Management Of Events Research Articles

Multidrug resistant tuberculosis risk factors in Makassar, Indonesia

Multidrug resistant tuberculosis (MDR-TB) is a significant public health concern in Indonesia, resulting in substantial morbidity and mortality rates. This study aimed to quantify the impact of risk factors of MDR-TB. A case-control study was conducted at Makassar Community Lung Health Center (BBKPM) in Makassar City. A total of 132 respondents, 66 cases, and 66 controls have participated in the study. Data was analyzed using the Stata version 14 tool, odds ratio (OR), and multiple logistic regression. Multiple logistic regression analysis identified significant risk factors for the occurrence of MDR-TB include previous TB treatment (OR=8.46, 95% CI: 3.278-21.858), positive acid-fast bacilli (AFB) sputum (OR=6.40, 95% CI: 2.525-16.260), and adverse drug event (OR=3.45, 95% CI: 1.008-11.867). The probability of developing MDR-TB is 95.9% if there is previous TB treatment with cases of relapse/loss to follow-up/failed treatment, positive AFB sputum, and adverse drug event. The most dominant risk factor for the occurrence of MDR-TB is a previous TB treatment. We suggest that an efficient directly observed treatment shortcourse (DOTS) strategy, particularly in the management of adverse drug event, overseeing and supporting patients who have recovered from MDR-TB, involves the collaboration of MDR-TB healthcare professionals and patient supporters in the Yamali TB community, moving synergistically as an effort to MDR-TB control and prevention.

Management of factor Xa inhibitor-related traumatic non-intracranial bleeding events with andexanet alfa or four-factor prothrombin complex concentrate in a US multicenter observational study.

This study describes clinical characteristics and management strategies for patients with factor Xa (FXa) inhibitor-related traumatic non-intracranial bleeds who were treated with andexanet alfa or four-factor prothrombin complex concentrate (4F-PCC). An observational cohort study (ClinicalTrials.gov Identifier: NCT05548777) was conducted using electronic health records from 354 US hospitals. Included patients were hospitalized with rivaroxaban- or apixaban-related bleeding, had received andexanet alfa or 4F-PCC treatment during their hospitalization, and were discharged between May 2018 and September 2022. This analysis was performed in the subgroup of patients with traumatic non-intracranial critical compartment/non-compressible bleeds or other traumatic bleeds. The study population included 250 patients (andexanet alfa, n=116; 4F-PCC, n=134). Critical compartment bleeds were the most common (86.8%), with retroperitoneal bleeds the most common subtype (30.9%). Most patients were admitted via the emergency department (82.0%). The median time from presentation to reversal/replacement treatment was 2.7 (interquartile range, 1.2, 6.6) h. For patients treated with andexanet alfa, 63.8% were administered the low-dose regimen. For 4F-PCC, a median of 2000 total units was administered per patient. Other treatment strategies used included intravenous fluids (26.0%), fresh frozen plasma (16.0%), and packed red blood cells (13.2%). Prior to hospital discharge, oral anticoagulants were restarted in 20.4% of patients. Overall, 25 (10.0%) patients died in hospital. This analysis provides insights into the clinical characteristics and management strategies, including time to treatment, for patients treated with andexanet alfa or 4F-PCC while hospitalized for FXa inhibitor-related traumatic bleeds.

CU-EVENTS: A Comprehensive Event Management System for University

CU-EVENTS: A Comprehensive Event Management System for University

Immune checkpoint inhibitor-induced pancreatic enzyme elevation in melanoma patients: Incidence, management and therapy-A multicentre analysis.

