Narrative Overview Research Articles

A narrative overview of the prognostic significance of the immune cellular milieu in tumor draining lymph nodes in non-small cell lung cancer

: Lung cancer is both the most common malignancy in the United States and the most fatal. Non-small cell lung cancer accounts for most lung malignancies and involves a complex immune response that has become the recent target of systemic therapy. Late-stage disease is now effectively treated with immunotherapy. As the role of immunotherapy expands, it is becoming increasingly important to understand the biology of the immune response in patients with non-small cell lung cancer and the association of this response with response to therapy and outcomes. In this narrative overview, we review the role of immune cells comprising tumor draining lymph nodes, the structure of tumor draining lymph nodes, and their role in the tumor microenvironment. To identify relevant immune cell interactions within the tumor draining lymph nodes, we reviewed published papers focusing on tumor draining lymph nodes and delineated the significance of the immune cells to the tumor microenvironment in both animal models and humans. This is the first comprehensive review of tumor-draining lymph nodes and their role in the tumor microenvironment and provides a foundation for further investigating the tumor microenvironment and the role of humoral and innate immune response mechanisms in non-small cell lung cancer.

Baseline FDG PET-CT imaging is necessary for newly diagnosed inflammatory breast cancer patients: a narrative review.

To review and discuss the rationale behind performing baseline 18-fluorodeoxyglucose positron emission tomography-computed tomography imaging for staging of inflammatory breast cancer patients. In the past three decades, the epidemiology of inflammatory breast cancer has resulted in separation of this entity from other breast cancer in staging and treatment. Advances in cancer imaging from 18-fluorodeoxyglucose positron emission tomography to 18-fluorodeoxyglucose positron emission tomography-computed tomography have now allowed for anatomic and functional correlation in evaluating extent of disease in cancer patients. Furthermore, studies throughout the past two decades have highlighted how 18-fluorodeoxyglucose positron emission tomography-computed tomography may play a role in staging inflammatory breast cancer patients given the uniqueness of this entity when compared to other breast cancers. Narrative overview of the literature summarizing findings in the literature from searches in computerized databases and authoritative texts. The use of 18-fluorodeoxyglucose positron emission tomography-computed tomography with respect to regional nodal staging and distant metastasis detection in inflammatory breast cancer patients is reviewed. In addition, an overview of studies conducted to date comparing the sensitivity and specificity of 18-fluorodeoxyglucose positron emission tomography-computed tomography for baseline staging in inflammatory breast cancer patients is also provided. Therapeutic influences and effect on overall survival is discussed. Baseline 18-fluorodeoxyglucose positron emission tomography-computed tomography allows for more optimal nodal staging, which has implications in prognosis and treatment of inflammatory breast cancer patients. It also allows for improved detection of metastasis on baseline presentation allowing therapy to potentially target these additional sites of disease.

Pharmacy practice in COVID-19 from a Middle Eastern and African perspective: A narrative review

The coronavirus disease 2019 (COVID-19) had a worldwide impact on all aspects of life and primarily on clinical practice involving all health-care professionals. Pharmacists are at the forefront of all clinical facilities in hospitals and the community. We aimed to provide a narrative overview of the global literature on the impact of COVID-19 changing roles and pharmacists' contribution to the overall clinical care during the COVID-19 pandemic. We conducted a narrative, nonsystematic review of the international literature from a single major medical online database, PubMed, between February 1, 2020, and June 30, 2021. The relevant articles were narrated in a concise thematic account. During the COVID-19 pandemic, pharmacists had to serve their responsibilities alongside other activities while the entire world was fighting an invisible virus. However, it was much more complicated than before because the novel coronavirus is intractable. There was no vaccine or established therapeutic guidelines when it manifested suddenly. As part of an interdisciplinary team, community pharmacists may carry out their responsibilities and play an essential role in disease control and management. However, they may need to be appropriately prepared, trained, and equipped to deal with pandemic and postpandemic situations.

