Category: Nevin Manimala

PLoS Negl Trop Dis. 2021 Mar 31;15(3):e0009256. doi: 10.1371/journal.pntd.0009256. Online ahead of print.

ABSTRACT

Residents of urban slums suffer from a high burden of zoonotic diseases due to individual, socioeconomic, and environmental factors. We conducted a cross-sectional sero-survey in four urban slums in Salvador, Brazil, to characterize how poverty and sanitation contribute to the transmission of rat-borne leptospirosis. Sero-prevalence in the 1,318 participants ranged between 10.0 and 13.3%. We found that contact with environmental sources of contamination, rather than presence of rat reservoirs, is what leads to higher risk for residents living in areas with inadequate sanitation. Further, poorer residents may be exposed away from the household, and ongoing governmental interventions were not associated with lower transmission risk. Residents at higher risk were aware of their vulnerability, and their efforts improved the physical environment near their household, but did not reduce their infection chances. This study highlights the importance of understanding the socioeconomic and environmental determinants of risk, which ought to guide intervention efforts.

PMID:33788864 | DOI:10.1371/journal.pntd.0009256

PLoS One. 2021 Mar 31;16(3):e0248518. doi: 10.1371/journal.pone.0248518. eCollection 2021.

ABSTRACT

BACKGROUND: Protecting people from financial hardship and impoverishment due to health care costs is one of the fundamental purposes of the Mongolian health system. However, the inefficient, oversized hospital sector is considered one of the main shortcomings of the system. The aim of this study is to contribute to policy discussions by estimating the extent of catastrophic health expenditure and impoverishment due to inpatient care at secondary-level and tertiary-level public hospitals and private hospitals.

METHODS: Data were derived from a nationally representative survey, the Household Socio-Economic Survey 2012, conducted by the National Statistical Office of Mongolia. A total of 12,685 households were involved in the study. “Catastrophic health expenditure” is defined as out-of-pocket payments for inpatient care that exceed a threshold of 40% of households’ non-discretionary expenditure. The “impoverishment” effect of out-of-pocket payments for inpatient care was estimated as the difference between the poverty level before health care payments and the poverty level after these payments.

RESULTS: At the threshold of 40% of capacity to pay, 0.31%, 0.07%, and 0.02% of Mongolian households suffered financially as a result of their member(s) staying in tertiary-level and secondary-level public hospitals and private hospitals respectively. About 0.13% of the total Mongolian population was impoverished owing to out-of-pocket payments for inpatient care at tertiary-level hospitals. Out-of-pocket payments for inpatient care at secondary-level hospitals and private hospitals were responsible for 0.10% and 0.09% respectively of the total population being pushed into poverty.

CONCLUSIONS: Although most inpatient care at public hospitals is covered by the social health insurance benefit package, patients who utilized inpatient care at tertiary-level public hospitals were more likely to push their households into financial hardship and poverty than the inpatients at private hospitals. Improving the hospital sector’s efficiency and financial protection for inpatients would be a crucial means of attaining universal health coverage in Mongolia.

PMID:33788865 | DOI:10.1371/journal.pone.0248518

Wound Manag Prev. 2021 Mar;67(3):30-35.

ABSTRACT

BACKGROUND: Medical device-related pressure ulcers/injuries (MDRPU/Is) are a serious concern in health care.

PURPOSE: To develop and assess the psychometric testing of a questionnaire to measure nursing students’ attitudes about the care and prevention of MDRPU/Is.

METHODS: Based on a review of the literature, a 26-item questionnaire was developed; face validity was assessed by ten (10) nursing students. The modified Lawshe’s model was used, and both the content validity index (CVI) and content validity ratio were calculated. Items with a CVI more than 0.63 were retained. The minimum optimal CVI for the new instrument was 79%. Qualitative assessments were performed by 10 experienced faculty members. One-hundred-and-eighty seven (187) nursing students participated in the construct validity testing of the 11-item questionnaire. The Kaiser-Meyer-Olkin test of sampling adequacy and Bartlett’s test of sphericity were performed. Following analysis of the main components and the varimax rotation, the factor analysis was determined. Internal consistency (Cronbach’s alpha) and test-retest were determined using Pearson’s correlation and intraclass correlation coefficient to evaluate reliability.

RESULTS: During the face validity phase of the initial 26 items, 7 items had impact scores less than 1.5. After calculating the CVI and content validity ratio for all items, 8 items did not achieve the desirable score. After performing exploratory factor analysis on the remaining 11 items, the Kaiser-Meyer-Olkin test value was 0.789, and Bartlett’s test of sphericity was 0.0001, which was statistically significant. Internal consistency of items (Cronbach’s alpha of 0.77) showed that all items had a high correlation. The reliability of test-retest was significant using an intraclass correlation coefficient of 0.75 and Pearson’s correlation coefficient of 0.86 at P < .005.

CONCLUSION: In this sample of nursing students, the Attitude Towards Medical-device Related Pressure Ulcers/Injuries Questionnaire was valid and reliable. Studies including licensed clinicians are needed to confirm these results.

