Category: Nevin Manimala

BMC Pediatr. 2022 Oct 14;22(1):594. doi: 10.1186/s12887-022-03644-0.

ABSTRACT

BACKGROUND: Neck circumference is one of the anthropometric parameters that is widely used in practical applications, clinical and epidemiological studies in children. It is aimed to determine the neck circumference cut-off points and to use them in the detection of overweight and obesity in children living in Northern Cyprus.

SUBJECTS: This cross-sectional study was conducted between October 2019 and January 2020, and covered a sample of 692 children (367 girls and 325 boys) aged 6-10 years attending primary schools in the Northern Cyprus.

METHODS: Body weight, height, neck circumference, waist circumference, subscapular and triceps skinfold tickness were measured. BF% was calculated with Slaughter equations. World Health Organization BMI cut-off points for age and gender percentiles were used to categorize obesity. BMI, WHtR, NC, body fat were calculated. The Pearson Correlation co-efficient between NC and the other anhtropometric measurements were calculated. Receiver operating characteristics analysis, sensitivity, specificity, PV + ve PV- was used to determine the optimal NC cut-off points for identifying children with overweight and obesity.

RESULTS: NC was a statistically significant positive and strong relationship with body weight, BMI, waist circumference and hip circumference (p < 0,005). NC cut-off values to define overweight and obesity were calculated as 26,9 cm in girls (AUC: 0,851, 95% CI: 0,811-0,891, sensitivity 70,50%, specificity 84,65%) and 27,9 cm in boys (AUC: 0,847, 95% CI: 0,805-0,888, sensitivity 76,4%, specificity 79,3%). The ROC curves accurately define overweight and obesity of the whole cohort regardless of age for both sexes of children.

CONCLUSIONS: The cut-off points for neck circumference were found to be 27,9 cm for boys and 26,9 cm for girls in determining overweight and obesity in children aged 6-10 years. The NC cut-off points obtained in this study can be used to define overweight and obesity in children in epidemiological studies. It is considered to shed light on studies that will examine the relationship between neck circumference and diseases with more people in future studies.

PMID:36229791 | DOI:10.1186/s12887-022-03644-0

BMC Geriatr. 2022 Oct 13;22(1):797. doi: 10.1186/s12877-022-03483-9.

ABSTRACT

BACKGROUND: Caregivers have considerable responsibilities in supporting persons in advanced stages of dementia, however they receive little education. Namaste Care is a multisensory program originally designed to be delivered by healthcare providers in long-term care homes for persons with advanced dementia. The program has not yet been adapted and evaluated for use by caregivers of persons with moderate to advanced dementia living at home. The purpose of this feasibility study is to determine the feasibility, acceptability and preliminary effectiveness of the adapted Namaste Care program for use by caregivers of community-dwelling older persons with moderate to advanced dementia.

METHODS: This feasibility study, with a one-group before-after design and interviews, was part of a larger study using a multiphase mixed methods design. A total of 12 caregivers delivered the program over three months. Caregivers completed questionnaires on caregiver quality of life, perceptions of caregiving, self-efficacy, and burden at baseline and 3-month follow-up. Caregivers participated in interviews at the 3-month follow-up to explore acceptability and perceived benefit. Descriptive statistics and paired t-tests were used to analyze quantitative data. A secondary analysis used multiple imputation to explore the impact of missing data. Experiential thematic analysis was used in analyzing qualitative data.

RESULTS: The adapted Namaste Care program was judged to be feasible, given that all caregivers used it at least twice a week over the 3-month period. The retention rate of caregivers was 83% (10 of 12). Caregivers perceived that the program was practical, enhanced the wellbeing of persons with dementia, and brought them closer in their relationships with persons with dementia. There were no statistically significant changes for quality of life, perceptions of caregiving, self-efficacy, or burden outcomes. Multiple imputation results revealed promising findings for an improvement in caregiver wellbeing related to quality of life.

CONCLUSIONS: The adapted Namaste Care program for use by caregivers of community-dwelling older persons with moderate to advanced dementia was feasible and acceptable. The program has the potential to enhance the quality of life and other outcomes of caregivers, however there is a need to conduct a larger trial that is adequately powered to detect these effects.

PMID:36229789 | DOI:10.1186/s12877-022-03483-9

BMC Bioinformatics. 2022 Oct 13;23(1):421. doi: 10.1186/s12859-022-04974-7.

