Medical Institutions Research Articles

Real-World Safety and Effectiveness of Infliximab in 255 Patients with Intestinal, Neurological, and Vascular Behçet's Disease: A Post-Marketing Surveillance.

Behçet's disease (BD) with intestinal, neurological (NBD), and vascular (VBD) manifestations often leads to poor outcomes. Infliximab is approved for the treatment of intestinal BD, NBD, and VBD in Japan; however, evidence regarding its safety and effectiveness in these patients is limited. We conducted a 2-year post-marketing surveillance to evaluate the safety and effectiveness of infliximab in patients with intestinal BD, NBD, and VBD in Japan. This 2-year, multicenter, prospective, observational study included all patients with intestinal BD, NBD, or VBD, who had experiencedan insufficient response to conventional therapies (e.g., glucocorticoids and immunosuppressants/immunomodulators), and initiated infliximab for the first time at participating medical institutions. The safety endpoints included adverse events and adverse drug reactions (ADRs), and the effectiveness endpoints included global improvement, and for patients with acute NBD, acute attacks. Between October 2015 and August 2018, 255 patients (171 intestinal BD, 49 NBD, and 51 VBD; including 16 with two disease types) were enrolled from 133 medical centers and treated with infliximab. Adverse events, ADRs, and serious ADRs occurred in 100 (39.2%), 72 (28.2%), and 38 (14.9%) patients, respectively; incidences were generally similar across intestinal BD, NBD, and VBD groups. No new safety concerns were identified. At the final evaluation, 68.8% of patients with intestinal BD showed improvement, most patients with chronic progressive NBD and VBD had not worsened (100% and 91.7%, respectively), and 93.3% of patients with acute NBD had no new acute attacks during the observation period. These results confirmed the safety and effectiveness of infliximab in clinical practice in 255 patients with intestinal BD, NBD, and VBD. There were no new safety concerns.

Perioperative immunotherapy for non-small cell lung cancer: consensus and controversy (2024 edition)

Lung cancer is the malignant tumour with the highest morbidity and mortality rate in China, among which non-small cell lung cancer (NSCLC) is the main pathological type of lung cancer, accounting for about 80% to 85%. Radial surgery is the standard treatment for early-stage NSCLC, but postoperative recurrence is an inevitable problem in clinical practice. Adding perioperative chemotherapy to surgery can only increase the 5-year overall survival rate by about 5%. There is an urgent need for better systemic treatments. In recent years, immunotherapeutic drugs, represented by PD-1/PD-L1 monoclonal antibodies, have brought breakthroughs from subsequent-line treatment to front-line treatment for NSCLC. Several Phase III studies on perioperative immunotherapy have shown that adding immunotherapy during the neoadjuvant and adjuvant treatment can significantly improve survival outcomes for patients, leading to the development of a new standard treatment for resectable NSCLC. In January 2024, the first PD-1 monoclonal antibodies (Toripalimab) were approved for perioperative treatment of NSCLC in China, starting a new era of perioperative immunotherapy. At present, there is still a lack of unified consensus on the application of perioperative immunotherapy at all levels of medical institutions. In order to privide diagnostic and treatment guidance for clinicians, promote the standardization of clinical practice for immunotherapy in resectable NSCLC, and clarify the controversial opinions regarding perioperative immunotherapy, Lung Cancer Expert Committee of the Chinese Anti-Cancer Association, Chinese Thoracic Oncology Group, Lung Cancer Expert Committee of the Chinese Medical Association Oncology Society jointly published this Consensus and Controversy to provide a guidance for the standardized management of perioperative immunotherapy for NSCLC.

