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Indian Journal of Public Health Apr 2024The medical devices industry plays a critical role in public health and requires attention in research and policy. The COVID-19 pandemic exposed a lack of resilience in...
BACKGROUND
The medical devices industry plays a critical role in public health and requires attention in research and policy. The COVID-19 pandemic exposed a lack of resilience in areas of drugs and vaccines but also in medical products.
OBJECTIVES
The study analyzes India's strengths and weaknesses in the trade of medical devices and identifies specific devices where India can attain self-sufficiency and areas where trade is still beneficial.
MATERIALS AND METHODS
A set of critical products traded during the COVID-19 pandemic were identified from the World Integrated Trade Solution website at the 6-digit Harmonized System code level. A detailed analysis of exports and imports of medical products at disaggregated 8-digit codes was carried out.
RESULTS
During the pandemic, India had a trade surplus in some low-technology-based products such as suture needles, catheters, and cannulae along with X-ray apparatus and electrocardiographs among the medium-tech products. The imports of high-tech devices like in vitro diagnostics almost doubled to meet the surge in demand. The requirement of pulse oximeters, ventilators, and other monitoring devices jumped, and their imports reported an 800% increase from $134 million in 2019-2020 to $1162 million in 2021-2022. Most of India's imports of medical devices come from the top five exporting countries, with the share of the USA and China at 39%-40%.
CONCLUSION
There is a need to expand the manufacturing capacity of surgical instruments, consumables and disposables, apart from some high-tech products. The public health care facilities should procure domestically manufactured medical devices and trade with neighbouring countries to reduce import concentration must be prioritised.
Topics: COVID-19; India; Humans; Equipment and Supplies; Commerce; SARS-CoV-2; Pandemics
PubMed: 38953811
DOI: 10.4103/ijph.ijph_1403_23 -
Indian Journal of Public Health Apr 2024The debate over the extent of the mortality impact of COVID-19 in India is still unsettled.
BACKGROUND
The debate over the extent of the mortality impact of COVID-19 in India is still unsettled.
OBJECTIVES
This article contributes to the debate, seeking to explore the true mortality impact of the pandemic, by answering four interrelated questions. First, is there any discrepancy between recorded and actual death count? Second, if so, how large it is? Third, what is the extent of misclassification of COVID-19 mortality, and fourth, what is the magnitude of deaths that could be indirectly linked to COVID-19?
MATERIALS AND METHODS
To answer the questions, we explored three sources of data-all-cause mortality data from the civil registration system, records maintained at the burial grounds/cemeteries and crematoriums, and a household survey. The data collection period was between August 2021 and November 2021. The instrument used for data collection of verbal autopsies was built on the instrument proposed by the World Health Organization for adult mortality.
RESULTS
The results revealed that deaths due to various causes including COVID-19 increased considerably at some points in 2020-2021 compared to the base year 2019 in the study setting. Notably, 5.5% of the noninstitutional deaths were unreported at the time of the survey and many deaths were plausibly misclassified, leading to undercounting of COVID-19 deaths. Overall, about half of our sampled deaths (48%) had either direct or indirect attribution to the pandemic.
CONCLUSION
The extent of undercounting of pandemic-related deaths is likely to be either similar or worse in other states. To get reliable state and national estimates, policymakers should conduct a large-scale study.
Topics: Humans; COVID-19; India; Cause of Death; SARS-CoV-2; Adult; Female; Male; Middle Aged; Pandemics; Adolescent; Death Certificates
PubMed: 38953810
DOI: 10.4103/ijph.ijph_1333_23 -
Diagnosis (Berlin, Germany) Jul 2024At the moment, the academic world is faced with various challenges that negatively impact science integrity. One is hijacked journals, a second, inauthentic website for...
At the moment, the academic world is faced with various challenges that negatively impact science integrity. One is hijacked journals, a second, inauthentic website for indexed legitimate journals, managed by cybercriminals. These journals publish any manuscript by charging authors and pose a risk to scientific integrity. This piece compares a journal's original and hijacked versions regarding authority in search engines. A list of 16 medical journals, along with their hijacked versions, has been collected. The MOZ Domain Authority has been used to check the authority of both original and hijacked journals, and the results have been discussed. It indicates that hijacked journals are gaining more credibility than original ones. This should alarm academia and highlights a need for serious action against hijacked journals. The related policies should be planned, and tools should be developed to support easy detection of hijacked journals. On the publishers' side, the visibility of journals' websites must be enhanced to address this issue.
