Nevin Manimala

World J Surg Oncol. 2023 Oct 11;21(1):318. doi: 10.1186/s12957-023-03215-2.

ABSTRACT

BACKGROUND: The main types of PD-L1 in the blood include soluble PD-L1 (sPD-L1), exosomal PD-L1 (exoPD-L1), and PD-L1 in circulating tumor cells (CTCs). However, the predictive and prognostic values of these three indicators in patients with non-small cell lung cancer (NSCLC) undergoing immune checkpoint inhibitor (ICI) therapy are unclear, warranting a systematic meta-analysis.

METHODS: A systematic literature search was performed in the PubMed, Cochrane Library, and Embase databases. The pooled hazard ratio (HR) and 95% confidence interval (CI) values were extracted from the included studies to investigate the correlation between the three PD-L1 indicators and overall survival (OS) or progression-free survival (PFS). The Newcastle-Ottawa Scale (NOS) was used to examine the quality of the included studies. Subgroup analyses were employed to investigate the heterogeneity. The publication bias of the included studies was assessed using Begg’s and Egger’s tests. P < 0.05 was regarded as significantly different.

RESULTS: The pooled results revealed that high pre-treatment sPD-L1 levels were significantly associated with inferior OS (HR = 2.32, 95% CI = 1.68-3.18, P < 0.001) and PFS (HR = 2.52, 95% CI = 1.72-3.68, P < 0.001). However, dynamic changes in sPD-L1 after immunotherapy were not statistically significant for OS (HR = 1.46, 95% CI = 0.65-3.26, P > 0.05) or PFS (HR = 1.62, 95% CI = 0.92-2.86, P > 0.05). Meanwhile, the upregulated pre-treatment exoPD-L1 levels were significantly associated with poor PFS (HR = 4.44, 95% CI = 2.87-6.89, P < 0.001), whereas the post-treatment dynamic upregulation of exoPD-L1 was significantly correlated with superior PFS (HR = 0.36, 95% CI = 0.24-0.54, P < 0.001) and OS (HR = 0.20, 95% CI = 0.07-0.53, P < 0.001). For PD-L1 in CTCs, the pooled results indicated that PD-L1 expression in CTCs was not significantly correlated with OS (HR = 0.75, 95% CI = 0.49-1.13, P = 0.170) and PFS (HR = 0.79, 95% CI = 0.59-1.06, P = 0.12).

CONCLUSIONS: Blood-based PD-L1 analysis is a potential strategy for predicting treatment efficacy and prognosis in patients with cancer.

PMID:37821941 | DOI:10.1186/s12957-023-03215-2

BMC Health Serv Res. 2023 Oct 11;23(1):1084. doi: 10.1186/s12913-023-10110-9.

ABSTRACT

BACKGROUND: Public assistance programs aim to prevent financial poverty by guaranteeing a minimum income for basic needs, including medical care. However, time poverty also matters, especially in the medical care adherence of people with chronic diseases. This study aimed to examine the association between the dual burden of working and household responsibilities, with unscheduled asthma care visits among public assistance recipients in Japan.

METHODS: This retrospective cohort study included public assistance recipients from two municipalities. We obtained participants’ sociodemographic data in January 2016 from the public assistance database and identified the incidence of asthma care visits. Participants’ unscheduled asthma visits and the frequency of asthma visits were used as the outcome variables. Unscheduled visits were defined as visits by recipients who did not receive asthma care during the first three months of the observation period. Participants’ age, sex, household composition, and work status were used as explanatory variables. Multiple Poisson regression analyses were performed to calculate the cumulative incidence ratio (IR) with a 95% confidence interval (CI) of unscheduled visits across the explanatory variables. The effect of modification on the work status by household composition was also examined.

RESULTS: We identified 2,386 recipients at risk of having unscheduled visits, among which 121 patients (5.1%) had unscheduled visits. The multivariable Poisson regression revealed that the working recipients had a higher incidence of unscheduled visits than the non-working recipients (IR 1.44, 95% CI 1.00-2.07). Among working recipients, the IRs of unscheduled visits were higher among recipients cohabiting with adults (IR 1.90 95% CI 1.00-3.59) and with children (IR 2.35, 95% CI 1.11-4.95) than for recipients living alone. Among non-working recipients, the IRs of unscheduled visits were lower for recipients living with family (IR 0.74, 95% CI 0.41-1.35) and those living with children (IR 0.50, 95% CI 0.20-1.23). A higher frequency in asthma visits was observed among working recipients living with family.