Association of Age and Sex With Multi-Modal Cerebral Physiology in Adult Moderate/Severe Traumatic Brain Injury: A Narrative Overview and Future Avenues for Personalized Approaches.

The impact of age and biological sex on outcome in moderate/severe traumatic brain injury (TBI) has been documented in large cohort studies, with advanced age and male sex linked to worse long-term outcomes. However, the association between age/biological sex and high-frequency continuous multi-modal monitoring (MMM) cerebral physiology is unclear, with only sparing reference made in guidelines and major literature in moderate/severe TBI. In this narrative review, we summarize some of the largest studies associating various high-frequency MMM parameters with age and biological sex in moderate/severe TBI. To start, we present this by highlighting the representative available literature on high-frequency data from Intracranial Pressure (ICP), Cerebral Perfusion Pressure (CPP), Extracellular Brain Tissue Oxygenation (PbtO2), Regional Cerebral Oxygen Saturations (rSO2), Cerebral Blood Flow (CBF), Cerebral Blood Flow Velocity (CBFV), Cerebrovascular Reactivity (CVR), Cerebral Compensatory Reserve, common Cerebral Microdialysis (CMD) Analytes and their correlation to age and sex in moderate/severe TBI cohorts. Then we present current knowledge gaps in the literature, discuss biological implications of age and sex on cerebrovascular monitoring in TBI and some future avenues for bedside research into the cerebrovascular physiome after TBI.

Classic Fabry disease: a clinical case presentation in a resident of Transcarpathia

Background. Fabry disease is an inherited X-linked disorder of α-galactosidase deficiency that results in the accumulation of globotriaosylceramide and related neutral glycosphingolipids and may cause a wide range of symptoms affecting multiple systems. We aimed to provide a narrative literature overview of Fabry disease, with a clinical case presentation. Materials and methods. We provided a comprehensive clinical, neurological, laboratory, and instrumental analysis of Fabry disease in a young white adult admitted to the Regional Clinical Center of Neurosurgery and Neurology (Uzhhorod, Ukraine). Results and conclusions. We have presented a brief literature overview of the disease, supported with a clinical case of classic Fabry disease in a young white resident of Transcarpathia.

National or population level interventions addressing the social determinants of mental health \u2013 an umbrella review

BackgroundSocial circumstances in which people live and work impact the population’s mental health. We aimed to synthesise evidence identifying effective interventions and policies that influence the social determinants of mental health at national or scaled population level. We searched five databases (Cochrane Library, Global Health, MEDLINE, EMBASE and PsycINFO) between Jan 1st 2000 and July 23rd 2019 to identify systematic reviews of population-level interventions or policies addressing a recognised social determinant of mental health and collected mental health outcomes. There were no restrictions on country, sub-population or age. A narrative overview of results is provided. Quality assessment was conducted using Assessment of Multiple Systematic Reviews (AMSTAR 2). This study was registered on PROSPERO (CRD42019140198).ResultsWe identified 20 reviews for inclusion. Most reviews were of low or critically low quality. Primary studies were mostly observational and from higher income settings. Higher quality evidence indicates more generous welfare benefits may reduce socioeconomic inequalities in mental health outcomes. Lower quality evidence suggests unemployment insurance, warm housing interventions, neighbourhood renewal, paid parental leave, gender equality policies, community-based parenting programmes, and less restrictive migration policies are associated with improved mental health outcomes. Low quality evidence suggests restriction of access to lethal means and multi-component suicide prevention programmes are associated with reduced suicide risk.ConclusionThis umbrella review has identified a small and overall low-quality evidence base for population level interventions addressing the social determinants of mental health. There are significant gaps in the evidence base for key policy areas, which limit ability of national policymakers to understand how to effectively improve population mental health.

A systematic review of behavioural smoking cessation interventions for people with severe mental ill health-what works?

