bluuebunny/crossref_metadata_2025 huggingface dataset:
OP156 Systematic Review And Meta-Analysis Of The Perioperative Association Of Gabapentinoids With Sedation And Respiratory Depression After Abdominal Surgery
Authors: Mansour Laure Taher , Seow Warren , Procter Nathan , Alexander Lucy , Pule Lettie , Duncan Joanna , Papa Lora , Singh Charlene , Maddern Guy
Published: December 2023

Introduction

With the increasing popularity of enhanced recovery protocols and the growing opioid epidemic, recent pain management pathways have emphasized opioid-sparing measures. As a result, gabapentinoids are being used following surgery and have become one of the most common opioid-sparing analgesics prescribed. However, they are not without risk, with several cases of respiratory depression and oversedation being reported.

Methods

This systematic review and meta-analysis aimed to evaluate the impact of gabapentinoids on sedative complications following abdominal surgery in order to guide future clinical decisions. The Pubmed and Embase databases were searched according to PRISMA guidelines to identify randomized controlled trials comparing gabapentinoids with placebo following abdominal surgery with respect to sedation complications. The Cochrane Risk of Bias Tool was used to assess study quality. A comparative meta-analysis was performed on the data.

Results

Of the 3,988 studies retrieved, 19 were eligible for meta-analysis. Eleven of the 19 studies assessed pregabalin (100 to 1,200 mg) and eight assessed gabapentin (300 to 1,200 mg). Postoperative sedation scores were higher in the gabapentinoid group (p<0.01) relative to placebo. Subgroup analyses demonstrated higher scores two hours after surgery for gabapentinoids (p=0.03), but no statistical difference at 24 hours (p=0.19). Different doses did not yield any differences on forest plot analyses.

Respiratory depression rates were higher in the gabapentinoid group, compared with placebo (p=0.02).

Conclusions

The preoperative use of gabapentinoids is associated with sedative complications, including respiratory depression. These results may help guide future perioperative pain protocols.
OP163 Applying A Local Economic Evaluation Framework To Make Evaluations More Relevant For Local Decision Makers
Authors: Gray Jodi , Karnon Jonathan
Published: December 2023

Introduction

Economic evaluation is infrequently used by local health services. To be useful to local decision makers, economic evaluations need to synthesize published evidence on effective interventions with local data and local stakeholder knowledge regarding patient and organizational contexts. A framework for local economic evaluation was applied by health economists working with a local health service to inform their decision-making regarding funding of health service delivery models to reduce hospital-acquired complications.

Methods

The framework engaged with local stakeholders to set priorities, assess the relevance of the published evidence, interpret local data, provide insight on the local context, and make recommendations to decision makers. It involved: (i) synthesizing the published evidence in a pragmatic review; (ii) determining local root causes and baseline incidence rates using local clinical and administrative data; and (iii) using expert elicitation to adjust published intervention effects to reflect the local context. This information was synthesized in a cost-consequence analysis that estimated the likely costs and effects of relevant interventions if they were implemented locally.

Results

Local stakeholders selected hypoglycemia and urinary tract infections as targets for intervention. Tools and resources developed for each case study included: clinical audit tools and analysis files; pragmatic literature reviews with templates to present interventions to local stakeholders; an expert elicitation framework; and R code for cost-consequence analyses that apply published and elicited intervention effects to local data.

Conclusions

The framework provided a feasible and acceptable process for undertaking local economic evaluations. Engagement with local stakeholders ensured the evaluations produced were relevant and tailored to the local setting and were therefore useful to local decision makers. The tools and resources developed can be applied by other local health services. The framework itself can be used for other case studies. However, the time and cost associated with the evaluations was not sustainable and alternative models for applying the framework need to be explored.
PP33 The Cost-effectiveness Of Regorafenib In The Treatment Of Advanced Hepatocellular Carcinoma From A Canadian Perspective
Authors: Hussain Mohammad Salman , Singh Ambrish
Published: December 2023

Introduction

Hepatocellular carcinoma (HCC) is the most common form of liver cancer and the fourth leading cause of cancer-related death globally. There are unmet needs for effective systematic therapy. The findings of the RESORCE trial highlighted the improvement in overall survival with regorafenib in advanced HCC patients progressing on sorafenib treatment. This study aimed to assess the cost-effectiveness of regorafenib compared with best supportive care (BSC) for advanced HCC from the Canadian healthcare system perspective.

Methods

We developed a Markov model based on four health states: live with adverse events, live without adverse events, progression, and dead. Health outcomes were measured using life-years (LYs), and quality-adjusted life-years (QALYs), and costs were presented in Canadian dollars (CAD). Clinical inputs were derived from the RESORCE trial. A 1.5 percent discount rate was applied to costs and outcomes. One-way and probabilistic sensitivity analyses were performed to assess the uncertainty in findings due to variability in parameters. TreeAge Pro software was used for model implementation.

Results

The use of regorafenib results in a gain of 0.38 LYs and 0.25 QALYs as compared to BSC with a high incremental cost of CAD26,954 (USD22,313). The ICER for regorafenib compared with BSC was CAD105,850/QALY (USD87,624/QALY) in the base-case analysis. Further, probabilistic sensitivity analyses revealed regorafenib not to be cost-effective at a willingness-to-pay threshold of CAD50,000/QALY.

