A comparison of health state utility values associated with oral potentially malignant disorders and oral cancer in Sri Lanka assessed using the EQ-5D-3 L and the EORTC-8D

Background: It has been suggested that the EQ-5D-3 L preference-based measure of health outcome lacks sensitivity to discriminate between health states in cancer patients. An alternative approach is to use a disease (cancer) specific preference-based measure, such as the EORTC-8D. A limited number of comparisons have been made between generic and disease specific preference-based measures. The aim of this study was to compare the utility scores from the EQ-5D-3 L and the EORTC-8D in a group of patients with oral cancer or with oral potentially malignant disorders (OPMD). Methods: Patients (n = 151) with OPMD or oral cancer were recruited consecutively from six hospitals in Sri Lanka. All participants completed both the EQ-5D-3 L and the EORTC's QLQC-30 instrument. The Sri Lankan EQ-5D-3 L and EORTC-8D scoring algorithms were employed to estimate utility scores. The utility scores from the two instruments were compared for discrimination, responsiveness and correlation. Results: There were significant differences across the two utility scores. The EQ-5D-3 L showed better discrimination than EORTC-8D with higher effect sizes. There were higher ceiling effects observed in the EQ-5D-3 L. There was poor correlation between the dimensions of the two instruments except for the mobility and physical functions. Conclusion: The two instruments captured different aspects of quality of life. The EQ-5D-3 L demonstrated better discrimination than the EORTC-8D. In mild conditions EORTC-8D was more responsive and we recommend further validation of this instrument in diverse cancer conditions

A comparison of health state utility values associated with oral potentially malignant disorders and oral cancer in Sri Lanka assessed using the EQ-5D-3 L and the EORTC-8D

Background: It has been suggested that the EQ-5D-3 L preference-based measure of health outcome lacks sensitivity to discriminate between health states in cancer patients. An alternative approach is to use a disease (cancer) specific preference-based measure, such as the EORTC-8D. A limited number of comparisons have been made between generic and disease specific preference-based measures. The aim of this study was to compare the utility scores from the EQ-5D-3 L and the EORTC-8D in a group of patients with oral cancer or with oral potentially malignant disorders (OPMD). Methods: Patients (n = 151) with OPMD or oral cancer were recruited consecutively from six hospitals in Sri Lanka. All participants completed both the EQ-5D-3 L and the EORTC's QLQC-30 instrument. The Sri Lankan EQ-5D-3 L and EORTC-8D scoring algorithms were employed to estimate utility scores. The utility scores from the two instruments were compared for discrimination, responsiveness and correlation. Results: There were significant differences across the two utility scores. The EQ-5D-3 L showed better discrimination than EORTC-8D with higher effect sizes. There were higher ceiling effects observed in the EQ-5D-3 L. There was poor correlation between the dimensions of the two instruments except for the mobility and physical functions. Conclusion: The two instruments captured different aspects of quality of life. The EQ-5D-3 L demonstrated better discrimination than the EORTC-8D. In mild conditions EORTC-8D was more responsive and we recommend further validation of this instrument in diverse cancer conditions

Key success factors for adoption of CI/CD with agile project management - systematic literature review

The adoption of Continuous Integration and Continuous Delivery (CI/CD) is increasingly critical for improving software development efficiency and quality, especially in Agile Project Management. However, limited research focuses on the success factors driving CI/CD adoption in Agile environments. This systematic literature review identifies key factors for successful CI/CD integration, such as Customer engagement, Effective communication, Measurement, Collaborative Organizational Culture, Team Roles and Dynamics, Top management support, Tools, Continuous Monitoring and Continuous Improvement, Critical Skills and Employee Engagement. The review also highlights challenges such as resistance to change, lack of expertise in CI/CD tools, and difficulties in fostering cross-functional collaboration. Addressing both technical and organizational challenges is essential for successful CI/CD adoption. The review emphasizes the need for further research, particularly in customized and project-based environments, to better understand CI/CD adoption complexities and provide actionable insights for organizations

The Use of Diagnostic Tumor Markers in Detecting Tobacco- and Betel Quid-Induced Oral Squamous Cell Carcinoma:A Scoping Review of Empirical Evidence

