Category: Nevin Manimala

BMC Public Health. 2023 May 30;23(1):1016. doi: 10.1186/s12889-023-15799-1.

ABSTRACT

BACKGROUND: The COVID-19 pandemic as a public health crisis has led to a significant increase in mental health difficulties. Smoking is strongly associated with mental health conditions, which is why the pandemic might have influenced the otherwise decline in smoking rates. Persons belonging to socioeconomically disadvantaged groups may be particularly affected, both because the pandemic has exacerbated existing social inequalities and because this group was more likely to smoke before the pandemic. We examined smoking prevalence in a French cohort study, focusing on differences between educational attainment. In addition, we examined the association between interpersonal changes in tobacco consumption and educational level from 2018 to 2021.

METHODS: Using four assessments of smoking status available from 2009 to 2021, we estimated smoking prevalence over time, stratified by highest educational level in the TEMPO cohort and the difference was tested using chi² test. We studied the association between interpersonal change in smoking status between 2018 and 2021 and educational attainment among 148 smokers, using multinomial logistic regression.

RESULTS: Smoking prevalence was higher among those with low education. The difference between the two groups increased from 2020 to 2021 (4.8-9.4%, p < 0.001). Smokers with high educational level were more likely to decrease their tobacco consumption from 2018 to 2021 compared to low educated smokers (aOR = 2.72 [1.26;5.89]).

CONCLUSION: Current findings showed a widening of the social inequality gap in relation to smoking rates, underscoring the increased vulnerability of persons with low educational level to smoking and the likely inadequate focus on social inequalities in relation to tobacco control policies during the pandemic.

PMID:37254131 | DOI:10.1186/s12889-023-15799-1

BMC Psychiatry. 2023 May 30;23(1):377. doi: 10.1186/s12888-023-04752-6.

ABSTRACT

BACKGROUND: There are considerable differences among mental healthcare services, and especially in developed countries there are a substantial number of different services available. The intensity of mental healthcare has been an important variable in research studies (e.g. cohort studies or randomized controlled trials), yet it is difficult to measure or quantify, in part due to the fact that the intensity of mental healthcare results from a combination of several factors of a mental health service. In this article we describe the development of an instrument to measure the intensity of mental healthcare that is easy and fast to use in repeated measurements.

METHODS: The Mental Healthcare Intensity Scale was developed in four stages. First, categories of care were formulated by using focus group interviews. Second, the fit among the categories was improved, and the results were discussed with a sample of the focus group participants. Third, the categories of care were ranked using the Segmented String Relative Rankings algorithm. Finally, the Mental Healthcare Intensity Scale was validated as a coherent classification instrument.

RESULTS: 15 categories of care were formulated and were ranked on each of 12 different intensities of care. The Mental Healthcare Intensity Scale is a versatile questionnaire that takes 2-to-3 min to complete and yields a single variable that can be used in statistical analysis.

CONCLUSIONS: The Mental Healthcare Intensity Scale is an instrument that can potentially be used in cohort studies and trials to measure the intensity of mental healthcare as a predictor of outcome. Further study into the psychometric characteristics of the Mental Healthcare Intensity Scale is needed.

PMID:37254123 | DOI:10.1186/s12888-023-04752-6

BMC Public Health. 2023 May 30;23(1):997. doi: 10.1186/s12889-023-15935-x.

ABSTRACT

BACKGROUND: HIV/AIDS-associated neurocognitive impairments negatively affect treatment adherence, viral load suppression, CD4 count, functionality, and the overall quality of life of people with seropositive status. However, huge variability is observed across primary studies regarding the prevalence and determinants of neurocognitive impairment in people with HIV/AIDS. This systematic review and meta-analysis sought to determine the pooled prevalence of neurocognitive impairment and identify factors contributing to variations in its estimate among people living with HIV/AIDS in Africa.

