Category: Nevin Manimala

BMC Nutr. 2024 Mar 4;10(1):42. doi: 10.1186/s40795-024-00821-5.

ABSTRACT

BACKGROUND: The aim of this study was to determine the association between dietary mineral intake and Coronavirus-disease 2019 (COVID-19) infection and its associated hospitalization.

METHODS: This cohort study utilized the MASHAD study population, which comprised individuals aged 35-65. Upon recruitment in 2007, dietary intake was documented using a validated 65-item food frequency questionnaire (FFQ). Data on COVID-19 PCR test results was collected from all relevant medical centers in Mashhad between February 2020 and June 2022. The regression model included dietary minerals and employed the backward variable selection method, along with advanced data analysis techniques.

RESULTS: The final analysis involved 1957 participants, including 193 COVID-19-positive patients. The mean age was 49.71 and 50.28 years in the COVID-19-positive and negative groups, respectively (p = 0.12). Dietary intakes of magnesium, iron, and potassium were notably lower in COVID-19-positive patients (P < 0.05). Following adjustments for age and sex, dietary iron remained significantly associated with COVID-19 incidence (OR = 0.94, 95% CI: 0.90-0.98). Furthermore, a statistically significant relationship was observed between dietary zinc and hospitalization due to COVID-19 (OR = 0.69, 95% CI: 0.51-0.93). In dynamical system models, intakes of calcium, zinc, and iron below the cut-offs of 1138, 9.7, and 8.17 mg/day, respectively, were linked to an increased risk of COVID-19 incidence.

CONCLUSION: Higher dietary iron and zinc intake are associated with decreased risk of COVID-19 infection and hospitalization, respectively.

PMID:38439106 | DOI:10.1186/s40795-024-00821-5

Cancer Imaging. 2024 Mar 4;24(1):33. doi: 10.1186/s40644-024-00677-9.

ABSTRACT

OBJECTIVES: To differentiate benign and malignant solitary pulmonary lesions (SPLs) by amide proton transfer-weighted imaging (APTWI), mono-exponential model DWI (MEM-DWI), stretched exponential model DWI (SEM-DWI), and ¹⁸F-FDG PET-derived parameters.

METHODS: A total of 120 SPLs patients underwent chest ¹⁸F-FDG PET/MRI were enrolled, including 84 in the training set (28 benign and 56 malignant) and 36 in the test set (13 benign and 23 malignant). MTRasym(3.5 ppm), ADC, DDC, α, SUV_max, MTV, and TLG were compared. The area under receiver-operator characteristic curve (AUC) was used to assess diagnostic efficacy. The Logistic regression analysis was used to identify independent predictors and establish prediction model.

RESULTS: SUV_max, MTV, TLG, α, and MTRasym(3.5 ppm) values were significantly lower and ADC, DDC values were significantly higher in benign SPLs than malignant SPLs (all P < 0.01). SUV_max, ADC, and MTRasym(3.5 ppm) were independent predictors. Within the training set, the prediction model based on these independent predictors demonstrated optimal diagnostic efficacy (AUC, 0.976; sensitivity, 94.64%; specificity, 92.86%), surpassing any single parameter with statistical significance. Similarly, within the test set, the prediction model exhibited optimal diagnostic efficacy. The calibration curves and DCA revealed that the prediction model not only had good consistency but was also able to provide a significant benefit to the related patients, both in the training and test sets.

CONCLUSION: The SUV_max, ADC, and MTRasym(3.5 ppm) were independent predictors for differentiation of benign and malignant SPLs, and the prediction model based on them had an optimal diagnostic efficacy.

PMID:38439101 | DOI:10.1186/s40644-024-00677-9

AIDS Res Ther. 2024 Mar 4;21(1):13. doi: 10.1186/s12981-024-00598-4.