Social anxiety and resilience among undergraduate medical students in Kolkata: A mixed-methods study

Background: Social anxiety disorder, or social phobia, involves an uncontrollable fear of social situations, exacerbating stress and hindering academic performance. Building resilience is crucial as it helps individuals cope with and recover from stress effectively. This study aimed to assess social anxiety and resilience among undergraduate medical students at a tertiary care institute in Kolkata and to identify any associated sociodemographic factors. Methods: A mixed-methods study was conducted from April to June 2022 among 200 undergraduate medical students of Phase-I of Bachelor of Medicine, Bachelor of Surgery. Quantitative data were collected via electronic method (Google Forms). Multinomial logistic regression was performed to examine relation between sociodemographic characteristics, social anxiety, and resilience. The qualitative component consisted of in-depth interviews with 12 purposively selected participants and was thematically analysed. Results: Most (80.0%) participants were aged between 17 and 20 years, and 63.7% were from urban residences. Social anxiety was prevalent in almost 78% of participants, while only 2.1% exhibited ‘high’ resilience. Students whose mothers had received primary education and less monthly pocket money had significantly higher odds of experiencing social anxiety. Qualitative findings revealed themes such as fear of judgment, avoidance of social situations, and impacts on academic performance, with coping mechanisms including seeking social support and practicing mindfulness. Conclusion: Most of the participants experienced social anxiety, with few displaying high resilience. These findings highlight the need for comprehensive mental health support systems within medical institutions.

Spontaneous eye blinking as a diagnostic and prognostic marker in disorders of consciousness: Protocol of an international multicentre longitudinal study.

Diagnostic and prognostic decision-making in patients with Disorders of Consciousness (DoC) is challenging. It has been suggested that spontaneous eye blink rate is an index of patients' level of consciousness easy to detect in clinical practice. Further blinking features (i.e., amplitude, duration, variability in intervals between blinks) may change as a function of cognitive load, but have not been investigated in patients with DoC. This multicentre, longitudinal study aims at exploring the diagnostic and prognostic value of spontaneous eye blinking features in DoC. Eight European medical institutions will enrol consecutively admitted adult patients with DoC. Within two weeks from study entry demographic, anamnestic and clinical data will be collected. Moreover, patients will undergo two 20-minute EEG-EOG recordings at rest, to collect blinking features and EEG activity. A clinical follow-up will be performed after 6 months. A group of healthy individuals will be enrolled for reference. Possible differences in blink features between patients and the reference group, differences across diagnostic sub-groups, and correlations between blinking features and clinical outcome will be investigated. The results of this study might help clinicians to reduce misdiagnosis rate in DoC and provide useful information for prognostication and care pathway plan.

LMCD-OR: a large-scale, multilevel categorized diagnostic dataset for oral radiography

In recent years, digital dentistry has increasingly utilized advanced image analysis techniques, such as image classification and disease diagnosis, to improve clinical outcomes. Despite these advances, the lack of comprehensive benchmark datasets is a significant barrier. To address this gap, our research team develop LMCD-OR, a substantial collection of oral radiograph images designed to support extensive artificial intelligence (AI)-driven diagnostics. LMCD-OR comprises 3,818 digital imaging and communications in medicine (DICOM) oral X-ray images from local medical institutions that are meticulously annotated to provide broad category information for both primary dental outpatient services and detailed secondary disease diagnoses. This dataset is engineered to train and validate multiclassification models to improve the precision and scope of oral disease diagnostics. To ensure robust dataset validation, we employ four cutting-edge visual neural network classification models as benchmarks. These models are tested against rigorous performance metrics, demonstrating the ability of the dataset to support advanced image classification and disease diagnosis tasks. LMCD-OR is publicly available at http://dentaldataset.zeroacademy.net.

Practice and reflections on regional mutual recognition of clinical research ethics review——based on survey results from medical and health institutions in Jiangsu Province

With the continuous advancement of medical research, the number of multi-center clinical studies has been steadily increasing, bringing about significant challenges to ethical review. Improving the efficiency and quality of ethical review has become a necessity driven by national policies and the development of the industry. Mutual recognition of ethical reviews is one of the most effective ways to enhance the efficiency of ethical review in multi-center clinical trials. The promotion of mutual recognition of ethical reviews is both feasible and practically significant; however, progress has been less than ideal. Through conducting surveys, this study attempts to understand the status of mutual recognition of ethical reviews in Jiangsu Province, identify the reasons hindering the implementation of mutual recognition, and propose possible solutions. The results indicate that while most medical and health institutions are aware of the policies related to mutual recognition of ethical reviews, the majority remain in a wait-and-see attitude. Ensuring policy guarantees and the high quality and homogeneity of ethical review across institutions are considered necessary conditions for achieving mutual recognition of ethical reviews.

