Category: Nevin Manimala

PLoS One. 2022 Aug 23;17(8):e0272612. doi: 10.1371/journal.pone.0272612. eCollection 2022.

ABSTRACT

BACKGROUND: Maternal and child mortality remains a major public health problem in Ethiopia. Improving short birth interval practice is a main strategy to reduce neonatal mortality, maternal mortality, adverse pregnancy outcomes, high fertility rate, and enhance economic development efforts. However, there has been limited study done regarding short birth intervals in the study area. Therefore, this study aimed to assess short birth intervals and associated factors among women who gave birth in the last three years in Dembecha district, Northwest Ethiopia, 2019.

METHOD: A community-based cross-sectional study was conducted among 880 reproductive-age multipara mothers using a stratified cluster sampling technique. The data were collected by face-to-face interviews through pretested and semi-structured questionnaires. Bivariable and multivariable logistic regression model was fitted. Variables with a p-value ≤0.05 were considered statistically significant factors. Adjusted odds ratio with a 95% confidence interval was used to report the association between predictors and the outcome variable.

RESULTS: The prevalence of short birth interval was found to be 43.4% (95% CI: 40.2, 46.9). Husband education (able to read and write) [AOR:2.81,(95% CI:1.04,7.85)], wealth index (lowest quartile) [AOR:3.75,(95% CI:2.35,5.97), residence (urban) [AOR:3.20,(95% CI:1.62,6.33)],age at first marriage (15-17 years old) [AOR: 1.65,(95% CI:1.15, 2.26),and non-use of contraceptive [AOR: 8.78, (95% CI: 6.18, 12.47) were statistically significant variables.

CONCLUSION: The study revealed that the prevalence of short birth intervals among multipara women is found to be high. Husband education, wealth index, urban residence, age at first marriage, and non-use of contraceptives were variables significantly associated with short birth intervals. Hence, to overcome the problem the focus should be on increasing family planning utilization, avoiding early marriage, strengthening paternal education, and improving family income.

PMID:35998184 | DOI:10.1371/journal.pone.0272612

PLoS One. 2022 Aug 23;17(8):e0273056. doi: 10.1371/journal.pone.0273056. eCollection 2022.

ABSTRACT

Substantial evidence suggests an important role of liver function in brain health. Liver function is clinically assessed by measuring the activity of hepatic enzymes in the peripheral blood. Brain-derived neurotrophic factor (BDNF) is an important regulator of brain function. Therefore, we hypothesized that blood BDNF levels are associated with liver function and fibrosis. To test this hypothesis, in this cross-sectional study, we investigated whether serum BDNF concentration is associated with liver enzyme activity, aspartate aminotransferase (AST)/ alanine aminotransferase (ALT) ratio, and fibrosis-4 (FIB-4) index in middle-aged and older women. We found that serum BDNF level showed a significant positive association with ALT and γ-glutamyltranspeptidase (GGT) activity and negative association with FIB-4 index, and a trend of negative association with the AST/ALT ratio after adjustment for age. Additionally, these associations remained statistically significant even after adjustment for body mass index (BMI) and fasting blood glucose level. These results demonstrate associations of serum BDNF levels with liver enzymes and hepatic fibrosis-related indices, which may underlie liver-brain interactions.

PMID:35998179 | DOI:10.1371/journal.pone.0273056

PLoS One. 2022 Aug 23;17(8):e0273019. doi: 10.1371/journal.pone.0273019. eCollection 2022.

ABSTRACT

The relative age effect (RAE) is a well-established phenomenon in football. However, while the majority of previous studies focussed on established football nations, it remains unclear if the constraint of a limited population of soccer players in smaller countries associated with less strict selection procedures may reduce the risk of RAE. This study aims to investigate the RAE in Luxembourg that follows an ‘open-door’ selection policy in youth football due to the limited pool of players. Birthdates from all licensed and actively playing Luxembourgish youth footballers including all players of the youth national teams (396 girls and 10981 boys) competing in the season 2018/2019 were analysed and categorised into birth quarters and semesters. To further investigate a performance dependence of the RAE in amateur leagues, success was determined based on the teams’ rankings at the end of the season. Differences between observed and expected birthdate distributions were calculated across all licensed players and age groups, within the national teams, and for the top- and bottom-tier football teams using chi-square statistics. While a RAE was absent across all age groups (except U7), significant RAEs with high effect sizes were observed in the top-level and national teams. These findings contrast the substantial RAE effects in large football nations and suggest that open selection systems might reflect an environmental constraint that limit the prevalence of RAE in football. Further, this study indicates that a performance dependence of the RAE is not limited to high level football but already occurs on an amateur level.

