Population Groups Research Articles

Mannose-Binding Lectin Gene Variants as Disease Susceptibility Biomarkers in Rheumatoid Arthritis.

Background: Rheumatoid arthritis (RA) is a chronic, inflammatory autoimmune disease characterized by progressive destruction of peripheral joints. About 1% of the human population worldwide is suffering from this disease. The pathophysiology of RA is largely being influenced by immune dysregulation. Mannose-binding lectin (MBL), an acute-phase protein, has been reported to play an important role in pathogenesis of RA by the activation of complement pathway. Various studies documented the established the role of MBL in pathogenesis of various autoimmune diseases, including RA. MBL protein is encoded by gene MBL2, mapped on chromosome 10q11.2-q21. Objective: Both MBL serum levels and activity are mainly determined genetically by its variants. So considering the putative clinical role of MBL2, this case-control association study was designed to assess its six functional variants in a northwestern Indian cohort. Methods: Genetic typing of six MBL2 variants was done by amplification refractory mutation system-polymerase chain reaction. Data were analyzed using suitable statistical tools. Results: Significant difference has been observed in genotypic and allelic distribution between cases and controls for rs11003125. Comparison of allelic distribution for rs1800450 showed significantly high prevalence of A allele in cases than controls. Conclusion: These results indicate that MBL2 variants may act as plausible marker for susceptibility toward RA. Keeping this in view, it is pertinent to screen these variants in other population groups of India.

Trends and social inequalities in self-reported health and activity limitations in France between 2017 and 2021: results from four nationwide representative surveys

BackgroundLike other countries in Europe and around the world, France was hit by the COVID-19 pandemic in 2020, although it had also experienced several social crises since 2017. This study assessed the evolution of self-reported health and activity limitations and explored the dynamics of their socio-territorial inequalities among the French population aged 18–75 years between 2017 and 2021.MethodsSelf-reported health (SRH) and global activity limitation indicator (GALI) were assessed in the same way in the four last editions of the French Health Barometer surveys conducted in the general population in 2017, 2019, 2020, and 2021, with between 9,200 and 24,500 subjects interviewed depending on the year. The prevalence of good or very good SRH and GALI (any limitation) and their evolution between 2017 and 2021 were studied according to sex, age, main socioeconomic positions (SEP), and regions. Poisson regression models were used to estimate adjusted prevalence ratios and potential modification effects of sociodemographic and geographic characteristics.ResultsBetween 2017 and 2021, SRH and GALI deteriorated in adults in France in a continuous way. Very good or good SRH decreased from 75.2% (CI95% [74.5–75.9]) of subjects in 2017 to 68.5% (CI95% [67.7–69.3]) in 2021. In parallel, GALI increased from 21.5% (CI95% [21.0–22.2) in 2017 to 25.2% (CI95% [24.5–26.0]) in 2021.The deterioration of indicators affected both sexes, all age classes (except 65–75 years), especially younger age classes (18–24 and 25–34 years), all geographical regions, and all SEP variables, with groups with a higher SEP deteriorating more than others. Negative variations exceeding 20% (8–10 percentage points on the absolute scale of indicators) were observed in several population groups from 2019 onwards.ConclusionThe previously observed deterioration of the SRH and GALI continued in France between 2017 and 2021, with narrowing socio-territorial gradients of inequalities. The impact of successive social and health crises on the poor evolution of self-reported health and activity limitations warrants further investigation over time and across locations using complementary and possibly more detailed indicators.