Engaging Diverse African American/Black and Latine Youth and Emerging Adults Living with HIV into Research: Description of Recruitment Strategies and Lessons Learned.

Improving engagement along the HIV care continuum and reducing racial/ethnic disparities are necessary to end the HIV epidemic. Research on African American/Black and Latine (AABL) younger people living with HIV (LWH) is essential to this goal. However, a number of key subgroups are challenging to locate and engage, and are therefore under-represented in research. Primary among these are persons with non-suppressed HIV viral load, severe socioeconomic disadvantage, transgender/gender expansive identities, and refugee/migrant/immigrant populations. Research in community settings is needed to complement studies conducted in medical institutions. The present study describes the efficiency of recruitment strategies used in the community to enroll AABL young and emerging adults LWH ages 19-28 years. Strategies were designed to be culturally responsive and structurally salient. They were: peer-to-peer, social media, classified advertisements (newspaper, craigslist), subway ads, dating apps (Jack'd, Positive Singles), and direct recruitment in community-based organizations. Data were analyzed using mainly descriptive statistics and interpreted using a consensus building approach. We screened 575 individuals in a first step, 409 were eligible (71%), of these 297 presented to the second screening step (73%), but 112 were lost. Almost all presenting at the second step were eligible (98%, 291/297) and 94% enrolled (274/291). Peer-to-peer, dating app (Jack'd), direct recruitment, and craigslist were the most efficient strategies. Recruitment on dating apps was superior to the peer-to-peer approach in yielding eligible participants (OR = 1.5; 95% CI: 0.98-2.3; p = 0.06). The sample enrolled was diverse with respect to HIV viral suppression, gender identify, sexual orientation, immigration status, and barriers to HIV care engagement. We discuss the advantages and disadvantages of each strategy. Recruitment is a vital aspect of research and warrants attention in the empirical literature.

Real-world pharmacovigilance study of FDA adverse event reporting system events for finerenone

ABSTRACT Objective This study analyzed the signal mining of adverse events caused by finerenone based on the US Food and Drug Administration Adverse Event Reporting System (FAERS) and evaluated the drug’s safety to provide a reference for the safe administration of this medication in medical institutions. Methods FAERS data from the third quarter of 2021 to the fourth quarter of 2023 were used, and the adverse event codes of the Medical Dictionary for Regulatory Activities were compared. After the data were processed, adverse event reports that featured finerenone as the most suspected drug were extracted. Results A total of 905 reported cases of adverse events including finerenone as the first suspected drug were extracted. The ratio of male to female patients was 1.25, and most were aged 65–85 years (30.1%). The adverse events that were reported more frequently with positive signals were decreased glomerular filtration rate, hyperkalemia, increased blood creatinine, and dizziness. The adverse events that were concentrated on in investigations were metabolism and nutrition disorders and diseases of the renal and urinary system. Conclusions Our study identified significant novel adverse events (AEs) signals for finerenone that could provide support for clinical monitoring of and risk identification for finerenone.

Profiles, tissue and microbial integrity of cadavers used in medical faculties in South-western Uganda: implication in anatomical education.

