Substantial Burden Research Articles

Seizure detection via reservoir computing in MoS2-based charge trap memory devices.

Neurological disorders are a substantial global health burden, affecting millions of people worldwide. A key challenge in developing effective treatments and preventive measures is the realization of low-power wearable systems with early detection capabilities. Traditional strategies rely on machine learning algorithms, but their computational demands often exceed what miniaturized systems can provide. Neuromorphic computing, inspired by the human brain, demonstrated capabilities of on-chip computing with low power consumption. In this context, bidimensional (2D) semiconductors hold notable promise, thanks to their unique electronic properties, atomic-scale thickness, and scalability, making them ideal for low-power applications. This work presents a neuromorphic reservoir computing system exploiting MoS2-based charge trap memories (CTMs) for processing of electrophysiological signals. Real-time seizures detection is achieved, thanks to the nonlinear integration of local-field potential (LFP) recorded from in vitro rodent models of ictogenesis. The results support MoS2-based CTMs for low-power biomedical devices in clinical diagnosis and treatment of epilepsy.

"Clinical outcomes and healthcare costs in status epilepticus: A multivariable analysis from a tertiary center in a resource-limited setting".

As a debilitating and severe repercussion, the clinical and economic impact of Status epilepticus (SE) has not been thoroughly explored in various regions around the world, especially those with limited resources. Therefore, we aimed to identify the predictors of mortality and healthcare costs associated with SE in one tertiary care center with limited resources. This retrospective single-center cohort study, carried out at Namazi Hospital, Shiraz, Iran, included 130 SE cases from March 21, 2021, to March 20, 2022. Patient data were extracted from medical records, including demographics, clinical presentations, hospital course, treatment modalities, and costs. Multivariable regression models were used to identify factors associated with mortality and hospital stay costs. Patients were aged 1month to 92years (mean 20.36years, median 7), with a male predominance of 59.23%. Pre-existing epilepsy was found to be associated with lower mortality (p<0.05), while cardiovascular complications (p<0.05) and cerebrovascular disease (p<0.001) were significantly associated with increased mortality risks. In addition, Intensive Care Unit (ICU) admission, necessitated by complex treatment regimens, was linked to significantly higher healthcare costs (p<0.001). Older age and the use of sedatives were also associated with higher costs, while psychiatric disorders were linked to lower costs. SE imposes a substantial clinical and economic burden in resource-limited settings, as limited availability of ICU beds is common. Thus, screening SE cases based on clinical characteristics (e.g., comorbidities) is paramount. Therefore, targeted strategies are essential for optimizing care and reducing costs.

Urgent modern trends in disability assessment after a stroke, life activity criteria according to the ICF and principles of neurorehabilitation (literature review and own research)

Background. The purpose of our work was to study the functional outcomes in stroke patients, the justification of a clinical diagnosis according to the International Classification of Functioning, Disability and Health (ICF), including criteria, principles of disability prevention and rehabilitation. Materials and methods. We conducted a prospective, case-control cohort study of 5,818 patients who suffered a cerebral stroke over the past 10 years, 4,520 (78 %) were survivors, with an average age of 73.0 ± 10.2 years. All participants underwent a standard neurological examination and ICF testing. Results. It is obvious that in every case after a stroke, there are functional disorders, and in most patients (from 76 to 85 %) this results in disability. Such trend is consistent worldwide and was also observed in our study. However, the overall 37% decrease in the disability rate over the specified period, in our opinion, can be attributed to population aging and the lack of workplace opportunities for the able-bodied population, which previously served as a form of social protection for patients. Therefore, the further optimization of preventive and rehabilitation measures, starting with addressing stroke risk factors and preventing recurrences, could significantly improve the quality of life of stroke patients without imposing a substantial burden on their families and society as a whole. Factors have been determined, criteria for limiting life activities in the main areas of life have been developed. The adaptation of the ICF makes it possible to use it in expert diagnosis, the formation of a correct clinical and functional diagnosis, and allows assessing the potential and effectiveness of rehabilitation measures in the post-stroke period. Conclusions. 1. The use of the ICF makes it possible to objectively assess the state of patients, the rehabilitation potential and the effectiveness of rehabilitation measures in people with the consequences of a stroke. 2. The use of the criteria for limiting life activities developed by the authors will improve the quality of medical and social examination of patients who have suffered a stroke, and further research will optimize new approaches to the rehabilitation of these patients and their adaptation in society. 3. Further optimization of preventive and rehabilitation measures, starting with addressing stroke risk factors and preventing recurrences, could significantly improve the quality of life of patients, their relatives and society as a whole.