Crowded‐out? Changes in informal childcare during the expansion of formal services in Germany

AbstractInformal childcare care by grandparents, other relatives or friends is an important source of support in many Western countries, including Germany. Yet the role of this type of care is often overlooked in accounts of social policies supporting families with children, which tend to focus on formal childcare. This article examines whether the large formal childcare expansion occurring in Germany in the last two decades has been accompanied by similar or opposite trends in informal childcare usage. It argues that accounting for both formal and informal childcare can offer a more accurate assessment of defamilisation effects of family policies. Drawing on representative data from the German Socio‐Economic Panel the analysis identifies long‐run developments of childcare arrangements for children aged 1–10 between 1997 and 2020, offering for the first time a comprehensive picture of how families with children of different ages mix informal care and service provision. Results show that on average the expansion of formal childcare was not associated with an equal reduction in informal childcare, lending little support to the crowding‐out hypothesis. Further analyses distinguishing between population groups with different propensity to use formal childcare reveal, unexpectedly, remarkable similarities in the use of informal care throughout the period examined. The only exception are families with a migrant background, who tend to use informal childcare less than their counterparts. The general trend is, however, one whereby informal and formal care are increasingly combined.

Trends in hepatitis C virus seroprevalence and associated risk factors among msm in Pakistan: insights from a community-based study

Pakistan bears a substantial burden of hepatitis C virus (HCV) infection, with the second-highest prevalence globally. This community-based cross-sectional study, conducted from January to December 2022 in Punjab, Pakistan, investigates the seroprevalence of HCV among the men who have sex with men (MSM) population. The study identifies demographic and behavioral risk factors associated with HCV infection within this population group. Among the 501 participants, the study found an HCV seroprevalence of 14.86%. The association between demographic characteristics and seroprevalence is assessed by calculating the percentage of positive cases, revealing notable associations with age, education level, and self-identified sexual orientation. Furthermore, the study identified several behavioral risk factors positively associated with HCV seroprevalence, including sharing personal items such as razors and toothbrushes, histories of surgery, blood transfusion, dental procedures, intravenous drug use, and therapeutic injection histories. These risk factors were identified through structured interviews, and the prevalence of HCV seropositivity among the exposed groups was calculated accordingly. Interestingly, a lower HCV positivity rate was observed among self-reported HIV-positive individuals, contradicting previous research. The findings underscore the need for comprehensive, targeted prevention strategies such as risk factor awareness campaigns and educational programs tailored for the MSM population in Pakistan. Further research is warranted to validate these findings and better understand the complex interplay of factors contributing to HCV seroprevalence in this high-risk population.

Exploring changes in attitudes towards doping in sport in different groups of the russian population: a mixed methods study with policy recommendations

Introduction: This article examines the evolution of anti-doping culture in Russia through a comparative analysis of sociological surveys conducted in 2019, 2020, and 2021. It focuses on the changing attitudes of Russian citizens towards doping in sports, their awareness of anti-doping regulations, and the underlying causes and motivations for violations of anti-doping rules. The significance of understanding public opinion on doping and countermeasures is highlighted, underscoring its value for specialists, researchers, and executive authorities in addressing and mitigating the issue. Materials and Methods: The study employed sociological surveys across various categories and groups within the Russian population, spanning three consecutive years. These surveys aimed to gather comprehensive insights into the public's perception of doping, knowledge of anti-doping efforts, and attitudes towards the effectiveness of existing anti-doping measures. The methodology was designed to enable a detailed comparative analysis, shedding light on trends and shifts in public opinion over time. Results: Findings from the surveys reveal a noticeable development in the anti-doping culture among the Russian population, marked by changes in attitudes towards doping use and a growing awareness of anti-doping rules. The research identified specific causes and motives behind anti-doping rule violations, illustrating the complex nature of the issue. Additionally, the study provided an objective assessment of the problem's scale, based on the attitudes of various social groups towards the use of banned substances, whether of natural, narcotic, or synthetic origin. Conclusions: The paper concludes with up-to-date data on the anti-doping situation in the Russian Federation and perspectives from scientists on enhancing anti-doping efforts. Based on the analysis, the authors propose a set of measures aimed at improving anti-doping activities in Russia. These recommendations are intended to bolster the fight against doping, reflecting the study's contribution to forming a comprehensive understanding of societal attitudes towards this challenge and paving the way for more effective countermeasures. Keywords: doping, sports, anti-doping rules, anti-doping measures, anti-doping culture, attitudes toward doping in sports, opinion poll.

Neck Circumference and Its Relation with Body Fat Percentage in Children 5-10 Years Old.

