Category: Nevin Manimala

Emerg Themes Epidemiol. 2023 Feb 16;20(1):1. doi: 10.1186/s12982-023-00120-7.

ABSTRACT

Low and middle-income countries continue to use Verbal autopsies (VAs) as a World Health Organisation-recommended method to ascertain causes of death in settings where coverage of vital registration systems is not yet comprehensive. Whilst the adoption of VA has resulted in major improvements in estimating cause-specific mortality in many settings, well documented limitations have been identified relating to the standardisation of the processes involved. The WHO has invested significant resources into addressing concerns in some of these areas; there however remains enduring challenges particularly in operationalising VA surveys for deaths amongst women and children, challenges which have measurable impacts on the quality of data collected and on the accuracy of determining the final cause of death. In this paper we describe some of our key experiences and recommendations in conducting VAs from over two decades of evaluating seminal trials of maternal and child health interventions in rural Ghana. We focus on challenges along the entire VA pathway that can impact on the success rates of ascertaining the final cause of death, and lessons we have learned to optimise the procedures. We highlight our experiences of the value of the open history narratives in VAs and the training and skills required to optimise the quality of the information collected. We describe key issues in methods for ascertaining cause of death and argue that both automated and physician-based methods can be valid depending on the setting. We further summarise how increasingly popular information technology methods may be used to facilitate the processes described. Verbal autopsy is a vital means of increasing the coverage of accurate mortality statistics in low- and middle-income settings, however operationalisation remains problematic. The lessons we share here in conducting VAs within a long-term surveillance system in Ghana will be applicable to researchers and policymakers in many similar settings.

PMID:36797732 | DOI:10.1186/s12982-023-00120-7

BMC Complement Med Ther. 2023 Feb 16;23(1):51. doi: 10.1186/s12906-023-03876-2.

ABSTRACT

BACKGROUND: The use of complementary and alternative medicine (CAM) by patients is widespread. However, there is a lack of knowledge regarding the extent and details of patient CAM use in Sweden, especially in rural Sweden. The aim of this study was to estimate the extent and characteristics of CAM use among cancer patients in Region Gävleborg.

METHODS: A total of 631 questionnaires were distributed to which 376 responses were registered, yielding a response rate of 59.6%. Questionnaires were distributed to oncology patients at their first visit for curative treatment at the Department of Oncology, Gävle Hospital. Palliative patients were recruited at their first visit and during enrollment in palliative outpatient care in their own homes. The characteristics of the respondents were presented with standard descriptive statistics. A multivariable logistic model was fitted to calculate odds ratios (ORs) and identify potential predictors (Age, Gender, Education, Diagnosis) of CAM use post-cancer diagnosis.

RESULTS: 54% of all participants reported lifetime CAM use, 34% reported CAM use post-diagnosis. The most common CAM methods used after diagnosis are vitamins, health food preparations, herbal teas, prayer and dietary methods. The most common source of information reported is family and friends. Almost 70% of those who used CAM after their diagnosis stated that they did not discuss their use with healthcare professionals. Most patients reported that they would like some CAM modalities to be offered within conventional care regardless of their own CAM use.

CONCLUSIONS: The use of CAM is common among patients with cancer in the region of Gävleborg, and previous studies show a similar use in Sweden in general. Based on the widespread use of CAM and patient interest in discussing CAM use with healthcare professionals, greater attention and focus should be placed on creating a basis for this dialogue. If we, as healthcare professionals, are to emphasise our commitment to providing patient-centred care, we must acknowledge that patients use CAM and are seeking a dialogue about CAM use in their care.

PMID:36797715 | DOI:10.1186/s12906-023-03876-2

BMC Nurs. 2023 Feb 16;22(1):43. doi: 10.1186/s12912-023-01199-8.

ABSTRACT

BACKGROUND: Nurses who play the leading role in caring for patients, especially nurses in the chemotherapy department who are constantly exposed to high-risk drugs and their side effects, should pay more attention to occupational safety. This study was performed to determine the effect of training chemotherapy safety standards using a smartphone application on nurses’ knowledge, attitude, and performance.

