Category: Nevin Manimala

Int Health. 2023 Jun 2:ihad038. doi: 10.1093/inthealth/ihad038. Online ahead of print.

ABSTRACT

BACKGROUND: Vitamin A deficiency (VAD) during pregnancy is a public health challenge in low-income countries. There are inconsistent findings that can affect policy in planning appropriate intervention. This systematic review and meta-analysis were conducted to summarize the evidence in order to identify existing gaps and propose strategies to reduce VAD during pregnancy in Ethiopia.

METHODS: This study included published and unpublished observational studies searched from different databases (PubMed, CINHAL [EBSCO], Embase, Google Scholar, Directory of Open Access Journals, Web of Sciences, MEDLINE, Cochrane Library, Scopus, Google Search and MedNar). Statistical analysis was conducted using Stata version 14 software. Heterogeneity and publication bias were assessed. Forest plots were used to present the pooled prevalence using the random effects model.

RESULTS: A total of 37 618 pregnant women from 15 studies were included. The overall pooled prevalence of VAD was 29% (95% confidence interval 21 to 36) with I2=99.67% and p<0.001. Socio-economic and sociodemographic factors were identified as affecting vitamin A deficiencies among pregnant women.

CONCLUSIONS: Nearly one-third of pregnant women in Ethiopia had VAD. Strengthening intervention modalities that aimed to increase the uptake of vitamin A-rich foods can avert VAD among pregnant women in Ethiopia.

PMID:37264928 | DOI:10.1093/inthealth/ihad038

Scand J Public Health. 2023 Jun 2:14034948231176708. doi: 10.1177/14034948231176708. Online ahead of print.

ABSTRACT

AIMS: Detrimental effects on health and well-being were reported during the COVID-19-induced lockdown periods in several countries, but these associations have not been studied in small-scale island societies. This study aimed to examine the lockdown period’s impact on general well-being, perceived stress and activity levels in the Faroe Islands.

METHODS: We used cross-sectional data from two extensive population-based surveys of the general health conducted in November 2019 (the pre-COVID survey; n=2906), and four to six weeks into the first national lockdown (the lockdown survey; n=1204).

RESULTS: A larger proportion of participants in the lockdown survey versus pre-COVID survey displayed excellent/very good self-rated health (68.1% vs. 62.0%; p<0.001), and the same pattern was observed for reporting good quality of life (85.7% vs. 82.7%; p<0.05). These associations remained statistically significant in a logistic regression model after adjusting for characteristics for which varying impact of the pandemic has been shown. Indicators of health behaviour showed that larger proportions of participants kept active during the lockdown survey versus pre-COVID survey, and these differences were statistically significant for physical, mental and spiritual activities (p<0.001). On the other hand, similar stress levels in the pre-COVID/lockdown periods were observed, but stratified analysis showed that participants with a high-stress level displayed better self-rated health in the lockdown period compared to the pre-COVID period (p=0.001).

CONCLUSIONS: Findings indicate that self-reported health and quality of life improved during the early phase of the COVID lockdown, and individuals reported higher activity levels associated with good mental health during the COVID-19-induced lockdown period.

PMID:37264919 | DOI:10.1177/14034948231176708

Stroke. 2023 Jun 2. doi: 10.1161/STROKEAHA.122.041260. Online ahead of print.

ABSTRACT

BACKGROUND: Several methods for conducting power analysis of studies with outcomes across the full ordinal modified Rankin Scale are proposed in the literature. No systematic comparison of accuracy, agreement, and sensitivity to small changes in hypothesized effect sizes for these methods is available. Our aim is to conduct such a systematic comparative analysis and to introduce a comprehensive freely available online tool to facilitate appropriate power analyses for ordinal outcomes.

METHODS: We performed simulation studies utilizing the control arm modified Rankin Scale distributions from the AVERT (A Very Early Rehabilitation Trial), EXTEND (Extending the Time for Thrombolysis in Emergency Neurological Deficits), and HERMES (Highly Effective Reperfusion Evaluated in Multiple Endovascular Stroke Trials) studies, as well as a uniform distribution, in combination with hypothetical treatment effects. We systematically evaluated published power formulas for Ordinal Logistic Regression and Tournament Methods (generalized odds ratio; Win Probability; Win Ratio; and Wilcoxon-Mann-Whitney U test). We also developed an online and downloadable Shiny R app facilitating sample size calculation for, and ordinal analysis of, modified Rankin Scale data.