PMID:35998177 | DOI:10.1371/journal.pone.0273019

PLoS Negl Trop Dis. 2022 Aug 23;16(8):e0010334. doi: 10.1371/journal.pntd.0010334. Online ahead of print.

ABSTRACT

BACKGROUND: Colombia has one of the highest burdens of arboviruses in South America. The country was in a state of hyperendemicity between 2014 and 2016, with co-circulation of several Aedes-borne viruses, including a syndemic of dengue, chikungunya, and Zika in 2015.

METHODOLOGY/PRINCIPAL FINDINGS: We analyzed the cases of dengue, chikungunya, and Zika notified in Colombia from January 2014 to December 2018 by municipality and week. The trajectory and velocity of spread was studied using trend surface analysis, and spatio-temporal high-risk clusters for each disease in separate and for the three diseases simultaneously (multivariate) were identified using Kulldorff’s scan statistics. During the study period, there were 366,628, 77,345 and 74,793 cases of dengue, chikungunya, and Zika, respectively, in Colombia. The spread patterns for chikungunya and Zika were similar, although Zika’s spread was accelerated. Both chikungunya and Zika mainly spread from the regions on the Atlantic coast and the south-west to the rest of the country. We identified 21, 16, and 13 spatio-temporal clusters of dengue, chikungunya and Zika, respectively, and, from the multivariate analysis, 20 spatio-temporal clusters, among which 7 were simultaneous for the three diseases. For all disease-specific analyses and the multivariate analysis, the most-likely cluster was identified in the south-western region of Colombia, including the Valle del Cauca department.

CONCLUSIONS/SIGNIFICANCE: The results further our understanding of emerging Aedes-borne diseases in Colombia by providing useful evidence on their potential site of entry and spread trajectory within the country, and identifying spatio-temporal disease-specific and multivariate high-risk clusters of dengue, chikungunya, and Zika, information that can be used to target interventions.

PMID:35998165 | DOI:10.1371/journal.pntd.0010334

PLoS One. 2022 Aug 23;17(8):e0273283. doi: 10.1371/journal.pone.0273283. eCollection 2022.

ABSTRACT

OBJECTIVE: The effect of the serum chloride (Cl) level on mortality in critically ill patients with acute kidney injury (AKI) remains unknown. We sought an association between mortality and serum Cl.

METHODS: We identified AKI patients in the eICU Collaborative Research Database from 2014 to 2015 at 208 US hospitals. The outcomes included in-hospital and intensive care unit (ICU) mortality. Time-varying covariates Cox regression models and the Kaplan-Meier (K-M) curves were used to assess the association between serum Cl levels and mortality. Multivariable adjusted restricted cubic spline models were used to analyze the potential nonlinear relationship between mortality and serum Cl.

RESULTS: In total, 4,234 AKI patients were included in the study. Compared with normochloremia (98≤chloride<108mEq/L), hypochloremia (Cl<98mEq/L) was associated with mortality (adjusted hazard ratio [HR] for in-hospital mortality 1.46, 95% confidence interval [CI] 1.20-1.80, P = 0.0003; adjusted HR for ICU mortality 1.37, 95% CI 1.05-1.80, P = 0.0187). Hyperchloremia showed no significant difference in mortality compared to normochloremia (adjusted HR for in-hospital mortality 0.89, 95% CI 0.76-1.04, P = 0.1438; adjusted HR for ICU mortality 0.87, 95% CI 0.72-1.06, P = 0.1712). Smoothing curves revealed continuous non-linear associations between serum Cl levels and mortality. The K-M curve showed that patients with hypochloremia presented with a lower survival rate.

CONCLUSIONS: Lower serum Cl levels after ICU admission was associated with increased in-hospital and ICU mortality in critically ill patients with AKI. The results should be verified in well-designed prospective studies.

PMID:35998143 | DOI:10.1371/journal.pone.0273283

Plast Reconstr Surg. 2022 Aug 24. doi: 10.1097/PRS.0000000000009622. Online ahead of print.

ABSTRACT

BACKGROUND: Confirmatory methods such as nerve conduction studies (NCS) are often performed to support a clinical carpal tunnel syndrome diagnosis and to rule out other upper extremity pathologies. Ultrasonography (US) provides another diagnostic option, especially when NCS are discordant with history and physical examination. This study seeks to explore the correlation of US findings with clinical CTS diagnosis in patients with normal NCS.

