Category: Nevin Manimala

PLoS One. 2021 Nov 19;16(11):e0260022. doi: 10.1371/journal.pone.0260022. eCollection 2021.

ABSTRACT

BACKGROUND: Visceral leishmaniasis (VL) is one of the major public health burden, mainly distributed throughout tropical and subtropical regions of the world. Among the Sub-Saharan African countries, Ethiopia is the second most affected country with VL. An Alteration of liver function is a typical manifestation of the disease.

OBJECTIVE: The purpose of conducting this study was to assess liver function tests and associated risk factors among VL patients at Leishmaniasis Research and Treatment Center of University of Gondar Comprehensive Specialized Hospital, North West Ethiopia.

METHOD: Hospital based comparative cross-sectional study design was conducted. A total of 102 study participants were involved in this study. Newly diagnosed VL patients who were attended at Leishmaniasis Research and Treatment Center of University of Gondar Comprehensive Specialized Hospital from 21st February 2020 to 30th September 2020 were included under case group category. On the other hand, age-sex matched apparently healthy study subjects were categorized as control group. Written consent was obtained willingness of patients to participate after ethical clearance was obtained from the Institutional Review Board of School of Medicine, University of Gondar. After overnight fasting, 5ml venous blood was drawn from both VL patients and controls to evaluate liver function tests, including AST, ALT, total bilirubin, albumin, and total protein. Thus, senior health professionals (laboratory technologist) investigate the results using Cobas Integra 400 Plus clinical chemistry analyzer. Data was entered into Epi-data version 4.6 and exported to STATA 14 for analysis of liver function tests and associated risk factors.

RESULT: The result of this study showed that significant mean difference was exhibited in aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin, serum albumin, and total protein level among VL patients and controls. It showed that there was a statistically significant elevation in the level of AST, ALT, and total bilirubin among cases as compared to control. The serum AST level was significantly (p<0.001) elevated among cases as compared to controls. Serum ALT was significantly (p<0.001) elevated among cases compared to controls. Additionally, the total serum bilirubin level was significantly increased (P<0.001) among cases as compared to controls. There was a statistically significant (P<0.001) reduction of serum albumin level among VL patients as compared to controls. Similarly, serum total protein was significantly (P<0.001) reduced in VL patients than control groups.

CONCLUSION: There were significantly higher mean levels of serum AST, ALT, and total bilirubin among VL patients as compared to controls. On the other hand, VL patients showed significantly lowered level of albumin and total protein as compared to controls.

PMID:34797863 | DOI:10.1371/journal.pone.0260022

PLoS One. 2021 Nov 19;16(11):e0260322. doi: 10.1371/journal.pone.0260322. eCollection 2021.

ABSTRACT

BACKGROUND: The measures implemented by governments worldwide to control and prevent the spread of the COVID-19 have impacted the populations and directly influenced individuals’ quality of life and consumption habits.

OBJECTIVE: This work investigates the Portuguese population’s changes in alcohol, stimulants drinks, illegal substances, and pharmaceutical consumptions habits during the COVID-19 pandemic.

METHODS: An online questionnaire comprising seven groups of questions-with one group referring to alcohol, stimulant drinks, illegal substances, and pharmaceuticals consumption habits-was made available to the general adult population of mainland Portugal from the 26th January through the 31st of March 2021. After applying the inclusion criteria, 1666 questionnaires were selected and analysed using descriptive and inferential statistics.

RESULTS: Our results show that 48.9% of the participants have alcohol drinking habits and increased their alcohol consumption by 16% after the beginning of the COVID-19 pandemic lockdown. Furthermore, 8.7% of the respondents felt the need to increase their consumption of stimulant drinks, especially coffee, the most consumed stimulant drink (77.9%). We also observed that of the 3.1% of respondents who are usual consumers of illegal substances, 26.9% increased their consumption of these substances during the COVID-19 pandemic. Concerning pharmaceuticals, 23.2% of the respondents expressed their need to take a therapeutic drug after the start of the COVID-19 pandemic. The profile of common consumers of alcohol, stimulant drinks, illegal substances, and pharmaceuticals in the COVID-19 pandemic context is contrasting and varies according to gender, age, and employment status.

