Category: Nevin Manimala

Arq Bras Cardiol. 2023 Sep;120(9):e20220835. doi: 10.36660/abc.20220835.

ABSTRACT

BACKGROUND: The long-term effects of mild COVID-19 on physical, cognitive, and mental health are not yet well understood.

OBJECTIVE: The purpose of this paper is to describe the protocol for the ongoing “Post-COVID Brazil” study 2, which aims to evaluate the factors associated with health-related quality of life and long-term cardiovascular and non-cardiovascular outcomes one year after a mild episode of symptomatic COVID-19.

METHODS: The “Post-COVID Brazil” study 2 is a prospective multicenter study that plans to enroll 1047 patients (NCT05197647). Centralized, structured telephone interviews are conducted at 1, 3, 6, 9, and 12 months after COVID-19 diagnosis. The primary outcome is the health-related quality-of-life utility score, assessed using the EuroQol-5D-3L (EQ-5D-3L) questionnaire at 12 months. Secondary endpoints include the EQ-5D-3L at 3, 6, and 9 months, as well as all-cause mortality, major cardiovascular events, hospitalization, return to work or education, persistent symptoms, new disabilities in instrumental activities of daily living, cognitive impairment, anxiety, depression, and post-traumatic stress symptoms at 3, 6, 9, and 12 months after SARS-CoV-2 infection. A p-value < 0.05 will be considered statistically significant for all analyses.

RESULTS: The primary endpoint will be presented as the overall frequency of the EQ-5D-3L domains 12 months after SARS-CoV-2 infection. Main analysis will explore the association of independent variables with the study outcomes.

CONCLUSION: The “Post-COVID Brazil” study 2 aims to clarify the impact of long COVID on the quality of life and cardiovascular and non-cardiovascular outcomes of Brazilian patients who have had mild COVID-19.

PMID:37851732 | DOI:10.36660/abc.20220835

Cad Saude Publica. 2023 Oct 13;39(10):e00083123. doi: 10.1590/0102-311XES083123. eCollection 2023.

ABSTRACT

A psychiatric reform is underway in Latin America and the Caribbean. Specifically in Argentina, a model of community mental health is being built, and prolonged psychiatric hospitalizations are still taking place, especially in neuropsychiatric hospitals. Therefore, it is necessary to closely monitor the psychiatric reform. One of the possible ways to monitor the reform is by analyzing society’s attitudes towards prolonged psychiatric hospitalization as a mean of mental health treatment. Thus, an analytical observational study was conducted at the Buenos Aires Province, Argentina, in 2021, to analyze the behavior of neighbors of people who had prolonged psychiatric hospitalizations and who received housing support. Questionnaires were applied to neighbors and non-neighbors, addressing the behaviors toward prolonged psychiatric hospitalization as a mean of treatment, social distance toward people who were hospitalized, as well as specific interviews with key informants from neighborhoods where people with severe mental health disorders and who receive housing support live. Based on the answers of neighbors and non-neighbors, no statistically significant differences were identified in behaviors toward prolonged psychiatric hospitalization as a mean of treatment, nor for social distance in relation to people who were hospitalized. Key informants conditioned their assessment of prolonged hospitalization and valued the role of support teams in making community life viable.

PMID:37851727 | DOI:10.1590/0102-311XES083123

Arq Bras Cardiol. 2023 Oct;120(10):e20230082. doi: 10.36660/abc.20230082.

ABSTRACT

BACKGROUND: Pericardial window, in addition to promoting pericardial drainage, can also provide samples of the pericardium for anatomopathological examination. However, such biopsies’ contribution to clarifying the etiology of pericardial effusion has been debated.

OBJECTIVE: To analyze the diagnostic value of non-targeted pericardial biopsy obtained from pericardial window procedures.

METHODS: Data from 80 patients who had undergone parietal pericardial biopsies from 2011 to 2020 were retrospectively reviewed. Statistical significance was considered if p < 0.05.