Immune checkpoint inhibitors (ICI) are considered standard-of-care in the systemic treatment of melanoma. However, management of certain ICI-associated adverse events (AE) can be challenging. Incidence, course and management of immune checkpoint inhibitor-induced pancreatic injury (ICIPI) are not well-documented and specific diagnostic and therapeutic algorithms are lacking. Current management includes serological monitoring of pancreatic enzymes, radiographic imaging and corticosteroid or further immunosuppressive treatment. Based on previous data regarding adjuvant ICI treatment, we suspected that elevation of pancreatic enzymes may occur more frequently than reported while the clinical relevance of-particularly asymptomatic-ICIPI is still unclear. A collaboration of eight Austrian and Swiss dermato-oncology centres was established to retrospectively analyse a large cohort of ICI-treated patients regarding incidence and management of ICIPI. Additionally, a questionnaire-based survey concerning ICIPI-management was conducted. Among 1516 melanoma patients receiving ICI therapy, 204 patients exhibited ≥CTCAE II° lipase elevation. Of these patients, 41 (20.1%) had symptoms suggestive of pancreatitis. Immunotherapy was interrupted or discontinued due to pancreatic AE in almost half of the patients. Systemic corticosteroids were administered in 103 patients (50.5%), with higher doses reported in symptomatic cases. Six per cent of asymptomatic patients had radiographically proven pancreatitis. Maximum lipase elevation was >5xULN in all of these patients. Routine lipase monitoring was conducted in all participating centres, although not recommended in respective guidelines. Elevation of serum lipase was observed more frequently than recently reported. Although radiographic findings indicating pancreatitis were rare in asymptomatic patients, ICI treatment was frequently paused or discontinued and systemic steroids were administered. To reduce the existing uncertainty in routine clinical practice reflected by our findings, we provide an algorithm to guide the monitoring and management of potential pancreatic adverse events. Lipase measurement should be limited to symptomatic patients and/or those with radiographic findings indicative of pancreatic injury.

Management of severe immune-related adverse events and outcomes in patients with advanced non-small cell lung cancer receiving immune checkpoint inhibitors.

Immune checkpoint inhibitors (ICIs) are associated with severe immune-related adverse events (s-irAEs) that result in hospitalization, emergency department (ED) visits, treatment discontinuation, or death. This study examined the impact of s-irAEs and their earliest management strategies on clinical outcomes in advanced non-small cell lung cancer (NSCLC). Data were derived from ConcertAI Patient360 NSCLC, a US-based electronic medical record database, between January 2012 and May 2021. Eligible patients had advanced NSCLC and received ICI-containing therapy. s-irAEs and management actions were abstracted from unstructured EHR data from ICI initiation through the earliest of 100 days after ICI discontinuation, start of a non-ICI-containing regimen, loss to follow up, end of study period, or death. Multivariable Cox regression analysis was used to evaluate the association between s-irAEs and their earliest management strategies, and real-world progression-free survival (rwPFS) and real-world overall survival (rwOS). The study included 3211 patients. Median (IQR) age was 67 (60-73) years, and 44.9% were female. Most patients (61.6%) initiated ICIs as first-line therapy; half (50.1%) initiated ICIs as monotherapy, with nivolumab monotherapy (29.5%) as the most common initial ICI-containing regimen in any line. Overall, 8.6% of patients experienced s-irAEs, most often diarrhea (3.5%), pneumonitis (1.4%), and rash (1.3%). Among patients who experienced at least one s-irAEs, over half (57.4%) were hospitalized, and 71.8% were treated with corticosteroids, any time after the occurrence of their first s-irAEs. Median rwPFS was 4.9 (95%CI, 4.6-5.2) months, and median rwOS was 13.6 (12.6-14.7) months from ICI initiation. rwPFS and rwOS were comparable between patients with s-irAEs vs patients without s-irAEs when s-irAEs were first managed with anti-cancer treatment interruptions. Patients with s-irAEs had a 53% (22.3%-91.4%) higher risk of death than patients without s-irAEs when s-irAEs initially required corticosteroids or other immunosuppressants, and a 61% (37.9%-87.9%) higher risk of death when s-irAEs first required hospitalization or ED admission. The impact of s-irAEs on clinical outcomes may depend on the initial intervention required to manage the adverse event. s-irAEs were associated with worse outcomes when they initially required hospital/ED admission, corticosteroids, or other immunosuppression.