CONCLUSIONS: The COVID-19 pandemic led to an increase in the consumption of alcohol, stimulant drinks, illegal substances, and pharmaceuticals prescribed to treat anxiety, depression, and sleep changes in the Portuguese population. These new consumption patterns have probably aggravated domestic violence, mental diseases, and impairment of family quality of life in the Portuguese population.

PMID:34797874 | DOI:10.1371/journal.pone.0260322

PLoS One. 2021 Nov 19;16(11):e0260243. doi: 10.1371/journal.pone.0260243. eCollection 2021.

ABSTRACT

BACKGROUND: Psoriasis is a chronic inflammatory disease characterized by keratinocyte hyperproliferation and aberrant differentiation with great negative impact on patients’ quality of life (QoL). This study aimed at assessing factors influencing management practice, and QoL and its associated factors among ambulatory psoriatic patients visiting All Africa Leprosy, Tuberculosis and Rehabilitation Training (ALERT) Center in Addis Ababa, Ethiopia.

MATERIALS AND METHODS: A cross sectional study was conducted in 207 patients with psoriasis attending the dermatology clinic of ALERT Center in Addis Ababa, Ethiopia. Data were collected using structured questionnaire and patients’ chart review. Dermatology Life Quality Index (DLQI) was used to measure patients’ QoL. Patients’ characteristics were summarized using descriptive statistics and predictors of QoL were identified by binary logistic regression.

RESULTS: Among 207 study participants, 122 (58.9%) were females. The mean age of the study population was 37.92 (SD = 14.86) years (ranging from 16 to 68 years). The mean age at which diagnosis of psoriasis made was 32 (SD = 13.7) years ranging from 10 to 62 years. The duration of the disease in 112 (54.1%) patients were more than or equal to 5 years. Majority of study participants 145 (70.0%) had plaque psoriasis followed by sebopsoriasis, 24 (11.6%). The majority of plaque psoriasis (80%) cases were managed by topical corticosteroids with or without salicylic acid or coal tar and only 21 (14.5%) treated by methotrexate alone. The mean DLQI was 6.25 corresponding to a moderate effect. Symptoms and feelings were the most affected domains of QoL. Factors associated with poor QoL were female [AOR = 0.17 (95%CI: 0.06, 0.48)], low, above average and high family income ([AOR = 0.12 (95% CI: 0.02, 0.56)], [AOR = 0.06 (95% CI:0.01, 0.32)], and [AOR = 0.03 (95% CI: 0.01, 0.22)]), respectively, and primary education level [AOR = 0.14 (95% CI: 0.03, 0.64)] while being on systemic therapy [AOR = 4.26 (CI: 1.18, 15.35)] was predictor of better QoL. Poor QoL was predominant in females [AOR = 0.17 (95%CI: 0.06, 0.48)], low income [AOR = 0.12 (95% CI: 0.02, 0.56] patients, and patients with primary education level [AOR = 0.14 (95% CI: 0.03, 0.64)]. Patients on systemic therapy [AOR = 4.26 (CI: 1.18, 15.35)] had good QoL.

CONCLUSION: Our study identified that topical corticosteroids were the mainstay of psoriasis treatment in the dermatology clinic of ALERT Center in Addis Ababa, Ethiopia. Moderate effect QoL was achieved by study participants based on DLQL score.

PMID:34797854 | DOI:10.1371/journal.pone.0260243

PLoS One. 2021 Nov 19;16(11):e0260194. doi: 10.1371/journal.pone.0260194. eCollection 2021.