ABSTRACT

BACKGROUND: Cardiovascular disease (CVD) remains a leading cause of death in people living with HIV. Myocardial fibrosis is well-described in HIV infection acquired in adulthood. We evaluate the burden of fibrosis by cardiac magnetic resonance in people with perinatal HIV infection.

METHODS: Individuals with perinatally acquired HIV (pnHIV) diagnosed before 10 years-old and on antiretroviral treatment for ≥ 6 months were matched with uninfected controls. Patients with significant cardiometabolic co-morbidities and pregnancy were excluded. Diffuse fibrosis was assessed by cardiac magnetic resonance (CMR) with native T1 mapping for calculation of extracellular volume fraction (ECV). Viability was assessed with late gadolinium enhancement. The normality of fibrosis was assessed using the Komogrov-Smirnov test. Fibrosis between the groups was analyzed using a Mann-Whitney U test, as the data was not normally distributed. Statistical significance was defined as a p-valve < 0.05.

RESULTS: Fourteen adults with pnHIV group and 26 controls (71% female and 86% Black race) were assessed. The average (± standard deviation) age in the study group was 29 (± 4.3) years-old. All pnHIV had been on ART for decades. Demographic data, CMR functional/volumetric data, and pre-contrast T1 mapping values were similar between groups. Diastolic function was normal in 50% of pnHIV patients and indeterminate in most of the remainder (42%). There was no statistically significant difference in ECV between groups; p = 0.24.

CONCLUSION: Perinatally-acquired HIV was not associated with diffuse myocardial fibrosis. Larger prospective studies with serial examinations are needed to determine whether pnHIV patients develop abnormal structure or function more often than unaffected controls.

PMID:38439093 | DOI:10.1186/s12981-024-00598-4

Hum Resour Health. 2024 Mar 4;22(1):19. doi: 10.1186/s12960-024-00902-3.

ABSTRACT

BACKGROUND: The ophthalmology workforce is an integral component of any health care system. However, the demand for eye care has imposed a heavy burden on this system. Hence, this study aimed to estimate the trends, demographic characteristics, distribution, and variation between Saudi and non-Saudi ophthalmologists and the future challenges of the ophthalmology workforce in the Kingdom of Saudi Arabia (KSA).

METHODS: This study was conducted in the KSA and included ophthalmologists practicing from 2010 to 2023. From the Saudi Commission for Health Specialties, we obtained the number, gender, nationality, and rank of ophthalmologists. The geographic distribution of ophthalmologists in the KSA was obtained from the Ministry of Health Statistical Yearbook 2021.

RESULTS: As of January 2023, the KSA had a total of 2608 registered ophthalmologists, with approximately 81.06 ophthalmologists per 1,000,000 people. Only 38% of all ophthalmologists in the country were Saudis. The percentage of Saudi female graduates increased from 13.3% to 37.2% over 12 years [Sen’s estimator of slope for median increase per year = 1.33 (95% CI 1.22-1.57) graduates; trend test P < 0.001). Additionally, we found that the geographic distribution of ophthalmologists varied (test for homogeneity of rates, P < 0.0001), with the larger regions having a higher concentration of ophthalmologists than the smaller regions (75.6 in Riyadh versus 42.8 in Jazan per 1,000,000 people). However, the World Health Organization’s target for the ophthalmologist-to-population ratio has been achieved in all 13 health regions of KSA.

CONCLUSION: The recommended ophthalmologist-to-population ratio has been achieved in the KSA, and the number of Saudi ophthalmologists has almost doubled over the past 8 years. However, the majority of ophthalmologists are still non-Saudi, as Saudi ophthalmologists constitute approximately one-third of the ophthalmology workforce in the KSA. The geographical distribution of ophthalmologists varies, which might affect access to care in peripheral regions. In response to the growing demand for eye care in the KSA, several more effective measures might need to be considered.

PMID:38439073 | DOI:10.1186/s12960-024-00902-3

BMC Sports Sci Med Rehabil. 2024 Mar 4;16(1):61. doi: 10.1186/s13102-024-00855-z.