PubMed: 38953515
DOI: 10.1515/dx-2024-0082 -
Journal of Clinical Hypertension... Jul 2024Our objectives were to ascertain the following: (1) the prevalence and socioeconomic distribution of hypertension (HTN), undiagnosed for HTN, and untreated cases of...
Our objectives were to ascertain the following: (1) the prevalence and socioeconomic distribution of hypertension (HTN), undiagnosed for HTN, and untreated cases of HTN-diagnosed individuals; (2) the relationship between SES and the prevalence of HTN, undiagnosed for HTN, and untreated for HTN; and (3) whether sex moderate this association. Data from the 2017-18 Bangladesh Demographic Health Survey were used. 11,776 participants who were 18 years of age or older responded to our analysis. The age-adjusted prevalence of HTN, undiagnosed for HTN, and untreated cases was 25.1%, 57.2%, and 12.3%. Compared to females, males were less likely to have HTN but more likely to have undiagnosed HTN. People in the rich SES groups had a higher odd of (adjusted odds ratio [aoR] 1.25; 95% confidence interval [CI] 1.08-3.45) of having HTN compared to those in the poor SES group. When compared to individuals in the poor SES group, those in the rich SES group had lower odds of undiagnosed (aoR 0.57; 95% CI 0.44-0.74) and untreated (aoR 0.56; 95% CI 0.31-0.98) for HTN. Sex moderated the association between SES and HTN prevalence, which showed that men from rich SES were more likely to suffer from HTN than men from poor SES. According to this study, the government and other pertinent stakeholders should concentrate more on developing suitable policy measures to reduce the risk of HTN, particularly for men in rich socioeconomic groups. They should also concentrate on screening and diagnosing HTN in socioeconomically disadvantaged populations, regardless of sex.
PubMed: 38953454
DOI: 10.1111/jch.14858 -
Cureus May 2024Post-intensive care syndrome (PICS) is the term used to describe the decline in the physical, cognitive, and/or mental condition of individuals who have been discharged... (Review)
Review
Post-intensive care syndrome (PICS) is the term used to describe the decline in the physical, cognitive, and/or mental condition of individuals who have been discharged from the intensive care unit (ICU). This complication could result in a significant reduction in quality of life, with some patients experiencing symptoms of prolonged weakness, depression, anxiety, and post-traumatic stress disorder (PTSD). Intensive care advancement over the years has resulted in an increase in ICU survival rates and a proportional increase in PICS, creating a need for more in-depth research into the prevention and management of the disease. Hence, this study aims to examine the present body of literature on PICS, encompassing its underlying physiological processes and elements that contribute to its development, methods for evaluating and diagnosing the condition, current treatment choices as well as potential new approaches, and the constraints in managing PICS and the necessity for further investigation. In this article, studies were compiled from several databases, including, but not limited to, Google Scholar, PubMed, and Cochrane Library. These studies were reviewed, and their data were used to highlight important aspects regarding the efficacy of current PICS screening tools, the optimization and limitations of both pharmacologic and non-pharmacologic treatment methods, and the feasibility and safety of emerging treatments and technologies. The major conclusions of this review were centered around the need for multidisciplinary management of PICS. From pharmacological management using analgesia to non-pharmacological management using early mobilization and exercise therapy, the effective treatment of PICS requires a multifaceted approach. Patient follow-up and its importance were touched upon, including strategies and policies to bolster proper follow-up, thereby increasing favorable outcomes. Lastly, the importance of family involvement and the increased need for research into this topic were highlighted.
PubMed: 38953087
DOI: 10.7759/cureus.61443 -
Risk Management and Healthcare Policy 2024This study investigates the influence of demographic changes on the effectiveness of hospital nurse staffing policy, measured by the cumulative response of inpatient...
