The acceptability of and willingness to pay for a herpes zoster vaccine: A systematic review

Patients, predominantly the elderly, with Herpes Zoster (HZ) not only suffer symptoms of the disease but also bear considerable expenses. This study systematically reviewed the acceptability of and willingness to pay for the HZ vaccine. This review was registered in PROSPERO 2023 (CRD42023403062). We used “acceptance”, “willing to pay”, and “HZ vaccine” (and variations thereof) as keywords in a systematic search for original English research articles published up to April 7, 2023. The search was conducted over Scopus, PubMed, ScienceDirect, Cochrane, and Google Scholar in accordance with PRISMA 2020 guidelines. The inclusion criteria were as follows: studies (1) that mentioned HZ vaccination, (2) related to acceptability or willingness to pay, and (3) with full texts available and peer-reviewed prior to final publication. Grey literature, letters to editors, commentaries, case reports or series, systematic reviews, meta-analyses, articles of poor quality, and articles with ambiguously defined and measured outcome variables were excluded. The Joanna Briggs Institute (JBI) critical appraisal checklist was used to evaluate the methodological quality of the studies. Finally, the search yielded 24 studies, of which 9 were conducted in Asia, 8 in Europe, and 7 in America. General adults or patients aged 50 or older were often the target populations, for whom treatments were accompanied by healthcare providers’ recommendations. The willingness to pay and willingness to accept the vaccine ranged from $8 to$150 and 16.6% to 85.8%, respectively. Compared to the US, Asia and Europe had higher acceptance rates for HZ immunization. The most frequent excuses given for not being vaccinated are side effects, cost, lack of recommendations, anti-vaccination views, ignorance about the HZ vaccine, and the belief that one is not at risk for the disease. National campaigns should be developed to increase public awareness of HZ, and more international research should be conducted to understand the WTA and WTP for HZ immunizations

Safety and efficacy of fluoxetine on functional outcome after acute stroke (AFFINITY): a randomised, double-blind, placebo-controlled trial

Background Trials of fluoxetine for recovery after stroke report conflicting results. The Assessment oF FluoxetINe In sTroke recoverY (AFFINITY) trial aimed to show if daily oral fluoxetine for 6 months after stroke improves functional outcome in an ethnically diverse population. Methods AFFINITY was a randomised, parallel-group, double-blind, placebo-controlled trial done in 43 hospital stroke units in Australia (n=29), New Zealand (four), and Vietnam (ten). Eligible patients were adults (aged ≥18 years) with a clinical diagnosis of acute stroke in the previous 2–15 days, brain imaging consistent with ischaemic or haemorrhagic stroke, and a persisting neurological deficit that produced a modified Rankin Scale (mRS) score of 1 or more. Patients were randomly assigned 1:1 via a web-based system using a minimisation algorithm to once daily, oral fluoxetine 20 mg capsules or matching placebo for 6 months. Patients, carers, investigators, and outcome assessors were masked to the treatment allocation. The primary outcome was functional status, measured by the mRS, at 6 months. The primary analysis was an ordinal logistic regression of the mRS at 6 months, adjusted for minimisation variables. Primary and safety analyses were done according to the patient's treatment allocation. The trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12611000774921. Findings Between Jan 11, 2013, and June 30, 2019, 1280 patients were recruited in Australia (n=532), New Zealand (n=42), and Vietnam (n=706), of whom 642 were randomly assigned to fluoxetine and 638 were randomly assigned to placebo. Mean duration of trial treatment was 167 days (SD 48·1). At 6 months, mRS data were available in 624 (97%) patients in the fluoxetine group and 632 (99%) in the placebo group. The distribution of mRS categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio 0·94, 95% CI 0·76–1·15; p=0·53). Compared with patients in the placebo group, patients in the fluoxetine group had more falls (20 [3%] vs seven [1%]; p=0·018), bone fractures (19 [3%] vs six [1%]; p=0·014), and epileptic seizures (ten [2%] vs two [<1%]; p=0·038) at 6 months. Interpretation Oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and epileptic seizures. These results do not support the use of fluoxetine to improve functional outcome after stroke