ABSTRACT

BACKGROUND: In sports sciences, normative data serve as standards for specific physical performance attributes, enhancing talent identification within a specific population. The aim of this study was to provide standard data for Agility-15 m, Ball-15 m tests, and skill index, considering maturation level, specifically age at peak height velocity (PHV). The study also investigated the relationship between relative performances in these tests and anthropometrics, jumping (squat jump [SJ], countermovement jump [CMJ]), and sprinting abilities (S-5 m, S-10 m, S-20 m, S-30 m) in young soccer players.

METHODS: The study involved 647 soccer players aged 11-18 years, categorized into three groups: pre-PHV, circum-PHV, and post-PHV. Statistical analysis was conducted using analysis of variance and Bonferroni post hoc testing to detect variations among maturation groups, and Pearson’s correlation test to examine the relationship between factors.

RESULTS: Agility-15 m and ball-15 m performances among maturity groups showed significant differences (p < 0.01). Significant correlations were identified in pre-PHV group, between lower limb length and Agility-15 m (r=-0.23, p < 0.05) and between height and Ball-15 m (r=-0.23, p < 0.05). In post-PHV group, there was a correlation between body fat percentage (BF %) and Agility-15 m (r = 0.17, p < 0.05) and Ball-15 m (r = 0.21, p < 0.05). In all maturity groups, there were significant correlations between agility and sprint tests (S-5 m, S-10 m, S-20 m, and S-30 m) and muscle power (SJ and CMJ).

CONCLUSION: The study revealed that both speed and lower limb power significantly influence agility in young soccer players, providing valuable insights for coaches and practitioners to create tailored training plans and interventions for different age groups and maturity levels.

PMID:38439052 | DOI:10.1186/s13102-024-00855-z

BMC Infect Dis. 2024 Mar 4;24(1):281. doi: 10.1186/s12879-024-09146-x.

ABSTRACT

BACKGROUND: The evolution of SARS-CoV-2 has been observed from the very beginning of the fight against COVID-19, some mutations are indicators of potentially dangerous variants of the virus. However, there is no clear association between the genetic variants of SARS-CoV-2 and the severity of COVID-19. We aimed to analyze the genetic variability of RdRp in correlation with different courses of COVID-19.

RESULTS: The prospective study included 77 samples of SARS-CoV-2 isolated from outpatients (1st degree of severity) and hospitalized patients (2nd, 3rd and 4th degree of severity). The retrospective analyses included 15,898,266 cases of SARS-CoV-2 genome sequences deposited in the GISAID repository. Single-nucleotide variants were identified based on the four sequenced amplified fragments of SARS-CoV-2. The analysis of the results was performed using appropriate statistical methods, with p < 0.05, considered statistically significant. Additionally, logistic regression analysis was performed to predict the strongest determinants of the observed relationships. The number of mutations was positively correlated with the severity of the COVID-19, and older male patients. We detected four mutations that significantly increased the risk of hospitalization of COVID-19 patients (14676C > T, 14697C > T, 15096 T > C, and 15279C > T), while the 15240C > T mutation was common among strains isolated from outpatients. The selected mutations were searched worldwide in the GISAID database, their presence was correlated with the severity of COVID-19.

CONCLUSION: Identified mutations have the potential to be used to assess the increased risk of hospitalization in COVID-19 positive patients. Experimental studies and extensive epidemiological data are needed to investigate the association between individual mutations and the severity of COVID-19.

PMID:38439047 | DOI:10.1186/s12879-024-09146-x

Scand J Trauma Resusc Emerg Med. 2024 Mar 4;32(1):16. doi: 10.1186/s13049-024-01190-5.

ABSTRACT

BACKGROUND: Procedural sedation and analgesia are commonly used in the Emergency Departments. Despite this common need, there is still a lack of options for adequate and safe analgesia and sedation in children. The objective of this study was to evaluate whether intranasal dexmedetomidine could provide more effective analgesia and sedation during a procedure than intranasal esketamine.