Neck circumference (NC) has been proposed as an indicator of upper trunk adiposity and a potential indicator of metabolic risk. The objective was to evaluate NC and its correlation with body fat percentage (BF%) and other indicators of adiposity in children with normal weight, overweight, and obesity. In a cross-sectional study, 112 children 5 to 10 years of age were included in the outpatient clinic from a public hospital. Measures of weight and height to calculate BMI (kg/m2), NC, mid-upper arm circumference, waist circumference, and tricipital skinfold thickness. Body composition measurements were performed using an electrical bioimpedance device (BIA). The relationship between anthropometric variables and BF% obtained by BIA was determined using Spearman correlation tests. Multivariate models were constructed with BF% as the dependent variable and anthropometric parameters as independent. In the entire group, there was a direct correlation between NC and BF% (r = 0.50, p < 0.001), but lost statistical significance in the case of normal weight. The relationship maintained its significance in subjects from the overweight and obesity groups. In multivariate models, BMI exhibited the highest correlation with BF%, followed by waist circumference and mid-upper arm circumference; for NC, the R2 value was 0.30 (p < 0.001). Neck circumference is useful in the screening of population groups with the advantage of not requiring any specialized instruments for its measurement other than a tape measure. BMI and waist circumference were the best indicators of general and central adiposity, respectively.

A Large-Scale Genome-Wide Study of Gene-Sleep Duration Interactions for Blood Pressure in 811,405 Individuals from Diverse Populations.

Although both short and long sleep duration are associated with elevated hypertension risk, our understanding of their interplay with biological pathways governing blood pressure remains limited. To address this, we carried out genome-wide cross-population gene-by-short-sleep and long-sleep duration interaction analyses for three blood pressure traits (systolic, diastolic, and pulse pressure) in 811,405 individuals from diverse population groups. We discover 22 novel gene-sleep duration interaction loci for blood pressure, mapped to 23 genes. Investigating these genes' functional implications shed light on neurological, thyroidal, bone metabolism, and hematopoietic pathways that necessitate future investigation for blood pressure management that caters to sleep health lifestyle. Non-overlap between short sleep (12) and long sleep (10) interactions underscores the plausible nature of distinct influences of both sleep duration extremes in cardiovascular health. Several of our loci are specific towards a particular population background or sex, emphasizing the importance of addressing heterogeneity entangled in gene-environment interactions, when considering precision medicine design approaches for blood pressure management.

Combination of toxicological and epidemiological approaches for estimating the health impact of atmospheric pollutants. A proof of concept for NO2

BackgroundRegular monitoring of the air pollutant nitrogen dioxide (NO2), an indicator for traffic-related emissions, is a priority in urban environments. The health impacts associated with NO2 exposure are the result of a combination of factors, including concentration, duration of exposure, and interactions with other pollutants. WHO has established air quality guidelines based on epidemiological studies. ObjectiveThis study develops a new concept "Health Impact Pathways (HIPs)" using adversity as a probabilistic indicator of health effects. For this purpose, it integrates available toxicological and epidemiological information, using Adverse Outcome Pathways (AOPs), in order to understand chemical-biological interactions and their consequences on health. MethodsLiterature review and meta-analysis of toxicological data supported by expert judgment were performed to establish: a) adversity pathways, b) quantitative criteria for scoring the observed toxicological effects (adversity indicators), c) NO2 exposure - adversity relationship for both long-term (1–36 months) and shortterm (1–7 days). The NO2 daily concentrations from January 2001 to December 2022, were obtained from Madrid city Air Quality network monitoring database. Adversity levels were compared with relative risk levels for all-cause and respiratory mortality estimated using linear equations from WHO 2021 guidelines. ResultsNon-linear relations were obtained for all long- and short-term NO2 related adversity indicators; for long-term effects, the best fitting was obtained with a modified Haber's law model with an exponential coefficient for the exposure time of 0.25. Estimations are presented for a set of case studies for Madrid city, covering temporal and spatial variability. A clear improvement trend along the two decades was observed, as well as high inter- and intra-station variability; the adversity indicators provided integrated information on the temporal and spatial evolution of population level risk. DiscussionThe proposed HIP conceptual approach offers promising advances for integrating experimental and epidemiological data. The next step is linking the concentration-adversity relationship with population health impacts through probability estimations, the preliminary estimations confirm the need for assessing independently different population groups.