Cadaveric dissection has remained an integral part of anatomical education globally; hence, the profiles of cadavers, their gross tissue and microbial integrity has great implication in anatomical education. This study determined the profiles, gross tissue and microbial integrity of cadavers used in South-western Uganda (SWU) medical schools. A cross-sectional study was carried out for three months in anatomy and microbiology laboratories of SWU medical teaching institutions. Ethical approval was obtained, cadavers were proportionately selected and examined grossly, and surface swabs taken for microbial analysis. Data collected was entered into Microsoft Excel, cleaned, and exported to Stata version 17 for analysis. Majority of cadavers were male (68%), adult (96%), blacks (100%), unknown cause of death (96%), obtained as unclaimed bodies (100%) and with no cadaver record tag (96%). Nearly a half (48%) cadavers had disrupted dentition, 68% had poor muscle integrity and 80% with abnormal fat. About 27% cadavers had poor surface microbial integrity among which 62.5% had a mixture of both bacteria and fungi, 25.0% had only fungi while 12.5% had only bacteria. A high number of cadavers had micro-organisms on their surfaces with majority having a mixture of bacteria and fungi. Majority of cadavers had poor gross tissue integrity. Better cadaver preservation methods should be adopted. To advocate for the establishment of cadaver donation policy and programs through which good quality cadavers can be obtained.

Patient selection for left ventricular assist device implantation. The main problems

To analyze the experience of Chazov National Medical Research Center of Cardiology in patient selection for left ventricular assist device (LVAD) implantation. 901 patients, whose documents were sent to Chazov National Medical Research Center of Cardiology from regional medical and prophylactic institutions, were screened as selection for LVAD implantation. Firstly, all patients underwent transthoracic echocardiography performed according to the extended protocol with a comprehensive assessment of the left and right ventricle size and function. Patients who underwent the screening procedure underwent further examination including both laboratory and instrumental diagnostic methods. In addition, the polyclinic database of patients diagnosed with chronic heart failure (CHF) and dilated cardiomyopathy was also analyzed. Among 901 screened patients 7.9% were suitable candidates for LVAD implantation and only 23 (2.6%) patients underwent surgery. Among those not eligible for surgery: 208 (29%) patients were not on optimal medical therapy, 15% of patients had indications for other surgical treatment of CHF, 12% of patients had severe right ventricular failure, 9.8% had severe comorbidities, 6.8% of patients refused surgery. The main problems of selection for LVAD implantation were: low awareness of doctors about the introduction of new treatment methods, poor quality of transthoracic echocardiography, a large percentage of patients not receiving basic therapy for CHF, untimely referral of patients for other types of surgical treatment.

Adipose tissue: A treasure trove of stem cells for regenerative medicine

Adipose tissue: A treasure trove of stem cells for regenerative medicine Adipose tissue, commonly known as fat, has long been considered a mere energy reservoir. However, recent discoveries have revolutionized our understanding of this tissue, placing it at the heart of advances in stem cells and regenerative medicine. To shed light on these questions, we will rely on the expertise of Doctors Saja Scherer and Giorgio Pietramaggiori from the Global Medical Institute clinic in Lausanne. These two eminent specialists are at the forefront of research and clinical applications of adipose tissue in regenerative medicine. Dr. Saja Scherer, a renowned plastic surgeon, is recognized for her innovative work on the use of adipose tissue in facial reconstruction and rejuvenation. Her research has contributed to improving fat grafting techniques, thus optimizing results for patients.

Health Care Worker Usage of Large-Scale Health Information Exchanges in Japan: User-Level Audit Log Analysis Study.

