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Open Access
June 26, 2025
The Relationship Between Lymphocyte Count and Mortality in Patients with Dysphagia
Min Wei
,
Chengming Ke
,
Sumin Wu
World Journal of Clinical Medicine Research
2025
,
5(1),
40-51.
DOI:
10.31586/wjcmr.2025.6128
Views
389
Downloads
50
Abstract
Background:
Dysphagia is a common functional impairment in elderly populations, often leading to severe complications such as malnutrition and aspiration pneumonia, significantly increasing healthcare burdens. Currently, effective prognostic assessment tools are lacking. The absolute lymphocyte count (ALC), a biomarker reflecting immune-nutritional status, has potential predictive value in this context, though its role in dysphagia prognosis remains unclear.
Methods:
This retrospective cohort study included 253 dysphagic patients who received percutaneous endoscopic gastrostomy (PEG) or total parenteral nutrition (TPN) between 2014 and 2017. Five patients with missing ALC were excluded. Cox regression models assessed the association between ALC and mortality. ALC was analyzed as both continuous variable (using restriocted cubic splines) and categorical tertiles, with additional threshold analyses to assess non-linearity. Kaplan–Meier survival curves and subgroup analyses were also performed.
Results:
Lower ALC was associated with poorer nutritional status, higher inflammatory markers, and greater comorbidity burden. Higher ALC was independently associated with reduced mortality (adjusted HR: 0.60; 95% CI: 0.44–0.83;
p
= 0.002). Patients in the highest tertile had significantly better survival than those in the lowest (HR: 0.37; 95% CI: 0.23–0.59;
P
< 0.001). A non-linear threshold effect was identified at ALC = 1.899×10
9
/L (
p
for non-linearity = 0.009). Kaplan–Meier analysis confirmed improved survival with higher ALC (
p
[...] Read more.
Background:
Dysphagia is a common functional impairment in elderly populations, often leading to severe complications such as malnutrition and aspiration pneumonia, significantly increasing healthcare burdens. Currently, effective prognostic assessment tools are lacking. The absolute lymphocyte count (ALC), a biomarker reflecting immune-nutritional status, has potential predictive value in this context, though its role in dysphagia prognosis remains unclear.
Methods:
This retrospective cohort study included 253 dysphagic patients who received percutaneous endoscopic gastrostomy (PEG) or total parenteral nutrition (TPN) between 2014 and 2017. Five patients with missing ALC were excluded. Cox regression models assessed the association between ALC and mortality. ALC was analyzed as both continuous variable (using restriocted cubic splines) and categorical tertiles, with additional threshold analyses to assess non-linearity. Kaplan–Meier survival curves and subgroup analyses were also performed.
Results:
Lower ALC was associated with poorer nutritional status, higher inflammatory markers, and greater comorbidity burden. Higher ALC was independently associated with reduced mortality (adjusted HR: 0.60; 95% CI: 0.44–0.83;
p
= 0.002). Patients in the highest tertile had significantly better survival than those in the lowest (HR: 0.37; 95% CI: 0.23–0.59;
P
< 0.001). A non-linear threshold effect was identified at ALC = 1.899×10
9
/L (
p
for non-linearity = 0.009). Kaplan–Meier analysis confirmed improved survival with higher ALC (
p
< 0.0001). Subgroup analyses showed the protective effect of higher ALC was consistent across age, sex, BMI, PEG use, and comorbidity strata, with no significant interactions.
Conclusions:
ALC is an independent, non-linear predictor of mortality in older dysphagic patients and may aid clinical risk stratification across diverse patient subgroups.
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Open Access
June 26, 2025
Mathematical modelling of the impact of HIV prevention strategies among female sex workers on public health in Burkina Faso
Serge M. A. SOMDA
,
Bernard E. A. DABONÉ
,
Boureima SANGARÉ
,
Sado TRAORÉ
Journal of Mathematics Letters
2025
,
3(1),
22-40.
DOI:
10.31586/jml.2025.6104
Views
384
Downloads
33
Abstract
This article presents a mathematical model designed to simulate the impact of targeted interventions aimed at preventing HIV transmission among female sex workers (FSWs) and their clients, while also analyzing their effects on the health of the general population. The compartmental model distinguishes between high-risk populations (FSWs and their clients) and low-risk populations (sexually active
[...] Read more.
This article presents a mathematical model designed to simulate the impact of targeted interventions aimed at preventing HIV transmission among female sex workers (FSWs) and their clients, while also analyzing their effects on the health of the general population. The compartmental model distinguishes between high-risk populations (FSWs and their clients) and low-risk populations (sexually active men and women in the general population), and links prevention efforts in high-risk groups to the evolution of the epidemic in the low-risk population. The fundamental properties of the model, such as the positivity of solutions and the boundedness of the system, have been verified, and the basic reproduction number R
0
has been calculated. Finally, the stability of the model was studied using Varga’s theorem and the Lyapunov method. Simulation results show that targeted prevention among FSWs and their clients reduces HIV incidence in the general population. This framework provides a valuable tool for guiding policymakers in the design of effective strategies to combat the epidemic, especially relevant in the context of suspension of USAID funding.