METHODS: The whole enumeration of fifty oncology nurses was recruited who they worked in 3 hospitals affiliated with Lorestan University of Medical Sciences (west of Iran). The study was conducted from June to November 2021. The training was done for four weeks with a smartphone application, including six main courses of familiarity with hazardous drugs, Personal Protective Equipment, preparation, storage and transfer, spilling, and wastes disposal of hazardous drudges . The nurses’ knowledge, attitude, and performance questionnaire were completed before, immediately after, and one month after the intervention. Data analysis was performed using SPSS version 26, descriptive and inferential statistical tests of independent t-test, one-way analysis of variance, Spearman’s rank correlation coefficient, repeated measures analysis of variance, and the Generalized Estimating Equation (GEE) model.

RESULTS: Mean knowledge score of participants before, immediately after, and one month after the intervention was (47.18 ± 8.19), (60.08 ± 3.82), and (61.88 ± 3.45), respectively. The mean attitude score of participants before, immediately after, and one month after the intervention was (30.34 ± 3.94), (34.32 ± 3.25), and (34.98 ± 2.88), in order, and the mean performance score of participants before, immediately after, and one month after the intervention was (43.60 ± 5.11), (51.78 ± 3.15) and (52.88 ± 3.06), respectively. The mean nurses’ knowledge, attitude, and performance score increased significantly over time (P < 0.001).

CONCLUSIONS: Teaching chemotherapy safety standards using the application improved oncology nurses’ knowledge, attitude, and performance. Appropriate educational programs, especially by new methods such as E-learning, are recommended for providing safety for nurses.

PMID:36797713 | DOI:10.1186/s12912-023-01199-8

BMC Cancer. 2023 Feb 16;23(1):160. doi: 10.1186/s12885-023-10639-2.

ABSTRACT

BACKGROUND: Clear cell renal cell carcinoma (ccRCC) is common in urinary system tumors. Cuproptosis is a non-apoptotic cell death pathway. Copper binds to fatty acylated mitochondrial proteins and activates various forms of cell death. LncRNA LINC02154 is significantly highly expressed in cells and tissues of many types of tumors, and the risk signature of LINC02154 in some tumors has been validated for effectiveness.

METHODS: We constructed a risk prognostic signature by obtaining differentially expressed long noncoding RNAs (lncRNAs) associated with ccRCC outcomes and cuproptosis from The Cancer Genome Atlas (TCGA). We used TCGA to construct training and testing sets to analyze the risk signature and the impact of LINC02154, and we performed relevant survival analyses. Tumor mutational burdens were analyzed in different LINC02154 expression groups and risk score groups. We next analyzed the immune microenvironment of LINC20154. We performed LINC20154-related drug sensitivity analyses. We also investigated the cellular function of LINC02154 in the ACHN cell line and performed CCK-8 assay, EdU, wound-healing assay, and Transwell assay. The essential genes FDX1 and DLST of cuproptosis were detected by western blot.

RESULTS: We demonstrated that LINC02154’s impact on outcomes was statistically significant. We also demonstrated the association of different ages, genders, stages, and grades with LINC02154 and risk models. The results showed a significant difference in tumor mutation burden between the groups, which was closely related to clinical prognosis. We found differences in immune cells among groups with different levels of LINC02154 expression and significant differences in immune function, immunotherapeutic positive markers, and critical steps of the immune cycle. The sensitivity analysis showed that differential expression of LINC02154 discriminated between sensitivity to axitinib, doxorubicin, gemcitabine, pazopanib, sorafenib, sunitinib, and temsirolimus. This difference was also present in the high-risk group and low-risk group. We demonstrated that the proliferation and migration of t ACHN cells in the LINC02154 knockdown group were inhibited. The western blot results showed that the knockdown of LINC02154 significantly affected the expression of FDX1 and DLST, critical genes of cuproptosis.