Associations between tinnitus and body composition: a cross-sectional study

The relationship between tinnitus and body composition in specific regions has not been extensively investigated. This study aimed to identify associations between tinnitus and body composition. Individuals with data on physical and otological examination findings, and bioelectrical impedance analysis were included from the ninth Korea National Health and Nutritional Examination Survey. They were divided into a tinnitus group and a non-tinnitus group. Participants with tinnitus were further classified into acute or chronic tinnitus group. The tinnitus group showed significantly higher body fat percentages in each region (arms: P = 0.014; legs: P = 0.029; trunk: P = 0.008; whole body: P = 0.010) and waist circumference (P = 0.007) than the non-tinnitus group, and exhibited lower leg muscle percentage (P = 0.038), total body fluid percentage (P = 0.010), and intracellular fluid percentage (P = 0.009) than the non-tinnitus group in men. Furthermore, men with chronic tinnitus showed a significantly higher trunk fat percentage (P = 0.015) and waist circumference (P = 0.043), and lower intracellular fluid percentage (P = 0.042) than their counterparts without tinnitus. No significant differences in body composition were observed among the groups in the female population. In men, body composition may be associated with tinnitus.

Spontaneous Splenic Rupture Secondary to Infectious Mononucleosis.

Spontaneous splenic rupture (SSR) is a relatively rare but potentially lethal complication of infectious mononucleosis (IM). While SSR is extremely rare in patients with proven IM, it is the most lethal complication of the infection (9% mortality rate) and can present completely asymptomatically or with abdominal pain and hemodynamic instability. As adolescents and young adults are the most affected population group, with this case report, we intend to raise the vigilance of any doctor treating those patients in the emergency department. We present the case of a 16-year-old patient with an atraumatic splenic rupture and hemoperitoneum secondary to an Epstein-Barr virus (EBV) infection. The patient underwent an exploratory laparotomy, and a splenectomy was performed. This case demonstrates that, even if SSR in patients with IM is extremely rare, it should always be considered in a patient with a relevant clinical presentation.

Determinants of parental demand of human papillomavirus vaccination for adolescent daughters in China: Contingent valuation survey.

Several types of human papillomavirus (HPV) vaccines have been approved for use in adolescent girls in China. These vaccines are regulated as non-National Immunisation Program vaccines and are optional and generally fully self-paid by vaccinees. To assess parents' demand for HPV vaccination by eliciting their willingness-to-pay for their adolescent daughters to be vaccinated against HPV and to examine the determinants of demand for HPV vaccination in China. A contingent valuation survey was conducted across three cities in Shandong Province in eastern China. We selected 11 junior middle schools with different socioeconomic features and randomly selected 6 classes in each school, and questionnaires were distributed to all girls aged 12-16 in the 66 classes for their parents to complete. A payment card approach was used to elicit parental willingness-to-pay for HPV vaccination for their daughters. We also collected a wide array of socioeconomic and psychological variables and interval regressions were applied to examine the determinants of parental willingness-to-pay. A total of 1074 eligible parents who completed valid questions were included in analyses. Over 85% of parents believed HPV vaccines were, in general, necessary and beneficiary. However, only around 10% believed that their daughters would be infected by HPV. About 8% of parents would not accept HPV vaccine even if the vaccine were free mainly due to concerns about the potential side effects and vaccine safety and quality issues, and 27.37% would only accept the vaccine if it were free. The median willingness-to-pay was 300 CNY (42 USD). Several factors were positively correlated with higher willingness-to-pay: income, urban residence (relative to rural residence), mothers (relative to fathers), parents' beliefs about vaccine benefits, whether they should make decisions for their daughters, and whether their daughters would be susceptible to HPV. Though education-level was not significantly correlated with willingness-to-pay in the main regressions, a subgroup analysis revealed interesting dynamics in the relation between education and willingness-to-pay across different income-levels. There is a large gap between parents' willingness-to-pay and the market price of HPV vaccine for girls in China. Parents generally believed the HPV vaccines were beneficial and necessary but when asked for their daughters, most parents did not believe their daughters would be infected by HPV despite the high prevalence in China. Future focus should be on ensuring the provision of accurate health information about HPV prevalence, vaccine quality, and safety to promote vaccine uptake, and promotional efforts tailored to different income groups might yield better effects. Government involvement in negotiating more widely acceptable and affordable prices or subsidising may be necessary for protecting high-risk population groups.