Conclusions

Regorafenib was not found to be cost-effective in the treatment of advanced HCC because of the lower health benefits and higher incremental costs. Lowering the official price of regorafenib or use for only selected patients who can achieve maximum benefits would enhance its cost-effectiveness and treatment preference value.
PP40 Structuring Unstructured Medical Device Reimbursement In India
Authors: Goel Ashwin , Fahim Arif , Pusha Monika , Kataria Kirti
Published: December 2023

Introduction

As India makes rapid strides towards universal health coverage, focusing on medical device reimbursement is key to ensuring patient access to device-based technologies. The nascent medical device reimbursement process offers a promising opportunity for interventions driven by a diverse group of stakeholders. We conducted policy research to capture these diverse perspectives and highlight key elements to develop a structured framework for reimbursement.

Methods

This research was a two-part process, including secondary research with expert interviews followed by policy research using focus group discussions (FGDs) through an online workshop with key stakeholders. We developed a white paper proposing changes to the reimbursement pathway, based on a benchmarking study of global markets and interviews with experts in the field. As a next step, key changes proposed in the white paper were deliberated upon by three focus groups (six to eight participants). Group participants were selected by quota sampling and represented key stakeholders in the reimbursement process. A discussion guide was used to capture participants’ opinions and an addendum to the white paper was released highlighting small, actionable, and impactful changes to the reimbursement process.

Results

FGDs with key stakeholders highlighted the need to establish a more structured, inclusive, and transparent process. Accordingly, we proposed key recommendations to the medical device reimbursement process in India. A first change is the creation of an online submission portal allowing different healthcare stakeholders to submit new technologies for consideration through a streamlined pathway. Secondly, we proposed enhancing evaluation transparency by improving availability of publicly shared information on the evaluation process, metrics, and assessment timelines. We also suggested adoption of adaptive health technology assessments to leverage existing evidence for faster, efficient decision-making.

Conclusions

Through this process, we created a pragmatic and concrete call for a stronger voice from care-providers and patient groups in the evaluation process. Consecutively, the proposed innovative framework introducing value-based incentives for implantable medical devices will be instrumental in enabling access to quality health care for poor patients. These strategies follow the principles of value-based care and will go a long way in achieving better health outcomes for the population. The scientific initiative has been made possible with the support of St. Jude Medical India Pvt Ltd (now Abbott).
PP42 Insights Of Health Technology Assessment In Brazilian Health Unified System: Areas Of Interests In Health
Authors: Pires Wolney , Borges Stefani , Rodrigues Fernanda , da Costa Nathalia , Louly Priscila , Prado Clementina , Santos Vania
Published: December 2023

Introduction

The National Committee for Health Technology Incorporation of the Brazilian Public Health System’ s (Conitec) principle is to advise the Ministry of Health (MS) in the tasks related to incorporation, exclusion or modification of any health technologies into the Unified Health System (SUS). Moreover, this also involves alteration of clinical protocols or therapeutic guidelines. All of the recommendations consider the international classification of diseases (CID) as a common language that allows health professionals and managers to understand standardized information, to identify trends and benefits of recommendations in each therapeutic area.

Methods

This exploratory, descriptive and retrospective study aims to provide qualitative and quantitative data from the technologies evaluated by the Conitec in the period June 2012 to November 2022. Data were extracted in Conitec’s website.

Results

The searches resulted in 763 recommendations in total. Among them, the most evaluated therapeutic area was Infectology with 126 technologies (16.5%). In this field the highlighted diseases and conditions were Hepatitis 42 (33.3%); HIV 23 (18.3%) and COVID-19 11 (8.7%). In Oncology, 113 recommended technologies (14.8%) were identified, in order of prominence for the diseases: Breast Cancer 21 (18.6%); Colorectal Cancer 11 (9.7%); Leukemias 17 (15.0%). In the Respiratory Diseases area, 89 technologies (11.7%) were recommended, among them: Chronic obstructive pulmonary disease (COPD) 17 (19.1%); Asthma 15 (16.9%) and COVID-19 11 (12.4%). These results clarify which diseases are most needing new technologies to be treated.

Conclusions

The results show what conditions and fields in health needs to be prioritized for public policies and prevention measures. This study demonstrates how important is to make accessible the public health information, improving public knowledge and social actions in SUS.
PP44 Time Is Now: Advancing Value Assessment Of Cancer Therapies To Help Eliminate Cancer As The Cause Of Death
Authors: Ryan James
Published: December 2023

Introduction

Earlier cancer diagnosis and advances in science are resulting in improved patient and societal outcomes. However, payer frameworks and methods can find it difficult to keep pace with scientific progress, evolution of endpoints, and assess the wider value of these advances.

Methods

A multidisciplinary, international group of experts working in the cancer field was brought together to reach consensus on key principles of defining and assessing of cancer treatment value. A Delphi-based approach including surveys, virtual panels, interviews and structured online discussions was used to reach consensus. This work was initiated and funded by AstraZeneca.