Over 200 health information exchanges (HIEs) are currently operational in Japan. The most common feature of HIEs is remote on-demand viewing or searching of aggregated patient health data from multiple institutions. However, the usage of this feature by individual users and institutions remains unknown. This study aims to understand usage of the on-demand patient data viewing feature of large-scale HIEs by individual health care workers and institutions in Japan. We conducted audit log analyses of large-scale HIEs. The research subjects were HIEs connected to over 100 institutions and with over 10,000 patients. Each health care worker's profile and audit log data for HIEs were collected. We conducted four types of analyses on the extracted audit log. First, we calculated the ratio of the number of days of active HIE use for each hospital-affiliated doctor account. Second, we calculated cumulative monthly usage days of HIEs by each institution in financial year (FY) 2021/22. Third, we calculated each facility type's monthly active institution ratio in FY2021/22. Fourth, we compared the monthly active institution ratio by medical institution for each HIE and the proportion of cumulative usage days by user type for each HIE. We identified 24 HIEs as candidates for data collection and we analyzed data from 7 HIEs. Among hospital doctors, 93.5% (7326/7833) had never used HIEs during the available period in FY2021/22, while 19 doctors used them at least 30% of days. The median (IQR) monthly active institution ratios were 0.482 (0.470-0.487) for hospitals, 0.243 (0.230-0.247) for medical clinics, and 0.030 (0.024-0.048) for dental clinics. In 51.9% (1781/3434) of hospitals, the cumulative monthly usage days of HIEs was 0, while in 26.8% (921/3434) of hospitals, it was between 1 and 10, and in 3% (103/3434) of hospitals, it was 100 or more. The median (IQR) monthly active institution ratio in medical institutions was 0.511 (0.487-0.529) for the most used HIE and 0.109 (0.0927-0.117) for the least used. The proportion of cumulative usage days of HIE by user type was complex for each HIE, and no consistent trends could be discerned. In the large-scale HIEs surveyed in this study, the overall usage of the on-demand patient data viewing feature was low, consistent with past official reports. User-level analyses of audit logs revealed large disparities in the number of days of HIE use among health care workers and institutions. There were also large disparities in HIE use by facility type or HIE; the percentage of cumulative HIE usage days by user type also differed by HIE. This study indicates the need for further research into why there are large disparities in demand for HIEs in Japan as well as the need to design comprehensive audit logs that can be matched with other official datasets.

Expert consensus on the passive immunization prevention of infant respiratory syncytial virus infection in China

Respiratory syncytial virus (RSV) infection, which has the very heavy disease burdens, is the most common viral pathogen that seriously threatens the health of infants and young children. In order to better guide and standardize the clinical diagnosis, treatment, monitoring and immunization prevention and control of RSV infection in China, the Chinese Preventive Medicine Association jointly organized multidisciplinary experts to form a special working group, drawing on the implementation experience of foreign passive immunization prevention of RSV, integrating the existing evidence and the latest progress as a problem oriented, and putting forward the expert consensus on the passive immunization prevention of infant RSV infection in China in the future. The aim is to answer some professional questions about RSV infection and its immunoprophylaxis, especially passive immunoprophylaxis, in order to provide reference for the practice of immunoprophylaxis for professionals in medical institutions, disease prevention and control institutions and community health service centers at all levels.

Association between health communication on integrated healthcare and primary healthcare visits among rehabilitation outpatients: A multicenter cross-sectional study in China

ObjectiveThis study examines the relationship between health communication on integrated healthcare and primary healthcare visits among rehabilitation outpatients in China. MethodsA multi-stage sampling scheme was used to select the rehabilitation outpatients as study participants. A total of 3415 participants from 21 medical institutions in seven cities in China were included in the final analysis. The measurement included primary healthcare visits, health communication on integrated healthcare, and basic characteristics (age, sex, educational level, marital status, household income, and diagnoses). The association between health communication on integrated healthcare and primary healthcare visits was modeled using logistic regression controlling the general characteristics and disease status. ResultsAmong 3415 rehabilitation outpatients, the mean age of participants was 45.3 years (SD:24.9), and more than half (54.0 %) were male. The majority (56.3 %) were diagnosed with orthopaedic disorders. Received information of integrated healthcare from organizational communication (OR = 2.00; 95 % CI = 1.56, 2.56) and interpersonal communication (OR = 6.03; 95 % CI = 2.49, 14.62), patients who had a higher level of knowledge on integrated healthcare (OR = 1.02; 95% CI = 1.00, 1.03), the interaction terms of ‘organizational communication ∗ knowledge’(OR = 0.98; 95 % CI = 0.97, 1.00), and ‘interpersonal communication ∗ knowledge’(OR = 0.92; 95 % CI = 0.87, 0.97) were associated with visiting primary healthcare initially when had an illness the last two weeks. ConclusionThis study indicated that rehabilitation outpatients display a low level of primary healthcare visits, calling for interpersonal-based health communication interventions to be implemented to improve their integrated healthcare knowledge and promote better primary healthcare visits practices in China.