PMID:33788773

Epidemiology. 2021 Mar 26. doi: 10.1097/EDE.0000000000001348. Online ahead of print.

ABSTRACT

BACKGROUND: Although many studies demonstrated reduced mortality risk with higher greenness, few studies examined the modifying effect of greenness on air pollution-health associations. We evaluated residential greenness as an effect modifier of the association between long-term exposure to fine particles (PM2.5) and mortality.

METHODS: We used data from all Medicare beneficiaries in North Carolina (NC) and Michigan (MI) (2001-2016). We estimated annual PM2.5 averages using ensemble prediction models. We estimated mortality risk per 1 µg/m3 increase using Cox proportional hazards modeling, controlling for demographics, Medicaid eligibility, and area-level covariates. We investigated health disparities by greenness using the Normalized Difference Vegetation Index (NDVI) with measures of urbanicity and socioeconomic status.

RESULTS: PM2.5 was positively associated with mortality risk. Hazard ratios (HRs) were 1.12 (95% confidence interval (CI) 1.12, 1.13) for NC and 1.01 (95% CI 1.00, 1.01 ) for MI. HRs were higher for rural than urban areas. Within each category of urbanicity, HRs were generally higher in less green areas. For combined disparities, HRs were higher in low greenness or low SES areas, regardless of the other factor. HRs were lowest in high-greenness and high-SES areas for both states.

CONCLUSIONS: In our study, those in low SES and high greenness areas had lower associations between PM2.5 and mortality than those in low SES and low greenness areas. Multiple aspects of disparity factors and their interactions may affect health disparities from air pollution exposures. Findings should be considered in light of uncertainties, such as our use of modeled PM2.5 data, and warrant further investigation.

PMID:33788795 | DOI:10.1097/EDE.0000000000001348

PLoS One. 2021 Mar 31;16(3):e0249310. doi: 10.1371/journal.pone.0249310. eCollection 2021.

ABSTRACT

Since the World Health Organization (WHO) announced that the coronavirus disease (COVID-19) is a worldwide pandemic, many countries’ authorities, including the Iraqi authorities, started responding and taking action to control the spread of the pandemic. The public’s knowledge and practices play an important role in curbing the spreading of the virus by following the health guidelines. This study aimed to assess the socio-demographic correlate of knowledge and practices of Iraqi living in Mosul-Iraq towards COVID-19 during its rapid rise. A cross-sectional online survey of 909 participants was conducted among a sample of the Mosul-Iraq population between 20th June to 1st July 2020. The survey included three parts: 1) socio-demographic characteristics, 2) participants’ knowledge, 3) participants’ practices. T-test, ANOVA, chi-square, and binary logistic regression were used. A p-value less than 0.05 (p < 0.05) was considered statistically significant. The results showed a knowledge and practice mean score of (12.91±1.67) and (21.56± 2.92) with cumulative knowledge and practice of 86% and 76% respectively towards COVID-19. Socio-demographic characteristics such as age, marital status, gender, level of education and employment were statistically related with a higher mean score of knowledge and practice towards the virus as P<0.05. We concluded that the majority of the respondents demonstrate a high level of knowledge and practices towards COVID-19 except for respondents with socio-demographic characteristics such as those who were younger, male respondents, those with lower education and those unemployed as such campaigns that will increase the knowledge and encourage adequate preventive practice towards COVID-19 should be targeted towards this group.

PMID:33788835 | DOI:10.1371/journal.pone.0249310

Anticancer Res. 2021 Mar;41(3):1203-1212. doi: 10.21873/anticanres.14877.

ABSTRACT

BACKGROUND/AIM: Hepatocellular carcinoma (HCC) remains one of the biggest medical issues. Pigment epithelial-derived factor (PEDF) is a glycoprotein that belongs to the superfamily of serine protease inhibitors. PEDF interacts with its two receptors, adipose triglyceride lipase (ATGL) and laminin receptor (LR).

MATERIALS AND METHODS: We conducted immunohistochemical staining for PEDF, LR and ATGL in 151 resected HCCs and their background liver tissues.

RESULTS: High expression of LR in HCC was associated with high histological grade and portal vein invasion, while high expression of PEDF in HCC was associated with absence of portal vein invasion. High LR expression in background liver was statistically associated with low serum albumin levels and was an independent prognostic factor of worse outcomes. No cases with more than 5% fatty degeneration in the background liver tissue showed high PEDF expression.

CONCLUSION: PEDF/LR/ATGL could be potential biomarkers in HCC and various chronic hepatic disorders.

PMID:33788711 | DOI:10.21873/anticanres.14877

Anticancer Res. 2021 Mar;41(3):1341-1348. doi: 10.21873/anticanres.14891.

ABSTRACT

BACKGROUND/AIM: Cancer profiling tests using formalin-fixed paraffin-embedded (FFPE) specimens with various conditions have become an essential tool for cancer treatment. The robustness of these tests needs to be addressed.