CONCLUSIONS: Working adults cohabiting with children are at the greatest risk of unscheduled visits among adults receiving public assistance. To support healthy lifestyles of public assistance recipients, medical care providers and policymakers should pay special attention to the potentially underserved populations.

PMID:37821936 | DOI:10.1186/s12913-023-10110-9

BMC Public Health. 2023 Oct 11;23(1):1977. doi: 10.1186/s12889-023-16880-5.

ABSTRACT

BACKGROUND: Increasing employment and immigration have been proposed as possible solutions to tackle the problem of the labour force shortage in aging societies. Ensuring sufficient health and work ability among migrants is a key factor in increasing and maintaining their employment. Many studies have found higher disability pension (DP) rates among migrants compared to natives but such studies lack in determining the risk of DP by occupational class and industrial sector. This study explores the risk of DP and the contribution of sociodemographic and work-related factors between migrants and natives in Finland.

METHODS: Full-population panel data obtained from the administrative registers of Statistics Finland were used to study 2.3 million individuals aged 25-60 years in 2010. We calculated hazard ratios (HR) and their 95% confidence intervals (CI) to estimate the risk of having a DP in 2011-2019 using Cox proportional hazard models adjusting for different sociodemographic and work-related factors.

RESULTS: Compared to natives, migrants had a lower risk of a DP (HR 0.58, 95% CI 0.53-0.63). We found great variation between countries of origin, where compared to natives, migrants from refugee-exporting countries (HR 1.37, 95% CI 1.22-1.53) and other non-European countries (HR 1.30; CI 1.18-1.43) had a higher risk of DP, but migrants from other countries did not differ or had a slightly lower risk of DP than natives. The associations between sociodemographic factors and the risk of DP were very similar between natives and migrants.

CONCLUSION: Migrants had a lower risk of a DP than natives except for migrants from outside Europe. The associations between different sociodemographic and work-related factors and the risk of DP were similar between natives and migrants and did not completely explain the differences in the risk of DP.

PMID:37821921 | DOI:10.1186/s12889-023-16880-5

J Pharm Policy Pract. 2023 Oct 11;16(1):120. doi: 10.1186/s40545-023-00629-x.

ABSTRACT

BACKGROUND: In middle-income countries like Nigeria, the misuse of antibiotics by consumers is posing serious threats to public health. This is contributing to the alarming increase in antimicrobial resistance, which is reducing the effectiveness of antibiotics against common infections. This study therefore aimed to assess the knowledge, perceptions, and factors associated with antibiotics misuse among consumers visiting selected community pharmacies.

METHODS: This cross-sectional study conducted in Ibadan, Nigeria, aimed at determining factors influencing antibiotics misuse among consumers. The questionnaires were completed by 509 consumers. The analysis was done using SPSS version 26 and the results were presented using descriptive statistics. The associations between categorical variables were analysed using Pearson’s Chi-square with statistical significance set at p < 0.05.

RESULTS: Results showed that 95.9% of the consumers believed that antibiotics prevent bacterial growth, and 60.7% thought they treat all infections. However, 57.4% were unaware of antibiotic resistance, while only 14.7% had adequate knowledge about antibiotics. Most of the consumers, 72.5% had used antibiotics in the last 12 months and, amoxicillin 42.4% was the most commonly used with, malaria 38.9% as the primary condition for which antibiotics were used. Some of the significant factors influencing antibiotics misuse included delays in test reports (p-value = 0.007), the belief in antibiotics’ quick relief (p-value = 0.001), proximity of the pharmacy to their house or workplace (p-value = 0.028), amongst others.

CONCLUSION: Most of the consumers had inadequate knowledge about rational antibiotic use which contributed to their misuse of antibiotics. Thus, targeted educational interventions are needed to improve knowledge and promote appropriate antibiotic use among consumers. Policies regulating the dispensing and selling of antibiotics with adequate counselling should be further enforced.

PMID:37821920 | DOI:10.1186/s40545-023-00629-x

BMC Public Health. 2023 Oct 11;23(1):1973. doi: 10.1186/s12889-023-16940-w.