ABSTRACT

BACKGROUND: Despite continuing technological advances, the cost for large-scale genotyping of a high number of samples can be prohibitive. The purpose of this study is to design a cost-saving strategy for SNP genotyping. We suggest making use of pooling, a group testing technique, to drop the amount of SNP arrays needed. We believe that this will be of the greatest importance for non-model organisms with more limited resources in terms of cost-efficient large-scale chips and high-quality reference genomes, such as application in wildlife monitoring, plant and animal breeding, but it is in essence species-agnostic. The proposed approach consists in grouping and mixing individual DNA samples into pools before testing these pools on bead-chips, such that the number of pools is less than the number of individual samples. We present a statistical estimation algorithm, based on the pooling outcomes, for inferring marker-wise the most likely genotype of every sample in each pool. Finally, we input these estimated genotypes into existing imputation algorithms. We compare the imputation performance from pooled data with the Beagle algorithm, and a local likelihood-aware phasing algorithm closely modeled on MaCH that we implemented.

RESULTS: We conduct simulations based on human data from the 1000 Genomes Project, to aid comparison with other imputation studies. Based on the simulated data, we find that pooling impacts the genotype frequencies of the directly identifiable markers, without imputation. We also demonstrate how a combinatorial estimation of the genotype probabilities from the pooling design can improve the prediction performance of imputation models. Our algorithm achieves 93% concordance in predicting unassayed markers from pooled data, thus it outperforms the Beagle imputation model which reaches 80% concordance. We observe that the pooling design gives higher concordance for the rare variants than traditional low-density to high-density imputation commonly used for cost-effective genotyping of large cohorts.

CONCLUSIONS: We present promising results for combining a pooling scheme for SNP genotyping with computational genotype imputation on human data. These results could find potential applications in any context where the genotyping costs form a limiting factor on the study size, such as in marker-assisted selection in plant breeding.

PMID:36229780 | DOI:10.1186/s12859-022-04974-7

BMC Microbiol. 2022 Oct 14;22(1):248. doi: 10.1186/s12866-022-02660-5.

ABSTRACT

BACKGROUND: Carbapenemase-producing Gram-negative (CPGN) bacteria impose life-threatening infections with limited treatment options. Rigor and rapid detection of CPGN-associated infections is usually associated with proper treatment and better disease prognosis. Accordingly, this study aimed at evaluating the phenotypic methods versus genotypic methods used for the detection of such pathogens and determining their sensitivity/specificity values.

METHODS: A total of 71 CPGN bacilli (30 Enterobacterales and 41 non-glucose-fermenting bacilli) were tested for the carbapenemase production by the major phenotypic approaches including, the modified Hodge test (MHT), modified carbapenem inactivation method (mCIM), combined disk test by EDTA (CDT) and blue-carba test (BCT). The obtained results were statistically analyzed and correlated to the obtained resistant genotypes that were determined by using polymerase chain reactions (PCR) for the detection of the major carbapenemase-encoding genes covering the three classes (Class A, B, and D) of carbapenemases.

RESULTS: In comparison to PCR, the overall sensitivity/specificity values for detection of carbapenemase-producing organism were 65.62%/100% for MHT, 68.65%/100% for mCIM, 55.22%/100% for CDT and 89.55%/75% for BCT. The sensitivity/specificity values for carbapenemase-producing Enterobacterales were, 74%100% for MHT, 51.72%/ 100% for mCIM, 62.07%/100% for CDT and 82.75%/100% for BCT. The sensitivity/specificity values for carbapenemase-producing non-glucose fermenting bacilli were, 62.16%/100% for MHT, 81.57%/100% for mCIM, 50/100% for CDT and 94.74%/66.66% for BCT. Considering these findings, BCT possess a relatively high performance for the efficient and rapid detection of carbapenemase producing isolates. Statistical analysis showed significant association (p < 0.05) between bla_NDM and/or bla_VIM genotypes with MHT/CDT; bla_KPC/bla_GIM genotypes with CDT and bla_GIM genotype with BCT.

CONCLUSION: The current study provides an update on the performance of the phenotypic tests which are varied depending on the tested bacterial genera and the type of the carbapenemase. The overall sensitivity/specificity values for detection of CPO were 65.62%/100% for MHT, 68.65%/100% for mCIM, 55.22%/100% for CDT and 89.55%/75% for BCT. Based on its respective diagnostic efficiency and rapid turnaround time, BCT is more likely to be recommended in a resource-limited settings particularly, when molecular tests are not available.

PMID:36229768 | DOI:10.1186/s12866-022-02660-5

J Gen Intern Med. 2022 Oct 13. doi: 10.1007/s11606-022-07793-x. Online ahead of print.

ABSTRACT

BACKGROUND: Despite widespread adoption of state prescription drug monitoring programs (PDMPs), it is unclear how often PDMPs are accessed through an electronic health record system (EHR-PDMP integration), or whether efforts to make PDMPs easier to access and use have improved their utility.

OBJECTIVE: To produce national-level estimates on the use of PDMPs among office-based physicians and benefits associated with their use.

DESIGN: We use nationally representative survey data to produce descriptive statistics on PDMP use and associated benefits among office-based physicians in the USA.