Results

Twenty-four experts from across the world (including patient advocates, oncologists, health economists, regulators, members of payer and health technology assessment (HTA) bodies) reached consensus on seven key principles across two themes, oncology relevant endpoints and dimensions of value. Three of the seven principles were found to be of particular relevance to HTA bodies and payers: assessing broad economic impact of new medicines (including socio-economic and caregiver impact), where early-stage cancer treatments can enhance patients’ ability to lead productive lives and contribute to economic activity; consider other value aspects of relevance to patients and society; use of Managed Entry Agreements (MEAs) supported by ongoing evidence collection to help address decision-maker evidence needs and address clinical uncertainty.

Conclusions

Incentivizing access to early-stage treatments can promote cancer control, improved outcomes and generate long-term societal benefit. Furthermore, early diagnosis and treatment at earlier stages of cancer can be cost-effective, and sometimes cost-saving, as well as provide opportunities for cure. Expanding value components in therapy assessments to include, for example, insurance value, the value of choice, scientific spillovers, and wider societal perspectives, along with structured MEAs to manage clinical uncertainty and balance budgets will help realize the potential to eliminate cancer as the cause of death.
PP53 Increasing Emergence Of Novel Digital Health Technologies Identified Through Horizon Scanning
Authors: Ng Zhen Long , Ju Hong , Ng Jaryl , Ng Kwong
Published: December 2023

Introduction

Recently, there have been calls for the development of new health technology assessment (HTA) methodologies to address the growing emergence of novel digital health technologies (DHTs). In particular, the lack of robust evidence base and technology-specific considerations of DHTs, such as software updates, present challenges for evaluation with conventional HTA methods. In Singapore, the Agency for Care Effectiveness (ACE) has established a horizon scanning (HS) system to provide the healthcare system with advance notice on emerging medical technologies (MedTechs) that may enter the Singapore market. This study aims to investigate the anticipated emergence of DHTs identified by ACE’s HS system and the potential implications on subsequent HTA methodology.

Methods

Based on ACE’s HS methodology, which is in line with international best practices, new and emerging MedTechs that address the top five local disease burden (i.e., cardiovascular, cancer, mental, neurological and musculoskeletal disorders) were identified from various sources and monitored for its development. These MedTechs were further filtered to shortlist potential technologies for HS assessment based on its innovative nature and appropriate time horizon to local regulatory approval. For this exercise, the filtered MedTechs were classified into categories such as DHTs, comprising technologies involving software or artificial intelligence (AI), and non-DHTs.

Results

Between 2021 and 2022, ACE has completed two topic filtration exercises. Based on 807 and 1,231 monitored MedTechs, 35 and 42 technologies remained after filtration, respectively. Among them, six out of 35 (17%) and 15 out of 42 (36%) filtered MedTechs were classified as DHTs, accounting for approximately two-fold increase in the number of DHTs shortlisted year-on-year. These DHTs include standalone AI software, software in a medical device, and digital therapeutics.

Conclusions

There is a substantial increase in DHTs identified that are anticipated to enter the local healthcare system. Given their unique characteristics, this may call for the modification of current HTA method to enable meaningful evaluation of DHTs.
PP70 Mapping Of Health Technology Assessment In China: A Comparative Study Between 2016 And 2021
Authors: Liu Shimeng , Xia Yu , Yang Yi , Ming Jian , Sun Hui , Wei Yan , Chen Yingyao
Published: December 2023

Introduction

This study aimed to compare changes in the level of health technology assessment (HTA) development from 2016 to 2021, and to inform policies and decisions to promote further development of HTA in China.

Methods

We conducted a cross-sectional and anonymous web-based survey to relevant stakeholders in China in 2016 and 2021 respectively. The mapping of the HTA instrument was used to reflect the HTA development from eight domains. To reduce the influence of confounders and to compare the mapping outcomes between 2016 and 2021 groups, we performed 1:1 propensity score matching methodology in this study. Univariate analysis was performed to compare the differences in these two groups. We also compared the overall results with that of a mapping study that included ten countries.

Results

A total of 212 and 255 respondents completed the survey in 2016 and 2021 respectively. After propensity score matching methodology, 183 cases from the 2016 group and 2021 group were matched. Overall, the mean score of 2021 in most of the domains was higher than in 2016 in China (p < 0.05), matching the level of HTA institutionalization and dissemination strategy, except for the assessment domain. Although China scored significantly lower among the three developed countries, the overall HTA development score for China was comparable among the ten countries.

Conclusions

Our study suggested the level of HTA development in China has made great progress from 2016 to 2021. Prior to HTA activities, the researcher or policy makers should first formulate an explicit assessment goal and scope, and during the assessment process, more attention should be paid to the clinical effectiveness and cost-effectiveness indicator to ensure a higher quality of HTA evidence.
PP81 Efficacy Of Transcranial Direct Current Stimulation For Depressive Episode Disorders
Authors: do Nascimento Martins Álex Brunno , Alvernaz dos Santos Bárbara Rodrigues , Pereira Elder Gomes , Prata Luana Oliveira , Araujo Maiara Silva , Muniz Júnior Roberto Lúcio , de Morais Martins Ursula Carolina , Guerra Júnior Augusto Afonso , de Assis Acúrcio Francisco , Teodoro Juliana Álvares
Published: December 2023

Introduction

Depression is a general term that describes different depressive disorders which are highly prevalent and disabling, characterized by decreases in quality of life. Transcranial Direct Current Stimulation (tDCS) is a non-invasive brain modulation technique used, among other purposes, for the treatment of chronic pain and headache. In order to clarify the effect of this stimulation on depressive disorders, the objective of this review was to evaluate efficacy and safety of treatment with tDCS for depressive disorders.