Infectious keratitis in pediatric population aged less than two years: a tertiary eye institute experience

BackgroundInfectious keratitis is a serious ocular condition, which can lead to corneal scarring, vision loss, and even blindness. Pediatric infectious keratitis accounts for about 13% of all cases, although there is a lack of comprehensive data regarding keratitis in less than two years of age population group. This study was aimed to determine predisposing factors, clinical characteristics, microbial profile, and management of infectious keratitis in a population of children aged less than two years.Materials and methodsA retrospective study was carried out in a tertiary eye institute over a period of 18 years from July 2005 to December 2022. Collected data was analyzed for demographics, predisposing factors, clinical features, and treatment methods.ResultsFifty-seven cases of keratitis were identified. Age of the patients ranged from 1 to 24 months (Median: 6, interquartile range: 2–10). Thirty cases were male (52.6%). Predisposing factors were identified in 39 cases (68.4%): consisting of prior ocular trauma (n = 15), previous intraocular surgery (n = 11), ocular surface disease (n = 10), nasolacrimal duct obstruction (n = 4), prematurity (n = 3), developmental delay (n = 2), TORCH infection (n = 1), and contact lens (n = 1). Corneal thinning was observed in 29 eyes (50.9%), which progressed to perforation in 13 eyes (22.8%). Three patients developed endophthalmitis (95% CI, 1.5–13.4%). Most eyes had negative smear (60.4%) and culture (59.6%) results. Pseudomonas aeruginosa was the most common microorganism (11 of 21). Candida albicans was isolated in one case. In vitro susceptibility results showed good coverage of the combined ceftazidime and vancomycin regimen (100%). Surgical procedures were carried out in 35 eyes (61.4%) and 15 eyes required tectonic procedures (26.3%).ConclusionDespite good coverage of medical treatment over cultured isolates, surgical tectonic intervention was required in nearly a quarter of cases to resolve the corneal infection. This finding indicates the necessity of prompt patient referring, corneal sampling and initiation of the treatment.

ESTIMATION OF STATURE FROM NASAL HEIGHT IN MALE AND FEMALE STUDENTS IN UDAIPUR

Objective: Stature refers to a person's height when standing upright. It is a vital measure of physical identity. In archaeological operations or forensic exams following a mass disaster, height is estimated using rudiments or bone pieces for identification. In order to determine stature, separate regression formulae should be developed for each population group. Methods: This cross-sectional study was conducted at Department of Anatomy, Pacific Institute of Medical Sciences, Umarda, and Udaipur. A total of 110 students (55 males and 55 females) aged between 18 to 25 y, participated in this study. Those with craniofacial defects were excluded from study. Height was measured from vertex to floor by stadiometer. Results: The study showed that in males mean values are significantly higher than females for both nasal height as well as stature; nasal height in (male 48.54±3.584 mm; female 46.75±3.763 mm) and stature in (male 170.3±7.902 cm; female 159.61±5.383 cm). In total student’s as well as in males and females, nasal height had a weak positive linear relationship with stature; r=0.283 in total students, r=0.222 for male and r=0.123 for female. The regression equation for stature and nasal height was found to be Y=134.053+0.648× nasal height for total students, Y=146.487+0.496×nasal height for males, Y=151.328+0.177× nasal height for females. Conclusion: The observed correlation is statistically significant in total students (p value&lt;0.05) but not significant in males and females (p value&gt;0.05). Overall nasal height had a weak positive linear correlation with stature.