RESULTS: Power formulas for Tournament Methods performed well, while the formula for ordinal logistic regression was inaccurate. Tang’s Wilcoxon-Mann-Whitney U test sample size formula exhibited the highest accuracy. All methods, including ordinal logistic regression, had almost identical empirical power for a given sample size. All power methods exhibited sensitivity to small changes in hypothesized effect size. The developed freely available online app supports analytical and visualization requirements for all investigated methods for power and statistical analyses of ordinal modified Rankin Scale outcomes.

CONCLUSIONS: As Tournament Method sample size formulas are assumption-free and accurately calculate power, stroke researchers should use these methods when designing studies with outcomes measured on the full or partially collapsed modified Rankin Scale as well as other ordinal scales, even if they intend to use ordinal logistic regression for analysis. Conducting sensitivity analyses of the effect size assumptions are essential for appropriate sample size estimation. Our developed tool supports both of these recommendations (https://www.thembc.com.au/tournamentmethods).

PMID:37264911 | DOI:10.1161/STROKEAHA.122.041260

Int J Artif Organs. 2023 Jun 2:3913988231178041. doi: 10.1177/03913988231178041. Online ahead of print.

ABSTRACT

BACKGROUND: The purpose of this study was to analyze the anti-adherent activity of nano-coatings deposited by Thermionic Vacuum Arc plasma on C. albicans ATCC 10231 biofilm.

MATERIALS AND METHODS: A total of 80 disc-shaped (2 × 10 mm) polymethymethacrylate samples were prepared and divided into four groups with 10 samples in each group (Control, ZnO, SnO₂, Ag) (n = 10). Using thermionic vacuum arc plasma, they were coated with ZnO, SnO₂, and Ag. 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and Crystal Viole (CV) assays were conducted for biofilm quantification. Scanning electron microscopy (SEM) was used to observe biofilm images of C. albicans biofilm.

RESULTS: MTT and CV mean values differ statistically significantly between all groups (p ⩽ 0.05). The SnO₂ group had the lowest mean value, whereas the control group received the highest value.

CONCLUSION: SnO₂ coating shown greater anti-adherent activity than either metal oxides. C. albicans biofilm formation on denture base surfaces is reduced following Thermionic Vacuum Arc plasma coating with SnO₂.

PMID:37264904 | DOI:10.1177/03913988231178041

Cephalalgia. 2023 Jun;43(6):3331024231180562. doi: 10.1177/03331024231180562.

ABSTRACT

BACKGROUND: Calcitonin gene-related peptide monoclonal antibodies (CGRP mAb) are an effective treatment of migraine however may have possible off-target effects. Pre-clinical studies implicate CGRP in several aspects of bone turnover and homeostasis. The clinical effect of CGRP mAb on bone turnover is not known, however.

METHODS: Between June 2021 and July 2022, a multi-centre prospective cohort study was undertaken with eligible patients undergoing paired testing of the validated bone turnover markers procollagen type I N-terminal propeptide (P1NP) and serum C-terminal telopeptide of type I collagen (CTX) prior to and at least three months following administration of a CGRP mAb.

RESULTS: A total of 45 patients with a mean age of 41.8 (SD 11.9) were included in the final analysis, all of whom received a ligand-targeting CGRP mAb. Administration of a CGRP mAb was associated with a statistically significant increase in P1NP from 44.5 microg/L to 51.5 microg/L (p = 0.004), but no significant change in CTX.

CONCLUSION: In otherwise homeostatic conditions, short-term administration of a CGRP mAb is associated with increased P1NP, a bone formation marker but not with increased CTX, a bone resorption marker. Further study is required to validate these findings over longer time periods, in a larger cohort, and in pre-existing states of increased calcium stress and bone-turnover.

PMID:37264889 | DOI:10.1177/03331024231180562

Behav Cogn Psychother. 2023 Jun 2:1-6. doi: 10.1017/S1352465823000176. Online ahead of print.

ABSTRACT

BACKGROUND: The COVID-19 pandemic highlighted the under-utilisation of statutory mental health care services by minority ethnic groups in the United Kingdom (UK).

AIM: To improve ethnicity reporting to better understand the needs of patients accessing a primary care talking therapies service.

METHOD: We conducted a clinical audit to observe outcomes from pre-COVID (2019), first wave of COVID-19 (2020) and 2021 for three broad ethnic categories: black African/Caribbean, Asian and white British. Intervention was conducted on staff to improve data recording of ethnicity. A patient survey was sent to those identified as dropped out from treatment from May 2020 to April 2021. A total of 229 patients responded to the survey. The survey asked for reasons that impacted on not continuing with sessions.

