were 98.3% and 100% in the ITT and PP analyses, respectively. Of 308 patients enrolled, adverse events were observed in 74 patients (24.0%), with grade ≥3 events in 8 patients (2.6%). There was no significant difference in any grade and grade ≥3 adverse events between the old-aged group and the rest of the study participants. Only one patient discontinued the treatment because of adverse events.Conclusion: G/P therapy is effective and safe for old-aged patients.

Positive impact of improved cookstove usage on respiratory health in Congolese refugees: a prospective cohort study.

Around 3 billion people worldwide use solid biomass fuels for cooking. Exposure to indoor biomass smoke is an important cause of COPD and therefore a target of many public health interventions, such as usage of improved cookstoves. The aim of our study was to show whether usage of improved cookstoves can lead to relevant improvement in lung function and CAT-score in a well characterized population including a subgroup of this population with preexisting airway obstruction. Interviews and spirometry were performed in Congolese women living in an UNHCR (United Nations High Commissioner for Refugees) refugee camp in Rwanda before (baseline, BL) and 9months after (follow-up, F9) they received an energy-efficient cookstove (Save80) and were trained how to use it. Two hundred sixty-two women completed both spirometry and interview appropriately at BL and F9 and were included in per protocol (pp) analysis, which showed no change in mean FEV1. The predefined subgroup of this population with airway obstruction at baseline (N = 31) showed a significant FEV1 increase (FEV1F9 = 1.70L; p < 0.01 vs FEV1BL = 1.58L, p < 0.01). Median CAT-scores were significantly lower in the F9 assessment. Our data indicate that usage of improved cookstoves has a positive impact on respiratory health especially in individuals with preexisting airway obstruction. Further studies to investigate long-term outcome are warranted.

Neoadjuvant therapy versus upfront surgery in resectable pancreatic cancer according to intention-to-treat and per-protocol analysis: A systematic review and meta-analysis

The effectiveness of neoadjuvant therapy (NAT) remains unclear in resectable pancreatic cancer (PC) as compared with upfront surgery (US). The aim of this study was to investigate the survival gain of NAT over US in resectable PC. PubMed and EMBASE were searched for studies comparing survival outcomes between NAT and US for resectable PC until June 2018. Overall survival (OS) was analyzed according to treatment strategy (NAT versus US) and analytic methods (intention-to-treat analysis (ITT) and per-protocol analysis (PP)). In 14 studies, 2,699 and 6,992 patients were treated with NAT and US, respectively. Although PP analysis showed the survival gain of NAT (HR 0.72, 95% CI 0.68–0.76), ITT analysis did not show the statistical significance (HR 0.96, 95% CI 0.82–1.12). However, NAT completed with subsequent surgery showed better survival over US completed with adjuvant therapy (HR 0.82, 95% CI 0.71–0.93). In conclusion, the supporting evidence for NAT in resectable PC was insufficient because the benefit was not demonstrated in ITT analysis. However, among the patients who completed both surgery and chemotherapy, NAT showed survival benefit over adjuvant therapy. Therefore, NAT could have a role of triaging the patients for surgery even in resectable PC.

Structure and Photoluminescence Properties of Hybrid Nanocomposites on the Base of PP/PbS/CdS

In given paper, were studied optical properties of nanocomposites obtained on base of PP + PbS/CdS with different concentration. The UV–Vis spectral analysis indicated that the optical band gap of the system was decreases with increasing of concentration of semiconductor nanoparticles inside the polymer. This can be explained by increasing of size of nanoparticles due to agglomeration of nanoparticles with increasing of concentration. SEM analysis of PP + PbS/CdS based nanocomposites showed that particle size in PP + 3% PbS/CdS, PP + 5% PbS/CdS, and PP + 15% PbS/CdS nanocomposites was the range of 5–10 nm, 12–18 nm, and 18–34 nm in respectively. At the same time, were investigated luminescence spectra of nanocomposites with different concentrations obtained on the base of PP + PbS/CdS. It has been established that the highest luminescence intensity is observed in nanocomposites PP + 3% PbS/CdS. This can be explained by the fact that in this concentration the luminescent centers are more active and more optimal structures are formed. At the same time, low luminescence intensity in PP + 15% PbS/CdS nanocomposites can be explained by reduction of the luminescence surface and weakening of activity of centers due to the growing size of particles by agglomerating with increasing of concentration.

A comparison between dexlansoprazole modified release-based and lansoprazole-based nonbismuth quadruple (concomitant) therapy for first-line Helicobacter pylori eradication: a prospective randomized trial.