Capturing the HIV-related social exclusion practices experienced by key populations through photovoice: an interpretative phenomenological study

BackgroundKey populations are defined as groups that are susceptible to HIV, including Men Sex with Men (MSM), Transgender (TG), Persons who Inject Drug (PID), and Female Sex Worker (FSW). These key populations groups are among the fastest-growing populations in Indonesia. These vulnerable groups are ostracized by society and health services, which makes it difficult to get treatment. This project was carried out to investigate the different experiences and perspectives of these key populations in facing and addressing social and spiritual exclusion.MethodsA qualitative phenomenological study using photovoice was carried out from July to December 2022. Key populations comprising MSM, TG, PID, and FSW were recruited from community-based peer groups in West Bandung Regency using snowball sampling. This was followed by the Photovoice stages, from workshops to focus group discussions and interviews with audio recordings. Furthermore, thematic data analysis was carried out by interpretative participant narratives and photographs supported by Atlas.ti software.ResultEighteen participants comprising four MSM, five TG, four PIDs, and five FSWs participated in this research. Among these eighteen participants, six were HIV-negative, including 3 PIDs and 3 FSWs, while the remaining were positive. The analysis of the collected data identified four main themes: 1) limited access like unequal treatment, disadvantage, and harassment, 2) social and spiritual impact, 3) coping mechanisms, and 4) self-reflection through photovoice. These results showed that social exclusion occurred in an environment where community values, beliefs, and norms dehumanised these key populations, and where removal of support and care was prominent. Despite these challenges, participant resilience was evidenced by using internal resources and peer support as coping mechanisms. The participants considered photovoice as a tool to foster self-confidence and self-awareness through a reflective process.ConclusionsThe findings of this study highlight the emphasis on participants' openness in sharing their experiences, which can build empathy and promote a more inclusive community in HIV prevention efforts. This research findings can be used to inform HIV policy and practice and inclusion of these key populations in the community. We advocate making the photovoice efforts accessible to a wider audience through exhibitions and various media.

"Lusog-Linang": Utilizing Community-engaged Research towards Capacity Building in Health of an Underserved Community.

Nurses have a pivotal role in nurturing the capabilities of individuals, families, and population groups for better health. However, underserved communities in the Philippines, such as those with socioeconomic inadequacies, geographic isolation, and service access problems, have significant limitations in attaining the highest possible level of health. Hence, a community extension service (Project "Lusog-Linang"), employing community-engaged research, was launched with the residents of an underserved locality in Central Luzon. The current paper aimed to describe the engagement of the community residents in describing their current health situation and related priority problems, as well as explore appropriate initiatives to manage the identified problems. Community-engaged research was utilized to enable the residents of Barangay San Vicente, Bamban, Tarlac to participate in health capacity building. Particularly, records review and focus group discussions were conducted to assess the community's health needs and to identify the residents' perceived problems. The findings were presented in a community assembly, where residents further discussed their priority health concerns and potential interventions to address them. Quantitative data were summarized through descriptive statistics, while qualitative information was synthesized via content analysis. The priority community health problems included healthcare inaccessibility (trained staff, health equipment, and facility access), food insecurity, water supply limitations, and environmental sanitation. Moreover, there was inadequate knowledge and skills among the residents in health promotion, disease prevention, and illness management. While Barangay San Vicente had limited socioeconomic resources to optimize their health capacities, the sense of community among the residents is a vital resource towards empowering them to improve their health. The results could be utilized as a launching pad for developing appropriate health programs for the residents of Barangay San Vicente. Hence, the next steps in Project "Lusog-Linang" should include the identification and training of core group members toward community mobilization, and further exploring collaborative and sustainable partnerships across organizations to ensure that the community will have long-term solutions to their problems. Consequently, this project could guide public health workers in ensuring the active involvement and participation of the community members in managing their own health.