RESULTS: Fifty patients were male (62.5%,) and 30 were female (37.5%). The median age was 52 years (interquartile range: 29 to 59) and 49 years (interquartile range: 38 to 65), respectively (p = 0.724). The suspected etiology of pericardial effusion was neoplastic in 31.3%, unclear in 25%, tuberculosis in 15%, autoimmune in 12.5%, edemagenic syndrome in 7.5%, and other miscellaneous conditions in 8.8%. The most frequent approach for pericardial drainage and biopsy was subxiphoid (74%), followed by video-assisted thoracoscopy (22%). Overall, in 78.8% of the biopsies, the histopathologic findings were compatible with nonspecific inflammation, and only 13.7% of all biopsies yielded a conclusive histopathological diagnostic. Those suffering from cancer and pericardial effusion had a higher proportion of conclusive histopathologic findings (32% had pericardial neoplastic infiltration). The hospital mortality rate was 27.5%, and 54.5% of the patients who died in the hospital had cancer. No deaths were attributed to cardiac tamponade or the drainage procedure.

CONCLUSION: Our results showed that pericardial window is a safe procedure, but it had little value to clarify the pericardial effusion etiology and no impact on the planned therapy for the primary diagnosis besides the cardiac decompression.

PMID:37851724 | DOI:10.36660/abc.20230082

Cad Saude Publica. 2023 Oct 13;39(9):e00076823. doi: 10.1590/0102-311XEN076823. eCollection 2023.

ABSTRACT

This study aimed to investigate differences in determinants of active aging between older Brazilian and English adults and to verify the association of behavioral, personal, and social determinants with physical health. This cross-sectional study was based on the ELSI-Brazil (2015-2016) and ELSA (2016-2017) cohorts. Active aging determinants included behavior (smoking, sedentary lifestyle, and poor sleep quality), personal (cognitive function and life satisfaction), and social determinants (education, loneliness, and volunteering), according to the World Health Organization. Physical health included activities limitation and multimorbidity. We estimated age- and sex-adjusted prevalence for each indicator and mean score, and used the negative binomial regression for statistical analysis. We included 16,642 participants, 9,409 from Brazil and 7,233 from England. Overall, all active aging determinants were worse in Brazil than in England, except for life satisfaction (no difference). The most remarkable difference was found for social determinants score in Brazil (mean difference of 0.18; p < 0.05), mainly due to a significantly lower education level in Brazil (70.6%; 95% confidence interval – 95%CI: 69.7-71.5) than England (37.1%; 95%CI: 35.1-39.1). All determinants (behavioral, personal, and social) were associated with health in Brazil and in England. However, the behavioral domain was stronger associated with health in England (coefficient = 2.76; 95%CI: 2.46-3.10) than in Brazil (coefficient = 1.38; 95%CI: 1.26-1.50; p < 0.001). Older English adults beneficiate more from healthier behaviors than Brazilians, which depend more on social policies.

PMID:37851723 | DOI:10.1590/0102-311XEN076823

Codas. 2023 Oct 13;35(5):e20220049. doi: 10.1590/2317-1782/20232022049pt. eCollection 2023.

ABSTRACT

PURPOSE: To verify the association between breathing nasal expiratory flow and posture of lips and tongue at rest, presence of repeated forward movements of the tongue and maternal complaint of respiratory difficulty in the newborn in the first days of life.

METHOD: A observational study was carried out in 130 babies, in a university hospital. Included newborn with Apgar score greater than or equal to 8 in exclusive breast milk. It was the following data: position of lips and tongue at rest, nasal expiratory flow and maternal complaint of difficulty in breathing in the newborn. The data were subjected to statistical analysis using the tests, Fisher’s exact test and the Chi-Square test, adopting a significance level of 5% .

RESULTS: there was a significant association between maternal complaint of newborn difficulty breathing with repeated forward tongue movements and nasal expiratory flow; tongue position with resting lips position at rest, repeated tongue forward movements with nasal expiratory flow and tongue position at rest; nasal expiratory flow exit with tongue position at rest.

CONCLUSION: Symmetrical nasal expiratory flow is associated with an elevated tongue position and closed lips at rest; on the other hand, increased and/or absent nasal expiatory flow in one nostril is associated with maternal complaints of difficulty in breathing, open/ half-open lips position and low tongue position during rest, as well as, repeated forward tongue movements.

PMID:37851717 | DOI:10.1590/2317-1782/20232022049pt

PLoS Comput Biol. 2023 Oct 18;19(10):e1011530. doi: 10.1371/journal.pcbi.1011530. eCollection 2023 Oct.