Examination of patients presenting to the emergency department as "apparently drunk".

Alcohol, a significant public health concern, contributes to a substantial burden on emergency services. Identifying avoidable causes of Emergency Department (ED) presentations may reduce hospital overcrowding and benefit public health. This prevalence study aims to provide a detailed analysis of patients presenting to the ED at Mercy University Hospital (MUH) as "Apparently Drunk" in 2022 and 2023. Data were sourced from the Integrated Patient Management Information System at MUH. All patients recorded as "Apparently Drunk" were included. Data collected included demographics, associated injuries or complaints, mode of arrival, admission status, and discharge status. Descriptive statistics were used to summarise the data and trends were examined by comparing 2022 and 2023 data. A total of 1662 presentations were categorised as "Apparently Drunk," representing 3% of all ED visits. There was an 18% increase in such presentations from 2022 to 2023. The majority of patients were male (72%). The median age was 39years. Notably, 23% of the presentations involved people experiencing homelessness, and 81% were conveyed by ambulance. Significant associated injuries included head injuries (7%), falls/collapses (6%), mental health issues (5%), and assaults (4%). The findings indicate a growing trend in patients presenting to the ED as "Apparently Drunk". The high incidence among people experiencing homelessness and the substantial resource utilisation underscores the need for targeted public health interventions and integrated services. Policymakers should consider these findings in the context of potential legislative changes that may impact alcohol availability.

Evaluating catastrophic health expenditures among patients with long bone fractures in Ghana's major teaching hospitals: a hospital-based analysis

BackgroundIn low and middle-income countries like Ghana, out-of-pocket (OOP) payments remain a significant barrier to healthcare access, often leading to catastrophic health expenditures (CHE). This study evaluates the incidence of CHE among patients treated for long bone fractures at Ghana’s major teaching hospitals, providing insight into the economic burdens faced by these patients.MethodsThis cross-sectional study analyzed data from 2,980 patients with long bone fractures treated at four major teaching hospitals in Ghana from July 2017 to July 2020. We collected demographic, clinical, and economic data, including OOP payments and patient-reported income, to assess the incidence of CHE at varying income thresholds (10%, 20%, 30%, 40%). Logistic regression models were used to identify predictors of CHE, with variables including age, gender, education, region, fracture type, injury severity, and NHIS coverage.ResultsThe incidence of CHE was highest at the 10% income threshold (53.21%) and decreased with higher thresholds. Male patients incurred higher average OOP payments ($343.68) than females ($271.63), and patients with tibia fractures faced the highest financial burden. Educational and regional disparities were evident, with lower CHE rates among patients with higher educational attainment and those from northern regions. NHIS coverage provided limited financial relief, particularly at lower income thresholds.ConclusionLong bone fractures impose a substantial financial burden on patients in Ghana, with significant gender, educational, and regional disparities in OOP payments and CHE. While NHIS provides some relief, it remains inadequate in protecting patients from financial distress. Policy interventions aimed at expanding NHIS coverage, reducing OOP payments for high-cost treatments, and addressing geographic inequities are urgently needed to improve financial protection for patients with long bone fractures in Ghana. Future research should focus on capturing long-term financial impacts and improving income data accuracy to better inform healthcare policies.

Coagulation indices and fibrinogen degradation products as predictive biomarkers for tumor-node-metastasis staging and metastasis in gastric cancer.