Sickle cell crisis: inpatient management

Sickle cell anemia is the world's most common monogenic disease, with a steady rise in the number of cases also in Switzerland. It presents as regenerative anemia and recurrent vaso-occlusive episodes, which can impact all organs. Acute and chronic complications increase morbidity and mortality, significantly reducing life expectancy compared to the general population. Optimal and multidisciplinary management of acute events is essential to improve patients' quality of life and overall prognosis. Vaso-occlusive crises and acute chest syndrome are the two most frequent acute complications. Their treatment, described here, is threefold: analgesia, treatment of causative factors and prevention of further complications.

Event-Based Optimization of Tourism at Pasir Padi Beach, Pangkalpinang City

Pasir Padi Beach, located in Pangkalpinang City, Bangka Belitung Island Province, has become a major tourist destination by hosting various events that attract local and foreign tourists. This study aims to optimize event-based beach tourism at Pasir Padi Beach by analyzing social, economic, infrastructural, and cultural impacts. Data were gathered through interviews with the Pangkalpinang City Tourism Office, observations, and secondary sources. The findings indicate high community participation, enhanced social cohesion, and significant economic benefits for local MSMEs, with income increases of 60-80% during events. However, challenges such as inadequate community readiness, lack of market research, and suboptimal stakeholder synergy were identified. To address these challenges, a comprehensive strategy is proposed, including improving infrastructure, diversifying events, and integrating local cultural elements to balance tourism development and cultural preservation. Government support, combined with local community empowerment and strong stakeholder collaboration, is essential. Effective marketing strategies, utilizing social media and influencers, and the implementation of sustainable tourism practices are recommended to maximize economic benefits while preserving environmental and cultural integrity. In conclusion, with strategic improvements in infrastructure, event management, and stakeholder involvement, Pasir Padi Beach can become a model for sustainable event-based beach tourism, promoting economic growth, social cohesion, and cultural preservation. The study’s limitation is the reliance on a single informant from the Tourism Office, which may limit perspective diversity. Future research should involve a wider range of stakeholders, including MSMEs, youth groups, local artists, and private sector representatives, to provide a more comprehensive understanding.

NSW cannabis medicines advisory service retrospective enquiry analysis to inform clinical guidance resource development

AbstractBackgroundAn innovative New South Wales government funded statewide Cannabis Medicines Advisory Service (CMAS) operated between January 2018 and June 2022. The service provided comprehensive patient‐specific and evidence‐based information to support health professionals in prescribing and patient care decisions. This study aimed to describe real‐world data collected by CMAS.MethodsA sub‐set of de‐identified, patient‐specific enquiries collected between January 2021 and June 2022 (n = 123/567; 21.7%) were analyzed using R version 4.2.1. Diagnosis, indication, and comorbidities were coded using Medical Dictionary for Regulatory Activities (MedDRA) terminology.ResultsMost patient‐specific enquiries from medical practitioners were from general practitioners (n = 103/123; 83.7%). Female (n = 53/123; 43.1%) and male (n = 59/123; 48.0%) patients were similarly represented. Sex was not specified for 8.9% (n = 11/123) of patients. The mean age of patients was 52.1 years (range <10–90). The most common three diagnoses were osteoarthritis, anxiety, and chronic pain. Indications that were most frequently reported included chronic pain, anxiety, back pain, non‐neuropathic pain, and insomnia. Comedications were most commonly non‐opioid and opioid analgesics and antidepressants. Most practitioners were considering prescribing a cannabidiol (CBD) product for their patient. Cannabinoid composition selection guidance provided by CMAS was predominantly (delta‐9‐tetrahydrocannabinol) THC:CBD ~1:1, followed by CBD‐only products. CMAS was contacted by health professionals regarding the management of potential adverse events for five patients.ConclusionThe findings of this study shed light on the information medical practitioners were seeking to inform their clinical decision‐making about medical cannabis and can inform the development of clinical guidance resources.