PARTICIPANTS: 1398 office-based physicians who prescribe controlled substances.

MAIN MEASURES: We examined physician-reported ease and frequency of PDMP use, and how EHR-PDMP integration affects frequency and ease of use. Multivariate models were used to assess whether characteristics of PDMP use were related to physician-reported benefits such as reduced prescribing of controlled substances and perceived improvements in clinical decision-making.

KEY RESULTS: In 2019, two-thirds of office-based physicians in the USA reported frequent use of their state PDMP and over three-quarters reported they were easy to use. Both frequency and ease of use were positively correlated with PDMP integration status. Respondents who frequently checked their state’s PDMP were 8.7 percentage points (95% CI -.4 to 17.8) more likely to report perceived benefits and reported 2.2 (95% CI 1.54 to 2.83) more benefits. Respondents who indicated their PDMP was easy to use were 12.7 percentage points (95% CI .040 to .214) more likely to report perceived benefits and reported 0.94 (95% CI 0.26 to 1.61) more benefits.

CONCLUSIONS: Our findings suggest efforts to make PDMPs easier to access and use aided physicians in making informed clinical decisions that may not be captured by reduced prescribing alone. Efforts to further increase frequency and ease of use-including advancing a standards-based approach to PDMP and EHR data interoperability-may further increase the benefit of PDMPs.

PMID:36229762 | DOI:10.1007/s11606-022-07793-x

Bull Math Biol. 2022 Oct 13;84(11):135. doi: 10.1007/s11538-022-01090-8.

ABSTRACT

Population persistence and spatial propagation and their dependence on demography and dispersal are of great importance in spatial ecology. Many species with highly structured life cycles invade new habitats through the dispersal of organisms in their early life stages (e.g., seeds, larvae, etc.). We develop a stage-structured continuous/discrete-time hybrid model to describe the spatiotemporal dynamics of such species, in which a reaction-diffusion equation describes the random movement of dispersing individuals, while two difference equations describe the demography of sedentary individuals. We obtain a formula for the spreading speed of the population in terms of model parameters. We show that the spreading speed can be characterized as the slowest wave speed of a class of traveling wave solutions. We provide an explicit formula for the critical domain size that separates population persistence from extinction. By comparing our stage-structured model with a physically unstructured model, we find that the structured model reduces to the unstructured one in some special cases. Accordingly, the results about the spreading speed and the critical domain size for the unstructured model represent some special cases of those for the structured one. This highlights the significance of including stage structure in studying the spatial dynamics of species with complex life cycles.

PMID:36229706 | DOI:10.1007/s11538-022-01090-8

Biomech Model Mechanobiol. 2022 Oct 13. doi: 10.1007/s10237-022-01634-w. Online ahead of print.

ABSTRACT

We consider a two-dimensional biomorphoelastic model describing post-burn scar contraction. This model describes skin displacement and the development of the effective Eulerian strain in the tissue. Besides these mechanical components, signaling molecules, fibroblasts, myofibroblasts, and collagen also play a significant role in the model. We perform a sensitivity analysis for the independent parameters of the model and focus on the effects on features of the relative surface area and the total strain energy density. We conclude that the most sensitive parameters are the Poisson’s ratio, the equilibrium collagen concentration, the contraction inhibitor constant, and the myofibroblast apoptosis rate. Next to these insights, we perform a sensitivity analysis where the proliferation rates of fibroblasts and myofibroblasts are not the same. The impact of this model adaptation is significant.

PMID:36229698 | DOI:10.1007/s10237-022-01634-w

Eur J Pediatr. 2022 Oct 14. doi: 10.1007/s00431-022-04656-9. Online ahead of print.

ABSTRACT

Dysregulation of zinc (Zn) homeostasis causes a shift in the Th1/Th2 balance towards a Th2 response, which may lead to a heightened inflammatory response. Asthma is associated with an exaggerated Th2 response to antigens. This study attempts to find the association of serum Zn with the status of symptom control of asthma in children and adolescents with bronchial asthma. A total of 67 asthmatic children, diagnosed as per Global Initiative for Asthma (GINA) 2019 guidelines, were included in the study. Symptom control of asthma was assessed by Asthma Control Test (ACT) and Childhood Asthma Control Test (C-ACT) scores. Spirometry was performed on those participants who were able to perform satisfactorily. Serum Zn was analyzed using the photometric method. Participants were divided into two groups: controlled and uncontrolled groups according to ACT/C-ACT score. Mean age of the participants was 10.78 ± 3.67 years. The mean S. Zn (µg/dL) was 136.97 ± 48.37. This study found a higher mean S. Zn value in the controlled asthma group as compared to the uncontrolled group (158.06 vs 129.23, p = 0.006). At a cutoff of S. Zn (µg/dL) ≥ 126.84, it predicted controlled asthma with a sensitivity of 89% and a specificity of 55%. No significant difference was found between the mean serum Zn levels in terms of age, sex, severity, and CRP levels.