ABSTRACT

Dengue fever is one of the biggest threats to public health in China, causing huge disease burden and economic loss. Aedes-mosquito surveillance could be a cornerstone for predicting the risk of Aedes-borne diseases and evaluating the effect of vector management during diseases outbreaks. The human landing catch (HLC) method is regarded as the “gold standard” for catching Aedes mosquitoes, but it potentially exposes field professionals to vectors of known or unknown pathogens. Human-baited double net (HDN) was recommended to replace HLC for emergency monitoring in China when Aedes-borne diseases break out, but it had been reported with low efficiency for capturing Aedes mosquitoes. In this study, we compared HLC with HDN and BG traps for field Aedes albopictus monitoring, with the aim of evaluating the effectiveness of HDN replacing HLC and finding an effective and safe alternative to the HLC for monitoring Aedes albopictus. Six sites in Hangzhou, Shaoxing, and Yiwu, Zhejiang Province, China, were chosen to conduct outdoor HLC, HDN, and BG trap catches from June to October 2021. The tests were performed 3 h apart: 8:30-9:30 AM, 16:30-17:30 PM, and 17:30-18:30 PM. A total of 2330 adult mosquitoes were collected, and Aedes albopictus was the most abundant species in all three catches with 848(98.95%), 559(97.39%) and 867 (96.44%) caught in HLC, HDN and BG traps respectively. Compared to HLC, HDN collected significantly less Ae. albopictus and Ae. albopictus females per trapping period (P < 0.001, P < 0.001), whereas no statistical differences were found between the HLC and BG trap (P = 0.970, P > 0.05). Statistically significant positive spatial correlations for Ae. albopictus sampling was found between HLC and HDN traps (r = 0.543, P < 0.001) and HLC and BG traps (r = 0.658, P < 0.001). In conclusion, both the BG trap and HDN have a significant positive spatial correlation with HLC, making them safer alternatives to HLC for Ae. albopictus monitoring in China. However, with better a sampling efficiency, being less labor intensive, and no human-baited attraction bias, the BG trap could be a better choice than the HDN trap.

PMID:37821916 | DOI:10.1186/s12889-023-16940-w

Eur J Med Res. 2023 Oct 12;28(1):427. doi: 10.1186/s40001-023-01265-6.

ABSTRACT

BACKGROUND: The neuropathological confirmation serves as the gold standard for diagnosing Alzheimer’s disease (AD), but it is usually not available to the living individuals. In addition, the gold standard for diagnosing Mild Cognitive Impairment (MCI) remains unclear yet. Neuropsychological testing, such as the Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE) and Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-cog), is commonly used tests in identifying AD and MCI, offering convenience, affordability, non-invasiveness, and accessibility in clinical settings. We aimed to accurately evaluate the discriminative ability of the three tests administrated at the same visit simultaneously in detecting AD and MCI due to AD in the absence of a gold standard.

METHODS: A total of 1289 participants aged over 65 were included from the baseline visits of Alzheimer’s disease Neuroimaging Initiative. Bayesian latent class models, accounting for conditional dependence between MoCA and MMSE, were conducted to assess the diagnostic accuracy of the three tests for detecting AD and MCI.

RESULTS: In detecting AD, the ADAS-cog had the highest Youden’s Index (0.829), followed by the MoCA(0.813) and MMSE(0.796). The ADAS-cog and MoCA showed similar sensitivity (0.922 vs 0.912) and specificity (0.907 vs 0.901), while the MMSE had lower sensitivity (0.874) and higher specificity (0.922). For MCI detection, the ADAS-cog had the highest Youden’s Index (0.704) compared to the MoCA (0.614) and MMSE (0.478). The ADAS-cog exhibited the highest sensitivity, closely followed by the MoCA and MMSE (0.869 vs 0.845 vs 0.757), and the ADAS-cog also had good specificity (0.835 vs 0.769 vs 0.721). The estimated true prevalence of AD among individuals aged over 65 was 20.0%, and the estimated true prevalence of MCI due to AD was 24.8%.

CONCLUSIONS: The findings suggest that the ADAS-cog and MoCA are reliable tools for detecting AD and MCI, while the MMSE may be less sensitive in detecting these conditions. A large underdiagnosis of the MCI and Alzheimer’s population still remains in clinical screening.