Boosting Campus Life with Real-Time Event Updates and Rewards

This project addresses the common issue of students being unaware of daily events happening on their college campus. To solve this problem, we have developed an innovative event management website designed to keep students informed and engaged. The platform provides realtime updates on upcoming events, allowing students to stay connected with campus activities easily.A unique feature of our website is the incorporation of a points-based incentive system. Students earn coins based on their level of engagement in events, fostering active participation. Event organizers, led by a designated head, assign points to participants: the head receives 15 points, while other team members earn between 5-10 points based on their involvement as determined by the organizing committee. These accumulated points can be redeemed for various rewards, including bonus marks, merchandise, or course subscriptions, providing tangible benefits for active participation. The implementation of this platform not only enhances awareness and participation in college events but also encourages a more vibrant and connected student community. By integrating gamification elements, we aim to motivate students to engage more actively in campus life, thereby enriching their overall educational experience. Future enhancements will focus on expanding the reward system and integrating feedback mechanisms to continually improve user engagement and satisfaction.

Management of carcinoid flare events following peptide receptor radionuclide therapy (PRRT) in neuroendocrine tumours (NET): our experience at the christie NHS foundation trust

Management of carcinoid flare events following peptide receptor radionuclide therapy (PRRT) in neuroendocrine tumours (NET): our experience at the christie NHS foundation trust

Integrating Artificial Intelligence into Traditional Sports: A Case Study of the Asian Games and Future Directions for Modernization

Abstract: This paper explores the integration of Artificial Intelligence (AI) into traditional sports, addressing a critical gap in existing research through a qualitative case study of the Asian Games. AI's application in modern sports has demonstrated its potential to enhance event management, athlete preparation, and scoring fairness. However, its adoption in traditional sports, such as Wushu and Chinese wrestling, remains limited. This study examines the challenges and opportunities associated with applying AI to traditional sports, offering development strategies to modernize these disciplines. By analyzing the impact of AI in modern competitive sports, the research proposes specific recommendations for integrating AI into traditional sports, aiming to preserve their cultural heritage while advancing their global relevance. Limitations include the focus on a single event and the exclusion of the most recent AI developments. Future research should consider a broader range of global sporting events and incorporate the latest advancements in AI technology. This study provides a theoretical and practical foundation for the application of AI in traditional sports, with implications for future technological innovation and the evolution of the sports industry.

Anterior Glenohumeral Instability

➢ Anterior glenohumeral instability is a complex orthopaedic problem that requires a detailed history, a thorough physical examination, and a meticulous review of advanced imaging in order to make individualized treatment decisions and optimize patient outcomes.➢ Nonoperative management of primary instability events can be considered in low-demand patients, including elderly individuals or younger, recreational athletes not participating in high-risk activities, and select in-season athletes. Recurrence can result in increased severity of soft-tissue and osseous damage, further increasing the complexity of subsequent surgical management.➢ Surgical stabilization following primary anterior instability is recommended in young athletes who have additional risk factors for failure, including participation in high-risk sports, hyperlaxity, and presence of bipolar bone loss, defined as the presence of both glenoid (anteroinferior glenoid) and humeral head (Hill-Sachs deformity) bone loss.➢ Several surgical treatment options exist, including arthroscopic Bankart repair with or without additional procedures such as remplissage, open Bankart repair, and osseous restoration procedures, including the Latarjet procedure.➢ Favorable results can be expected following arthroscopic Bankart repair with minimal (<13.5%) bone loss and on-track Hill-Sachs lesions following a primary instability event. However, adjunct procedures such as remplissage should be performed for off-track lesions and should be considered in the setting of subcritical glenoid bone loss, select high-risk patients, and near-track lesions.➢ Bone-grafting of anterior glenoid defects, including autograft and allograft options, should be considered in cases with >20% glenoid bone loss.