Health and equity impacts from transportation noise

Transportation noise is a widespread issue throughout the developed world and is some places is considered a more significant issue than crime. The World Health Organization (WHO) has evaluated the effects of transportation noise on public health in Europe, however, there is no equivalent research in the United States. This paper evaluates transportation noise exposure in the United States, compares this exposure to WHO recommendations, and identifies population groups that are most likely to be affected through a case study. This study uses publicly available resources from the Bureau of Transportation Statistics and the Environmental Protection agency.

Pembrolizumab combined with chemotherapy versus placebo combined with chemotherapy for HER2-negative advanced gastric cancer in China: a cost-effectiveness analysis

ABSTRACT Objective This study aims to conduct a cost-effectiveness analysis of pembrolizumab in combination with chemotherapy for HER2-negative advanced gastric cancer in China. Methods A partitioned survival approach model was constructed to simulate the progression of HER2-negative advanced gastric cancer and evaluate the outcomes of different treatment strategies. We calculated incremental cost-effectiveness ratios (ICER) to assess the cost associated with each quality-adjusted life-year (QALY) gained. One-way sensitivity analysis and probabilistic sensitivity analysis were performed to assess robustness and reliability. Results The analysis conducted in the base case demonstrated that the ICER associated with pembrolizumab was $177405.83/QALY gained in all population. In the subgroup analysis, it was found that individuals with a PD-L1 CPS ≥ 1 and those with a PD-L1 CPS ≥ 10 had ICERs of $152397.06/QALY and $109534.13/QALY, respectively. All ICER values for both the all population groups and the subgroups exceeded the WTP threshold in China. Our analysis shows the robustness of these results, as they remained consistent when input parameters were varied within a ± 25% range. Conclusion The findings of this cost-effectiveness analysis suggest that pembrolizumab in combination with chemotherapy is not a cost-effective treatment option for HER2-negative advanced gastric cancer in China.

West Street Durban 1977 (1)

West Street is the official main road of Durban. Some of the smaller buildings in it are so old-world in appearance that they might well have been part of any average Karoo town, although by contrast there are also imposing structures representing the stark International Style. The Baroque town hall and the Neo-Classical post office have already been declared national monuments, and buildings typical of the innovation at the turn of the century should surely be protected from the demolishers. The Indian complex in Grey Street adds to the street front both further variety and that hint of mystery which the traditions of one population group always have for others.

The effects of online pilates on the mood and fear of birth of pregnant women: a randomized controlled study

The Pilates exercise method is applied online to various population groups. This study aimed to determine the effect of online Pilates exercises on depression, anxiety, and fear of childbirth in pregnant women. Our randomized controlled study divided participants into the online pilates group (OPG) and the control group (CG). Pilates exercises were applied to the OPG according to the American College of Obstetricians and Gynecologists guidelines, while the CG was given a home program. Assessments were made before and after the training. All measurements improved after Online Pilates (p < 0.05), while there was no change in the control group (p > 0.05). While initial measurement values were similar in both groups (p > 0.05), a statistical difference was observed in favor of OPG with a moderate effect percentage in all results after training (p < 0.05). These results revealed that eight weeks of online Pilates training could effectively reduce depression, anxiety, and fear of childbirth.Trial registration:Clinical trial registry: NCT05305716.

Need and Rationale of the Adult Immunisation in India: A Review

Abstract A comprehensive literature review of published articles (till October 2023) was done through PubMed, Embase and Google Scholar search engines to delineate the need for adult immunisation, recommended adult vaccines, barriers to adult immunisation, future research areas and way forward in the Indian context. A total of 29,894 articles were screened from PubMed, Embase and Google Scholar. Of these, a full-text review of 53 articles was done. The findings emphasised the need for adult immunisation in India because of the growing vulnerable elderly population with comorbidities, immunosenescence, waning immunity, rising incidence of VPDs leading to higher morbidity and mortality amongst them, rising cost of hospitalisation and the emergence of antimicrobial resistance. The recommended adult vaccines include human papilloma virus vaccine, pneumococcal vaccine, influenza and typhoid vaccine for healthy adults and special population groups, respectively. Challenges include less prioritisation in the National Vaccination Policy, insufficient awareness amongst healthcare providers and vaccine hesitancy.