Study On Real Estate Location Based on GIS Technology

Through a review of relevant literature,this study categorizes factors affecting real estate site selection into three main categories: environmental, social, and economic, termed as the "triple bottom line." Based on the "triple bottom line," a PUM (Portfolio Underwriting Model) model was constructed. Meanwhile, GIS technology was utilized to identify the locations of public transportation stations, medical institutions, schools, and fire stations within Xiamen City. Additionally, different regions were delineated into suitable residential areas based on slope, aspect, land type, and per capita GDP. Combining the PUM model with GIS technology ultimately aids in real estate market site selection. The research findings indicate that integrating the PUM model and GIS technology for real estate site selection allows for a more scientific and comprehensive evaluation of various site selection factors, thereby providing important decision-making support for developers and investors.

Expert consensus on the passive immunization prevention of infant respiratory syncytial virus infection in China

Respiratory syncytial virus (RSV) infection, which has the very heavy disease burdens, is the most common viral pathogen that seriously threatens the health of infants and young children. In order to better guide and standardize the clinical diagnosis, treatment, monitoring and immunization prevention and control of RSV infection in China, the Chinese Preventive Medicine Association jointly organized multidisciplinary experts to form a special working group, drawing on the implementation experience of foreign passive immunization prevention of RSV, integrating the existing evidence and the latest progress as a problem oriented, and putting forward the expert consensus on the passive immunization prevention of infant RSV infection in China in the future. The aim is to answer some professional questions about RSV infection and its immunoprophylaxis, especially passive immunoprophylaxis, in order to provide reference for the practice of immunoprophylaxis for professionals in medical institutions, disease prevention and control institutions and community health service centers at all levels.

Effective prevention of early resignation of newly graduated nurses: a transactional analysis

BackgroundNew employees often exhibit stress reactions to changes in their environment and some of these may result in resignations. Employees in medical institutions are no exceptions. Considering the shortage of nurses in Japan, countermeasures are needed against the resignation of newly graduated nurses. Many studies have indicated that multifaced factors affect the resignation of newly graduated nurses. Even though individual characteristics are important factors in this regard, training and support for newly graduated nurses do not focus on the nurses’ characteristics. The purpose of this study is to examine the characteristics influencing the early resignation of newly graduated nurses and suggest ways to support them and prevent their early resignation based on their characteristics.MethodsWith the approval of the Ethics Committee, various characteristics of 353 newly graduated nurses (personality, interpersonal relationships, trait anxiety, nurse orientation, desire to be a nurse, and self-proclaimed academic ability) were assessed using a transactional analysis, the State-Trait Anxiety Inventory, and self-reporting numerical rating scales. The characteristics of those who resigned within 1 year (case group) and those who did not (control group) were compared using chi-square test and logistic regression analysis.ResultsOur sample of 353 participants included 32 nurses from the case group and 304 nurses from the control group. Most participants showed similar personality traits. However, the control group had a significantly lower percentage with negative self, strong trait anxiety, negative self and strong trait anxiety, and low orientation compared to the case group. Our logistic regression analysis showed that strong trait anxiety and low nurse orientation are significantly related with the early resignation of nurses.ConclusionsThe early resignation of newly graduated nurses may be prevented by understanding their characteristics at the time of gaining employment and implementing early intervention programs, such as education programs to reduce anxiety, and helping those with strong trait anxiety and low nurse orientation to find meaning in work.