Gastric cancer (GC) is a prevalent malignancy with a substantial health burden and high mortality rate, despite advances in prevention, early detection, and treatment. Compared with the global average, Asia, notably China, reports disproportionately high GC incidences. The disease often progresses asymptomatically in the early stages, leading to delayed diagnosis and compromised outcomes. Thus, it is crucial to identify early diagnostic biomarkers and enhance treatment strategies to improve patient outcomes and reduce mortality. To investigate coagulation and fibrinogen products in GC tumor-node-metastasis (TNM) stage and metastasis correlation. Retrospectively analyzed the clinical data of 148 patients with GC treated at the Civil Aviation Shanghai Hospital between December 2022 and December 2023. The associations of coagulation indices - partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), fibrinogen, fibrinogen degradation products (FDP), fasting blood glucose, and D-dimer (D-D) with TNM stage and distant metastasis were examined. Prolongation of APTT, PT, and TT was significantly correlated with the GC TNM stage. Hence, abnormal coagulation system activation was closely related to disease progression. Elevated FDP and D-D were significantly associated with distant metastasis in GC (P < 0.05), suggesting that increased fibrinolytic activity contributes to increased metastatic risk. Our Results reveal coagulation indices, FDPs as GC biomarkers, reflecting abnormal coagulation/fibrinolysis, aiding disease progression, metastasis prediction, and helping clinicians assess thrombotic risk for early intervention and personalized treatment plans.

Exercise as Medicine: Tackling Chronic Pain and Depression to Boost Quality of Life—A Narrative Review

Depression and chronic pain are prevalent and often co-occurring conditions that pose substantial treatment challenges and economic burdens in the developed world. Research suggests that depression and chronic pain share overlapping pathways, particularly within the anterior cingulate cortex, which plays a critical role in emotional regulation and pain perception. Research indicates that exercise may alleviate depression. Given the shared neurobiology between depression and chronic pain, it is plausible that exercise could improve outcomes for individuals experiencing depression and chronic pain. Therefore, this review aims to provide clinicians with evidence-based tools to assess the role of exercise in the management of patients with coexistent pain and depression.

Direct and indirect healthcare costs of ocular diseases in Italy: a literature review on glaucoma, diabetic retinopathy, and macular degeneration.

Glaucoma, diabetic retinopathy, and age-related macular degeneration impose substantial economic burdens on healthcare systems due to their high prevalence and chronic nature. Nevertheless, comprehensive Italian data is limited. This study aims to collect Italian evidence on the economic impact of these conditions to support more effective healthcare planning. Systematic review. A systematic literature search was conducted in accordance with PRISMA guidelines across PubMed, Scopus, Web of Science, and EMBASE databases. Studies reporting cost evaluations of managing glaucoma, diabetic retinopathy, and age-related macular degeneration in Italy were included. Direct, indirect and non-medical costs were considered. The review included 23 studies exhibiting considerable heterogeneity in timeframes, regions, and economic evaluation approaches. For glaucoma, annual direct costs ranged from €788.70 for early-stage cases to €8,368.51 for advanced cases requiring surgery. Annual costs associated with diabetic retinopathy ranged from €4,050 to €5,799 per patient, depending on disease severity and treatment approach. The financial burden of age-related macular degeneration varied considerably, with costs ranging from €1,399.20 for early-stage cases to €3,973.30 for advanced stages. Although non-medical and indirect costs, such as lost productivity and caregiving expenses were less frequently assessed, they represented a significant contributor to the overall financial burden. This study highlights the substantial economic burden ocular diseases place on the Italian healthcare system. Early intervention and preventive strategies could reduce the long-term costs of managing diabetic retinopathy and age-related macular degeneration. Further research into indirect costs and cost-effective interventions is necessary to support more efficient healthcare resource allocation.

Global trends and hotspots of type 2 diabetes in children and adolescents: A bibliometric study and visualization analysis.

Epidemiological surveys indicate an increasing incidence of type 2 diabetes mellitus (T2DM) among children and adolescents worldwide. Due to rapid disease progression, severe long-term cardiorenal complications, a lack of effective treatment strategies, and substantial socioeconomic burdens, it has become an urgent public health issue that requires management and resolution. Adolescent T2DM differs from adult T2DM. Despite a significant increase in our understanding of youth-onset T2DM over the past two decades, the related review and evidence-based content remain limited. To visualize the hotspots and trends in pediatric and adolescent T2DM research and to forecast their future research themes. This study utilized the terms "children", "adolescents", and "type 2 diabetes", retrieving relevant articles published between 1983 and 2023 from three citation databases within the Web of Science Core Collection (SCI, SSCI, ESCI). Utilizing CiteSpace and VoSviewer software, we analyze and visually represent the annual output of literature, countries involved, and participating institutions. This allows us to predict trends in this research field. Our analysis encompasses co-cited authors, journal overlays, citation overlays, time-zone views, keyword analysis, and reference analysis, etc. A total of 9210 articles were included, and the annual publication volume in this field showed a steady growth trend. The United States had the highest number of publications and the highest H-index. The United States also had the most research institutions and the strongest research capacity. The global hot journals were primarily diabetes professional journals but also included journals related to nutrition, endocrinology, and metabolism. Keyword analysis showed that research related to endothelial dysfunction, exposure risk, cardiac metabolic risk, changes in gut microbiota, the impact on comorbidities and outcomes, etc., were emerging keywords. They have maintained their popularity in this field, suggesting that these areas have garnered significant research interest in recent years. Pediatric and adolescent T2DM is increasingly drawing global attention, with genes, behaviors, environmental factors, and multisystemic interventions potentially emerging as future research hot spots.