CONCLUSION: Finally, we demonstrated that LINC02154 and our constructed risk signature could predict outcomes and have potential clinical value.

PMID:36797708 | DOI:10.1186/s12885-023-10639-2

BMC Public Health. 2023 Feb 16;23(1):349. doi: 10.1186/s12889-023-15228-3.

ABSTRACT

BACKGROUND: In countries such as Eswatini, where there is a high HIV prevalence and low male circumcision the World Health Organization and the Joint United Nations Programme for HIV/AIDS recommend infant and adult circumcision be implemented. The aim of this study was to assess the knowledge, attitudes and acceptability of voluntary medical male circumcision amongst males attending high school in Eswatini.

METHODS: An observational cross-sectional study was conducted during February and March of 2018 amongst 407 young males (15-21 years) attending Form 4, in nine high schools in the Shiselweni region of Eswatini using a self-administered questionnaire of 42 close ended questions. Sociodemographic details, circumcision status, acceptance of voluntary medical male circumcision, knowledge and attitude scores analysed in Stata® 14 statistical software were described using frequencies, medians and ranges respectively. Bivariate and multivariate linear regression was used to assess the impact of independent variables on circumcision status and acceptance of voluntary medical male circumcision. The level of statistical significance was p < 0.05.

RESULTS: Amongst the 407 high school-going males, 48.98% (n = 201) reported being circumcised. The majority of the adolescents (75.74%; n = 306) were knowledgeable about voluntary medical male circumcision. However, an even larger majority (84.90% (n = 343) had a negative attitude towards it. In the multivariate logistic regression analysis, having parented their own children (aOR: 3.55; 95%CI: 1.2-10.48), and having circumcised friends (aOR: 3.99; 95%CI: 1.81-8.84) were significantly associated with being circumcised. Neither knowledge nor attitude were associated with the acceptability of voluntary medical male circumcision.

CONCLUSION: In Eswatini male high school students are knowledgeable about voluntary medical male circumcision but have a negative attitude towards it. Having parented their own children, and having circumcised friends influenced being circumcised.

PMID:36797696 | DOI:10.1186/s12889-023-15228-3

BMC Neurol. 2023 Feb 16;23(1):74. doi: 10.1186/s12883-023-03118-5.

ABSTRACT

BACKGROUND: Stroke is the second leading cause of disease-related death and the third leading cause of disability worldwide. However, how to accurately warn of stroke onset remains extremely challenging. Recently, phenylacetyl glutamine (PAGln) has been implicated in the onset of stroke, but evidences from cohort studies of onset are lacking, especially in patients with first-onset or recurrent. It is necessary to deeply demonstrate the effectiveness of PAGln level on warning stroke onset.

METHODS: One hundred fifteen first onset stroke patients, 33 recurrent stroke patients, and 135 non-stroke controls were included in the analysis. Risk factors associated with stroke attacking were evaluated, and plasma PAGln levels were detected via HPLC-MS based method. LASSO regression, Pearson correlation analysis, and univariate analysis were carried out to demonstrate the associations between PAGln levels and risk factors of stroke. Random forest machine learning algorithm was used to build classification models to achieve the distinction of first-onset stroke patients, recurrent stroke patients, and non-stroke controls, and further demonstrate the contribution of PAGln levels in the distinction of stroke onset.

RESULTS: The median level of PAGln in the first-onset stroke group, recurrent stroke group, and non-stroke group was 933 ng/mL, 1014 ng/mL, and 556 ng/mL, respectively. No statistical correlation was found between PAGln level and subject’s living habits, eating preferences, and concomitant diseases (hypertension, hyperlipidemia, and diabetes). Stroke severity indicators, mainly age and NIHSS score, were found associate with the PAGln levels. Machine learning classification models confirmed that PAGln levels, as the main contributing variable, could be used to distinguish recurrent stroke patients (but not first-onset stroke patients) from non-stroke controls.