PMID:37821912 | DOI:10.1186/s40001-023-01265-6

BMC Health Serv Res. 2023 Oct 12;23(1):1091. doi: 10.1186/s12913-023-10075-9.

ABSTRACT

BACKGROUND: The Community Paramedicine at Home (CP@home) program is a health promotion program where community paramedics conduct risk assessments with frequent 9-1-1 callers in their homes, with a goal of reducing the frequency of 9-1-1 calls in this vulnerable population. The effectiveness of the CP@home program was investigated through a community-based RCT conducted in four regions in Ontario, Canada. The purpose of this current recruitment study is to examine the challenges met when recruiting for a community randomized control trial on high frequency 9-1-1 callers.

METHODS: Eligible participants were recruited from one of four regions participating in the CP@home program and were randomly assigned to an intervention group (n = 1142) or control group (n = 1142). Data were collected during the recruitment process from the administrative database of the four paramedic services. Whether they live alone, their parental ethnicity, age, reason for calling 9-1-1, reason for not participating, contact method, and whether they were successfully contacted were recorded. Statistical significance was calculated using the Chi-Squared Test and Fisher’s Exact Test to evaluate the effectiveness of the recruitment methods used to enroll eligible participants in the CP@home Program.

RESULTS: Of the people who were contacted, 48.0% answered their phone when called and 53.9% answered their door when a home visit was attempted. In Total, 110 (33.1%) of people where a contact attempt was successful participated in the CP@home program. Most participants were over the age of 65, even though people as young as 18 were contacted. Older adults who called 9-1-1 for a lift assist were more likely to participate, compared to any other individual reason recorded, and were most often recruited through a home visit.

CONCLUSIONS: This recruitment analysis successfully describes the challenges experienced by researchers when recruiting frequent 9-1-1 callers, which are considered a hard-to-reach population. The differences in age, contact method, and reason for calling 9-1-1 amongst people contacted and participants should be considered when recruiting this population for future research.

PMID:37821905 | DOI:10.1186/s12913-023-10075-9

Ann Gen Psychiatry. 2023 Oct 11;22(1):39. doi: 10.1186/s12991-023-00471-0.

ABSTRACT

BACKGROUND: In Kalhbaum’s first characterization of catatonia, the emotional symptoms, such as decreased or restricted expression of feelings and emotions, which is described as blunted affect, are related to the motor symptoms. In later years, the affective domain was excluded from the concept of catatonia and was not included among the diagnostic criteria in the various Diagnostic Statistical Manual (DSM) versions. In recent times, some authors have proposed the proposition of reevaluating the notion of catatonia through the reintroduction of the affective domain. The objective of this study was to examine the correlation between catatonic-like behavior (CLB), such as emotional withdrawal, blunted affect, and psychomotor slowing, and inflammatory markers, namely the neutrophil/lymphocytes ratio (NLR) and lymphocytes/monocytes ratio (LMR), in individuals diagnosed with schizophrenia.

METHOD: A sample of 25 patients with schizophrenia (10 females, 15 males) was recruited, and the Brief Psychiatric Rating Scale (BPRS) was used to assess the severity of emotional withdrawal, blunted affect, and psychomotor slowing.

FINDINGS: The correlation analysis (Spearman ρ) revealed a robust direct association between blunted affect and psychomotor slowing (ρ = 0.79, P = 0.001), and a significant direct correlation between CLB (emotional withdrawal, ρ = 0.51, P = 0.05; blunted affect ρ = 0.58, P = 0.05; motor retardation, ρ = 0.56, P = 0.05) and LMR (ρ = 0.53, P = 0.05). In addition, patients with a duration of illness (DOI) older than five years had a higher presence of CLB and a higher LMR than patients with a more recent diagnosis of the disease. Likely, patients with positive symptoms and in the prodromal and active stages of the disease have a different immune profile than patients in the residual stage and with a predominance of negative symptoms.

CONCLUSIONS: Psychomotor slowing and blunted affect are two significantly related features, representing the two-faced Janus of immobility. Furthermore, aggregating them in CLB is more predominant the longer the duration of schizophrenia and is associated with different a specific pattern of immune activation.

PMID:37821904 | DOI:10.1186/s12991-023-00471-0

BMC Oral Health. 2023 Oct 11;23(1):747. doi: 10.1186/s12903-023-03459-0.