Background and aimsTobacco and betel quid are two major causes of oral squamous cell carcinoma (OSCC). Tumor biomarkers offer potential headway for improved diagnosis of OSCC caused by tobacco and betel quid. Currently, several empirical investigations have explored the use of diverse types of tumor biomarkers in the diagnosis of tobacco- and betel quid-induced OSCC; however, no known study has mapped the evidence reported in those studies. This scoping review aims to map existing empirical evidence on the biomarkers of OSCC caused by these carcinogenic substances.MethodsThis scoping review adhered to the PRISMA-ScR checklist. Seven databases (PubMed, SCOPUS, AMED, APA PsycArticles, APA PsycINFO, CINAHL Ultimate, Dentistry, and Oral Sciences Source) were searched to retrieve literature on diagnostic tumor markers used in detecting tobacco- and betel quid-induced OSCC. After deduplication and screening of research articles based on the eligibility criteria. Only 36 peer-reviewed articles met the inclusion criteria of the scoping review. Data from the selected articles were charted, collated, summarized, and presented.ResultsAll the included articles were on studies published within the past decade. Most of them (26 articles) reported case-control studies. More than half (20 articles) were on studies conducted in India. A total of 6707 participants were investigated in the included articles, and different oral anatomical sites were involved. The biomarkers investigated were of diverse types, ranging from genomic biomarkers to transcriptomic markers. Specifically, these markers include micronuclei, miRNAs, protein markers, gene alterations, and salivary markers. These biomarkers were used in the early detection, risk assessment, and prognosis evaluation of tobacco-/betel quid-induced OSCC.ConclusionThis scoping review provides insights into the current global research landscape on the use of biomarkers in the diagnosis of tobacco- and betel quid-induced OSCC; it also provides potential avenues for improving early detection and management of this prevalent oral malignancy

Influence of Socio-economic and Demographics factors on Households’ Savings in Sri Lanka

The purpose of this paper is to examine the factors influencing saving behavior among households in a developing country. Sri Lanka being a developing country, has recorded a relatively lower households’  saving rate when compared with its peer regional counterparts. The study approximates the socio-economic and demographic factors towards the level of saving of households in Sri Lanka using a quantile regression approach based on the Household Income and Expenditure Survey, conducted by the Department of Census and Statistics of Sri Lanka. Results were obtained by using the stepwise quantile regression technique. The findings of this study conclude that when Sri Lankan households have a higher per-capita income, they tend to have a higher saving level. Moreover, age and marital status have a significant impact on the level of saving in Sri Lankan households. Additionally, poverty and employment status have a significant impact to the level of saving on Sri Lankan households. This research paper bridges empirical gaps in this area of study. Furthermore, this study has been conducted encompassing the entire country rather than limiting it to a district or segment, hence, is comprehensive. As per the generated results gender, income and education levels have shown a significant positive impact towards the level of saving, whilst marital status and poverty have shown a significant negative impact towards the level of saving. It is considered that when the demographic and socio-economic factors are affecting favorably, the level of saving tends to increase and vice versa. Accordingly, findings of the study can provide insights to policymakers to devise policies and incentives to encourage savings behaviour and level of savings among households in Sri Lanka. This is beneficial as coping strategies specially during crises, where dependency of households on government assisted welfare schemes is likely to be less. Keywords: Household Saving Behaviour, Motives of Savings, Barriers to Saving, Quantile Regressio

EQ-5D-3L Derived Population Norms for Health Related Quality of Life in Sri Lanka

Background Health Related Quality of Life (HRQoL) is an important outcome measure in health economic evaluation that guides health resource allocations. Population norms for HRQoL are an essential ingredient in health economics and in the evaluation of population health. The aim of this study was to produce EQ-5D-3L-derived population norms for Sri Lanka. Method A population sample (n =  780) was selected from four districts of Sri Lanka. A stratified cluster sampling approach with probability proportionate to size was employed. Twenty six clusters of 30 participants each were selected; each participant completed the EQ-5D-3L in a face-to-face interview. Utility weights for their EQ-5D-3L health states were assigned using the Sri Lankan EQ-5D-3L algorithm. The population norms are reported by age and socio-economic variables. Results The EQ-5D-3L was completed by 736 people, representing a 94% response rate. Sixty per cent of the sample reported being in full health. The percentage of people responding to any problems in the five EQ-5D-3L dimensions increased with age. The mean EQ-5D-3L weight was 0.85 (SD 0.008; 95%CI 0.84-0.87). The mean EQ-5D-3L weight was significantly associated with age, housing type, disease experience and religiosity. People above 70 years of age were 7.5 times more likely to report mobility problems and 3.7 times more likely to report pain/discomfort than those aged 18-29 years. Those with a tertiary education were five times less likely to report any HRQoL problems than those without a tertiary education. A person living in a shanty was 4.3 more likely to have problems in usual activities than a person living in a single house. Conclusion The population norms in Sri Lanka vary with socio-demographic characteristics. The socioeconomically disadvantaged have a lower HRQoL. The trends of population norms observed in this lower middle income country were generally similar to those previously reported in high income countries