Background and AimsPeople with severe mental ill health smoke more and suffer greater smoking‐related morbidity and mortality. Little is known about the effectiveness of behavioural interventions for smoking cessation in this group. This review evaluated randomized controlled trial evidence to measure the effectiveness of behavioural smoking cessation interventions (both digital and non‐digital) in people with severe mental ill health.DesignSystematic review and random‐effects meta‐analysis. We searched between inception and January 2020 in Medline, EMBASE, PsycINFO, CINAHL, Health Management Information Consortium and CENTRAL databases.Setting and participantsRandomized controlled trials (RCTs) assessing the effects of behavioural smoking cessation and reduction interventions in adults with severe mental ill health, conducted in any country, in either in‐patient or community settings and published in English.MeasurementsThe primary outcome was biochemically verified smoking cessation. Smoking reduction and changes in mental health symptoms and body mass index (BMI) were included as secondary outcomes. Narrative data synthesis and meta‐analysis were conducted and the quality of included studies was appraised using the risk of bias 2 (RoB2) tool.FindingsWe included 12 individual studies (16 articles) involving 1861 participants. The first meta‐analysis (three studies, 921 participants) demonstrated effectiveness of bespoke face‐to‐face interventions compared with usual care across all time‐points [medium‐term: relative risk (RR) = 2.29, 95% confidence interval (CI) = 1.38–3.81; long‐term: RR = 1.58, 95% CI = 1.09–2.30]. The second (three studies, 275 participants) did not demonstrate any difference in effectiveness of bespoke digital on‐line interventions compared with standard digital on‐line interventions (medium‐term: RR = 0.87, 95% CI = 0.17–4.46). A narrative overview revealed mixed results when comparing bespoke face‐to‐face interventions with other active interventions. The methodological quality of studies was mixed, with the majority having some concerns mainly around risk of selective reporting.ConclusionsFace‐to‐face bespoke smoking cessation interventions for adults with severe mental ill health appear to be effective when compared with treatment as usual, but evidence is equivocal when compared with other active interventions. There is limited evidence comparing bespoke digital interventions with generic interventions, and we found no studies comparing them with usual treatment.

THE DARK SIDE OF A B2B CO-CREATION RELATIONSHIP IN THE FRONT END OF INNOVATION: A GENERATIVE REVIEW

This study aims to conceptualise the risks of a co-creation relationship between providers and customers in the front end of innovation (FEI). The existing literature on the topic of the interactions between customers and providers is vast but mostly reflects the vision of each respective field of science addressing specific issues and dynamics. This review paper combines integrative and generative approaches (Post et al., 2020). The narrative overview methodology (Green et al., 2006) fits the purpose to integrate the contributions of scholars from different areas and with distinct perspectives. The authors present a comprehensive view of the complex and, sometimes, conflictual customer–provider relationship in a business-to-business (B2B) context applied to the FEI. The review, mostly focused in the service industry, included the identification of inconsistencies and poorly explained phenomena. This work contributes decisively to the innovation, management and organisation literature, advancing a model of the projected risks of the specific customer–provider relationship in the FEI phase.

ARTIFICIAL INTELLIGENCE IN DENTISTRY: A MILESTONE

The concept of "articial intelligence" (AI) refers to machines that are capable of executing human-like tasks. AI can also be dened as a eld concerned with computational models that can reason and act intelligently. Perspicacious software for data computation has become a necessity as the amount of documented information and patient data has increased dramatically. The applicability, limitations, and potential future of AI-based dental diagnoses, treatment planning, and conduct are described in this concise narrative overview. AI has been used in a variety of ways, from processing of data and locating relevant information to using neural networks for diagnosis and the introduction of augmented reality and virtual reality in dental education. AI-based apps will improve patient care by relieving the dental workforce of tedious routine duties, improving population health at lower costs, and eventually facilitating individualized, anticipatory, prophylactic, and collaborative dentistry. The convergence of AI and digitization has ushered in a new age in dentistry, with tremendously promising future prospects.The applicability, limitations, and potential future of AI-based dental diagnoses, treatment planning, and conduct are described in this concise narrative overview.