Evaluasi Tingkat Kematangan Sistem Informasi Rumah Sakit Menggunakan Information Technology Infrastructure Library Versi 3

Hospital Information System (HIS) is an important component in supporting effective and efficient health services. Evaluation of the maturity of information systems is needed to ensure that the implementation of SIRS is in accordance with the standards and needs of the organization. This study aims to evaluate the maturity level of information systems at Amanah Hospital using the Information Technology Infrastructure Library (ITIL) version 3 framework, specifically in the Service Operation domain. The research method uses a quantitative approach with data collection through questionnaires distributed to respondents involved in managing information systems. The evaluation was carried out on five subdomains, namely Event Management, Incident Management, Request Fulfillment, Problem Management, and Access Management. The results showed that the maturity level of the Amanah Hospital information system was at level 3.81 (Managed), with the highest value in the Incident Management and Access Management subdomains (4.00), while the lowest value in Event Management and Request Fulfillment (3.66). Based on these results, several improvements are recommended including the development of an integrated monitoring system, strengthening operational procedures, improving HR competencies, and implementing more structured periodic evaluations to achieve an optimal level of maturity.

Abstract 4147606: The Risk of Cardiac Events Associated with Psychiatric Drugs in Patients with Long QT Syndrome.

Introduction: Long QT syndrome (LQTS) is a potentially life-threatening genetic heart disease. Patients with LQTS may also have co-existent mental health illnesses that may benefit from psychiatric medications. However, because many of these medications have QT-prolonging potential (www.crediblemeds.org), many of these patients receive suboptimal mental health care. Objective: To evaluate the frequency, management, and incidence of breakthrough cardiac events (BCEs) in patients with LQTS and concomitant mental health issues treated with psychiatric medications. Methods: A retrospective review was conducted on patients cared for in Mayo Clinic's Windland Smith Rice Genetic Heart Rhythm Clinic between 2000 and 2024 focusing on patients with LQTS and a concomitant psychiatric diagnosis requiring medication with known, possible or conditional risk of torsades de pointes (TdP). Electronic medical records were reviewed for data. BCEs were defined as LQTS-triggered syncope, seizures, appropriate ICD therapy, sudden cardiac arrest (SCA), or sudden cardiac death (SCD). Patients with missing information were excluded. Results: Overall, 195 /1899 LQTS patients [10%, 86 (43%) with LQT1, 83 (42%) with LQT2, and 16 (8%) with LQT3] had a concomitant psychiatric diagnosis requiring medication [150 female (76%), mean age at diagnosis 27 ± 18 years, median follow-up time 6.6 years (IQR 2.9-13)]. The most common psychiatric conditions were depression (71%), anxiety (62%), and ADHD (9%). The mean duration of therapy was 3.36 +/- 3.48 years and the most common medications used were fluoxetine (26%), sertraline (14%), and escitalopram (11%). There was no significant difference in QTc after starting the first psychiatric medication when compared to baseline (473 ± 33 vs 474 ± 35 ms, p=0.6). Prior to their LQTS diagnosis and while therefore untreated, 61/195 (31%) had at least 1 LQTS-associated cardiac event. This occurred in the setting of a psychiatric drug in 7 patients (11%). Following LQTS diagnosis and treatment, 14/195 patients (7%) have experienced a non-lethal BCE of which only 3/14 (21%) while on psychiatric medications. Conclusions: Although avoidance of medications with known QT-prolonging potential is prudent, attention to patient’s overall well-being besides just their LQTS must be given. After correct diagnosis and treatment, LQTS patients with concomitant mental health issues may be safely and effectively treated with medications known to prolong QTc.

Abstract 4137991: Association of the 2022 AHA/ACC/HFSA Heart Failure Staging and Cardiovascular and Kidney Outcomes in Patients with Diabetes and Kidney Disease: A Secondary Analysis of the SCORED Trial