The role of vitamin K2 in cognitive impairment: linking vascular health to brain health

Cognitive impairment, marked by a decline in essential mental aspects such as attention, memory, and problem-solving, is significantly correlated with advancing age. This condition presents a major challenge for the elderly, adversely affecting quality of life, diminishing independence, and imposing substantial burdens on healthcare systems. Recent research indicates that vitamin K2 may be vital for preserving brain health and cognitive function. Traditionally recognized primarily for its role in blood coagulation, vitamin K has emerged in recent years as a nutrient with diverse biological effects essential for healthy aging. A growing body of evidence from both observational and interventional studies underscores the pivotal role of vitamin K2 in mitigating arterial calcification. This mechanism may link vascular health to cognitive function, suggesting that vitamin K2 could play a critical role in the prevention of cognitive impairment in aging populations.

The burden of Alagille syndrome: uncovering the potential of emerging therapeutics - a comprehensive systematic literature review.

Aim: Alagille syndrome (ALGS) is a rare, cholestatic multiorgan disease associated with bile duct paucity, leading to cholestasis. Clinical symptoms of cholestasis include debilitating pruritus, xanthomas, fat-soluble vitamin deficiencies, growth failure, renal disease and impaired health-related quality of life (HRQoL). The main objective was to review the current literature on the epidemiological, clinical, psychosocial and economic burden of ALGS in view of the development of ileal bile acid transporter (IBAT) inhibitors. Methods: Electronic literature databases were searched in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Results: 330 publications were screened, 119 were relevant: 11 randomized controlled trials (RCTs), 21 non-RCTs, 10 HRQoL studies, two studies assessing cost/resource use and 77 epidemiological studies across several databases through 31 July 2024. Studies confirm that patients with ALGS experience cardiac anomalies, impaired growth, renal disease, poor HRQoL, fat-soluble vitamin deficiencies and debilitating pruritus; until the approval of IBAT inhibitors for the treatment of cholestatic pruritus in patients with ALGS, supportive management was the standard of care. Conclusion: This review confirms the substantial clinical, economic and HRQoL burden associated with ALGS and consolidates current treatment evidence. Data from recent trials in ALGS demonstrate the potential impact of IBAT inhibitors to transform lives by improving cholestatic pruritus symptoms, HRQoL and native liver survival.

AN EVALUATION OF ONSITE TRAINING AND SUPPORTIVE SUPERVISION PLUS (OTSS+) TO IMPROVE MALARIA DIAGNOSTIC SERVICE DELIVERY IN 22 HOSPITALS IN SIERRA LEONE