Methods

A systematic research study was carried out on 30 June 2022 in MEDLINE (by Pubmed), Embase, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), PsycInfo e Global Mental Health databases. Were included systematic reviews (SR) with meta-analysis that selected patients with depression, in use of tDCS, using as comparator sham stimulation (placebo) or any other treatment (pharmacologic or no) or any comparison between pre-and post-intervention.

Results

Eight SR with meta-analysis of randomized clinical trials (RCTs) on the efficacy and safety of tDCS in the treatment of depressive disorders were retrieved. Subjects were assessed for clinical response, remission, change in scores on depression scales, occurrence of procedure-related adverse events, and treatment dropout. Three systematic reviews showed results that point to the effectiveness of tDCS for the clinical response outcome and one considering the remission outcome. As for the outcome measured by the change in depression scale scores, all included reviews showed favorable results for tDCS. It is noteworthy that the studies included in the reviews have methodological limitations. With regard to safety, an increased risk treatment-emergent mania or hypomania (TEM) has been observed.

Conclusions

The tDCS association with antidepressants showed favorable results to this technology in a sample with depression and varied clinical characteristics. Regarding safety of this technology, tDCS did not show adverse effects of greater severity, but was verified to have an increased risk of TEM.
PP110 Knowledge Transfer From Scoping Review Into Primary Research In The Context Of Clinical Practice Guidelines Update
Authors: Sabalete Trinidad , Blasco Juan Antonio , Engelhard Ruth , Gracia Javier
Published: December 2023

Introduction

In the development and update process of clinical practice guidelines (CPG) is necessary to focus research questions as much as possible to optimize the systematic reviews. We carried out a scoping review as a precursor to a systematic review to update the recommendation of a CPG for the Management of Patients with Autism Spectrum Disorders in Primary Care. To our knowledge, there is limited information in the existing literature on graphical options for visually presenting scales or other available instruments and classification in a timeline graph.

Methods

We conducted a systematic search to identify instruments for screening of neurodevelopmental disorders and early detection and diagnosis of autism spectrum disorder (ASD). All studies were analyzed to retrieve scales and other instruments used in the assessment of neurodevelopment in the preschool children, and detection of signs and symptoms of neurodevelopment disorder or ASD. We developed a timeline graphic to compile all of the instruments retrieved.

Results

The information about the name of instrument, type, age of application, diagnostic accuracy, and context of validation was transferred to spreadsheet of the software program Microsoft Excel in tabular format. The instruments found were finally categorized according to the role of each of them in the diagnostic of autism, and age in which they are used. We developed a timeline graph for visually presenting classified instruments according to utility in the routine developmental surveillance, detection of specific signs and symptoms of ASD and diagnostics and evaluation of autism.

Conclusions

The proposed graphical timeline could assist methodologists and researchers in identifying gaps of evidence and lines of research related to use and validation in different contexts the scales and other instruments actually developed. The process of review of evidence can provide information useful for future research in the context of primary research. The relationship between groups of work of health technology assessment and primary research promote the knowledge transfer and optimization of research.
PP118 The Value Of New Antibiotic Treatment Strategies In Zhejiang Province, China
Authors: Wenqianzi Yang , Xuemei Zhen , Danhong Yang , Yixi Chen , Peng Dong , Al-Taie Amer , Hengjin Dong
Published: December 2023

Introduction

The rising antimicrobial resistance (AMR) and the difficulty in developing new antibiotics are causing a global public health problem. This analysis aims to better understand the clinical and economic value of new antibiotic treatment strategies, in order to inform clinical and antibiotic formulary decisions.

Methods

We applied a published and validated dynamic disease transmission and cost-effectiveness model of AMR with a 10-year time horizon and discount rate of five percent to evaluate the clinical and economic outcomes of introducing a new antibiotic, namely, Ceftazidime/Avibactam (CAZ-AVI) for treating AMR infections in Zhejiang Province, China. Together with piperacillin-tazobactam (pip/taz) and meropenem, we explored the impact of six treatment strategies across three common infections (complicated intra-abdominal infection (cIAI), hospital-acquired/ventilator-associated pneumonia (HAP/VAP) and infections with limited treatment options (LTO)), and pathogens (Escherichia coli, Klebsiella spp., and Pseudomonas aeruginosa). These treatment strategies included (i) current treatment strategy (pip/taz and meropenem, no CAZ-AVI), (ii) CAZ-AVI at the third line, (iii) CAZ-AVI at the second line, (iv) CAZ-AVI at the first line, (v) first line diversity (i.e., equal pip/taz and CAZ-AVI at the first line; meropenem at the last line) and (vi) all-lines diversity (pip/taz, meropenem and CAZ-AVI used randomly and only once). The data with a total of 10,905 patients were collected from a tier-3 hospital from 2018 to 2021.