METHODS: A comprehensive literature search of scientific databases (Medline/PubMed, SCOPUS, Web of Science, PsycINFO, and EMBASE) was performed from inception onward. Google and Google Scholar were also searched for grey literature. Research articles available until July 15, 2022 were included. We used STATA-version 14 statistical software for analysis. A random effect model was executed to pool the reported prevalence of neurocognitive impairments. Subgroup analysis was done to show variations in the prevalence of neurocognitive impairments and factors that might contribute to these variations.

RESULTS: A literature search resulted in 8,047 articles. After the removal of duplications and thorough evaluation, a total of 49 studies were included in the meta-analysis. The prevalence of HIV/AIDS-associated neurocognitive impairments was highly variable across studies, ranging from 14% to 88%, yielding the pooled prevalence of HIV/AIDS-associated neurocognitive impairment to be 46.34% [95% CI (40.32, 52.36)] and I² = 98.5% with a P-value of 0.001.

CONCLUSIONS: A large proportion of people living with HIV/AIDS in Africa have HIV/AIDS-associated neurocognitive impairment. This illustrates the need to establish practical approaches to early identification and effective control of HIV/AIDS-associated neurocognitive impairments. However, there were variabilities in the reported prevalence of HIV/AIDS-associated neurocognitive impairments across studies. This further demonstrates the need to have consistent measurement approaches.

TRIAL REGISTRATION: PROSPERO 2022, “CRD42020166572”.

PMID:37254121 | DOI:10.1186/s12889-023-15935-x

BMC Cancer. 2023 May 30;23(1):483. doi: 10.1186/s12885-023-10991-3.

ABSTRACT

BACKGROUND: The authors intend to compare the effects of each targeted therapy (TT) in the treatment of patients with metastatic renal cell carcinoma (mRCC) using big data based on the Korean National Health Insurance System (NHIS) and determine the optimal treatment sequence.

METHODS: Data on the medical use of patients with kidney cancer were obtained from the NHIS database from January 1, 2002, to December 31, 2020. Patient variables included age, sex, income level, place of residence, prescribing department, and duration from diagnosis to the prescription date. The primary outcome was overall survival (OS) for each drug and sequencing. We performed propensity score matching (PSM) according to age, sex, and Charlson Comorbidity Index based on the primary TTs.

RESULTS: After 1:1 PSM, the sunitinib (SUN) (n = 1,214) and pazopanib (PAZ) (n = 1,214) groups showed a well-matched distribution across the entire cohort. In the primary treatment group, PAZ had lower OS than SUN (HR, 1.167; p = 0.0015). In the secondary treatment group, axitinib (AXI) had more favorable OS than cabozantinib (CAB) (HR, 0.735; p = 0.0118), and everolimus had more adverse outcomes than CAB (HR, 1.544; p < 0.0001). In the first to second TT sequencing, SUN-AXI had the highest OS; however, there was no statistically significant difference when compared with PAZ-AXI, which was the second highest (HR, 0.876; p = 0.3312). The 5-year survival rate was calculated in the following order: SUN-AXI (51.44%), PAZ-AXI (47.12%), SUN-CAB (43.59%), and PAZ-CAB (34.28%). When the four sequencing methods were compared, only SUN-AXI versus PAZ-CAB (p = 0.003) and PAZ-AXI versus PAZ-CAB (p = 0.017) were statistically significant.

CONCLUSIONS: In a population-based RWD analysis of Korean patients with mRCC, SUN-AXI sequencing was shown to be the most effective among the first to second TT sequencing methods in treatment, with a relative survival advantage over other sequencing combinations. To further support the results of this study, risk-stratified analysis is needed.

PMID:37254112 | DOI:10.1186/s12885-023-10991-3

BMC Musculoskelet Disord. 2023 May 30;24(1):429. doi: 10.1186/s12891-023-06563-y.

ABSTRACT

BACKGROUND: Kickboxing is considered as a combat sport in progress, in which injuries are frequent and significant, and close injury monitoring is highly recommended. Sports injuries to the head and neck are estimated to cause 70% deaths and 20% permanent disabilities although they are much less common than those to the limbs. Whiplash mechanism involves the rapid extension (opening) and flexion (bending) of neck. The purpose of the current study was to investigate the electromyographic activity of selected muscles in the whiplash mechanism in aware and unaware conditions of the safe punching in kickboxing so that we can design special exercises.