ABSTRACT

We introduce Catalyst.jl, a flexible and feature-filled Julia library for modeling and high-performance simulation of chemical reaction networks (CRNs). Catalyst supports simulating stochastic chemical kinetics (jump process), chemical Langevin equation (stochastic differential equation), and reaction rate equation (ordinary differential equation) representations for CRNs. Through comprehensive benchmarks, we demonstrate that Catalyst simulation runtimes are often one to two orders of magnitude faster than other popular tools. More broadly, Catalyst acts as both a domain-specific language and an intermediate representation for symbolically encoding CRN models as Julia-native objects. This enables a pipeline of symbolically specifying, analyzing, and modifying CRNs; converting Catalyst models to symbolic representations of concrete mathematical models; and generating compiled code for numerical solvers. Leveraging ModelingToolkit.jl and Symbolics.jl, Catalyst models can be analyzed, simplified, and compiled into optimized representations for use in numerical solvers. Finally, we demonstrate Catalyst’s broad extensibility and composability by highlighting how it can compose with a variety of Julia libraries, and how existing open-source biological modeling projects have extended its intermediate representation.

PMID:37851697 | DOI:10.1371/journal.pcbi.1011530

PLoS One. 2023 Oct 18;18(10):e0287367. doi: 10.1371/journal.pone.0287367. eCollection 2023.

ABSTRACT

Social media has been tremendously used worldwide for a variety of purposes. Therefore, engagement activities such as comments have attracted many scholars due its ability to reveal many critical findings, such as the role of users’ sentiment. However, there is a lacuna on how to detect crisis based on users’ sentiment through comments, and for such, we explore framing theory in the study herein to determine users’ sentiment in predicting crisis. Generic content framing theory consists of conflict, economic, human interest, morality, and responsibility attributes frame as independent variables whilst sentiment as dependent variables. Comments from selected Facebook posting case studies were extracted and analysed using sentiment analysis via Application Programme Interface (API) webtool. The comments were then further analysed using content analysis via Positive and Negative Affect Schedule (PANAS) scale and statistically evaluated using SEM-PLS. Model shows that 44.8% of emotion and reactions towards sensitive issue posting are influenced by independent variables. Only economic consequences and responsibility attributes frame had correlation towards emotion and reaction at p<0.05. News reporting on direction towards economic and responsibility attributes sparks negative sentiment, which proves that it can best be described as pre-crisis detection to assist the Royal Malaysian Police and other relevant stakeholders to prevent criminal activities in their respective social media.

PMID:37851696 | DOI:10.1371/journal.pone.0287367

PLoS One. 2023 Oct 18;18(10):e0292952. doi: 10.1371/journal.pone.0292952. eCollection 2023.

ABSTRACT

This study aimed to improve our understanding of how the hypothalamus mediates the effects of prenatal and postnatal challenges on behavior and sensitivity to stimuli. A pig model of virally initiated maternal immune activation (MIA) was used to investigate potential interactions of the prenatal challenge both with sex and with postnatal nursing withdrawal. The hypothalami of 72 females and males were profiled for the effects of MIA and nursing withdrawal using RNA-sequencing. Significant differential expression (FDR-adjusted p value < 0.05) was detected in the profile of 222 genes. Genes involved in the Gene Ontology biological process of regulation of hormone levels tended to be over-expressed in individuals exposed to both challenges relative to individuals exposed to either one challenge, and most of these genes were over-expressed in MIA females relative to males across nursing levels. Differentially expressed genes included Fshb, Ttr, Agrp, Gata3, Foxa2, Tfap2b, Gh1, En2, Cga, Msx1, and Npy. The study also found that prenatal and postnatal challenges, as well as sex, impacted the regulation of neurotransmitter activity and immune effector processes in the hypothalamus. In particular, the olfactory transduction pathway genes were over-expressed in weaned MIA males, and several transcription factors were potentially found to target the differentially expressed genes. Overall, these results highlight how multiple environmental challenges can interact and affect the molecular mechanisms of the hypothalamus, including hormonal, immune response, and neurotransmitter processes.

PMID:37851674 | DOI:10.1371/journal.pone.0292952

J Womens Health (Larchmt). 2023 Oct 17. doi: 10.1089/jwh.2023.0300. Online ahead of print.