ABSTRACT

OBJECTIVES: Anatomical structure classification is necessary task in medical field, but the inevitable variability of interpretation among experts makes reliable classification difficult. This study aims to introduce cluster analysis, unsupervised machine learning method, for classification of three-dimensional (3D) mandibular canal (MC) courses, and to visualize standard MC courses derived from cluster analysis in the Korean population.

MATERIALS AND METHODS: A total of 429 cone-beam computed tomography images were used. Four sites in the mandible were selected for the measurement of the MC course and four parameters, two vertical and two horizontal parameters were measured per site. Cluster analysis was carried out as follows: parameter measurement, parameter normalization, cluster tendency evaluation, optimal number of clusters determination, and k-means cluster analysis. The 3D MC courses were classified into three types with statistically significant mean differences by cluster analysis.

RESULTS: Cluster 1 showed a smooth line running towards the lingual side in the axial view and a steep slope in the sagittal view. Cluster 2 ran in an almost straight line closest to the lingual and inferior border of mandible. Cluster 3 showed the pathway with a bent buccally in the axial view and an increasing slope in the sagittal view in the posterior area. Cluster 2 showed the highest distribution (42.1%), and males were more widely distributed (57.1%) than the females (42.9%). Cluster 3 comprised similar ratio of male and female cases and accounted for 31.9% of the total distribution. Cluster 1 had the least distribution (26.0%) Distributions of the right and left sides did not show a statistically significant difference.

CONCLUSION: The MC courses were automatically classified as three types through cluster analysis. Cluster analysis enables the unbiased classification of the anatomical structures by reducing observer variability and can present representative standard information for each classified group.

PMID:34797856 | DOI:10.1371/journal.pone.0260194

PLoS One. 2021 Nov 19;16(11):e0257979. doi: 10.1371/journal.pone.0257979. eCollection 2021.

ABSTRACT

Public health interventions such as social distancing and mask wearing decrease the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, but it is unclear whether they decrease the viral load of infected patients and whether changes in viral load impact mortality from coronavirus disease 2019 (COVID-19). We evaluated 6923 patients with COVID-19 at six New York City hospitals from March 15-May 14, 2020, corresponding with the implementation of public health interventions in March. We assessed changes in cycle threshold (CT) values from reverse transcription-polymerase chain reaction tests and in-hospital mortality and modeled the impact of viral load on mortality. Mean CT values increased between March and May, with the proportion of patients with high viral load decreasing from 47.7% to 7.8%. In-hospital mortality increased from 14.9% in March to 28.4% in early April, and then decreased to 8.7% by May. Patients with high viral loads had increased mortality compared to those with low viral loads (adjusted odds ratio 2.34). If viral load had not declined, an estimated 69 additional deaths would have occurred (5.8% higher mortality). SARS-CoV-2 viral load steadily declined among hospitalized patients in the setting of public health interventions, and this correlated with decreases in mortality.

PMID:34797838 | DOI:10.1371/journal.pone.0257979

PLoS Comput Biol. 2021 Nov 19;17(11):e1009579. doi: 10.1371/journal.pcbi.1009579. Online ahead of print.

ABSTRACT

Organisms are composed of various cell types with specific states. To obtain a comprehensive understanding of the functions of organs and tissues, cell types have been classified and defined by identifying specific marker genes. Statistical tests are critical for identifying marker genes, which often involve evaluating differences in the mean expression levels of genes. Differentially expressed gene (DEG)-based analysis has been the most frequently used method of this kind. However, in association with increases in sample size such as in single-cell analysis, DEG-based analysis has faced difficulties associated with the inflation of P-values. Here, we propose the concept of discriminative feature of cells (DFC), an alternative to using DEG-based approaches. We implemented DFC using logistic regression with an adaptive LASSO penalty to perform binary classification for discriminating a population of interest and variable selection to obtain a small subset of defining genes. We demonstrated that DFC prioritized gene pairs with non-independent expression using artificial data and that DFC enabled characterization of the muscle satellite/progenitor cell population. The results revealed that DFC well captured cell-type-specific markers, specific gene expression patterns, and subcategories of this cell population. DFC may complement DEG-based methods for interpreting large data sets. DEG-based analysis uses lists of genes with differences in expression between groups, while DFC, which can be termed a discriminative approach, has potential applications in the task of cell characterization. Upon recent advances in the high-throughput analysis of single cells, methods of cell characterization such as scRNA-seq can be effectively subjected to the discriminative methods.