METHOD: In the present study, 24 male kickboxing athletes aged 18-40 years were selected based on a purposive sampling method. The surface electromyography (EMG) signals of muscles were recorded with and without awareness of safe punching by using a nine-channel wireless EMG device. Additionally, a nine-channel 3D inertial measurement unit (IMU, wireless,) was utilized to determine the acceleration, kinematics, and angular velocity of the subjects’ head. The statistical dependent t-test was applied to compare the EMG activity of each muscle, as well as its participation ratio.

RESULTS: The results of statistical analysis represented a significant increase in the EMG activity of sternocleidomastoid (p = 0.001), upper trapezius (p = 0.001) and cervical erector spinae muscles (p = 0.001), as well as the neck extension and flexion angles between the athletes aware (open eyes) and unaware (closed eyes) of the safe punching.

CONCLUSION: In this study, the EMG activity of the sternocleidomastoid, upper trapezius, and cervical erector spine muscles in the aware condition was significantly different from the activity under unaware condition. In fact, the intended muscles exhibited significantly different behaviors in preventing extension and flexion in the two conditions.

PMID:37254094 | DOI:10.1186/s12891-023-06563-y

BMC Public Health. 2023 May 30;23(1):1010. doi: 10.1186/s12889-023-15987-z.

ABSTRACT

BACKGROUND: Although sugar-sweetened beverage consumption has become an important and widespread concern, there are few studies on the association between sugar-sweetened beverage consumption frequency and muscle strength in Chinese adolescents. The objective of this study was to analyze the association between sugar-sweetened beverage consumption frequency and muscle strength in Chinese adolescents.

METHODS: A stratified whole-group sampling method was used to survey 25,893 adolescents aged 13-15 years old in China for sugar-sweetened beverage consumption frequency and muscle strength for grip strength and standing long jump. The subjects’ basic information, body mass index (BMI), and covariates were investigated. The association between sugar-sweetened beverage consumption frequency and muscle strength was analyzed by multivariate logisitc regression analysis.

RESULTS: The proportions of Chinese adolescents who consumed sugar-sweetened beverage ≥ 3 times/week, 1-2 times/week, and < 1 time/week were 12.23%, 52.79%, and 34.98%, respectively. The differences in sugar-sweetened beverage consumption frequency were statistically significant when compared across gender, parental education, duration of physical activity, snacks, and mode of commuting to school (χ² values = 228.570, 51.422, 275.552, 3165.656, 10.988, P < 0.01). Logistic regression analysis showed that overall Chinese adolescents with sugary drinks 1-2 times/week (OR = 1.207, 95% CI:1.132-1.287) and sugary drinks ≥ 3 times/week (OR = 1.771, 95% CI:1.611-1.947) were associated with lower muscle strength compared to sugary drinks < 1 time/week showed a positive association (P < 0.01). The same trend was found for boys and girls.

CONCLUSION: Chinese adolescents’ sugar-sweetened beverage consumption is common, and high-frequency sugar-sweetened beverage consumption is associated with lower muscle strength. In the future, we should control the use of sugar-sweetened beverages and increase muscular strength training in Chinese adolescents to promote healthy growth.

PMID:37254093 | DOI:10.1186/s12889-023-15987-z

BMC Bioinformatics. 2023 May 30;24(1):220. doi: 10.1186/s12859-023-05352-7.

ABSTRACT

BACKGROUND: Circular RNAs (circRNAs) play a significant role in some diseases by acting as transcription templates. Therefore, analyzing the interaction mechanism between circRNA and RNA-binding proteins (RBPs) has far-reaching implications for the prevention and treatment of diseases. Existing models for circRNA-RBP identification usually adopt convolution neural network (CNN), recurrent neural network (RNN), or their variants as feature extractors. Most of them have drawbacks such as poor parallelism, insufficient stability, and inability to capture long-term dependencies.