PurposeSteadily maintaining high intra-gastric PH is the major factor for successful Helicobacter pylori (H.pylori) eradication. It is important to search for a stronger PPI. Dexlansoprazole MR is a dual delayed release formulation PPI taken once daily which is capable of maintaining longer duration of high intra-gastric PH. It is very effective in treating gastroesophageal disease but reports on H, pylori eradication is very rare. This study sought to compare dexlansoprazole MR-based concomitant treatment and lansoprazole-based concomitant treatment in H. pylori infection and to investigate the factors that affect the eradication rates.MethodsTwo hundred two participants with H. pylori infection were included and randomly assigned to seven days of dexlansoprazole MR-based concomitant therapy (dexlansoprazole MR 60 mg once daily, clarithromycin 500 mg twice daily, amoxicillin 1 g twice daily and metronidazole 500 mg twice daily; DACM group) or a seven days of lansoprazole-based concomitant therapy (lansoprazole 30 mg twice daily, clarithromycin 500 mg twice daily, amoxicillin 1 g twice daily, and metronidazole 500 mg twice daily; LACM group). The participants were asked to perform urea breath tests eight weeks later.ResultsThe eradication rates in the DACM group were 86.1% [95% confidence interval (CI): 77.8%–92.2%] in the ITT analysis and 90.6% (95% CI: 82.9%–95.6%) in the PP analysis, respectively, as compared with 90.1% (95% CI: 82.6%–95.2%) and 92.6% (95% CI: 85.5%–96.9%) (p=0.384 and p=0.572, respectively) in the LACM group for the same analyses. The adverse event rates were 11.5% in the DACM group and 10.2% in the LACM group (p=0.779).ConclusionAs a first-line H. pylori treatment regimen, dexlansoprazole MR-based concomitant therapy attained a successful eradication rate of 90%, which was non inferior to that of lansoprazole-based concomitant treatment.ClinicalTrials.gov identifierNCT03829150.

Financial Analysisof Rain Water Harvesting Tools in Pamor Hamlet, Banjardowo Village, Kradenan Sub District, Grobogan District

The drought that occurs in the dry season is one of the hydrometeorological disasters. A total of 82 villages of 12 districts in Grobogan, Central Java, experience a clean water crisis due to drought because the well, as their main source of water, is likely to go dry. Therefore, a solution is needed to anticipate the water shortage. The aims of this paper is to analyze financially the water harvesting building which can be used as a reference for the community. The research was conducted in Pamor Hamlet, Banjardowo Village, Kradenan District, Grobogan Regency. The method used was to build the rainwater harvesting engineering models, namely (a) recycling tools for washing and bathing, (b) dirt filter wells, (c) three meters depth infiltration wells (1 well and 2 wells), and (d) five meters deep infiltration wells (1 well and 2 wells). Data collection was done by conducting a survey of the community. The data collected were the costs required for the construction of the rainwater harvesting equipment, maintenance, electricity, supporting materials, etc. The income was approached with replacement costs if the community buys water during the dry season. The financial analyses of NPV, IRR, BCR, and PP were employed. The results showed several feasible models to be applied, namely recycling equipment for washing and bathing, dirt filtering equipment, three meters deep infiltration wells (1 piece) and a depth of 5 meters (1 piece). This model is very good to be adopted by the community because it is easy and has minimal costs.

Estrogen therapy before hysteroscopic adhesiolysis improves the fertility outcome in patients with intrauterine adhesions.

To describe the fertility outcomes after hysteroscopic adhesiolysis combined with preoperative hormone treatment in women with intrauterine adhesion (IUA). This study is a retrospective cohort study. A total of 230 patients with IUA underwent hysteroscopic adhesiolysis combined with hormone treatment from Jan 2012 to Jun 2018. 148 patients who received preoperative estrogen treatment were enrolled into group A and 82 patients without preoperative estrogen treatment were enrolled into group B. All the patients underwent hysteroscopic adhesiolysis and received postoperative estrogen therapy, intrauterine indwelling device. Second or third look was performed after 2-3months. 90.87% (209/230) patients complete the study. The AFS scores at baseline were higher in the group A than group B. After the preoperative E2 treatment, group A achieved the comparable AFS score to group B before the surgery. The cumulative fertility rate in group A was comparable in group B, both in the ITT analysis (49.32% vs. 52.44%, p = 0.651) and the PP analysis (54.07% vs.58.10%, p = 0.575).The mean conception time was also similar in group A and group B (8.30 ± 6.47 vs. 8.54 ± 5.68months, p = 0.837). Besides, the surgery times in group A were less than group B. There was no difference in the rate of adverse events between two groups. Hysteroscopic adhesiolysis combined with preoperative oestrogen could reduce the preoperative AFS scores and the times of surgery which yield a similar conception rate in women with less severe intrauterine adhesions.