Results

Under the current treatment strategy, the hospital length of stay (LOS) and costs over ten years were estimated to be 1,588,763 days and CNY3,898,198,802 (USD559,781,348), respectively, associated with 142,999 quality-adjusted life-years (QALYs) lost, resulting in the resistance of pip/taz and meropenem being 42.0 percent and 49.9 percent respectively. In contrast, the other five treatment strategies all have shown improved outcomes, among which the “all-lines diversity” carried the greatest benefit, saving CNY1,646.04 (USD236.37) for each additional QALY gained, with the net monetary benefit being CNY24,727,102,215 (USD3,550,811,878).

Conclusions

Introducing CAZ-AVI had positive impact on clinical and economic outcomes for treating AMR, and diversifying early the antibiotics might yield the best benefits.
PP128 A Transparent Methodology To Assess Innovativeness Of Health Technologies At Marketing Authorization Time
Authors: Gargano Ludmila , Freitas Isabela , Henriques Luila , André Ariane , Álvares-Teodoro Juliana , Acurcio Francisco , Guerra Augusto
Published: December 2023

Introduction

Defining drug innovation can be challenging and there is no consensus on what a truly “innovative” medicine is. The Italian Medicine Agency (AIFA) has established an approach to assess innovativeness based on therapeutic need, added therapeutic value, and quality of evidence. However, judgment can be subjective and may not be adequate for assessment at the time of marketing authorization, when only preliminary evidence – often from non-comparative or non-randomized trials – are available. We developed a transparent methodology for early assessment of innovativeness at the time of marketing authorization, based on AIFA guidelines.

Methods

Since the perspective was the marketing authorization date, only data available at agency’s Medical Review or pivotal trial publications were considered. AIFA criteria were revisited, using oncology medicines approved in the last 10 years as a base case. Impact of preliminary evidence and inadequate study design was considered.

Results

Each assessment should refer to the first approved specific indication and predefined clinically relevant outcomes. When more than one study was presented, best methodological quality, larger sample and/or longer follow-up was selected. Four domains were established: Therapeutical need: existence and clinical benefits of alternative therapies; Clinical benefit added when compared to those alternatives; Suitability of study design considering adequate comparator group, relevant outcome assessed and randomization; Risk of bias. For each domain, clear and specific criteria were defined in consensus by a group of experts in health technology assessment (HTA) and were applied to all cancer drugs evaluated.

Conclusions

Efficacy evidence available for marketing authorization are often based on preliminary data, arising from single randomized clinical trials or even non-comparative studies, which difficult early assessments of innovativeness. For this reason, transparent and reproducible methodologies can be useful not only to HTA bodies, but also for other key stakeholders in the pharmaceutical market, such as investors, researchers, doctors, and governments.
PP145 The Impacts Of The Corona Virus Disease 2019 Pandemic On Bariatric Surgeries In The Private Healthcare In Brazil
Authors: Kelles Silvana , Pereira Camila , Martins Carina , Reis Daniel , Azevedo Ernesto , Ribeiro Geraldo , Zocrato Karina , Carvalho Lélia , Freitas Marcela , Horta Maria , Barbosa Mariana , Talim Mariza , Borin Marcus
Published: December 2023

Introduction

The Corona Virus Disease 2019 (COVID-19) pandemic has impacted the functioning of health systems, imposing the need for adaptations. Elective surgeries also needed to adapt, and research has shown higher mortality in newly infected surgical patients after or during procedures. Thus, was recommended the suspension of elective surgeries during the pandemic. Early studies evaluating the effect of COVID-19 pandemic on bariatric surgery have reported a substantial reduction in procedures performed.

Methods

This retrospective study evaluated the impact of the suspension of bariatric surgeries for a Brazilian Health Maintenance Organization: UNIMED-BH, based on the analysis of data from before and during the pandemic of COVID-19.

Results

There were 2,641 bariatric procedures conducted in 2019 with a 14.1 percent reduction in volume to 2,314 procedures in 2020. In 2021, there were 2,813 bariatric procedures and 1,700 procedures were observed from January to August 2022. Therefore, it appears that in 2022 the demand for bariatric procedures will be similar to the year 2019, which was before the COVID-19 pandemic.

Conclusions

From the analysis of the data, a decrease in bariatric surgical volume was evidenced during the year 2020 when compared to 2019. Post-pandemic, monitoring is necessary to assess whether the system was able to meet the demand for bariatric surgical procedures.
COVID-19 vaccine hesitancy in Turkey: A systematic review and meta-analysis
Authors: Gulle Bugra Taygun , Oren Meryem Merve , Dal Tuba
Published: December 2023