Pellet feed improvements through vitamin c supplementation for snakehead, channa striata (Bloch 1793), culture

Vitamin C, or ascorbic acid (AA), is important in growth and physiological functions of fish. Six soybean meal-based (SBM) diets containing 0, 125, 250, 500, 1000 and 2000 mg.kg-1 of AA were fed to snakehead, Channa striata (Bloch 1793) (initial weight 6.63 + 0.16 g) for 8 weeks in the laboratory. Survival of snakehead in the 250 and 500 mg.kg-1 treatments was significantly higher (P \u3c 0.05) than the control, but not in the other treatments. Final weight and specific growth rate (SGR) of fish in all the AA-supplemented diet treatments were significantly higher (P \u3c 0.05) than the control. Feed intake (FI), feed conversion ratio (FCR), and protein efficiency ratio (PER) also differed significantly, but not in a clearly dose-dependent manner. The requirement of AA for snakehead was calculated to be 277 mg.kg-1. No vertebral anomalies were observed. Erythrocyte count was significantly (P \u3c 0.05) higher at 1000 and 2000 mg.kg-1 than at 0 and 125 mg.kg-1. Fish in 250 mg.kg-1 had significantly (P \u3c 0.05) higher leukocyte count than those in 0, 1000, and 2000 mg.kg-1. A bacterial challenge test with Aeromonas hydrophila revealed that 500 and 1000 mg.kg-1 had the lowest cumulative mortality. In an on-farm trial, SBM-based and commercial diets augmented with 0, 500, 750, or 1000 mg.kg-1 AA were fed to C. striata for 23 weeks. All AA-supplemented SBM-based diets provided significantly (P \u3c 0.05) higher final weights and overall yield than did all the AA-supplemented commercial diets. Maximum survival (85.3 %), final fish weight (573.5 g), yield (293.3 kg.hapa-1) and profit (0.38 USD.kg fish-1), as well as minimum FCR (1.16), production cost (1.12 USD.kg fish-1) and feed cost (0.98 USD.kg fish-1) were obtained with the 500 mg.kg-1 SBM diet

Non-Alcoholic Fatty Liver Disease in Patients with Type 2 Diabetes: Evaluation of Hepatic Fibrosis and Steatosis Using Fibroscan

Patients with type 2 diabetes mellitus (T2DM) are at increased risk of non-alcoholic fatty liver disease (NAFLD) and might eventually progress to advanced fibrosis, cirrhosis and hepatocellular carcinoma (HCC). Recommendations on whether to screen for NAFLD in diabetic patients remains conflicted between major guidelines. Transient elastography using FibroScan with CAP (controlled attenuation parameter) can assess both liver steatosis and fibrosis simultaneously. This paper took a new look at the prevalence of NAFLD and the severity of fibrosis among T2DM patients in Vietnam. The study was conducted using a cross-sectional design in T2DM adults who attended Dai Phuoc Ho Chi Minh Polyclinic and Polyclinic of Pham Ngoc Thach University of Medicine. Liver steatosis and fibrosis was assessed by FibroScan. NAFLD was diagnosed if CAP &gt; 233 dB/m (steatosis &gt; 5%). Data were analyzed using STATA 12 software program. We found that a total of 307 type 2 diabetic patients qualified for the study&rsquo;s criteria. The prevalence of NAFLD in T2DM patients based on FibroScan was 73.3%. Rates of mild, moderate and severe steatosis were 20.5%, 21.8% and 30.9%, respectively. The prevalence of significant fibrosis (&ge; F2), advanced fibrosis (&ge; F3) and cirrhosis (F4) was 13.0%, 5.9% and 3.6%, respectively. On multivariate analysis, aspartate aminotransferase (AST) (OR: 1.067; 95% CI: 1.017&ndash;1.119; p = 0.008) and platelet levels (OR: 0.985; 95% CI: 0.972&ndash;0.999; p = 0.034) were independent of risk factors of advanced fibrosis. Thus, our study supports screening for NAFLD and for evaluating the severity of liver fibrosis in T2DM patients

The acceptability of and willingness to pay for a herpes zoster vaccine: A systematic review