METHODS: This was a double-blind equally randomized (1:1) superiority trial of 30 children aged 1-3 years presenting to the Emergency Department with a laceration or a burn and requiring procedural sedation and analgesia. Patients were randomized to receive 2.0 mcg/kg intranasal dexmedetomidine or 1.0 mg/kg intranasal esketamine. The primary outcome measure was highest pain (assessed using Face, Legs, Activity, Cry, Consolability scale (FLACC)) during the procedure. Secondary outcomes were sedation depth, parents’ satisfaction, and physician’s assessment. Comparisons were done using Mann-Whitney U test (continuous variables) and Fisher’s test (categorical variables).

RESULTS: Adequate analgesia and sedation were reached in 28/30 patients. The estimated sample size was not reached due to changes in treatment of minor injuries and logistical reasons. The median (IQR) of highest FLACC was 1 (0-3) with intranasal dexmedetomidine and 5 (2-6.75) with intranasal esketamine, (p-value 0.09). 85.7% of the parents with children treated with intranasal dexmedetomidine were “very satisfied” with the procedure and sedation compared to the 46.2% of those with intranasal esketamine, (p-value 0.1). No severe adverse events were reported during this trial.

CONCLUSIONS: This study was underpowered and did not show any difference between intranasal dexmedetomidine and intranasal esketamine for procedural sedation and analgesia in young children. However, the results support that intranasal dexmedetomidine could provide effective analgesia and sedation during procedures in young children aged 1-3 years with minor injuries.

TRIAL REGISTRATION: Eudra-CT 2017-00057-40, April 20, 2017. https://eudract.ema.europa.eu/.

PMID:38439043 | DOI:10.1186/s13049-024-01190-5

BMC Res Notes. 2024 Mar 4;17(1):64. doi: 10.1186/s13104-024-06721-y.

ABSTRACT

BACKGROUND: The interplay between vitamin D status and inflammatory cytokines in a supposedly sufficient sunshine environment has not well been evaluated. The study sought to determine their association.

METHODS: This cross-sectional study involved 500 healthy adult blood donors from some selected hospitals in Ghana enrolled from June to November 2016. Venous blood samples were obtained from participants, 25(OH)D, TNF-alpha, IFN-gamma, and IL 10 were measured using enzyme linked immunosorbent assay (ELISA) technique. Serum levels of 25(OH)D < 20ng/ml were classified as being deficient or low.

RESULTS: The average age of the participants was 27.97 years. No statistically significant association was established between 25(OH) D status, mean age (p = 0.1693), and gender (p = 0.5461) of study participants. Similarly, the median 25(OH) D (p = 0.8392), IL-10 (p = 0.5355), TNF-alpha (p = 0.9740), and IFN-gamma (p = 0.6908) were not significantly different across gender. There was a significantly increased levels of TNF-alpha (p < 0.0001) and IFN-gamma (p < 0.0001) among participants with 25(OH) D deficiency compared to those without deficiency. Concurrently, participants with 25(OH)D deficiency had a significantly reduced levels of IL-10 (p < 0.0001) compared to those without 25 (OH) D deficiency. The most accurate biochemical markers for identifying 25 (OH) D deficiency were IFN-gamma (AUC = 0.879; p < 0.0001) followed by TNF-gamma (AUC = 0.849; p < 0.0001) and IL-10 (AUC = 0.707; p < 0.0001).

CONCLUSION: There was a significant association between vitamin D levels and pro-inflammatory cytokines (TNF-alpha, IFN-gamma) and anti-inflammatory cytokine (IL 10) among healthy Ghanaian populace.

PMID:38439034 | DOI:10.1186/s13104-024-06721-y

Trials. 2024 Mar 4;25(1):164. doi: 10.1186/s13063-024-08014-y.