This systematic review and meta-analysis aims to estimate the prevalence of coronavirus disease 2019 (COVID-19) vaccine hesitancy in Turkey, which can aid future health policies and strategies. A comprehensive search was conducted on various databases using keywords related to COVID-19 vaccine hesitancy in Turkey. Quality assessment was performed using Joanna Briggs Institute (JBI) checklist for prevalence studies. Data extraction was conducted. The random effect model (DerSimonian and Laird method) was used in pooled prevalence data analysis (95% confidence interval [CI]). A total of 1,072 articles were identified. After removing duplicates and excluding articles, 61 articles remained for bias assessment. Among these, 19 articles with low risk of bias were included in the review and meta-analysis. Total population included in the analysis was 15,164, vaccine hesitancy was 30.5% (95% Cl: 24.3–36.8%). Prevalence of the vaccine hesitancy was found to be 39.8% (95% Cl: 31.4–48.2%) in studies conducted before the initiation of vaccination, while in studies conducted after the commencement of vaccination, hesitancy was 20.4% (95% Cl: 12.9–28%). We suggest conducting high-quality studies in different populations to understand the level of vaccine hesitancy, as many of the previous studies have mainly focused on healthcare workers and students, and rest were community-based studies, which have generally shown high bias. Also, we suggest that early vaccination can reduce vaccine hesitancy.
Prevalence and determinants of goitre among children of South Kordofan state, Sudan, 2021: an urgent need for effective implementation of universal salt iodisation
Authors: Abdalla Azza Elfadil , Altahir Anfal Mahmoud , Hasabo Elfatih A. , Alrawa Salma Salah , Elazrag Amna Mutasim , Ahmed Hayat Abdoallah , Ali Hiba Abubakr , Abdelrazig Ibrahim Mysara , Ahmed Mohamed Yaser , Alagib Mohamed Alsiddig , Siddig Musab Mohammed , Asmally Rofida Salah , Mohamedelrasheed Salma Mohamed , Elnaiem Walaa Abdulgadir , Malik Elfatih Mohammed
Published: December 2023

Objective:

This study aimed to determine the prevalence and determinants of goitre among children aged 6–12 years at South Kordofan state.

Design:

This was a cross-sectional facility-based study.

Setting:

The study was conducted in twenty villages of South Kordofan state during a medical mission.

Participants:

All 575 school-age children (6–12 years) who attended the medical day were examined for clinical assessment of goitre.

Results:

The prevalence of goitre among children of South Kordofan was 42·8 % (grade 1: 15·7 %, grade 2: 27·1 %). Only 24·2 % of caregivers reported using iodised salt. Mothers working as farmers (OR: 3·209, CI 95 % 1·437, 7·167; P = 0·004) and children of Darforian tribes (OR: 21·799, CI 95 % 2·566, 185·226; P = 0·005) were found to be significantly associated with higher prevalence of goitre among children. This contrasts with children of African tribes, where they were found to have less goitre prevalence (OR: 0·432, CI 95 % 0·213, 0·875; P = 0·02). Iodised salt utilisation (OR = 0·523, CI 95 % 0·320, 0·854; P = 0·01) was found associated with a lower prevalence of goitre.

Conclusion:

Even though National Iodine Deficiency Disorders control programs were initiated in Sudan more than 25 years ago, the prevalence of goitre among children in South Kordofan state was alarming (42·8 %). Efforts to improve access to iodised salt, increase utilisation and raise awareness are urgently needed.
PIM1 drives lipid droplet accumulation to promote proliferation and survival in prostate cancer
Authors: Chauhan Shailender S. , Casillas Andrea L. , Vizzerra Andres D. , Liou Hope , Clements Amber N. , Flores Caitlyn E. , Prevost Christopher T. , Kashatus David F. , Snider Ashley J. , Snider Justin M. , Warfel Noel A.
Published: December 2023

Lipid droplets (LDs) are dynamic organelles with a neutral lipid core surrounded by a phospholipid monolayer. Solid tumors exhibit LD accumulation, and it is believed that LDs promote cell survival by providing an energy source during energy deprivation. However, the precise mechanisms controlling LD accumulation and utilization in prostate cancer are not well known. Here, we show peroxisome proliferator-activated receptor α (PPARα) acts downstream of PIM1 kinase to accelerate LD accumulation and promote cell proliferation in prostate cancer. Mechanistically, PIM1 inactivates glycogen synthase kinase 3 beta (GSK3β) via serine 9 phosphorylation. GSK3β inhibition stabilizes PPARα and enhances the transcription of genes linked to peroxisomal biogenesis (PEX3 and PEX5) and LD growth (Tip47). The effects of PIM1 on LD accumulation are abrogated with GW6471, a specific inhibitor for PPARα. Notably, LD accumulation downstream of PIM1 provides a significant survival advantage for prostate cancer cells during nutrient stress, such as glucose depletion. Inhibiting PIM reduces LD accumulation in vivo alongside slow tumor growth and proliferation. Furthermore, TKO mice, lacking PIM isoforms, exhibit suppression in circulating triglycerides. Overall, our findings establish PIM1 as an important regulator of LD accumulation through GSK3β-PPARα signaling axis to promote cell proliferation and survival during nutrient stress.
Insights into the various mechanisms by which Shewanella spp. induce and inhibit steel corrosion
Authors: Philips Jo , Procopio Luciano , Marshall Ian P. G.
Published: December 2023