A narrative overview of antimicrobial activity of metal nanoparticles

A narrative overview of antimicrobial activity of metal nanoparticles

A historical overview of legislated alcohol policy in the Northern Territory of Australia: 1979\u20132021

BackgroundThe Northern Territory (NT) has the highest levels of alcohol consumption and harms in Australia. Since the creation of the NT Liquor Act 1978, which came into effect in 1979, numerous legislated alcohol policies have been introduced to attempt to address these harms. We present a narrative historical overview of alcohol policies implemented in the NT from 1979 to 2021.MethodsUsing scoping review methodology, databases were searched from 1979 to 2021. Of 506 articles screened, 34 met inclusion criteria. Reference lists of all included articles were searched, resulting in the inclusion of another 41 articles and reports, totalling 75 final documents. Policies were organised using Babor and colleagues (2010) established framework: 1. pricing/ taxation; 2. regulating physical availability; 3. modifying drinking environments; 4. drink-driving countermeasures; 5. restrictions on marketing; 6. education/persuasion; 7. treatment/early intervention.ResultsTwo pricing/taxation policies have been implemented, Living With Alcohol (LWA) and Minimum Unit Price, both demonstrating evidence of positive effects on health and consumption outcomes. Eight policies approaches have focused on regulating physical availability, implemented at both individual and local area levels. Several of these policies have varied by location and been amended over time. There is some evidence demonstrating reduction in harms attributable to Liquor Supply Plans, localised restrictions, and General Restricted Areas, although these have been site specific. Of the three policies which targeted modifying the drinking environment; one was evaluated, finding a relocation of social harms, rather than a reduction. The literature outlines a range of controversies, particularly regarding policies in domain 2–3, including racial discrimination and a lack of policy stability. No policies relating to restricting marketing or education/persuasion programs were found. The only drink-driving legislated policy was considered to have contributed to the success of the LWA program. Three policies relating to treatment were described; two were not evaluated and evidence showed no ongoing benefits of Alcohol Mandatory Treatment.DiscussionThe NT has implemented a large number of alcohol policies, several of which have evidence of positive effects. However, these policies have often existed in a context of clear politicisation of alcohol policy, frequently with an implicit focus on Aboriginal people’s consumption.

The Role of Occupational Therapy in Supporting the Needs of Older Adults who Identify as Lesbian, Gay, Bisexual, and/or Transgender (LGBT)

There are growing numbers of older individuals who identify as lesbian, gay, bisexual, and transgender (LGBT) who are in need of health care services provided by culturally and clinically competent providers, including occupational therapists. The LGBT community presents with unique needs and circumstances that impact occupational therapy (OT) practice. This Opinions in the Profession article presents an overview of the unique narratives of and special considerations for LGBT older adults that the OT profession needs to address to meet the needs of this population and improve our service delivery. We assert essential implications for OT practice and education to better support the needs of LGBT older adults and strategies for occupational therapists to promote culturally and clinically competent care and serve as agents of change in practice.

Human-Animal Interaction and Perinatal Mental Health: A Narrative Review of Selected Literature and Call for Research.

There is a paucity of research exploring how relationships with household pets may impact maternal mental health. We are unaware of any study to date that has examined associations between individuals’ relationships with their pets and psychological adjustment in the perinatal period. Using a biobehavioral lens, this paper provides a narrative overview of the literature on perinatal mental health and human–animal interaction (HAI). We focus on the role of social relationships, stress, and stress reduction in relation to perinatal mental health; the role of HAI in perceptions of social support, stressors, and stress reduction; and gaps in empirical knowledge concerning the role of HAI in perinatal mental health. Finally, we integrate contemporary biobehavioral models of perinatal mental health and HAI (i.e., Comprehensive Model of Mental Health during the Perinatal Period and the HAI–HPA Transactional Model) to propose a new conceptual framework that depicts ways in which HAI during the perinatal period may influence maternal and child health and wellbeing. To our knowledge, this is the first paper to consider the role of HAI in biobehavioral responses and mental health during the perinatal period. We conclude with recommendations for future research and improved perinatal care.

