Comparison of new-generation drug-eluting stents versus drug-coated balloon for in-stent restenosis: a meta-analysis of randomised controlled trials

OBJECTIVE: The study sought to compare angiographic and clinical outcomes of new-generation drug-eluting stents (DES) versus drug-coated balloon (DCB) in patients with coronary in-stent restenosis (ISR). DESIGN: Meta-analysis using data from randomised trial found by searches on PubMed, the Cochrane Library, ClinicalTrials.gov and websites of major cardiovascular congresses. SETTING: Only randomised trials comparing DES with DCB were included. PARTICIPANTS: Patients with ISR in the included trials. INTERVENTIONS: New-generation DES versus DCB. OUTCOMES: The angiographic and clinical outcomes including cardiac death, all-cause death, myocardial infarction, target lesion revascularisation (TLR), target vessel revascularisation (TVR), major adverse cardiac events (MACE) and stent thrombosis were investigated. RESULTS: Five trials including 913 patients were eligible and included. Pooled analysis in angiographic results identified that new-generation DES were associated with higher acute luminal gain (-0.31 mm, 95% CI -0.42 to -0.20, P<0.001) and lower per cent diameter stenosis (risk ratio (RR): 0.28, 95% CI 0.02 to 0.55, P=0.04). DES significantly reduced the risk of TLR (RR: 1.96, 95% CI 1.17 to 3.28, P=0.01) compared with DCB; however, there was no statistical differences for MACE (RR: 1.21, 95% CI 0.67 to 2.17, P=0.53), myocardial infarction (RR: 1.16, 95% CI 0.55 to 2.48, P=0.69) and cardiac death (RR: 1.80, 95% CI 0.60 to 5.39, P=0.29). CONCLUSIONS: Interventions with new-generation DES appear to be associated with significant reduction in per cent diameter stenosis and TLR at short-term follow-up, but had similar MACE, myocardial infarction and cardiac death for patients with coronary ISR compared with DCB. Appropriately powered studies with longer term follow-up are warranted to confirm these findings

Enhancing privacy protections in national identification systems: an examination of stakeholders’ knowledge, attitudes, and practices of privacy by design

Privacy by Design (PbD) is a well-known concept that aims to provide a high level of protection for privacy throughout the entire life cycle of systems development. Despite the considerable attention from stakeholders such as researchers, government agencies, and system suppliers, the widespread adoption of PbD faces obstacles due to a lack of knowledge, insufficient awareness of PbD benefits, and the absence of specific implementation guidelines. In this study, stakeholders are identified primarily as diverse participants from government agencies and system suppliers engaged in National Identification Systems (NIDS). Specifically, government agencies representing regulatory bodies and administrators of NIDS, setting the legal framework that governs the NIDS’s privacy aspects. The NIDS system suppliers includes private companies playing a crucial role in the development and implementation of NIDS with a focus on privacy considerations. Through the perspectives of NIDS stakeholders, this study aimed to examine the Knowledge, Attitudes and Practices (KAP) of PbD principles and its integration in NIDS. A survey involving 203 participants from government agencies and NIDS system suppliers engaged in NIDS development was conducted. Subsequently, a focus group discussion was held with 11 members to provide qualitative insights into the KAP of PbD. The survey results revealed a significant correlation between attitudes and practices but a weak correlation between knowledge and attitudes or practices. The focus group discussion assured these findings, emphasizing the role of positive attitudes in facilitating PbD practices and highlighting knowledge-practice gaps. In conclusion, this study offers tailored recommendations for improving the integration of PbD in NIDS development. The recommendations includes strategies such as developing training programs, establishing clear guidelines and standards and creating awareness campaigns.publishedVersio

A comprehensive overview of radioguided surgery using gamma detection probe technology

The concept of radioguided surgery, which was first developed some 60 years ago, involves the use of a radiation detection probe system for the intraoperative detection of radionuclides. The use of gamma detection probe technology in radioguided surgery has tremendously expanded and has evolved into what is now considered an established discipline within the practice of surgery, revolutionizing the surgical management of many malignancies, including breast cancer, melanoma, and colorectal cancer, as well as the surgical management of parathyroid disease. The impact of radioguided surgery on the surgical management of cancer patients includes providing vital and real-time information to the surgeon regarding the location and extent of disease, as well as regarding the assessment of surgical resection margins. Additionally, it has allowed the surgeon to minimize the surgical invasiveness of many diagnostic and therapeutic procedures, while still maintaining maximum benefit to the cancer patient. In the current review, we have attempted to comprehensively evaluate the history, technical aspects, and clinical applications of radioguided surgery using gamma detection probe technology