CONCLUSION: PAGln may be an effective indicator to monitor the recurrence in stroke patients.

PMID:36797695 | DOI:10.1186/s12883-023-03118-5

J Am Podiatr Med Assoc. 2022 Apr 22:1-39. doi: 10.7547/21-215. Online ahead of print.

ABSTRACT

BACKGROUND: Given that excess opioid prescriptions contribute to the United States opioid epidemic and there are few national opioid prescribing guidelines for the management of acute pain, it is pertinent to determine if prescribers can sufficiently assess their own prescribing practice. The purpose of this study was to investigate podiatric surgeons’ ability to evaluate if their own opioid prescribing practice is less than, near, or above that of an “average” prescriber.

METHODS: We administered a scenario-based, voluntary, anonymous, online questionnaire via Qualtrics which consisted of five surgery-based scenarios commonly performed by podiatric surgeons. Respondents were asked the quantity of opioids they would prescribe at the time of surgery. Respondents were also asked to rate their prescribing practice compared to the average (median) podiatric surgeons. We compared self-reported behavior to self-reported perception (“I prescribe less than average,” “I prescribed about average,” and “I prescribe more than average”). ANOVA was used for univariate analysis between the three groups. We used linear regression to adjust for confounders. Data restriction was used to account for restrictive state laws.

RESULTS: One hundred fifteen podiatric surgeons completed the survey from in April 2020. Less than half of the time, respondents accurately identified their own category. Consequently, there were no statistically significant differences between podiatric surgeons who reported that they “prescribe less,” “prescribe about average,” and “prescribe more.” Paradoxically, there was a flip in scenario #5, whereas respondents who reported they “prescribe more” actually prescribed the least and respondents who believed that they “prescribe less” actually prescribed the most.

CONCLUSIONS: Cognitive bias, in the form of a novel effect, occurs in postoperative opioid prescribing practice; in the absence of procedure-specific guidelines or an objective standard, podiatric surgeons, more often than not, were unaware of how their own opioid prescribing practice measured up to other podiatric surgeons.

PMID:36795491 | DOI:10.7547/21-215

Elife. 2023 Feb 16;12:e82201. doi: 10.7554/eLife.82201.

ABSTRACT

Proper differentiation of sperm from germline stem cells, essential for production of the next generation, requires dramatic changes in gene expression that drive remodeling of almost all cellular components, from chromatin to organelles to cell shape itself. Here, we provide a single nucleus and single cell RNA-seq resource covering all of spermatogenesis in Drosophila starting from in-depth analysis of adult testis single nucleus RNA-seq (snRNA-seq) data from the Fly Cell Atlas (FCA) study. With over 44,000 nuclei and 6000 cells analyzed, the data provide identification of rare cell types, mapping of intermediate steps in differentiation, and the potential to identify new factors impacting fertility or controlling differentiation of germline and supporting somatic cells. We justify assignment of key germline and somatic cell types using combinations of known markers, in situ hybridization, and analysis of extant protein traps. Comparison of single cell and single nucleus datasets proved particularly revealing of dynamic developmental transitions in germline differentiation. To complement the web-based portals for data analysis hosted by the FCA, we provide datasets compatible with commonly used software such as Seurat and Monocle. The foundation provided here will enable communities studying spermatogenesis to interrogate the datasets to identify candidate genes to test for function in vivo.

PMID:36795469 | DOI:10.7554/eLife.82201

J Fam Psychol. 2023 Feb 16. doi: 10.1037/fam0001065. Online ahead of print.