CONCLUSION: A significant difference was observed between the mean value of Zn and symptom control of asthma (p = 0.006) with a weak positive correlation between the two which was statistically significant (rho = 0.26, p = 0.031). However, low levels of zinc were not significantly associated with symptom control of asthma. Thus, we conclude that maintaining an adequate zinc level could help in achieving better control of asthma in pediatric populations.

WHAT IS KNOWN: • Zinc has a role in immunological response in the pathophysiology of immunological disorders such as bronchial asthma.

WHAT IS NEW: • This study adds a significant association of serum zinc levels with symptom control of asthma in pediatric populations. • This study also gives a cut-off value of serum zinc level which predicts adequate symptom control of asthma.

PMID:36229694 | DOI:10.1007/s00431-022-04656-9

Eur Arch Otorhinolaryngol. 2022 Oct 13. doi: 10.1007/s00405-022-07690-3. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to investigate the relationship of cepstral analysis (Cepstral Peak Prominence [CPP] and Cepstral Peak Prominence-Smoothed [CPPS]) with voice self-assessments (The Persian version of vocal tract discomfort [VTDp] scale and non-standard hoarseness self-assessment [NHS] questionnaire).

METHODS: 223 participants (159 with and 64 without dysphonia) were asked to utter the vocal tasks namely vowels /a/ and /e/, six standard sentences, and a non-standard connected speech sample. CPP and CPPS were calculated in these three vocal tasks using the “Praat” software. The participants also asked to complete the VTDp scale and the NHS questionnaire.

RESULTS: The means of frequency and severity the VTDp and the means of NHS were statistically different between the dysphonic and normal voice groups (P < 0.05), except for tickling (P > 0.05). There was a very low significant correlation between cepstral analysis with aching and in the dysphonic group (P < 0.05). However, a very low to low significant correlation between cepstral analysis with burning, tight, aching, tickling, sore, and both frequency and severity subscales scores of the VTDp in the normal voice group (P < 0.05). Moreover, the means of the cepstral analysis did not differ significantly between all scores of the NHS in the dysphonic the normal voice groups (P > 0.05), except for 1 with 3, 4, and 5 in the dysphonic group (P < 0.05).

CONCLUSION: The cepstral analysis can provide some information about the status of vocal tract and person’s perception of his/her own voice quality.

PMID:36229669 | DOI:10.1007/s00405-022-07690-3

Langenbecks Arch Surg. 2022 Oct 14. doi: 10.1007/s00423-022-02712-4. Online ahead of print.

ABSTRACT

PURPOSE: Despite continuous improvement in minimally invasive surgery (MIS) and growing evidence for its superiority in procedures in various organ systems, a routinely application in patients with acute bowel obstruction (ABO) cannot be seen to date. Besides very general explanations for this attitude, not much is known about the decision process in a particular patient. This retrospective study aims at investigating surgeon- and patient-specific factors for or against MIS in acute bowel obstruction.

METHODS: A retrospective analysis of all patients undergoing either MIS or open surgery (OS) for ABO at a single center between 2009 and 2017 was performed. All available preoperative parameters were included in the analysis and subdivided into patient- (age, gender, BMI, previous abdominal procedures, inflammatory process, ASA score, bowel dilatation) and surgeon-specific (time of patient admission, senior surgeon performed the procedure or taught the case, availability of a surgical resident or junior doctor as assisting surgeon) factors. Statistical analysis was performed to reveal their influence on the surgeon’s decision for or against MIS.

RESULTS: Of 106 patients requiring surgical intervention, 57 were treated by OS (53.77%) and 49 by MIS (46.23%). Patients with a higher ASA score (ASA III) and a bowel width of ≥ 3.8 cm in preoperative radiologic imaging were more likely to undergo OS (p < 0.01). Also, a late admission time to the hospital (x̄ = 14.78 h) was associated with OS (p = 0.01). Concerning previous abdominal surgical interventions, patients with prior appendectomy rather were assigned to MIS (p < 0.01) whereas those with prior colectomy to OS (p < 0.01).

CONCLUSIONS: The choice of procedure in patients with bowel obstruction is a highly individualized decision. Whereas scientifically proven parameters, such as high age and BMI, had no influence on the decision process, impaired general health condition (ASA score), high bowel width, previous surgical intervention, and a late admission time influenced the decision process towards open surgery.

TRIAL REGISTRATION: Retrospectively registered with the German Clinical Trials Register: DRKS00021600.

PMID:36229667 | DOI:10.1007/s00423-022-02712-4