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Open Access
June 25, 2025
Performance and Validity of Knee Function Assessment Tools After Total Knee Arthroplasty: A Systematic Review
Andrei Machado Viegas da Trindade
,
Helder Rocha da Silva Araújo
,
Mário Soares Ferreira Júnior
,
Karine Kelly Rangel de Andrade Monte
,
Marcos Vinícius Amorim Silva
,
Rebecca Gomes Moura Bastos
,
João Gabriel Ventura Bariani
,
Fernanda Grazielle da Silva Azevedo Nora
Global Journal of Orthopedics
2025
,
1(1),
60-69.
DOI:
10.31586/gjo.2025.6123
Views
403
Downloads
39
Abstract
Objective:
To identify and evaluate the main functional assessment tools applied in the postoperative monitoring of patients undergoing total knee arthroplasty (TKA), and to synthesize the functional outcomes reported through these instruments in the current scientific literature.
Method
ology
:
A structured review was conducted following PRISMA 2020 guidelines.
[...] Read more.
Objective:
To identify and evaluate the main functional assessment tools applied in the postoperative monitoring of patients undergoing total knee arthroplasty (TKA), and to synthesize the functional outcomes reported through these instruments in the current scientific literature.
Method
ology
:
A structured review was conducted following PRISMA 2020 guidelines. Thirty-one peer-reviewed studies were selected through a targeted manual search based on predefined eligibility criteria. Included studies evaluated functional recovery following TKA using validated outcome measures such as the WOMAC, KSS, KOOS, IKDC, SF-36, and SANE. Data extraction focused on the instruments used, patient population characteristics, and reported outcomes. A descriptive synthesis was compiled in Table 1. Additionally, 15 studies with quantitative data were analyzed using a forest plot to illustrate risk ratios (RR) and 95% confidence intervals (CI) for functional improvement. Risk of bias was assessed qualitatively based on methodological rigor, clarity of reporting, and validation of the outcome tools.
Results:
All included studies reported improvements in functional status following TKA. Most risk ratios ranged from 0.66 to 0.85, indicating a consistent reduction in the risk of postoperative functional limitation. High-quality studies demonstrated more precise effect estimates and greater internal validity. The SANE scale emerged as a valid and practical tool with high responsiveness, including in its culturally adapted Brazilian version. Despite heterogeneity in study design, the direction of effect remained consistent across all included studies.
Conclusion:
Validated functional assessment tools are essential for monitoring recovery after total knee arthroplasty. Instruments such as WOMAC and SANE demonstrate strong clinical utility and psychometric validity. Their systematic use enhances outcome comparability, supports individualized rehabilitation planning, and improves decision-making in orthopedic care.
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Systematic Review
Open Access
April 30, 2025
Psychological Flexibility and Cardiovascular Health Behaviors Among Filipino Outpatients: A Correlational Study
Zander Antonio
,
Ronalyn Topacio
,
Aqeel Al-Mahdaly Steven Zheng
,
Roison Andro Narvaez
,
Marilane Ferrer
World Journal of Nursing Research
2025
,
4(1),
67-76.
DOI:
10.31586/wjnr.2025.6090
Views
687
Downloads
53
Abstract
(1)
Background
: Psychological flexibility, the ability to adapt to changing demands while staying true to personal values, is linked to better health behaviors. However, its relationship with cardiovascular health behaviors, particularly in Filipino populations, remains underexplored. (2)
Aim
: This study aimed to examine the relationship between psychological flexibility and
[...] Read more.
(1)
Background
: Psychological flexibility, the ability to adapt to changing demands while staying true to personal values, is linked to better health behaviors. However, its relationship with cardiovascular health behaviors, particularly in Filipino populations, remains underexplored. (2)
Aim
: This study aimed to examine the relationship between psychological flexibility and cardiovascular health behaviors among outpatients in Rizal, Philippines, focusing on BMI, smoking, physical activity, and dietary habits. (3)
Methods
: A cross-sectional, descriptive-correlational design was used with 100 outpatient participants from selected hospitals. Psychological flexibility was measured using the Acceptance and Action Questionnaire-II (AAQ-II), and cardiovascular health behaviors were assessed using a modified version of the American Heart Association’s Life Simple 7 tool. Descriptive statistics and Pearson’s correlation were applied. (4)
Results
: The findings showed that respondents had neutral levels of psychological flexibility. While most exhibited intermediate BMI and physical activity, dietary habits varied. A significant positive correlation was found between psychological flexibility and whole grain consumption. However, no significant associations were found with BMI, smoking, or physical activity. (5)
Conclusions
: Psychological flexibility appears to influence specific health behaviors, such as dietary choices, but does not strongly correlate with other cardiovascular health behaviors. Further research is needed to explore its broader role in cardiovascular disease prevention.
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