PURPOSE
This study investigates the influence of demographic changes on the effectiveness of hospital nurse staffing policy, measured by the cumulative response of inpatient care quality to adjustments in hospital nurse staffing levels in Taiwan.
METHODS
The research design utilized in this study aligns with the observational time-series methodology, and a total of 99 monthly time-series observations were collected from multiple databases administered by the Taiwan government over the period from January 2015 to March 2023. Specifically, the time-varying parameter vector autoregressive and autoregressive distributed lag models were employed to investigate the association between age distribution and nurse staffing policy effectiveness.
RESULTS
The time-varying impulse responses of the unplanned 14-day readmission rate after discharge to changes in nurse staffing levels indicate a positive association between patient-to-nurse ratios and unplanned 14-day readmission rates across various types of hospitals. Nevertheless, the effectiveness of hospitals' nurse staffing policy is observed to diminish with population aging, particularly evident in medical centers and regional hospitals.
CONCLUSION
Policymakers should establish lower mandated patient-to-nurse ratios, grounded in practical nurse workforce planning, to address the needs of an aging society and enhance inpatient care quality through improved nurse staffing in hospitals.
PubMed: 38953037
DOI: 10.2147/RMHP.S468178 -
Risk Management and Healthcare Policy 2024The Sars-CoV-2 pandemic imposed unprecedented and drastic changes in health care organizations all over the world.
BACKGROUND
The Sars-CoV-2 pandemic imposed unprecedented and drastic changes in health care organizations all over the world.
PURPOSE
To evaluate the impact of the pandemic on hospitalizations in an acute psychiatric ward.
PATIENTS AND METHODS
We retrospectively identified and compared acute psychiatric hospitalizations in the Service for Psychiatric Diagnosis and Care (SPDC) of AUSL-Modena during the pre-pandemic (n = 1858) and pandemic period (n = 1095), from 01/01/2017 to 31/12/2022. Data were statistically analyzed using STATA12.
RESULTS
We collected 1858 hospitalizations in the pre-pandemic and 1095 in the pandemic. During the pandemic, we observed a progressively sharp reduction in voluntary hospitalizations, whereas involuntary ones remained stable with an increase in 2022 (p < 0.001), longer hospital stays (12.32 mean days vs 10.03; p < 0.001), longer periods of involuntary hospitalizations (8.45 mean days vs 5.72; p < 0.001), more frequent aggressive behaviour (16.10% vs 9.12%; p < 0.001) and referral to psychiatric communities at discharge (11.04% vs 6.13%; p < 0.001); non-Italians (p = 0.001), people with disability pension (p < 0.001) and Support Administrator (p < 0.001) were more frequently hospitalized.
CONCLUSION
During the pandemic, voluntary psychiatric hospitalizations decreased, but not involuntary ones, and the most vulnerable people in serious clinical conditions were hospitalized.
PubMed: 38953036
DOI: 10.2147/RMHP.S465858 -
Sexual Medicine Jun 2024Cardiovascular diseases (CVDs) and erectile dysfunction (ED) frequently co-occur, significantly affecting the quality of life of individuals. (Review)
Review
BACKGROUND
Cardiovascular diseases (CVDs) and erectile dysfunction (ED) frequently co-occur, significantly affecting the quality of life of individuals.
AIM
To assess the impact of cardiac rehabilitation (CR) on ED in patients with CVD through a systematic review and meta-analysis.
METHODS
This study analyzed randomized controlled trials and other studies comparing CR with usual care for adult males (≥18 years) with any cardiac disease. Literature searches were extensive, and the risk of bias was evaluated by the Cochrane Collaboration tool. Data from 6 studies involving 668 participants were included in the meta-analysis.
OUTCOMES
The primary outcome was the improvement in ED, as measured with the International Index of Erectile Function.
RESULTS
A statistically significant improvement in erectile function was observed across 6 studies, with a Morris dppc2 effect size of 0.38 (95% CI, 0.17-0.59). Despite initial high heterogeneity ( = 95.7%), identification and correction for selective outcome reporting bias mitigated this issue.
CLINICAL TRANSLATION
CR has a modest but statistically significant impact on improving ED in patients with CVD, indicating its potential positive contribution to the quality of life of this group.