A Narrative Overview of Current Anesthetic Drugs in Electroconvulsive Therapy.

Electroconvulsive therapy (ECT) is a definitive treatment for patients with psychiatric disorders that are severe, acute, or refractory to pharmacologic therapy. Providing anesthesia for ECT is challenging, as the effect of drugs on hemodynamics, seizure duration, comfort, and recovery must be considered. We highlight and aim to review the common anesthetics used in ECT and related evidence. While drugs such as methohexital, succinylcholine, and etomidate have been used in the past, other drugs such as dexmedetomidine, ketamine, and remifentanil may provide a more balanced anesthetic with a greater safety profile in select populations. Overall, it is essential to consider the patient’s co-morbidities and associated risks when deciding on an anesthetic drug.

Revisiting the International Classification of Functioning, Disability and Health, a Comprehensive Model for Exploring Disablement in Low- and Middle-income Countries: A Narrative Overview

Objectives: To overcome the inherent limitations of the medical and social models of disability, the World Health Organization developed the first international conceptualization of disability: the International Classification of Functioning, Disability, and Health (ICF). Despite the ICF’s robustness, it is still underutilized in research and practice in Low- and Middle-Income Countries (LMICs). This article discusses the applications, strengths, limitations, and unique considerations when using the ICF to explore disabilities in LMICs like Nigeria. Methods: A literature search was conducted in Medline, CINAHL, Web of Science, AMED, and Google Scholar. Articles were selected if they reported on any of the development, structure, applications, strengths, and limitations of the ICF. The review draws from the selected articles using a narrative discussion. Results: The literature search yielded 22 articles that met the eligibility criteria. The ICF is a classification of components of health and functioning, which views disability as an outcome of a dynamic interaction between a person’s health condition and contextual factors. The ICF was developed cross-culturally; thus, it is applicable in various socio-environmental contexts. However, despite its comprehensiveness, the ICF is criticized for lack of clear theoretical underpinnings, overlapping and redundant components, and absence of systematized personal factors. Discussion: The ICF has brought a significant paradigm shift in the measurement of disability by explicitly recognizing the role of contextual factors in the incapacitation process and placing all health conditions on an equal footing. Hence, stakeholders in disability research and practice in LMICs need to prioritize the ICF over other disablement models.

Gambling behaviors during COVID-19: a narrative review

The COVID-19 pandemic has ushered the world into unforeseen circumstances, prompting the authorities to impose restrictions and cut back various events including many gambling avenues. Professional sports have been postponed, land casinos are closed, and social distancing has shut home games down. The present narrative overview has addressed the following changes in gambling behavior since the start of the pandemic: - a) Change in the number of gamblers and intensity of gambling b) differences among various types of gambling modalities (land-based, horse betting, casino, online). and transitioning between them. c) Psychosocial effects on gamblers owing to the shutdown of gambling avenues in the early phase of COVID-19 lockdown. It alludes to several survey studies conducted so far in Northern Europe (Sweden, UK, Italy), North America (Canada, USA), and Australia on the potential impact of the SARS-Cov2 pandemic on gambling figures. Problem Gambling Severity Index (PGSI) scale is used by most of the studies to demonstrate the severity among gamblers i.e., low-risk, high-risk, and problem gamblers respectively. The majority of studies are based on self-reported questionnaires, few tracked data from online gambling operators, and one study used revenue-based taxation of land-based and online gambling as its information source. The decline in the overall gambling activity attributable to the situational changes was predominant in a majority of surveys. The impact of the COVID-19 pandemic on gambling is diverse – possibly causing a reduction in current or future problems in some, but also promoting increased problematic gambling in others.