METHODS: In this paper, we propose a new method completely using the self-attention mechanism to capture deep semantic features of RNA sequences. On this basis, we construct a CircSSNN model for the cirRNA-RBP identification. The proposed model constructs a feature scheme by fusing circRNA sequence representations with statistical distributions, static local contexts, and dynamic global contexts. With a stable and efficient network architecture, the distance between any two positions in a sequence is reduced to a constant, so CircSSNN can quickly capture the long-term dependencies and extract the deep semantic features.

RESULTS: Experiments on 37 circRNA datasets show that the proposed model has overall advantages in stability, parallelism, and prediction performance. Keeping the network structure and hyperparameters unchanged, we directly apply the CircSSNN to linRNA datasets. The favorable results show that CircSSNN can be transformed simply and efficiently without task-oriented tuning.

CONCLUSIONS: In conclusion, CircSSNN can serve as an appealing circRNA-RBP identification tool with good identification performance, excellent scalability, and wide application scope without the need for task-oriented fine-tuning of parameters, which is expected to reduce the professional threshold required for hyperparameter tuning in bioinformatics analysis.

PMID:37254080 | DOI:10.1186/s12859-023-05352-7

BMC Psychiatry. 2023 May 30;23(1):376. doi: 10.1186/s12888-023-04816-7.

ABSTRACT

BACKGROUND: Academic pressure is a prevalent stressor among Chinese adolescents and is often linked to anxiety symptoms, although the underlying mechanism remains unclear. This study aimed to investigate the association between NR3C1 gene methylation, academic pressure, and anxiety symptoms among Chinese adolescents.

METHODS: This nested-case control study included 150 adolescents (boys: 38.7%; baseline age: 12-17 years) from a school-based longitudinal study of Chinese adolescents. Cases (n = 50) were defined as those with anxiety symptoms at both baseline and follow-up, while controls (n = 100) were randomly selected from those without anxiety symptoms at both timepoints. The cases and controls were 1:2 matched by age. Academic pressure, anxiety symptoms, and potential covariates were measured using a self-report questionnaire. Peripheral whole blood samples were collected from each participant for the detection of cortisol level (i.e., morning serum cortisol level) and DNA methylation. The methylation analysis included a total of 27 CpG units at the NR3C1 promoter region.

RESULTS: The final adjusted models showed that students with heavy academic pressure at baseline were at a higher risk of anxiety symptoms at follow-up compared to those with mild academic pressure (β estimate: 6.24 [95% CI: 3.48 ~ 9.01]). After adjusting for covariates, the methylation level of one CpG unit (NR3C1-16 CpG10) in NR3C1 differed significantly between cases and controls (F = 6.188, P = 0.014), and the difference remained significant after correction for multiple testing (P < 0.025). The adjusted regression models showed that moderate (β estimate = 0.010 [95% CI: 0.000 ~ 0.020], P = 0.046) and heavy (β estimate = 0.011 [95% CI: 0.001 ~ 0.020], P = 0.030) academic pressure were significantly associated with the methylation level of NR3C1-16 CpG 10. Further mediation analysis demonstrated that the association of academic pressure and anxiety symptoms was significantly mediated by the methylation of NR3C1-16 CpG 10 (β estimate for indirect effect = 0.11 [95% CI: 0.005 ~ 0.32]; indirect/total effect = 8.3%).

CONCLUSION: The present study suggests that NR3C1-16 CpG 10 DNA methylation might be a potential mechanism that partially explains the lasting effects of academic pressure on subsequent anxiety symptoms among adolescents. Further studies with larger sample sizes are recommended to replicate this finding.

PMID:37254074 | DOI:10.1186/s12888-023-04816-7

BMC Infect Dis. 2023 May 30;23(1):362. doi: 10.1186/s12879-023-08347-0.