Shewanella species are frequently selected as model strains to investigate microbially influenced steel corrosion. This selection is due to their relevance for corrosion, but also because of their easy cultivation in aerobic media. Unfortunately, these cultivation advantages do not lead to a straight-forward interpretation of their corrosion inducing or inhibiting mechanisms. The metabolic versatility of Shewanellae indeed enables a wide variety of corrosion mechanisms. This work reviews the metabolic capacities and the extracellular electron transfer mechanisms of Shewanellae and explains how these abilities lead to the various mechanisms by which Shewanellae induce and inhibit corrosion. It should be emphasized that the medium composition (presence of electron donor, acceptor, carbon source) strongly affects which mechanism is in play. Overall, this work concludes that Shewanellae model strains offer great opportunities to study corrosion, thanks in part due to genetic engineering options, but the full complexity of their corrosion processes should always be kept mind.
Enhancement of intra-cardiac flow-field data using adaptive Kernel filtering
Authors: Banerjee Shataneek , Ghosh Amardip , Pal Prasanta
Published: December 2023

A method of determining the optimal kernel size for filtering noise in vortex dominated flow-fields, as found in the cardiac chambers is presented in this paper. Using synthetic flow fields generated using harmonic functions and perturbed using Gaussian noises of different amplitudes and spreads, the effect of kernel size on noise removal using the Median filter is tested systematically. It is shown that there exists an optimal kernel size at which the Median filter works best. The size of the optimal kernel is shown to be related to the vortex size. When applied to MRI generated cardiac flow-fields, the approach is seen to reveal underlying vortex patterns thereby aiding as an effective tool in the diagnosis and prognosis of cardiac diseases based on vortices as clinical biomarkers. The behavior of the restored cardiac flow fields which are filtered with the optimal kernel size and also with some values preceding and succeeding it are similar to that observed in studies with synthetic flow fields. This confirms that the optimal size of the kernel is related to the cardiac vortex size as is observed in the case of synthetic flow fields.
Circulating cytotoxic immune cell composition, activation status and toxins expression associate with white matter microstructure in bipolar disorder
Authors: Aggio Veronica , Fabbella Lorena , Poletti Sara , Lorenzi Cristina , Finardi Annamaria , Colombo Cristina , Zanardi Raffaella , Furlan Roberto , Benedetti Francesco
Published: December 2023

Patients with bipolar disorder (BD) show higher immuno-inflammatory setpoints, with in vivo alterations in white matter (WM) microstructure and post-mortem infiltration of T cells in the brain. Cytotoxic CD8+ T cells can enter and damage the brain in inflammatory disorders, but little is known in BD. Our study aimed to investigate the relationship between cytotoxic T cells and WM alterations in BD. In a sample of 83 inpatients with BD in an active phase of illness (68 depressive, 15 manic), we performed flow cytometry immunophenotyping to investigate frequencies, activation status, and expression of cytotoxic markers in CD8+ and tested for their association with diffusion tensor imaging (DTI) measures of WM microstructure. Frequencies of naïve and activated CD8+ cell populations expressing Perforin, or both Perforin and Granzyme, negatively associated with WM microstructure. CD8+ Naïve cells negative for Granzyme and Perforin positively associates with indexes of WM integrity, while the frequency of CD8+ memory cells negatively associates with index of WM microstructure, irrespective of toxins expression. The resulting associations involve measures representative of orientational coherence and myelination of the fibers (FA and RD), suggesting disrupted oligodendrocyte-mediated myelination. These findings seems to support the hypothesis that immunosenescence (less naïve, more memory T cells) can detrimentally influence WM microstructure in BD and that peripheral CD8+ T cells may participate in inducing an immune-related WM damage in BD mediated by killer proteins.
Biological sex-related differences in whole-body coordination during standing turns in healthy young adults
Authors: Khobkhun Fuengfa , Thanakamchokchai Jenjira
Published: December 2023

Biological sexes (male and female) have been reported to influence postural control and balance due to differences in musculoskeletal structures, hormonal factors, and neuromuscular control. These factors can contribute to the turning performance, potentially leading to an increased incidence of falls, particularly during turning. Therefore, this study aimed to explore the whole-body coordination and stepping characteristics and during standing turns in healthy adults to determine the effects of biological sex and turn speed. Fifty participants (25 males and 25 females) completed 180° standing turns on level ground. Inertial Measurement Units (XSENS) were used to measure whole-body movement turning kinematics and stepping characteristics. Moreover, clinical outcome of dynamic balance was measured by the Timed Up and Go (TUG). Participants were randomly tasked to turn at three speeds; fast, moderate, or slow to the left and right sides. Mann–Whitney U tests were used to compare the independent variables between male and females, and Friedman tests with Dunn’s tests for pairwise comparisons were used to compare between the three turning speeds within the two groups. The results demonstrated that significant differences were seen between males and females during fast turning for the leading foot onset (p = 0.048) and in the slow speed for the total step (p = 0.033), showing that these were greater in female with an increase in turn speed. In addition, significant differences were seen only in the males when comparing different speeds in the trailing foot onset latency (p = 0.035), step size (p = 0.009), and total number of steps (p = 0.002), while in the females a significant difference was found in peak head yaw velocity between fast and slow turn speeds, and moderate and slow turn speeds. Finally, there was no significant difference in TUG between groups. Therefore, these findings show differences between biological sexes in the response to whole-body coordination and step characteristics, indicating that females tend to have more changes in stepping characteristics compared to males due to differences in turning speed. This can affect their balance and stability. However, the differences in biological sex did not impact the dynamic balance and fall risk due to the lack of a significant difference shown by TUG between males and females.
Prediction of cell migration potential on human breast cancer cells treated with Albizia lebbeck ethanolic extract using extreme machine learning
Authors: Umar Huzaifa , Aliyu Maryam Rabiu , Usman Abdullahi Garba , Ghali Umar Muhammad , Abba Sani Isah , Ozsahin Dilber Uzun
Published: December 2023