STRENGTHS AND LIMITATIONS
The study's strengths include a comprehensive literature search and a rigorous methodological approach. Limitations involve high heterogeneity among studies and a low level of evidence due to small sample sizes and study quality; however, the source of heterogeneity was identified and mitigated following risk-of-bias assessment.
CONCLUSION
The results suggest that CR has a statistically significant but modest impact on improving ED in patients with CVD. Clinicians should consider the integration of CR into the clinical management of these individuals. This study underscores the potential for CR to contribute positively to the quality of life for patients with CVD by addressing associated ED (PROSPERO: CRD42022374625).
PubMed: 38953013
DOI: 10.1093/sexmed/qfae043 -
Pathology Oncology Research : POR 2024Lung cancer is a leading cause of cancer-related death worldwide in both men and women, however mortality in the US and EU are recently declining in parallel with the... (Review)
Review
Lung cancer is a leading cause of cancer-related death worldwide in both men and women, however mortality in the US and EU are recently declining in parallel with the gradual cut of smoking prevalence. Consequently, the relative frequency of adenocarcinoma increased while that of squamous and small cell carcinomas declined. During the last two decades a plethora of targeted drug therapies have appeared for the treatment of metastasizing non-small cell lung carcinomas (NSCLC). Personalized oncology aims to precisely match patients to treatments with the highest potential of success. Extensive research is done to introduce biomarkers which can predict the effectiveness of a specific targeted therapeutic approach. The EGFR signaling pathway includes several sufficient targets for the treatment of human cancers including NSCLC. Lung adenocarcinoma may harbor both activating and resistance mutations of the EGFR gene, and further, mutations of KRAS and BRAF oncogenes. Less frequent but targetable genetic alterations include ALK, ROS1, RET gene rearrangements, and various alterations of MET proto-oncogene. In addition, the importance of anti-tumor immunity and of tumor microenvironment has become evident recently. Accumulation of mutations generally trigger tumor specific immune defense, but immune protection may be upregulated as an aggressive feature. The blockade of immune checkpoints results in potential reactivation of tumor cell killing and induces significant tumor regression in various tumor types, such as lung carcinoma. Therapeutic responses to anti PD1-PD-L1 treatment may correlate with the expression of PD-L1 by tumor cells. Due to the wide range of diagnostic and predictive features in lung cancer a plenty of tests are required from a single small biopsy or cytology specimen, which is challenged by major issues of sample quantity and quality. Thus, the efficacy of biomarker testing should be warranted by standardized policy and optimal material usage. In this review we aim to discuss major targeted therapy-related biomarkers in NSCLC and testing possibilities comprehensively.
Topics: Humans; Carcinoma, Non-Small-Cell Lung; Lung Neoplasms; Biomarkers, Tumor; Proto-Oncogene Mas
PubMed: 38953007
DOI: 10.3389/pore.2024.1611733 -
RSC Advances Jun 2024Here is a comprehensive overview of iron's potential in low-carbon energy technologies, exploring applications like metal fuel combustion, iron-based batteries, and... (Review)
Review
Here is a comprehensive overview of iron's potential in low-carbon energy technologies, exploring applications like metal fuel combustion, iron-based batteries, and energy-carrier cycles, as well as sustainable approaches for production and recycling with a focus on reducing environmental impact. Iron, with its abundance, safety, and electrochemical characteristics, is a promising material to contribute to a decarbonized future. This paper discusses the advancements and challenges in iron-based energy storage technologies and sustainable iron production methods. Various innovative approaches are explored as energy storage solutions based on iron, like advancements in thermochemical Fe-Cl cycles highlight the potential of iron chloride electrochemical cycles for long-term high-capacity energy storage technology. Additionally, the utilization of iron as a circular fuel in industrial processes demonstrates its potential in large-scale thermal energy generation. Sustainable iron production methods, such as electrolysis of iron chloride or oxide and deep eutectic solvent extraction, are investigated to reduce the carbon footprint in the iron and steel industry. These findings also show the importance of policy and technology improvements that are vital for the widespread use and recycling of iron-based tech, stressing the need for collaboration toward a sustainable future.
PubMed: 38952947
DOI: 10.1039/d4ra03565h