ABSTRACT

BACKGROUND: The aim of the scoping review was to identify and synthesize the available literature concerning the relationship between the status of refugees, migrants, and internally displaced persons (IDPs) and Early Childhood Caries (ECC) as it relates to the United Nation’s Sustainable Development Goal 16 (SDG 16).

METHODS: Data regarding the links between the status of refugees, migrants, and internally displaced persons (IDPs) and Early Childhood Caries (ECC), and the associations between ECC and maternal and child exposure to physical and sexual abuse, insecurity, crime, exploitation, torture, and displacement were extracted. The search was carried out in January 2023 across three databases (PubMed, Web of Science, and Scopus). Only publications in English with accessible full texts were included. Descriptive statistics were utilized to summarize the categories of the retrieved papers, and graphical representation was employed for visualization purposes. The relationships between the publications and each of the 10 targets of Sustainable Development Goal 16 (SDG 16) were also assessed.

RESULTS: Forty-five studies were reviewed. Most studies (42.2%) originated from the Americas Regions, while no studies were identified from the Africa Region. A significant portion (46.7%) of the papers focused on abuse, violence, and neglect as risk factors for ECC. Migrants, refugees, and IDPs were the most investigated populations (44.4%). Only one study specifically focused on IDPs and migrants respectively. The prevalence of untreated caries was higher among migrants, refugees, and IDPs compared to the host community, ECC was more prevalent among children who experienced abuse, neglect, or were in protective care. The was no clear direction on the associations between ECC and intimate partner violence, adverse childhood experiences, and wars. In terms of the SDGs, the reviewed publications addressed four targets (SDG16.1, SDG16.2, SDG16.3, and SDG16.5) out of the ten targets outlined in SDG 16.

CONCLUSION: There is available evidence regarding the connections between ECC and war, refugees, migration, violence, and neglect, as outlined in SDG 16. Future studies are needed to investigate how forced movements directly affects ECC status, how disruptions of peace and stability is a risk factor for ECC, and the associations between ECC and other indicators related to SDG 16 targets.

PMID:37821894 | DOI:10.1186/s12903-023-03459-0

BMC Oral Health. 2023 Oct 11;23(1):746. doi: 10.1186/s12903-023-03399-9.

ABSTRACT

BACKGROUND: The variabilities in design and material of scan bodies have a major role in the positional transfer accuracy of implants. The purpose of this invitro study was to compare the 3D transfer accuracy (trueness and precision) of titanium base (TB) abutment position provided by 2 different scan bodies: one-piece scan body (SB) in comparison to two-piece healing abutment and scan peg (HA-SP).

METHODS: A maxillary model with a dummy implant in the 2nd premolar (Proactive Tapered Implant; Neoss) was 3D printed and TB (Ti Neolink Mono; Neoss) was tightened on the implant and scanned by using a laboratory scanner (inEos X5; Dentsply Sirona) (reference scan). An SB (Elos Medtech) and an HA-SP (Neoss) were subsequently connected to the implant and were scanned 10 times each by using the same scanner (test scans). All the scans were exported as STL files and imported into CAD software where the TBs were formed. Test scans were superimposed on reference scans for transfer accuracy analysis using 3D metrology software (GOM Inspect; GOM GmbH) in terms of angular deviation in vertical and horizontal directions, linear deviation in each XYZ axis of TBs and total linear deviation in all axes. Statistical analysis was done using independent sample t test. When Levene’s test for equality of variances was significant, Welch’s t-test was used. (P value < 0.05) RESULTS: Significant differences were found amongst the tested groups in both angular and linear deviation in terms of trueness with less deviation values for the SB group (P < 0.001). For the precision, significant differences were found amongst the tested groups in angular deviation in vertical direction with less deviation value for the SB group compared to HA-SP group (P < 0.001). However, no significant difference was found between the tested groups regarding the angular deviation in horizontal direction (P = 1.000). Moreover, significant differences were found amongst the tested groups in linear deviations with less linear deviations in XYZ axes for SB compared to HA-SP group (P = 0.020, < 0.001, = 0.010 respectively).

CONCLUSIONS: SB showed less angular and linear deviation values in the 3D positional transfer of TB than HA-SP indicating higher degree of accuracy of SB.

PMID:37821890 | DOI:10.1186/s12903-023-03399-9