RESULTS: Quantitative analysis showed a statistically significant difference on discharge outcome between white British and black African/Caribbean (p=<0.0001), with black African/Caribbean patients most likely to drop out of treatment, and in 2020 the Asian population was below the recovery target of 50%. Qualitative analysis revealed therapist factors included lack of confidence in therapist and not being listened to, patient factors included neurodiversity, being unsure whether it would be helpful and confidentiality concerns, and service factors included being notified of discharge from the service, remote delivery of therapy, treatment options, and treatment materials.

DISCUSSIONS: Services must work towards improving service provision by capturing hidden disparities and socialising treatment to meet the needs of minority ethnic groups in the UK. The present study recommends culturally adapted treatment and co-producing therapy materials.

PMID:37264882 | DOI:10.1017/S1352465823000176

Vopr Virusol. 2023 Feb 7;67(6):527-537. doi: 10.36233/0507-4088-151.

ABSTRACT

INTRODUCTION: The development of the COVID-19 pandemic has stimulated the scientific research aimed at studying of the mechanisms of formation the immunity against SARS-CoV-2. Currently, there is a need to develop a domestic simple and cost-effective specific method suitable for monitoring of T-cell response against SARS-CoV-2 in reconvalescents and vaccinated individuals.

AIM: Development of a screening method for evaluation specific T-cell immunity against SARS-CoV-2.

MATERIALS AND METHODS: Total 40 individuals who had mild to moderate COVID-19 and 20 healthy volunteers who did not have a history of this disease were examined. The presence and levels of IgG and IgM antibodies to SARS-CoV-2 were identified in participants sera by ELISA using the diagnostic kits from JSC Vector-Best (Novosibirsk, Russian Federation). Antigenic stimulation of mononuclear cells was carried out on commercial plates with adsorbed whole-virion inactivated SARS-CoV-2 antigen (State Research Center of Virology and Biotechnology VECTOR Novosibirsk, Russian Federation). The concentration of IFN- was measured in ELISA using the test systems from JSC Vector-Best (Novosibirsk, Russian Federation). The immunophenotyping of lymphocytes was performed on a flow cytometer Cytomics FC500 (Beckman Coulter, USA). Statistical data processing was carried out using the Microsoft Excel and STATISTICA 10 software package.

RESULTS: Stimulation of mononuclear cells isolated from the peripheral blood with whole-virion inactivated SARS-CoV-2 antigen fixed at the bottom of the wells of a polystyrene plate showed a significantly higher median response in terms of IFN- production in 40 people who had history of COVID-19 compared to 20 healthy blood donors (172.1 [34.3575.1] pg/ml versus 15.4 [6.925.8] pg/ml, p 0.0001). There was no difference in median IFN- levels in supernatants collected from unstimulated mononuclear cells from COVID-19 reconvalescents and healthy donors (2.7 [0.411.4] pg/ml versus 0.8 [0.023.3] pg/ml, p 0.05). The overall sensitivity and specificity of this method were 73% (95% CI 5888%) and 100% (95% CI 100100%), respectively, at a cut-off of 50 pg/ml.

CONCLUSION: The developed method for assessment of the cellular immune response to SARS-CoV-2 can be used as a screening method for monitoring the T-cell response in a population against a new coronavirus infection in recovered people.

PMID:37264842 | DOI:10.36233/0507-4088-151

J Hum Lact. 2023 Jun 2:8903344231175870. doi: 10.1177/08903344231175870. Online ahead of print.

ABSTRACT

BACKGROUND: Research gaps exist with regard to paternal attitudes towards breastfeeding and the association between fathers’ attitudes and the type of breastfeeding.

RESEARCH AIMS: (1): To analyze the psychometric properties of the Spanish version of the Iowa Infant Feeding Attitude Scale in fathers, and (2) to examine the association between fathers’ attitudes and type of breastfeeding.

METHOD: We used a cross-sectional study design to analyze the scale’s psychometric properties and performance.

RESULTS: A total of 639 fathers participated in the study. The mean age was 35.83 years (SD = 4.65) and 67.3% (n = 430) were married or in a civil partnership. We observed an adequate fit in the confirmatory factor analysis: TLI = 0.96, CFI = 0.97 and RMSEA = 0.05. The overall internal consistency was 0.76. Between 1-6 months, 48% (n = 307) of participants’ babies were exclusively breastfed, 35.2% (n = 225) were partially breastfed, and 16.7% (n = 107) were exclusively formula fed. Statistically significant differences were shown in attitudes towards breastfeeding, depending on the type of breastfeeding, between 1 and 6 months (F = 54.67; p < .001). Fathers who reported that their baby had been exclusively breastfed scored higher on attitudes towards breastfeeding. Statistically significant differences were also found between partial breastfeeding and formula feeding.