Microbiome in Precision Psychiatry: An Overview of the Ethical Challenges Regarding Microbiome Big Data and Microbiome-Based Interventions

There has been a spurt in both fundamental and translational research that examines the underlying mechanisms of the human microbiome in psychiatric disorders. The personalized and dynamic features of the human microbiome suggest the potential of its manipulation for precision psychiatry in ways to improve mental health and avoid disease. However, findings in the field of microbiome also raise philosophical and ethical questions. From a philosophical point of view, they may yet be another attempt at providing a biological cause for phenomena that ultimately cannot be so easily localized. From an ethical point of view, it is relevant that the human gut microbiome comprises data on the individual’s lifestyle, disease history, previous medications, and mental health. Massive datasets of microbiome sequences are collected to facilitate comparative studies to identify specific links between the microbiome and mental health. Although this emerging research domain may show promise for psychiatric patients, it is surrounded by ethical challenges regarding patient privacy, health risks, effects on personal identity, and concerns about responsibility. This narrative overview displays the roles and advances of microbiome research in psychiatry and discusses the philosophical and ethical implications of microbiome big data and microbiome-based interventions for psychiatric patients. We also investigate whether these issues are really “new,” or “old wine in new bottles.”

Buprenorphine management in the perioperative period: educational review and recommendations from a multisociety expert panel

BackgroundThe past two decades have witnessed an epidemic of opioid use disorder (OUD) in the USA, resulting in catastrophic loss of life secondary to opioid overdoses. Medication treatment of opioid...

Diagnosis and Non-Surgical Management of Urinary Incontinence - A Literature Review with Recommendations for Practice.

Urinary incontinence (UI) is a bothersome symptom with population studies suggesting a prevalence of 13.1% in women and 5.4% in men. While a significant cohort of patients with this complaint may ultimately require surgical management to achieve complete continence, a number of non-surgical measures exist to improve symptoms and quality of life. A range of guidelines exist on this topic, including those published by the European Association of Urology (EAU), the International Continence Society (ICS), the American Urological Association (AUA) and the UK’s National Institute for Health and Care Excellence (NICE). The aim of our study is to provide an overview of the initial assessment of patients with UI including history taking, examination and basic investigations. Our review outlines non-surgical management strategies for UI, including conservative measures, behavioral and physical therapies and drug treatment. We shall also examine the above guidelines and present a narrative overview of the literature surrounding the diagnosis and non-surgical management of urinary incontinence.

Recommendations to plan a national burden of disease study

BackgroundThe InfAct (Information for Action) project is a European Commission Joint Action on Health Information which has promoted the potential role of burden of disease (BoD) approaches to improve the current European Union-Health Information System (EU-HIS). It has done so by raising awareness of the concept, the methods used to calculate estimates and their potential implications and uses in policymaking. The BoD approach is a systematic and scientific effort to quantify and compare the magnitude of health loss due to different diseases, injuries, and risk factors with estimates produced by demographic characteristics and geographies for specific points in time. Not all countries have the resources to undertake such work, and may therefore start with a more restricted objective, e.g., a limited number of diseases, or the use of simple measures of population health such as disease prevalence or life expectancy. The main objective to develop these recommendations was to facilitate those countries planning to start a national burden of disease study.ResultsThese recommendations could be considered as minimum requirements for those countries planning to start a BoD study and includes following elements: (1) Define the objectives of a burden of disease study within the context of your country, (2) Identify, communicate and secure the benefits of performing national burden of disease studies, (3) Secure access to the minimum required data sources, (4) Ensure the minimum required capacity and capability is available to carry out burden of disease study, (5) Establish a clear governance structure for the burden of disease study and stakeholder engagement/involvement, (6) Choose the appropriate methodological approaches and (7) Knowledge translation. These were guided by the results from our survey performed to identify the needs of European countries for BoD studies, a narrative overview from four European countries (Belgium, Germany, The Netherlands and Scotland) and the summary of a comparative study of country health profiles with national health statistics.ConclusionsThese recommendations as minimum requirements would facilitate efforts by those European countries who intend to perform national BoD studies.