ABSTRACT

BACKGROUND: Mortality, cerebral injury, and necrotizing enterocolitis (NEC) are common complications of very preterm birth. An important risk factor for these complications is hemodynamic instability. Pre-clinical studies suggest that the timing of umbilical cord clamping affects hemodynamic stability during transition. Standard care is time-based cord clamping (TBCC), with clamping irrespective of lung aeration. It is unknown whether delaying cord clamping until lung aeration and ventilation have been established (physiological-based cord clamping, PBCC) is more beneficial. This document describes the statistical analyses for the ABC3 trial, which aims to assess the efficacy and safety of PBCC, compared to TBCC.

METHODS: The ABC3 trial is a multicenter, randomized trial investigating PBCC (intervention) versus TBCC (control) in very preterm infants. The trial is ethically approved. Preterm infants born before 30 weeks of gestation are randomized after parental informed consent. The primary outcome is intact survival, defined as the composite of survival without major cerebral injury and/or NEC. Secondary short-term outcomes are co-morbidities and adverse events assessed during NICU admission, parental reported outcomes, and long-term neurodevelopmental outcomes assessed at a corrected age of 2 years. To test the hypothesis that PBCC increases intact survival, a logistic regression model will be estimated using generalized estimating equations (accounting for correlation between siblings and observations in the same center) with treatment and gestational age as predictors. This plan is written and submitted without knowledge of the data.

DISCUSSION: The findings of this trial will provide evidence for future clinical guidelines on optimal cord clamping management at birth.

TRIAL REGISTRATION: ClinicalTrials.gov NCT03808051. Registered on 17 January 2019.

PMID:38439024 | DOI:10.1186/s13063-024-08014-y

BMC Public Health. 2024 Mar 4;24(1):696. doi: 10.1186/s12889-024-18191-9.

ABSTRACT

BACKGROUND: Multimorbidity is becoming an increasingly serious public health challenge in the aging population. The impact of nutrients on multimorbidity remains to be determined and was explored using data from a UK cohort study.

METHOD: Our research analysis is mainly based on the data collected by the United Kingdom Women’s Cohort Study (UKWCS), which recruited 35,372 women aged 35-69 years at baseline (1995 to 1998), aiming to explore potential associations between diet and chronic diseases. Daily intakes of energy and nutrients were estimated using a validated 217-item food frequency questionnaire at recruitment. Multimorbidity was assessed using the Charlson comorbidity index (CCI) through electronic linkages to Hospital Episode Statistics up to March 2019. Cox’s proportional hazards models were used to estimate associations between daily intakes of nutrients and risk of multimorbidity. Those associations were also analyzed in multinomial logistic regression as a sensitivity analysis. In addition, a stratified analysis was conducted with age 60 as the cutoff point.

RESULTS: Among the 25,389 participants, 7,799 subjects (30.7%) were confirmed with multimorbidity over a median follow-up of 22 years. Compared with the lowest quintile, the highest quintile of daily intakes of energy and protein were associated with 8% and 12% increased risk of multimorbidity respectively (HR 1.08 (95% CI 1.01, 1.16), p-linearity = 0.022 for energy; 1.12 (1.04, 1.21), p-linearity = 0.003 for protein). Higher quintiles of daily intakes of vitamin C and iron had a slightly lowered risk of multimorbidity, compared to the lowest quintile. A significantly higher risk of multimorbidity was found to be linearly associated with higher intake quintiles of vitamin B12 and vitamin D (p-linearity = 0.001 and 0.002, respectively) in Cox models, which became insignificant in multinomial logistic regression. There was some evidence of effect modification by age in intakes of iron and vitamin B1 associated with the risk of multimorbidity (p-interaction = 0.006 and 0.025, respectively).

CONCLUSIONS: Our findings highlight a link between nutrient intake and multimorbidity risk. However, there is uncertainty in our results, and more research is needed before definite conclusions can be reached.

PMID:38439008 | DOI:10.1186/s12889-024-18191-9