THE POTENTIAL OF DIGITAL TECHNOLOGIES IN IMPROVING THE PROCESS OF TRAINING AND RETRAINING OF MILITARY DOCTORS

The issue of improving the process of training and retraining of military doctors is determined by changes in the security environment of the state today, and the need to develop the military medical sector in the conditions of long-term resistance to russian aggression. This article highlights the potential of using digital technologies to improve the process of training and retraining of military doctors. The results of a survey of trainees at the Ukrainian Military Medical Academy (a higher military medical educational institution that provides training, retraining and advanced training of specialists in almost all specialties for the Armed Forces of Ukraine and other military establishment of Ukraine) are presented. It is shown that for the implementation of changes in the system of training and retraining of military doctors the Academy provides for a number of measures: introducing innovative changes in the content and methodology of education; introduction of flexible technology for planning and organizing the educational process, focused on personalization of learning; development of international scientific and scientific-medical collaborations. Based on the conducted research, it was determined that in the conditions of active hostilities in Ukraine, it is digital technologies that make it possible to quickly introduce changes in the process of training and retraining of military doctors by improving the educational and informational environment. It was established that improving the readiness of military doctors to use digital technologies in their professional activities requires their end-to-end use in the entire training system. The article provides examples of the use of digital technologies in the process of training and retraining of military doctors.

Role of Immunotherapy in Non-Small Cell Lung Cancer (NSCLC)

Background: Non-small cell lung cancer accounts for approximately 85% of all lung cancers and presents a serious public health challenge due to an increasing incidence and poor prognosis, with only a 5-year survival rate of 5-10% in advanced disease stages. Objective: The aim of this work is an overview of the clinical efficacy and safety profile of ICIs in NSCLC patients, mainly focusing on the predictive role played by PD-L1 expression and tumor mutational burden as predictive biomarkers of treatment response. Methods: A total of 63 NSCLC patients treated with ICIs at a Department of Respiratory Medicine, Dhaka National Medical Institute Hospital, Dhaka, Bangladesh and National Institute of Diseases of the Chest and Hospital (NIDCH), and National Institute of Cancer Research & Hospital (NICRH), Mohakhali, Dhaka, Bangladesh from July 2023 to December 2023, were retrospectively analyzed. Demographical information, treatment regimens, and clinical outcomes were collected and analyzed. Treatment responses were evaluated based on Response Evaluation Criteria in Solid Tumors, and safety was assessed through monitoring adverse events. Results: The median age of the cohort was 62 years, with presentation in advanced stages, III and IV in 70%. An objective response rate of 42% was observed; median PFS was 8.5 months. Of note, patients with high PD-L1 expression of ≥ 50% had a response rate of 60%, whereas those with lower expression had a rate of 30%. It was observed in TMB analysis that high mutational burden is associated with a median PFS of 10 months versus 5 months in the case of low TMB. About 15% of patients developed adverse events, mostly immune-mediated. Conclusion: This study has exemplified the promising efficacy of ICIs in the improvement of treatment outcomes for patients with NSCLC and underlined critical roles that PD-L1 expression and TMB have played in guiding personalized treatment strategies. Although encouraging, these findings are retrospective and ..

THE USE OF DANCE-MOVEMENT THERAPY IN CORRECTIONAL WORK WITH PRIMARY SCHOOL CHILDREN WITH NEURODEVELOPMENTAL DISORDERS

This study analyses the effectiveness of innovative methods of psychological support aimed at primary school children with autism and attention deficit hyperactivity disorder (ADHD). Based on the theory of movement behaviour of N. A. Bernstein and approaches of V. M. Sechenov, V. M. Bekhterev, and other prominent specialists in the field of defectology, special and clinical psychology, the article makes a significant contribution to the practice of correcting the psychoemotional state and behavioural reactions of children with the mentioned disorders. The central aspect of the work is the assessment of the use of the mirror dance method for children with autism and adaptation of specialised approaches of psychological support for children with ADHD. The study includes 50 participants aged 6 to 10, selected through educational and medical institutions. The results demonstrate the significance of individualised approaches in correcting behavioural and emotional problems, emphasising that targeted psychological intervention facilitates adaptation to school life and reduces emotional discomfort in children...