Malaria, a formidable global health issue, disproportionately impacts sub-Saharan Africa, including Sierra Leone, where a substantial burden persists with a significant number of reported cases annually. This global health challenge necessitates a comprehensive approach to address its impact on public health, emphasizing the crucial role of accurate and prompt diagnosis in effective case management. Laboratory technicians play a pivotal role in malaria diagnosis, conducting microscopy examinations of blood samples for the detection of malaria parasites. The competency and reliability of these technicians are paramount for appropriate treatment and surveillance, as malaria diagnosis forms the cornerstone of case management. However, studies in sub-Saharan Africa highlight the challenges associated with maintaining and enhancing the skills of laboratory technicians over time. Factors such as inadequate training, inconsistent adherence to standard operating procedures, and limited access to necessary equipment contribute to the variable and often poor quality of microscopy. The primary aim of this research is to assess the impact of supportive supervision on malaria diagnosis service delivery among laboratory technicians in Sierra Leone The study employs a quasi-experimental design to assess the impact of supportive supervision on malaria diagnosis service delivery among laboratory technicians. A pre-designed checklist of four thematic area (Lab evaluation, Proficiency testing, External Quality Assurance and Microscopy observation) was used to collect data from 22 hospitals in three rounds of supervisory visits. Laboratory Evaluation: There was a significant improvement from R1 (64%) to R2 (93%), with a slight decrease in R3 (81%). Stockouts of consumables for microscope microscopy and stockouts of malaria RDT showed moderate improvement from R1 to R3. For example, stockouts of malaria RDT improved from 35% to 59%. Scores related to microscopes, spare parts, and maintenance showed consistent improvement, particularly from R1 (29%) to R3 (47%). Both internal and external quality assurance scores showed an upward trend. Internal Quality Assurance increased from 49% in R1 to 81% in R3. There was a consistent improvement in this category, with scores rising from 50% in R1 to 90% in R3. The significant improvement across the rounds in all categories, particularly in the later rounds, suggests that supportive supervision played a crucial role. implying that continuous oversight and guidance significantly enhanced both accuracy and timeliness in malaria diagnosis. KEY WORDS: Microscope, Malaria Diagnosis, Laboratory Evaluation

An evaluation study of direct economic losses from surgical site infections in adults: structural equation modeling

IntroductionSurgical site infection (SSI) represents a significant postoperative complication, resulting in extended hospital stays and substantial economic burdens. Previous research on the direct economic impact of SSIs using recursive systems modeling is limited. This study aims to quantify the direct economic losses attributable to SSIs and to dissect the various factors to these losses.MethodsA retrospective 1:1 matched case–control study was conducted from January 2023 to March 2024 in three tertiary hospitals in Xinjiang, China. Patients with SSIs were matched on a 1:1 basis by hospital, department, age (±5 years), sex, primary diagnosis, and procedure with controls to form case and control groups. Wilcoxon Signed Ranks Test was utilized to quantify the direct economic loss from SSIs. Influencing factors were analyzed using a recursive system model.ResultsAmong the 74,258 patients surveyed, 226 developed SSIs, resulting in an infection rate of 0.3%. The total direct economic loss from SSIs at three hospitals was $467,867, with an average loss of $1,364.37 per SSI patient. SSI patients experienced hospital stays 11 days longer than uninfected patients. Multivariate linear regression identified the duration of hospital stay, catheter and ventilator usage, age, number of surgeries, and duration of antibiotic treatment as influencing factors. Recursive system modeling revealed the indirect contributions of the number of surgeries (indirect effect: 0.074), antibiotic use for 17–36 days (indirect effect: 0.063) and ≥ 37 days (indirect effect: 0.045), and debridement procedures (indirect effect: 0.054), as well as the direct contributions of hospital days (direct effect: 0.276), indwelling catheter days (direct effect: 0.260), ventilator days (direct effect: 0.221), and age (direct effect: 0.182).ConclusionRecursive system modeling helped identify the key factors influencing the economic losses from SSIs. These findings provide a theoretical basis for healthcare departments to develop targeted policies.

Mechanisms of mitochondrial damage-associated molecular patterns associated with inflammatory response in cardiovascular diseases.

Cardiovascular diseases (CVDs) continue to be a substantial global healthcare burden despite considerable progress in therapies. The inflammatory response during the progression of CVD has attracted considerable attention. Mitochondria serve as the principal energy source for the heart. In cardiovascular illnesses, mitochondrial homeostasis is disrupted, accompanied by structural and functional impairments. During mitochondrial stress or injury, mitochondrial damage-associated molecular patterns (mtDAMPs), such as mitochondrial DNA, cardiolipin, N-formyl peptide, and adenosine triphosphate, are released to activate pattern recognition receptors and trigger immunological responses. Inflammatory responses mediated by mtDAMPs substantially contribute to the pathophysiology of cardiovascular illnesses. In this review, we discuss the molecular mechanisms by which different mtDAMPs control the inflammatory response, address the pathological consequences of mtDAMPs in inducing or exacerbating the inflammatory response in CVDs, and summarize potential therapeutic targets in relevant experimental studies. Preventing or reducing mtDAMP release may play a role in CVD progression by alleviating the inflammatory response.