CONCLUSIONS: The Spanish version of the Iowa Infant Feeding Attitude Scale is a valid and reliable instrument for measuring paternal attitudes towards breastfeeding.

PMID:37264803 | DOI:10.1177/08903344231175870

Pediatr Obes. 2023 Jun 1:e13061. doi: 10.1111/ijpo.13061. Online ahead of print.

ABSTRACT

BACKGROUND: As childhood obesity prevalence increases, determining which patients respond to anti-obesity medications would strengthen personalized approaches to obesity treatment. In the SCALE Teens trial among pubertal adolescents with obesity (NCT02918279), liraglutide 3.0 mg (or maximum tolerated dose) significantly reduced body mass index (BMI) standard deviation score on average versus placebo. That said, liraglutide effects on BMI reduction varied greatly among adolescents, similar to adults.

OBJECTIVES: To identify post hoc characteristics predictive of achieving ≥5% and ≥10% BMI reductions at 56 weeks with liraglutide versus placebo in adolescents from the SCALE Teens trial.

METHODS: Logistic regression analysis was performed in 251 adolescents treated with liraglutide (n = 125) or placebo (n = 126) for 56 weeks. Baseline characteristics (selected a priori) included sex, race, ethnicity, age, Tanner (pubertal) stage, glycemic status (hyperglycemia [type 2 diabetes/prediabetes] vs. normoglycemia), obesity category (Class II/III vs. I), severity of depression symptoms (Patient Health Questionnaire-9), and weight variability (weight fluctuations over time). The effects of early responder status (≥4% BMI reduction at week 16) on week 56 response were assessed using descriptive statistics.

RESULTS: Baseline characteristics did not affect achievement of ≥5% and ≥10% BMI reductions at week 56 in adolescents treated with liraglutide. Further, there was no association between weight variability and BMI reduction. Early liraglutide responders appeared to have greater BMI and body weight reductions at week 56 compared with early non-responders.

CONCLUSIONS: This secondary analysis suggests that adolescents with obesity may experience significant BMI reductions after 56 weeks of liraglutide treatment, regardless of their sex, race, ethnicity, age, pubertal stage, glycemic status, obesity category, severity of depression symptoms, or weight variability. Early response may predict greater week 56 response.

PMID:37264767 | DOI:10.1111/ijpo.13061

ESC Heart Fail. 2023 Jun 1. doi: 10.1002/ehf2.14406. Online ahead of print.

ABSTRACT

BACKGROUND: The clinical value of cardiopulmonary exercise testing (CPET) in cardiac amyloidosis (CA) is uncertain. Due to the growing prevalence of the disease and the current availability of disease-modifying drugs, prognostic stratification is becoming fundamental to optimizing the cost-effectiveness of treatment, patient phenotyping, follow-up, and management. Peak VO₂ and VE/VCO₂ slope are currently the most studied CPET variables in clinical settings, and both demonstrate substantial, independent prognostic value in several cardiovascular diseases. We aim to study the association of peak VO₂ and VE/VCO₂ slope with prognosis in patients with CA.

METHODS AND RESULTS: We performed a systematic review and searched for clinical studies performing CPET for prognostication in patients with transthyretin-CA and light-chain-CA. Studies reporting hazard ratio (HR) for mortality and peak VO₂ or VE/VCO₂ slope were further selected for quantitative analysis. HRs were pooled using a random-effect model. Five studies were selected for qualitative and three for quantitative analysis. A total of 233 patients were included in the meta-analysis. Mean peak VO₂ resulted consistently depressed, and VE/VCO₂ slope was increased. Our pooled analysis showed peak VO₂ (pooled HR 0.89, 95% CI 0.84-0.94) and VE/VCO₂ slope (pooled HR 1.04, 95% CI 1.01-1.07) were significantly associated with the risk of death in CA patients, with no significant statistical heterogeneity for both analyses.

CONCLUSIONS: CPET is a valuable tool for prognostic stratification in CA, identifying patients at increased risk of death. Large prospective clinical trials are needed to confirm this exploratory finding.

PMID:37264762 | DOI:10.1002/ehf2.14406