Introduction: The 2022 AHA/ACC/HFSA heart failure (HF) classification newly incorporates cardiac biomarkers to identify patients at risk of HF. Research Question: Given shared risk factors between HF and other cardiorenal events, the HF stages may also guide prognosis and management of cardiovascular (CV) and kidney-related events beyond HF. Aims: Examine the association of HF stage with CV and kidney events. Methods: SCORED was a randomized trial in diabetes with kidney disease comparing sotagliflozin (sota) v. placebo on CV death, hospitalizations for HF, and urgent HF visits. SCORED participants were grouped by HF stage post hoc . Stage A: No HF, normal cardiac biomarkers (NT-proBNP; <125 pg/mL, hs-cTnT; <14 ng/L) and normal cardiac structure/function by echocardiography. Stage B (pre-HF): No HF but elevated NTproBNP, hsTNT or abnormal echocardiography. Stage C/D: symptomatic HF. Endpoints of interest included the primary composite endpoint (CV death and HF-related events), major adverse CV events (MACE), and kidney-related composites (See Figure caption). Using Cox regression, we examined the association between HF stage and these endpoints, and whether the effect of sota v. placebo varied by HF stage. Results: There were 741 patients in stage A, 6560 in stage B (pre-HF) and 3283 in stage C/D (established HF). The mean NTproBNP and hs-cTnT increased with HF stage. Stepwise increases in HF stage were associated with a 2-4 fold higher incidence of the primary, MACE and kidney endpoints in the placebo group, although the incidence of the kidney-specific composite was similar in stage B and C/D (Figure). The relative risk reduction with sota v. placebo for all endpoints was similar irrespective of HF stage (p-interaction>0.05), with higher absolute benefit in each HF stage (Figure). The absolute benefit for the kidney-specific endpoint was comparable for stage B and C/D. Conclusions: Increasing HF stage is associated with higher risk of HF, MACE, and kidney events, but the risk of kidney events is similar in stage B (pre-HF) and stage C/D (established HF). Sota has similar relative benefits for all endpoints, irrespective of HF stage, with a corresponding increase in absolute benefits at higher stages.

From Clinical to Non-clinical Outcomes in the Treatment of HIV: An Economic and Organizational Impact Assessment.

The aim of this study was to define the economic and organizational impacts related to a broader utilization of bictegravir/emtricitabine/alafenamide (BIC/FTC/TAF) in Italian clinical practice. A budget impact analysis-representing the evolution of the Italian National Healthcare Service (NHS) healthcare expenditure over 3years-was developed, considering the overall Italian population treated for human immunodeficiency virus (HIV). Model input variables were treatment history, therapeutic regimen, development of adverse events, achievement of an undetectable viral load and total direct healthcare costs. Besides the BIA, an organizational impact assessment was conducted to determine the impact on the use of healthcare resources, assessing the release of organizational hospital assets, focusing on the management of drug-related adverse events. Data were collected from scientific evidence, Italian national and regional legislations and healthcare professionals' reports. To verify the robustness of the economic and organizational impact assessment, sensitivity analyses were performed. Results demonstrate economic savings of about 26million euros in total health spending, assuming a higher penetration rate for BIC/FTC/TAF. This change in the current case mix would lead to a reduction in the specific costs related to adverse event management (0.9million euros; -2.09%) and in the medical management of patients (38million euros; -7.79%), with a positive impact on the achievement of virological control. From an organizational perspective, a wider use of BIC/FTC/TAF generates a reduction in the utilization of healthcare resources due to a decrease in adverse events and complications. The model estimated a 19.64% reduction in HIV-related inpatient days, which freed up healthcare professional time. Capable of improving both economic and organizational sustainability for the entire HIV care continuum, BIC/FTC/TAF is an efficient therapeutic strategy for people with HIV.

Leveraging Microsoft sentinel and logic apps for automated cyber threat response

An integrated approach to automated cyber threat response is explored in this paper, with Microsoft Sentinel's Security Information and Event Management (SIEM) capabilities being leveraged alongside Logic Apps' workflow automation within the Azure ecosystem. Efficient identification and automated mitigation of security incidents are enabled by a combination of AI-driven analytics and advanced threat-hunting capabilities, resulting in a substantial reduction of manual intervention and response times. The approach is demonstrated to contribute scientifically across three core areas: (1) a novel integration of Sentinel's SIEM with Logic Apps is proposed to streamline response workflows using automated playbooks; (2) the effectiveness of the system is assessed through multiple cyber threat scenarios, including automated account blocking and virtual machine isolation in response to identified threats; and (3) Sentinel's performance is evaluated relative to other SIEM solutions, such as Splunk and IBM QRadar, particularly in Azure-centric and hybrid environments. The potential of Microsoft Sentinel and Logic Apps to advance proactive cybersecurity defenses is underscored, while key limitations in scalability and cross-platform adaptability are also identified.