METHODS: A database of 220 CTS patients was retrospectively analyzed to reveal 24 patients (28 hands) with clinically diagnosed CTS and normal NCS. Patient demographics and NCS and US findings were compared to those of a control group of non-CTS patients (42 patients, 52 hands). Median nerve cross-sectional area (CSA) was recorded, with values ≥ 10mm2 considered positive for CTS. Statistical and correlation analyses were performed between control and CTS groups comparing key parameters of interest.

RESULTS: Mean CSA was significantly increased in CTS patients with normal NCS than in controls. Similarly, the proportion of CTS positive, NCS negative patients with CSA measurements greater than 10mm2 was significantly greater than the proportion for control patients. Neither age nor BMI correlated with CSA measurements. NCS latencies and amplitudes did not correlate with ultrasound abnormalities.

CONCLUSIONS: Clinically diagnosed CTS patients with normal NCS were found to have clinically significant median nerve CSA on ultrasound (10.1 ± 2.1 mm2, p<0.001). Furthermore, CSA measurements on ultrasound do not correlate with NCS parameters. These results suggest that ultrasound holds a unique diagnostic utility in the evaluation of CTS, especially when NCS are negative.

PMID:35998137 | DOI:10.1097/PRS.0000000000009622

Plast Reconstr Surg. 2022 Aug 24. doi: 10.1097/PRS.0000000000009608. Online ahead of print.

ABSTRACT

BACKGROUND: Craniosynostosis is rarely diagnosed in utero, but rather postnatally through clinical exam and radiographic findings. Prenatal diagnosis would allow for improved parental counseling and facilitate timely intervention. The authors’ purpose is to determine if prenatal ultrasound can be used to diagnose nonsyndromic craniosynostosis, by quantitatively comparing calvarial dimensions of fetuses with known craniosynostosis, to age-matched controls.

METHODS: The authors reviewed 22 prenatal ultrasounds of infants known to have nonsyndromic craniosynostosis and 22 age matched controls. Cross sectional images at the plane used to measure biparietal diameter (BPD) were selected, and cranial shape of each subject was parameterized with a radial spoke model. Cephalic indices were calculated from the cross-sectional ultrasound images for cases of sagittal synostosis and compared to age-matched controls without craniosynostosis. We used the radial parameterization to discriminate affected patients from controls. The results from quantitative shape analysis were compared to results from a blinded visual inspection of ultrasound images conducted by the two senior authors (SRS, HOT).

RESULTS: Among the 22 patients, the most common diagnosis was sagittal synostosis (11), followed by metopic synostosis (6). The average gestational age at time of ultrasound of both controls and synostotic patients was 26 weeks and 6.8 days, at the junction of the second and third trimesters. The controls and synostotic cases segregated into statistically different populations by their shape profiles (P<0.001). An automatic shape classifier using leave-one-out cross validation correctly classified the 44 images as normals vs. synostotic cases 85% of the time (sensitivity 82%, specificity 87%). Cephalic index was a poor indicator of sagittal synostosis (45% sensitivity). Visual inspection alone demonstrated only a fair level of accuracy (40-50% agreement) in identifying cases of synostosis (kappa 0.09-0.23).

CONCLUSIONS: Cases of craniosynostosis can be identified on prenatal ultrasound with good sensitivity using formal shape analysis. Cephalic index and visual inspection alone performed poorly in identifying cases of craniosynostosis.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Diagnostic, II.

PMID:35998125 | DOI:10.1097/PRS.0000000000009608

Mil Med. 2022 Aug 23:usac251. doi: 10.1093/milmed/usac251. Online ahead of print.

ABSTRACT

INTRODUCTION: The aim is to investigate the impact of large-group, motor learning-based running gait training on injury risk in United States Air Force (USAF) Basic Military Training (BMT).

DESIGN: A prospective quasi-experimental program evaluation is used.

MATERIALS AND METHODS: Medical providers taught running gait form to groups of trainees in the first week of training of BMT from August 2020 to March 2021. The main outcome measures included risk ratio of reported injuries, removal from training because of injury, and separation from service because of injury.

RESULTS: Of BMT trainees, 2,205 underwent group, motor learning-based running gait training; this was compared with two intake groups (nA = 3,941 and nB = 2,041) who were only given introductions to sports medicine staff in a classroom setting. Reported pain complaints increased (χ2 = 27.4A and 20.83B, P < .001). Risk ratios for more severe injuries necessitating time out of training or separation from USAF were reduced, although these were statistically not significant (13%, P = .48 and 22%, P = .29, respectively). Leadership implemented gait training across BMT, and data from the following 8 weeks of intake (n = 6,223) demonstrated similar trends in increases in patient reports of pain (χ2 = 67.25, P < .001) but significantly reduced risk ratios of removal from training (32%, χ2 = 16.35, P < .001) or separation (32%, χ2 = 12.54, P < .001).