The Emerging Role of Mitochondria Oxygen Redox in Pathological Progression of Neurodegenerative Disorders.

Neurodegenerative diseases, such as Alzheimer's disease, Parkinson's disease, and Huntington disease, pose serious threats to human health, leading to substantial economic burdens on society and families. Despite extensive research, the underlying mechanisms driving these diseases remain incompletely understood, impeding effective diagnosis and treatment. In recent years, growing evidence has highlighted the crucial role of oxidative stress in the pathogenesis of various neurodegenerative diseases. However, there is still a lack of comprehensive reviews that systematically summarize the impact of mitochondrial oxidative stress on neurodegenerative diseases. This review aims to address this gap by summarizing the molecular mechanisms by which mitochondrial oxidative stress promotes the initiation and progression of neurodegenerative disorders. Furthermore, it discusses the potential of antioxidant-based therapeutic strategies for the treatment of these diseases. By shedding light on the role of mitochondrial oxidative stress in neurodegenerative diseases, this review not only serves as a valuable reference for further research on the disease mechanisms, but also offers novel perspectives for the treatment of these disorders.

Insights into age-related osteoporosis from senescence-based preclinical models and human accelerated aging paradigms.

Preclinical models of age-related osteoporosis have been developed based on the accumulation and clearance of senescent cells. The former include animal models based on telomere dysfunction and focal radiation; the latter based on genetic and pharmacological targeting (i.e., removal) of senescent cells. The weight of evidence using these models suggests that cellular senescence plays a key role in the pathophysiology of aging-onset bone loss with the senescence-associated secretory phenotype (SASP) mediating local and systemic deleterious effects on the skeleton. Mitochondrial dysfunction has also been implicated in senescence and age-related comorbidities, including osteoporosis, and knock-in mutations in the mtDNA polymerase gamma (Polg) gene in mice may recapitulate similar respiratory chain complex defects in aged individual with osteoporosis. This and other contributions to senile osteoporosis may also be identified by the careful evaluation of non-genetic paradigms of human accelerated aging. Premature aging syndromes, especially those with a prominent bone loss phenotype, include clinical scenarios of skeletal unloading, premature ovarian failure and survival from childhood cancers. These non-hereditary progeroid syndromes implicate the involvement of lineage switching to an adipogenic fate, inhibition of Wnt signaling, increased osteoclastogenesis and activation frequency of osteoclasts, as well as the substantial burden of senescent cell accumulation.

The burden of headache disorders among medical students in Vietnam: estimates from a cross-sectional study with a health-care needs assessment

BackgroundIn our previous study, we demonstrated that headaches are highly prevalent among medical students in Vietnam. In the present study, we provide estimates of the associated symptom burden and impaired participation, utilizing these estimates to assess headache-related healthcare needs within this population.MethodsThe study followed the standardized methodology established by the Global Campaign against Headache. Participants included medical students who were randomly selected from two medical universities in Vietnam. Data collection utilized the HARDSHIP questionnaire, which included diagnostic questions based on ICHD-3 criteria, measures of symptom burden, quality of life (QoL) assessments using the WHOQoL-8, evaluations of impaired participation through the HALT index, and questions about headache yesterday (HY). The definition of health care “need” was based on the likelihood of benefit from intervention, including all participants with probable medication-overuse headache (pMOH), other headaches occurring on ≥ 15 days/month (H15+), migraine on ≥ 3 days/month, or migraine or tension-type headache (TTH) meeting at least one of two criteria related to symptom burden and impaired participation.ResultsA total of 1,362 participants (57.3% female) were included, of whom 1,125 students (61.3% female) were diagnosed with a headache disorder, and 165 students (69.1% female) reported experiencing a HY. The mean frequency of any headache was 3.6 days per month, with an average duration of 5.3 h, and 58% of participants reported an intensity of moderate/severe. For all headache, the mean pTIS was 2.8%. The mean number of lost days over a period of 3 months was 4.3 for work/school tasks, 3.8 for household chore, and 1.7 for social or leisure activities. Among those reporting a HY, 35.8% were able to complete less than half of their expected activities, while 9.7% could complete none. QoL of students with any headache was significantly lower than that of students without headache. A mong students with headache, 43.8% fulfilled atleast one of our needs assessment criteria.ConclusionsThis first study on headache burden in Vietnam reveals substantial symptom burden alongside a correspondingly high level of impaired participation among medical students.