Cancer is one of the major causes of death in the modern world, and the incidence varies considerably based on race, ethnicity, and region. Novel cancer treatments, such as surgery and immunotherapy, are ineffective and expensive. In this situation, ion channels responsible for cell migration have appeared to be the most promising targets for cancer treatment. This research presents findings on the organic compounds present in Albizia lebbeck ethanolic extracts (ALEE), as well as their impact on the anti-migratory, anti-proliferative and cytotoxic potentials on MDA-MB 231 and MCF-7 human breast cancer cell lines. In addition, artificial intelligence (AI) based models, multilayer perceptron (MLP), extreme gradient boosting (XGB), and extreme learning machine (ELM) were performed to predict in vitro cancer cell migration on both cell lines, based on our experimental data. The organic compounds composition of the ALEE was studied using gas chromatography-mass spectrometry (GC–MS) analysis. Cytotoxicity, anti-proliferations, and anti-migratory activity of the extract using Tryphan Blue, MTT, and Wound Heal assay, respectively. Among the various concentrations (2.5–200 μg/mL) of the ALEE that were used in our study, 2.5–10 μg/mL revealed anti-migratory potential with increased concentrations, and they did not show any effect on the proliferation of the cells (P < 0.05; n ≥ 3). Furthermore, the three data-driven models, Multi-layer perceptron (MLP), Extreme gradient boosting (XGB), and Extreme learning machine (ELM), predict the potential migration ability of the extract on the treated cells based on our experimental data. Overall, the concentrations of the plant extract that do not affect the proliferation of the type cells used demonstrated promising effects in reducing cell migration. XGB outperformed the MLP and ELM models and increased their performance efficiency by up to 3% and 1% for MCF and 1% and 2% for MDA-MB231, respectively, in the testing phase.
The trends of disease burden due to high temperature in Mainland China from 1990 to 2019 and its prediction to 2030
Authors: Zheng Jiaolong , Lin Haiyan , Ling Jingyi , Huang Jiaofeng , Li Dongliang
Published: December 2023

The risk of high-temperature-related diseases is increasing owing to global warming. This study aimed to assess the trend of disease burden caused by high temperatures in Mainland China from 1990 to 2019 and to predict the trend of disease burden over the next 10 years. The latest data were downloaded from the Global Burden of Disease Database (GBD) for analysis, and the disease burden related to high temperature was described by mortality and disability-adjusted life-years (DALYs) and stratified by etiology, sex, and age. Statistical analyses were performed using the R software. In 2019, there were 13,907 deaths attributed to high temperatures in Mainland China, and this was 29.55% higher than the 10,735 deaths in 1990. Overall, the age-standardized mortality and DALYs attributed to high temperatures showed a downward trend from 1990 to 2019. We observed an etiological shift in high-temperature-related diseases. The age-standardized DALYs contribution attributed to high temperatures in 1990 was mainly from communicable, maternal, neonatal, and nutritional diseases (CMNND) (21.81/100,000), followed by injury (18.30/100,000) and non-communicable diseases (10.40/100,000). In 2019, the largest contribution shifted to non-communicable diseases (10.07/100,000), followed by injuries (5.21/100,000), and CMNND (2.30/100,000). The disease burden attributed to high temperatures was higher in males than in females and increased with age. In 2030, the mortality rate and DALYs due to high temperatures are predicted to decrease further, and the largest contribution will come from chronic non-communicable diseases, the occurrence of which will remain at a high level over the next 10 years. The burden of disease due to high temperatures in Mainland China is still heavy, mainly due to population aging and an increase in non-communicable diseases.
A protein–protein interaction analysis tool for targeted cross-linking mass spectrometry
Authors: Park Jongham , Son Ahrum , Kim Hyunsoo
Published: December 2023

Protein networking is critical to understanding the biological functions of proteins and the underlying mechanisms of disease. However, identifying physical protein–protein interactions (PPIs) can be challenging. To gain insights into target proteins that interact with a particular disease, we need to profile all the proteins involved in the disease beforehand. Although the cross-linking mass spectrometry (XL-MS) method is a representative approach to identify physical interactions between proteins, calculating theoretical mass values for application to targeted mass spectrometry can be difficult. To address this challenge, our research team developed PPIAT, a web application that integrates information on reviewed human proteins, protein–protein interactions, cross-linkers, enzymes, and modifications. PPIAT leverages publicly accessible databases such as STRING to identify interactomes associated with target proteins. Moreover, it autonomously computes the theoretical mass value, accounting for all potential cross-linking scenarios pertinent to the application of XL-MS in SRM analysis. The outputs generated by PPIAT can be concisely represented in terms of protein interaction probabilities, complemented by findings from alternative analytical tools like Prego. These comprehensive summaries enable researchers to customize the results according to specific experimental conditions. All functions of PPIAT are available for free on the web application, making it a valuable tool for researchers studying protein–protein interactions.