ABSTRACT

Background: Endometriosis is a common chronic disorder, which leads to dysmenorrhea, dyspareunia, pelvic chronic pain, and infertility. It affects ∼6% to 10% of the general female population. However, the etiology of endometriosis remained unclear. We aimed to systematically assess the association between pelvic inflammatory disease (PID) and the risk of endometriosis. Materials and Methods: Eligible studies published until May 21, 2022, were retrieved from the PubMed, EMBASE, and Web of Science databases. The studies were included based on the following criteria: (1) original articles on the association between PID and risk of endometriosis; (2) randomized controlled trials and cross-sectional, case-control, and cohort studies; and (3) studies involving humans. The Newcastle-Ottawa Quality Assessment Scale was used to assess the quality of the studies included in this systematic review. The association between PID and risk of endometriosis was evaluated using the overall odds ratio (OR) and correlative 95% confidence interval (CI). Results: The meta-analysis included 14 studies with 747,733 patients. The mean prevalence of PID in women with endometriosis was 33.80%. Our quantitative synthesis revealed that endometritis was associated with a significantly increased risk of endometriosis (OR: 1.63, 95% CI: 1.53-1.74, I² = 59%). Conclusion: We study a statistically significant association between PID and the risk of endometriosis. In particular, endometritis might play an important role in endometriosis, based on the lower heterogeneity of the subgroup analysis. This finding suggests that reducing the incidence of endometritis might aid in the prevention and treatment of endometriosis.

PMID:37851499 | DOI:10.1089/jwh.2023.0300

J Med Internet Res. 2023 Oct 18;25:e49385. doi: 10.2196/49385.

ABSTRACT

BACKGROUND: ChatGPT is a powerful pretrained large language model. It has both demonstrated potential and raised concerns related to knowledge translation and knowledge transfer. To apply and improve knowledge transfer in the real world, it is essential to assess the perceptions and acceptance of the users of ChatGPT-assisted training.

OBJECTIVE: We aimed to investigate the perceptions of health care trainees and professionals on ChatGPT-assisted training, using biomedical informatics as an example.

METHODS: We used purposeful sampling to include all health care undergraduate trainees and graduate professionals (n=195) from January to May 2023 in the School of Public Health at the National Defense Medical Center in Taiwan. Subjects were asked to watch a 2-minute video introducing 5 scenarios about ChatGPT-assisted training in biomedical informatics and then answer a self-designed online (web- and mobile-based) questionnaire according to the Kirkpatrick model. The survey responses were used to develop 4 constructs: “perceived knowledge acquisition,” “perceived training motivation,” “perceived training satisfaction,” and “perceived training effectiveness.” The study used structural equation modeling (SEM) to evaluate and test the structural model and hypotheses.

RESULTS: The online questionnaire response rate was 152 of 195 (78%); 88 of 152 participants (58%) were undergraduate trainees and 90 of 152 participants (59%) were women. The ages ranged from 18 to 53 years (mean 23.3, SD 6.0 years). There was no statistical difference in perceptions of training evaluation between men and women. Most participants were enthusiastic about the ChatGPT-assisted training, while the graduate professionals were more enthusiastic than undergraduate trainees. Nevertheless, some concerns were raised about potential cheating on training assessment. The average scores for knowledge acquisition, training motivation, training satisfaction, and training effectiveness were 3.84 (SD 0.80), 3.76 (SD 0.93), 3.75 (SD 0.87), and 3.72 (SD 0.91), respectively (Likert scale 1-5: strongly disagree to strongly agree). Knowledge acquisition had the highest score and training effectiveness the lowest. In the SEM results, training effectiveness was influenced predominantly by knowledge acquisition and partially met the hypotheses in the research framework. Knowledge acquisition had a direct effect on training effectiveness, training satisfaction, and training motivation, with β coefficients of .80, .87, and .97, respectively (all P<.001).

CONCLUSIONS: Most health care trainees and professionals perceived ChatGPT-assisted training as an aid in knowledge transfer. However, to improve training effectiveness, it should be combined with empirical experts for proper guidance and dual interaction. In a future study, we recommend using a larger sample size for evaluation of internet-connected large language models in medical knowledge transfer.

PMID:37851495 | DOI:10.2196/49385