Current situation of central nervous system tumour survivors in a spanish hospital.

Despite the increasing number of central nervous system (CNS) tumour survivors, long-term (LT) sequelae remain a substantial burden on their health through various life stages. The aim of our study was to evaluate late morbidity, health-related quality of life (HRQoL), self-esteem, functional status, adaptive behaviour, physical activity and social outcomes such as education, employment, relationship status and possession of a driver's license, in addition to the role of LT effects of radiotherapy (RTx) on these outcomes. The study included 111 CNS tumour survivors with a minimum of 10 years of follow-up. The assessment of patients included a comprehensive clinical evaluation and psychological questionnaires: SF-36 for HRQoL and Rosenberg self-esteem scale. Functional status was assessed with the Lansky/Karnosky scales and adaptive behaviour with the Vineland-II scale. Patients also completed one questionnaire that assessed physical activity and another that assessed other social variables. The mean current age of CNS tumour survivors was 20 years (range, 12-34). The median time since diagnosis was 13 years (range, 10-26). The median age at diagnosis was 6 years (range, 1-18). The most prevalent LT sequelae were neurologic (55%), followed by neuropsychiatric (53.1%) and endocrine (49.5%) sequelae. Survivors treated with RTx (n = 52) had poorer outcomes in terms of adaptive behaviour, educational attainment and relationship status compared to those who did not receive RTx, but we did not find differences in quality of life or self-esteem scores between these groups. We found a high prevalence of long-term sequelae in CNS tumour survivors, especially in those who received RTx. In these patients, LT sequelae have a significant impact on functional status and social outcomes, but not on quality of life or self-esteem.

Educating Healthcare Workers in Snakebite Management: A Study to Determine the Effectiveness of the Snake Bite Life Support Workshop.

Snakebite envenomation is a significant global health issue, with India bearing a substantial burden. Despite the development of guidelines, knowledge gaps and lack of training persist among healthcare workers (HCWs), contributing to high morbidity and mortality. This study aimed to evaluate the impact of the Snake Bite Life Support (SBLS) workshop on HCWs' knowledge, practices, self-efficacy, and advocacy skills in snakebite management. A pre-post interventional study was conducted during the SBLS workshop at a tertiary care center in May 2024. HCWs' knowledge, practical skills, self-efficacy, and advocacy skills were assessed using standardized questionnaires and a modified General Self-Efficacy (GSE) scale, both before and after the workshop. Data were analyzed using SPSS v25.0, employing paired t-tests and Wilcoxon signed-rank tests for comparison. Forty-one HCWs completed the pre- and post-workshop assessments. Significant improvements were observed in knowledge, particularly in avoiding false positive 20-minute whole blood clotting test (20WBCT) results (p=0.020) and premedication for antivenom (p<0.001). Participants reported a marked increase in self-efficacy across all GSE parameters and demonstrated enhanced advocacy intent in resource management, policy influence, and educational outreach. The workshop influenced practice changes, notably reducing the administration of antivenom in confirmed hump-nosed pit viper bites. The SBLS workshop effectively enhanced HCWs' knowledge, management practices, self-efficacy, and advocacy intentions, emphasizing the need for integrating such training into healthcare education to drive systemic change in snakebite management and improve patient outcomes. Future studies should focus on long-term impacts and broader implementation.

Childhood Tuberculosis-Advances in Treatment and Prevention.

Tuberculosis (TB) in childhood presents a substantial global burden with nearly two million episodes of disease in children and adolescents annually. The majority of children who die from TB never receive appropriate treatment. Advancements in childhood TB treatments have been slow and there are many challenges with TB treatment in children. However, recently, there have been renewed efforts toward better options for TB treatment in children. The shortened duration of treatment (4 months) in nonsevere TB and an all-oral treatment for multidrug-resistant TB are major landmarks in childhood TB treatment. Although BCG remains the only vaccine for TB prevention, there are candidate vaccines that target infants and adolescents.