PMID:34797848 | DOI:10.1371/journal.pcbi.1009579

J Orthop Trauma. 2021 Dec 1;35(12):e475-e480. doi: 10.1097/BOT.0000000000002127.

ABSTRACT

OBJECTIVES: (1) To evaluate adequacy and reproducibility of the gravity and manual stress imaging in the diagnosis of unstable ankle fractures and (2) to evaluate the diagnostic utility of lateral talar displacement ratio (LTDR) derived in relation to the talar body width on ankle stress imaging.

DESIGN: Retrospective cohort study.

SETTING: Level 1 Trauma Center.

PATIENTS: One hundred seventy consecutive patients who presented with supination-external rotation 2 ankle fractures (OTA/AO 44-B2.1) requiring dynamic stress testing.

INTERVENTION: Dynamic stress imaging to determine ankle stability.

MAIN OUTCOME MEASURE: Ankle instability and subsequent need for surgical fixation as determined by dynamic stress imaging.

RESULTS: No statistical significant difference was found between the adequacy of gravity stress radiographs and manual stress images in regards to surgical decision-making (P = 0.595). Using manual and gravity stress images, receiver operating characteristic curves were generated for medial clear space (MCS) (area under the curve = 0.793, 0.901) and LTDR (0.849, 0.850), corresponding to thresholds of 10.5% and 10.2% for manual and gravity, respectively. Seventy-three of 105 patients (69.5%) with MCS > 5 mm and 62 of 75 patients (82.7%) with LTDR > 10% were offered surgical intervention. Sixty-two of the 77 patients (80.5%) offered surgery had both MCS > 5 mm and LTDR > 10%.

CONCLUSION: This study shows that manual stress radiographs are just as effective as gravity stress radiographs in making an assessment of ankle fracture stability as there was no difference in diagnostic value between gravity and manual stress imaging in regards to surgical decision-making. Use of additional radiographic measurements such as the LTDR can provide additional information in determining stability when MCS is within a clinical gray area.

LEVEL OF EVIDENCE: Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.

PMID:34797783 | DOI:10.1097/BOT.0000000000002127

PLoS One. 2021 Nov 19;16(11):e0257335. doi: 10.1371/journal.pone.0257335. eCollection 2021.

ABSTRACT

Political elites both respond to public opinion and influence it. Elite policy messages can shape individual policy attitudes, but the extent to which they do is difficult to measure in a dynamic information environment. Furthermore, policy messages are not absorbed in isolation, but spread through the social networks in which individuals are embedded, and their effects must be evaluated in light of how they spread across social environments. Using a sample of 358 participants across thirty student organizations at a large Midwestern research university, we experimentally investigate how real social groups consume and share elite information when evaluating a relatively unfamiliar policy area. We find a significant, direct effect of elite policy messages on individuals’ policy attitudes. However, we find no evidence that policy attitudes are impacted indirectly by elite messages filtered through individuals’ social networks. Results illustrate the power of elite influence over public opinion.

PMID:34797826 | DOI:10.1371/journal.pone.0257335

J Orthop Trauma. 2021 Dec 1;35(12):654-659. doi: 10.1097/BOT.0000000000002117.

ABSTRACT

OBJECTIVES: To identify factors associated with the need for reoperations in patients treated surgically for fracture nonunion.

DESIGN: Retrospective cohort study.

SETTING: One urban Level 1 trauma center and an orthopaedic specialty hospital.