ABSTRACT

BACKGROUND: Although tuberculosis (TB) patients coinfected with HIV are at risk of poor treatment outcomes, there is paucity of data on changing trends of TB/HIV co-infection and their treatment outcomes. This study aims to estimate the burden of TB/HIV co-infection over time, describe the treatment available to TB/HIV patients and estimate the effect of TB/HIV co-infection on TB treatment outcomes.

METHODS: This was a retrospective data analyses from TB surveillance in two counties in Kenya (Nyeri and Kilifi): 2012‒2020. All TB patients aged ≥ 18 years were included. The main exposure was HIV status categorised as infected, negative or unknown status. World Health Organization TB treatment outcomes were explored; cured, treatment complete, failed treatment, defaulted/lost-to-follow-up, died and transferred out. Time at risk was from date of starting TB treatment to six months later/date of the event and Cox proportion with shared frailties models were used to estimate effects of TB/HIV co-infection on TB treatment outcomes.

RESULTS: The study includes 27,285 patients, median (IQR) 37 (29‒49) years old and 64% male. 23,986 (88%) were new TB cases and 91% were started on 2RHZE/4RH anti-TB regimen. Overall, 7879 (29%, 95% 28‒30%) were HIV infected. The proportion of HIV infected patient was 32% in 2012 and declined to 24% in 2020 (trend P-value = 0.01). Uptake of ARTs (95%) and cotrimoxazole prophylaxis (99%) was high. Overall, 84% patients completed six months TB treatment, 2084 (7.6%) died, 4.3% LTFU, 0.9% treatment failure and 2.8% transferred out. HIV status was associated with lower odds of completing TB treatment: infected Vs negative (aOR 0.56 (95%CI 0.52‒0.61) and unknown vs negative (aOR 0.57 (95%CI 0.44‒0.73). Both HIV infected and unknown status were associated with higher hazard of death: (aHR 2.40 (95%CI 2.18‒2.63) and 1.93 (95%CI 1.44‒2.56)) respectively and defaulting treatment/LTFU: aHR 1.16 (95%CI 1.01‒1.32) and 1.55 (95%CI 1.02‒2.35)) respectively. HIV status had no effect on hazard of transferring out and treatment failure.

CONCLUSION: The overall burden of TB/HIV coinfection was within previous pooled estimate. Our findings support the need for systematic HIV testing as those with unknown status had similar TB treatment outcomes as the HIV infected.

PMID:37254064 | DOI:10.1186/s12879-023-08347-0

Lung Cancer. 2023 May 24;181:107254. doi: 10.1016/j.lungcan.2023.107254. Online ahead of print.

ABSTRACT

KRAS G12C mutations are found in about 12-13% of LUAD samples and it is unclear whether they are associated with worse survival outcomes in resected, stage I LUAD. We assessed whether KRAS-G12C mutated tumours had worse DFS when compared to KRAS-nonG12C mutated tumours and to KRAS wild-type tumours in a cohort of resected, stage I LUAD (IRE cohort). We then leveraged on publicly available datasets (TCGA-LUAD, MSK-LUAD⁶⁰⁴) to further test the hypothesis in external cohorts. In the stage I IRE cohort we found a significant association between the KRAS-G12C mutation and worse DFS in multivariable analysis (HR: 2.47). In the TCGA-LUAD stage I cohort we did not find statistically significant associations between the KRAS-G12C mutation and DFS. In the MSK-LUAD⁶⁰⁴ stage I cohort we found that KRAS-G12C mutated tumours had worse RFS when compared to KRAS-nonG12C mutated tumours in univariable analysis (HR 3.5). In the pooled stage I cohort we found that KRAS-G12C mutated tumours had worse DFS when compared to KRAS-nonG12C mutated tumours (HR 2.6), to KRAS wild-type tumours (HR 1.6) and to any other tumours (HR 1.8); in multivariable analysis, the KRAS-G12C mutation was associated with worse DFS (HR 1.61). Our results suggest that patients with resected, stage I LUAD with a KRAS-G12C mutation may have inferior survival outcomes..

PMID:37253296 | DOI:10.1016/j.lungcan.2023.107254