Trastuzumab plus chemotherapy versus chemotherapy alone in HER2-positive gastric cancer treatment in Iran: a cost-effectiveness analysis

BackgroundCombining Trastuzumab with chemotherapy for HER2-positive gastric cancer shows treatment promise but may raise costs. We aimed to evaluate the cost-effectiveness of combining Trastuzumab with chemotherapy for HER2-positive gastric cancer treatment in Iran.MethodsWe employed a partitioned survival model (PSM) to evaluate the cost-effectiveness of trastuzumab plus chemotherapy versus chemotherapy alone. The PSM framework included three distinct health states: progression-free, post-progression, and death. Clinical data, including overall survival and progression-free survival rates, were derived from the ToGA trial, a randomized controlled study. A bottom-up approach was used to calculate costs by considering drug costs, adverse event management costs and other disease management costs separately for the progression-free and post-progression states. The analysis was conducted from the Iranian healthcare system’s perspective, considering direct medical costs. We performed a cost-effectiveness analysis to determine the optimal strategy by comparing the incremental cost-effectiveness ratio (ICER) to Iran’s cost-effectiveness threshold, set at one to three times the GDP per capita. Additionally, we conducted sensitivity analyses to assess the robustness of our findings.ResultsBoth FOLFOX-based regimens were strongly dominated. In comparison, the CAPOX regimen cost $2,811.11 for 0.75 QALYs. Adding Trastuzumab to CAPOX increased the cost to $6,128 and improved effectiveness to 0.92 QALYs, resulting in an ICER of $19,089.94 per QALY, which is between 2 and 3 times the GDP per capita in 2022.ConclusionThe addition of trastuzumab to chemotherapy regimens improved clinical outcomes in HER2-positive gastric cancer patients. From an economic perspective, the CAPOX regimen is the most cost-effective option when considering a cost-effectiveness threshold of up to two times Iran’s GDP per capita. However, when the threshold increases to three times the GDP per capita, the CAPOX + Trastuzumab regimen becomes the preferred choice. These findings provide valuable insights for healthcare policymakers in Iran.

Innovation in Sports Event Management: A Case Study of the NBA

Innovation in Sports Event Management: A Case Study of the NBA

Factors influencing participation of elderly population in mass drug administration for lymphatic filariasis: a cross-sectional study.

The success of mass drug administration (MDA) for lymphatic filariasis (LF) elimination relies on achieving a participation rate of at least 65% within the endemic community. However, participation of sub-population in the community varies and a significant treatment gap among the elderly population, remains to be addressed. The present study explores the factors influencing the elderly participation in MDA and propose possible solutions to bridge the gap. A cross-sectional study of individuals aged 60years and above was conducted from August to December 2023 in Yadgiri district of Karnataka, which is endemic for LF. The participants were interviewed using a structured questionnaire, focusing on the perception about LF and MDA and drug consumption behaviours. STATA 14 software was used to analyse the data. We used a logistic regression model to determine the factors influencing drug consumption. The study included 315 elderly individuals with a mean age (SD) of 67.4 (6.2) years. Although, 58.4% of them received the drugs during the last round of MDA in 2023, only 40.6% consumed it. The drug refusal rate was 19.4%. Fear of side effects (22.9%) was cited as the primary reason for not accepting the drugs. Weak perception of LF transmission risk (25.7%) and mistrust of drug safety (42.5%) were reported as reasons for non-compliance. Logistic regression identified significant associations, including residence (peri-urban: OR = 6.80), chronic disease (diabetes: OR = 2.89), trust on drug safety (OR = 16.27), and opinion of neighbours (OR = 5.35). Participation of elderly population in MDA was suboptimal (40.6%). Tailored interventions to improve consumption such as addressing misconceptions, building trust in MDA and effective monitoring and management of adverse events are vital to enhance their participation. The National Programme should have specific guidelines and strategies to address this issue to improve their participation in MDA for elimination of LF.