ABSTRACT

Executive function (EF) plays a key role in healthy development and human functioning across multiple domains, including socially, behaviorally, and in the self-regulation of cognition and emotion. Prior research has associated lower levels of maternal EF with harsher and more reactive parenting, and mothers’ social cognitive attributes like authoritarian child-rearing attitudes and hostile attribution biases also contribute to harsh parenting practices. There have been few studies that explore the intersection of maternal EF and social cognitions. The present study addresses this gap by testing whether the relationship between individual differences in maternal EF and harsh parenting behaviors is statistically moderated separately by maternal authoritarian attitudes and hostile attribution bias. Participants were 156 mothers in a socioeconomically diverse sample. Multi-informant and multimethod assessments of harsh parenting and EF were utilized, and mothers self-reported on their child-rearing attitudes and attribution bias. Harsh parenting was negatively associated with maternal EF and hostile attribution bias. Authoritarian attitudes significantly interacted with EF (and the attribution bias interaction was marginally significant) in prediction of variance in harsh parenting behaviors. Commensurate with social information processing theory, EF and social cognitive attributes play critical and distinct roles in the causes of harsh caregiving practices. Findings elucidate that reforming parental social cognitions, in addition to targeting EF, may be effective prevention and intervention methods for yielding more positive parenting behaviors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:36795419 | DOI:10.1037/fam0001065

JAMA Netw Open. 2023 Feb 1;6(2):e2255631. doi: 10.1001/jamanetworkopen.2022.55631.

ABSTRACT

IMPORTANCE: Most epidemiologic studies examine the brain as an outcome in relation to adiposity (ie, the brain-as-outcome perspective), but it is also a potential risk factor associated with adiposity accumulation over time (ie, the brain-as-risk factor perspective). The bidirectionality hypothesis has not been fully explored in adolescent samples previously.

OBJECTIVE: To assess bidirectional associations between adiposity and cognitive function in youth and test mediational pathways through brain morphology (specifically the lateral prefrontal cortex [LPFC]), lifestyle behaviors, and blood pressure.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study uses data (wave 1-3; 2 years of follow-up) from the Adolescent Brain Cognitive Development (ABCD) Study, a long-term longitudinal investigation of brain development in the United States launched in 2015, which recruited 11 878 children aged 9 to 10 years at inception. Data analysis was performed from August 2021 to June 2022.

MAIN OUTCOMES AND MEASURES: Multivariate multivariable regression analyses were used to assess bidirectional associations of indicators of cognitive function (eg, executive function, processing speed, episodic memory, receptive vocabulary and reading skills) and adiposity (eg, body mass index z scores [zBMI] and waist circumference [WC]). Mediators considered for this investigation were lifestyle variables (eg, diet and physical activity), blood pressure, and the morphology of the LPFC and its subregions.

RESULTS: A total of 11 103 individuals (mean [SD] age, 9.91 [0.6] years; 5307 females [48%]; 8293 White individuals [75%] and 2264 Hispanic individuals [21%]) were included in the current study. Multivariate multivariable regression analyses revealed that higher baseline zBMI and WC were associated with worse follow-up episodic memory (β, -0.04; 95% CI, -0.07 to -0.01) and better vocabulary (β, 0.03; 95% CI, 0.002 to 0.06) task performance, in covariate adjusted models. Similarly, superior baseline executive function (zBMI: β, -0.03; 95% CI, -0.06 to -0.01; WC: β, -0.04; 95% CI, -0.07 to -0.01) and episodic memory (zBMI: β, -0.04; 95% CI, -0.07 to -0.02; WC: β, -0.03; 95% CI, -0.06 to -0.002) task performance were associated with better follow-up adiposity status in covariate adjusted models. Cross-lagged panel models with latent variable modeling had a bidirectional association with executive function task performance (brain-as-outcome: β, -0.02; 95% CI, -0.05 to -0.001; brain-as-risk factor: β, -0.01; 95% CI, -0.02 to -0.003). The hypothesized associations were statistically mediated by LPFC volume and thickness, physical activity, and blood pressure.

CONCLUSIONS AND RELEVANCE: In this cohort study, executive function and episodic memory were bidirectionally associated with adiposity indices over time in this adolescent sample. These findings suggest that the brain can be both a risk factor and an outcome of adiposity; this complex bidirectional association should be taken into account in future research and clinical practice.

PMID:36795417 | DOI:10.1001/jamanetworkopen.2022.55631