CONCLUSIONS: While not previously shown to mitigate injury, large-group, running gait training was associated with a significant reduction in injury severity defined by training delays and separation from service in USAF BMT.

PMID:35998101 | DOI:10.1093/milmed/usac251

Transl Behav Med. 2022 Aug 23:ibac055. doi: 10.1093/tbm/ibac055. Online ahead of print.

ABSTRACT

Movement integration (MI) products are one of many MI strategies that aim to reduce students’ sedentary behavior (SB) and increase physical activity (PA) during classroom time. This study examined elementary classroom teachers’ off-the-shelf (i.e., no researcher support) use of MI products (GoNoodle Plus [GN], ABC for Fitness [ABC], Take10) and their impact on students’ SB and PA. Teachers (N = 57) at five schools received one MI product and reported MI strategy uses/day while student (n = 1,098, 52% female, 66% Black) accelerometer-determined SB and PA was assessed. Mixed regression models estimated changes in MI uses/day and SB and PA during the school day prior to and after teachers received the MI product. GoNoodle was the only MI product where overall MI strategy uses/day increased (∆ = 0.8, 95% CI = 0.1, 1.4). Across products, students’ SB increased (∆ = 2.2, 95% CI = 1.2, 3.1) while light (∆ = -1.7, 95% CI = 1.2, 3.1) and MVPA (∆ = -0.5, 95% CI = -0.8, -0.2) decreased. For GN SB (∆ = -3.3, 95% CI = -7.8, 1.3), light (∆ = 2.5, 95% CI = -0.7, 5.7), and MVPA (∆ = 0.8, 95% CI = -0.9, 2.5), did not show statistically significant change. For Take10 SB (∆ = 1.0, 95% CI = -0.2, 2.2) and MVPA (∆ = 0.1, 95% CI = -0.3, 0.6) did not change while light PA decreased (∆ = -1.1, 95% CI = -2.0, -0.3). For ABC SB increased (∆ = 11.1, 95% CI = 8.4, 13.9) while light (∆ = -7.0, 95% CI = -8.9, -5.0) and MVPA (∆ = -4.2, 95% CI = -5.2, -3.1) decreased. GN shows promise for classroom teacher use. However, given limited uptake of the other products and the lack of change in children’s SB and PA, this study suggests that off-the-shelf MI products cannot be integrated into classroom routines without additional support.

PMID:35998100 | DOI:10.1093/tbm/ibac055

J Crohns Colitis. 2022 Aug 23:jjac119. doi: 10.1093/ecco-jcc/jjac119. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Over the past decade, the DNA methylome has been increasingly studied in peripheral blood of inflammatory bowel disease (IBD) patients. However, a comprehensive summary and meta-analysis of peripheral blood leukocyte (PBL) DNA methylation studies has thus far not been conducted. Here, we systematically reviewed all available literature up to February 2022 and summarized the observations by means of meta-analysis.

METHODS: We conducted a systematic search and critical appraisal of IBD-associated DNA methylation studies in PBL using the biomarker-based cross-sectional studies (BIOCROSS) tool. Subsequently, we performed meta-analyses on the summary statistics obtained from epigenome-wide association studies (EWAS) that included patients with Crohn’s Disease (CD), ulcerative colitis (UC) and/or healthy controls (HC).

RESULTS: Altogether, we included 15 studies for systematic review. Critical appraisal revealed large methodological and outcome heterogeneity between studies. Summary statistics were obtained from 4 studies based on a cumulative 552 samples (177 CD, 132 UC and 243 HC). Consistent differential methylation was identified for 256 differentially methylated probes (DMPs; Bonferroni-adjusted p-value ≤0.05) when comparing CD with HC and 103 when comparing UC with HC. Comparing IBD (CD + UC) with HC resulted in 224 DMPs. Importantly, several of the previously identified DMPs, such as VMP1/TMEM49/MIR21 and RPS6KA2, were consistently differentially methylated across all studies.

CONCLUSION: Methodological homogenization of IBD epigenetic studies is needed to allow for easier aggregation and independent validation. Nonetheless, we were capable of confirming previous observations. Our results can serve as the basis for future IBD epigenetic biomarker research in PBL.

PMID:35998097 | DOI:10.1093/ecco-jcc/jjac119