PATIENTS/PARTICIPANTS: This study included 365 patients who did not and 95 patients who did undergo a reoperation after nonunion repair.

INTERVENTION: All patients who underwent fracture nonunion repair were identified. Baseline demographic, injury, and surgical information were collected. These factors were compared between patients who did and did not require an unplanned reoperation.

MAIN OUTCOME MEASUREMENTS: An unplanned reoperation after index fracture nonunion surgery.

RESULTS: When compared with patients who did not undergo a reoperation after their index fracture nonunion surgery, patients who underwent at least 1 reoperation had a greater proportion of those who sustained an open fracture, a high-energy injury, initial neurologic or vascular injuries, the need for a flap or soft tissue graft at initial treatment, and lower extremity injuries with univariate analysis. Unplanned reoperation was also associated with diagnosis of “infected” nonunion at initial nonunion surgery. Multivariate analysis confirmed initial nerve or vascular injuries and positive infection status were statistically significant predictors of a reoperation.

CONCLUSIONS: Initial injury characteristics such as nerve or vascular injury at initial injury and positive infection status at the index nonunion surgery were associated with the need for a secondary surgery after nonunion repair. Appropriate care of these patients should be aimed at adjusting expectations of unplanned reoperation in the future and potentially enhanced treatment strategies.

LEVEL OF EVIDENCE: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

PMID:34797782 | DOI:10.1097/BOT.0000000000002117

J Chem Theory Comput. 2021 Nov 19. doi: 10.1021/acs.jctc.1c00919. Online ahead of print.

ABSTRACT

An extended theoretical benchmark set, NS372, for light main-group nuclear shieldings and NMR shifts has been constructed based on high-level GIAO-CCSD(T)/pcSseg-3//CCSD(T)/cc-pVQZ reference data. After removal of the large static-correlation cases O₃, F₃^–, and BH from the statistical evaluations for the ¹⁷O, ¹⁹F, and ¹¹B subsets, the benchmark comprises overall 372 shielding values in 117 molecules with a wide range of electronic-structure situations, containing 124 ¹H, 14 ¹¹B, 93 ¹³C, 43 ¹⁵N, 31 ¹⁷O, 47 ¹⁹F, 14 ³¹P, and 6 ³³S shielding constants. The CCSD(T)/pcSseg-3 data are shown to be close to the basis-set and method limit and thus provide an excellent benchmark to evaluate more approximate methods, such as density functional approaches. This dataset has been used to evaluate Hartree-Fock (HF) and MP2, and a wide range of exchange-correlation functionals from local density approximation (LDA) to generalized gradient approximations (GGAs) and meta-GGAs (focusing on their current-density functional implementations), as well as global hybrid, range-separated hybrid, local hybrid, and double-hybrid functionals. Starting with absolute shielding constants, the DSD-PBEP86 double hybrid is confirmed to provide the highest accuracy, with an aggregate relative mean absolute error (rel. MAE) of only 0.9%, followed by MP2 (1.1%). MP2 and double hybrids only show larger errors for a few systems with the largest static-correlation effects. The double-hybrid B2GP-PLYP, the two local hybrids cLH12ct-SsirPW92 and cLH12ct-SsifPW92, and the current-density functional meta-GGA cB97M-V follow closely behind (all 1.5%), as do some further functionals, cLH20t and cMN15-L (both 1.6%), as well as B2PLYP and KT3 (both 2.0%). Functionals on the lower rungs of the usual ladder offer the advantage of lower computational cost and access to larger molecules. Closer examination also reveals the best-performing methods for individual nuclei in the test set. Different ways of treating τ-dependent functionals are evaluated. When moving from absolute shielding constants to chemical shifts, some of the methods can benefit from systematic error compensation, and the overall error range somewhat narrows. Further methods now achieve the 2% threshold of relative MAEs, including functionals based on TPSS (TPSSh, cmPSTS).

PMID:34797677 | DOI:10.1021/acs.jctc.1c00919