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Open Access June 26, 2025

The Relationship Between Lymphocyte Count and Mortality in Patients with Dysphagia

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 = 1.899×109/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 = 1.899×109/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

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 R0 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 April 27, 2023

Adolescent Students’ Knowledge of Sexually Transmitted Infections in Eastern Region Schools for the Deaf, Ghana

Abstract This study investigated adolescent students‟ knowledge of sexually transmitted infections (STIs) in eastern region schools for the deaf in Ghana. A descriptive survey design was used for the study. The researchers used HIV- The knowledge Questionnaire to assess the knowledge of respondents on STIs. Stratified sampling and simple random sampling techniques were employed. Proportional representation [...] Read more.
This study investigated adolescent students‟ knowledge of sexually transmitted infections (STIs) in eastern region schools for the deaf in Ghana. A descriptive survey design was used for the study. The researchers used HIV- The knowledge Questionnaire to assess the knowledge of respondents on STIs. Stratified sampling and simple random sampling techniques were employed. Proportional representation was used to select a sample of ninety-five (95) adolescent students with deafness from JHS2 and JHS3 between the ages of 13 and 24 years. Data were analyzed descriptively into frequencies and percentages. The results of the study indicated that the students knew of some of the types of STIs such as Gonorrhea, Syphilis, and HIV/AIDS. They, however, had inadequate knowledge of STIs such as Hepatitis B and Chlamydia.
Article
Open Access October 29, 2022

Patient Perspectives on Factors Influencing Initiation of Gynecologic Care

Abstract Addressing adolescent and sexual reproductive healthcare is essential to providing young patients with the resources they need to navigate and empower themselves with. However, there is limited data about how often this occurs. Several studies have previously indicated that there is a large gap in accessing this gap in low-income neighborhoods. Our study aims to identify the establishment of [...] Read more.
Addressing adolescent and sexual reproductive healthcare is essential to providing young patients with the resources they need to navigate and empower themselves with. However, there is limited data about how often this occurs. Several studies have previously indicated that there is a large gap in accessing this gap in low-income neighborhoods. Our study aims to identify the establishment of gynecologic care among adolescent cisgender women and elucidate potential reasons for seeking or not seeking out care. We approached women in the pediatric emergency room that matched the inclusion criteria set out. Qualitative surveys were conducted until thematic saturation was reached and a cross-section study design was employed. Interviews were analyzed through modified ground theory. The study was conducted at the pediatric emergency department at University Hospital located in Newark, NJ. In 2018 estimates, the Newark population consists of 47.0% Black and 39.2% Hispanic or Latinos. Semi-structured interviews were conducted with 27 cisgendered, English-speaking females between ages 18 to 25 presenting to the pediatric emergency room who may or may not have previously established primary care with a gynecologist. Transcriptions were analyzed using modified grounded theory and themes were identified using inductive coding of patient interviews.
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