Patients, predominantly the elderly, with Herpes Zoster (HZ) not only suffer symptoms of the disease but also bear considerable expenses. This study systematically reviewed the acceptability of and willingness to pay for the HZ vaccine. This review was registered in PROSPERO 2023 (CRD42023403062). We used “acceptance”, “willing to pay”, and “HZ vaccine” (and variations thereof) as keywords in a systematic search for original English research articles published up to April 7, 2023. The search was conducted over Scopus, PubMed, ScienceDirect, Cochrane, and Google Scholar in accordance with PRISMA 2020 guidelines. The inclusion criteria were as follows: studies (1) that mentioned HZ vaccination, (2) related to acceptability or willingness to pay, and (3) with full texts available and peer-reviewed prior to final publication. Grey literature, letters to editors, commentaries, case reports or series, systematic reviews, meta-analyses, articles of poor quality, and articles with ambiguously defined and measured outcome variables were excluded. The Joanna Briggs Institute (JBI) critical appraisal checklist was used to evaluate the methodological quality of the studies. Finally, the search yielded 24 studies, of which 9 were conducted in Asia, 8 in Europe, and 7 in America. General adults or patients aged 50 or older were often the target populations, for whom treatments were accompanied by healthcare providers’ recommendations. The willingness to pay and willingness to accept the vaccine ranged from $8 to$150 and 16.6% to 85.8%, respectively. Compared to the US, Asia and Europe had higher acceptance rates for HZ immunization. The most frequent excuses given for not being vaccinated are side effects, cost, lack of recommendations, anti-vaccination views, ignorance about the HZ vaccine, and the belief that one is not at risk for the disease. National campaigns should be developed to increase public awareness of HZ, and more international research should be conducted to understand the WTA and WTP for HZ immunizations

Zona pellucida removal resulted in a successful live birth: Report on a case with recurrent implantation failure due to embryonic bacteria contamination

Key clinical message In in vitro fertilization (IVF), laser offers several advantages. In this study, we employed laser to eliminate the zona pellucida of a contaminated embryo. This approach helps to rescue embryo with bacterial contamination, and improve embryo‐endometrium interaction. Abstract To present a case report on the removal of a contaminated zona pellucida from an embryo of patient with a history of recurrent implantation failure (RIF), which was followed by a successful live birth. We present the case of a 34‐year‐old patient with a history of 3 years of infertility who underwent in vitro fertilization. During the culture process, the embryos became contaminated, leading to three failed implantations. Despite the aneuploidy of the embryo and the implementation of a washing technique, the contamination persisted. In the final attempt, the contaminated zona pellucida was successfully removed using laser, followed by embryo transfer, resulting in a live birth. We provided detailed clinical information, including patient demographics, infertility history, ovarian response, evidence of bacterial contamination, embryo development, treatment protocols, and outcomes. Laser excision of the zona pellucida is a safe and effective method for addressing bacterial infection in embryos

Platelet rich fibrin and MTA in the treatment of teeth with open apices

Abstract Background The present study aimed to evaluate the effectiveness of using platelet-rich fibrin (PRF) as the apical matrix for the placement of MTA in nonsurgical endodontic therapy for teeth with periapical lesions and open apices. Methods Twelve teeth from eleven patients with periapical periodontitis and open apices were enrolled in the study. Nonsurgical endodontic therapy was performed with the PRF used as an apical barrier and the MTA manipulated as an apical plug for further thermoplasticized gutta percha in the remaining part of the root canal. Clinical signs and periapical digital radiographs were recorded and analyzed to evaluate the curing progress after periodical follow-ups of 1, 3, and 6 months. The horizontal dimension of the periapical lesion was determined, and the changes in the dimensions were recorded each time. The Friedman test was used for statistical analysis, with P < .05 serving as the threshold for determining statistical significance. Results All patients had no clinical symptoms after the first month of treatment, with a significant reduction in the periapical lesion after periodical appointments. Conclusions PRF is an effective barrier when combined with MTA for the treatment of teeth with periapical periodontitis and open apices

Additional file 1 of A study of genetic variants associated with skin traits in the Vietnamese population

Supplementary Material