The understanding of digital communication experts and oral cancer at-risk persons on oral cancer, their uptake of educational mobile health applications on oral cancer, and their opinions on how a good application of such should look like:findings from a qualitative study

BACKGROUND: Existing educational mobile health applications (MHAs) on oral cancer are not very effective due to the features they possessed. To create an educational MHA on oral cancer with superior features, this study explored MHA creators (digital communication experts) and persons at risk of oral cancer (potential end-users of educational MHA on oral cancer) on their understanding of oral cancer, their uptake of educational MHAs on oral cancer, and how a good MHA on oral cancer should look like. METHODS: This qualitative study involved four online focus group discussions among seventeen digital communication experts, sexually active persons, and tobacco/alcohol users, who were recruited from five countries through volunteer sampling technique. Collected data was thematically analysed. RESULTS: Some participants had misconceptions on oral cancer. Although, majority of them opined that MHA will be useful in improving literacy on oral cancer, but none of them had ever used an educational MHA on oral cancer before. Features such as having oral health tips, ability to geospatially locate dental surgeries, streak functions, user-friendliness, basic operability, inclusivity, absence of advertisements, auto-notification functions, ability to operate offline, online, and at a high speed, ability to have a personal tracker, informative content on oral cancer in diverse formats (e.g. texts, infographics, and videos), and operability in multiple languages were identified as the most important features such MHA should have. CONCLUSION: The findings generated from this qualitative study identified educational MHA to be a useful tool for improving literacy on oral cancer. Also, the study findings have provided insightful ideas needed for the creation of a more comprehensive and inclusive mobile health application that can be used to educate diverse populations on oral cancer.</p

Quality of life of dental patients treated with laser surgery:A scoping review

Background and AimsThe use of lasers has been increasing in various surgical procedures. Its specific characteristics have conquered the scalpel used to a major extent in certain surgical procedures. This scoping review aimed to assess the empirical evidence that exists on the quality of life (QoL) of dental patients treated with laser surgery.MethodsThis scoping review was conducted in accordance with the Arksey and O'Malley's guidelines for scoping reviews. Four electronic databases (PubMed, SCOPUS, CINAHL Complete, and APA PsycInfo) were systematically searched through a stepwise approach, informed by the PEO (Population [P], Exposure [E], and Outcome [O]) framework, to retrieve literatures relevant to the review question. After a two-staged and Rayyan-aided screening process, only those literatures meeting the inclusion criteria were included into the review. From the included literatures, data were extracted, collated, summarized, and presented.ResultsThe literature search retrieved 246 articles, of which only 10 articles were selected according to the inclusion criteria. Five of the studies were from the United Kingdom and three were from Italy. Study designs were either cohort (60%) or randomized controlled trials (40%). A vast variation was observed in the study populations. The used QoL instruments were mostly disease/condition-specific and oral cancer was the most reported disease in the included articles. The patients who underwent laser surgery had better QoL on the 7th day postoperatively, although it was not significant in later days.ConclusionDepending on the indication, Laser is a safe surgical approach that could enhance the clinical outcome as well as the QoL of dental patients. Laser effects were more significant in the domain of postoperative pain. Due to the limited number of studies evaluated in this review, further longitudinal studies are needed to corroborate the findings of this review

Salivary Interleukin Levels in Oral Squamous Cell Carcinoma and Oral Epithelial Dysplasia : Findings from a Sri Lankan Study

Acknowledgments The authors would like to thank the laboratory staff at the Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Gangodawila, Nugegoda, Sri Lanka. The authors would like to thank Thilini Nisansala and Chamikara Liyanage for their help in the laboratory analysis. Funding N.S.P. was financially supported by the Elphinstone Scholarship, University of Aberdeen, UK and the University Grants Commission, Sri Lanka.Peer reviewedPublisher PD

Serious games: a game changer in cancer education

The enormous global burden of cancer has created the need to develop cutting-edge strategies for enhancing public education on cancer. Over the years, conventional educational strategies, such as the use of posters and leaflets, have been preferentially employed as public education strategies on oral cancer; however, the use of digital education-based strategies has been largely underutilized. Notably, the use of digital education-based strategies, particularly serious games, has proven to be a superior cancer education strategy, when compared to conventional strategies, due to their rigorous design and features. This commentary discusses serious games as a game changer in cancer education, itemizing their diverse roles in cancer prevention, advocacy, and management. Also, this commentary also detailed those factors that might limit the use and availability of serious games in resource-limited settings