MATERIALS AND METHODS: A cancer profiling test, NCC oncopanel, was tested with FFPE specimens from various tissues with different storage conditions and fixation lengths. Next generation sequencing was performed with Miseq and the data were assembled using the human reference genome hg19.

RESULTS: Duration of storage and fixation affected the mapping statistics. Prolonged storage increased outward read paring and longer fixation rates caused increased singletons and unmapped reads.

CONCLUSION: Our results indicate that a cancer profiling test with target capturing method, NCC oncopanel, shows robustness for FFPE cancer specimens with various storage conditions.

PMID:33788725 | DOI:10.21873/anticanres.14891

Anticancer Res. 2021 Mar;41(3):1671-1676. doi: 10.21873/anticanres.14930.

ABSTRACT

BACKGROUND/AIM: This study aimed to investigate the efficacy of first-line gemcitabine monotherapy for metastatic breast cancer (MBC) and its effect on health-related quality of life (HRQoL) compared with treatment of physician’s choice (TPC).

PATIENTS AND METHODS: We enrolled 96 patients into the first-line gemcitabine group (n=47) or other treatment of physician’s choice (TPC) group (n=49) from May 2010 to April 2013. HRQoL was evaluated every 4 weeks.

RESULTS: There was no significant difference in the median time to treatment failure (5.3 vs. 4.6 months, hazard ratio=0.87, p=0.546) and the incidence rates of grade 3/4 haematological toxicity (10.6% vs. 8.1%, p=0.677) and grade 3/4 non-haematological toxicity (4.2% vs. 8.1%, p=0.429) between the gemcitabine and TPC groups. Changes in HRQoL from baseline to 12 weeks were not significantly different.

CONCLUSION: Gemcitabine achieves similar efficacy and HRQoL benefit to other chemotherapy and can be used as first-line treatment for MBC.

PMID:33788764 | DOI:10.21873/anticanres.14930

Exp Oncol. 2021 Mar;43(1):41-45.

ABSTRACT

AIM: To assess the level of erythropoietin (EPO) in blood sera of patients with different subtypes of myelodysplastic syndromes (MDS) from different risk subgroups and to determine its prognostic role.

MATERIALS AND METHODS: EPO was measured by enzyme-linked immunosorbent assay in peripheral blood of 54 patients with different MDS subtypes according to the French-American-British (FAB) classification. The comparison group consisted of 15 healthy individuals. Complete blood count (hemoglobin, leukocyte and platelet levels) was determined and bone marrow cells were characterized morphologically. The overall and leukemia-free survivals were estimated by Kaplan – Meier method.

RESULTS: The level of ЕРО in MDS was reliably higher in comparison with healthy persons (p < 0.01, Mann – Whitney test). No statistically significant difference was found in serum EPO concentration between the groups of patients with low- and high-risk MDS (603.5 pg/ml vs 721.0 pg/ml; p > 0.05). In transfusion-dependent patients, the level of EPO was significantly higher than in other patients, which may be due to increased endogenous EPO secretion resulting from chronic hypoxia. A negative correlation was revealed between EPO level and Hb level as well as between EPO level and percentage of blast cells in bone marrow in high-risk MDS patients but not in patients with less aggressive variants of MDS. Instead, patients with low-risk MDS had a negative relationship between concentrations of EPO and tumor necrosis factor alpha (p = 0.06, Kendall’s tau test). No significant difference was found between EPO concentration in cases differing by bone marrow cellularity or the presence of cytogenetic abnormalities. An EPO concentration below 200 pg/ml was a predictor of shorter overall survival in patients with all MDS subtypes (p < 0.05, Mann – Whitney test). In patients with all FAB disease subtypes, there was no relationship between the leukemia-free survival and serum EPO concentration.

CONCLUSION: This study shows that lower serum EPO level may be considered as one of the additional adverse prognostic factors in MDS patients.

PMID:33785713

Med Sci Monit. 2021 Mar 31;27:e930349. doi: 10.12659/MSM.930349.

ABSTRACT

BACKGROUND This study compared the effects of a bean-based and a white rice-based breakfast diet on postprandial glucose and insulin levels in Chinese patients with type 2 diabetes mellitus (T2DM). MATERIAL AND METHODS We recruited 63 patients with T2DM. The patients participated in the randomized 2×2 crossover trial. The bean-based diet group and white rice control group were matched for 50 g of available carbohydrate at breakfast. The patients followed the diets for 3 days. Vein blood samples were collected at 0, 30, 60, 120, and 180 min after eating. Data were analyzed using a repeated-measures analysis of variance. The results are expressed as the mean±standard error of mean (SEM) or as the median with interquartile range values. RESULTS Compared with the white rice control, postprandial glucose was significantly lower with the bean-based diet treatments at 60 min (P=0.004), 120 min (P=0.000), and 180 min (P=0.000). The insulin levels of the bean-based diet group were significantly higher at 60 min (P=0.013). The C-peptide levels of the bean-based diet group were significantly higher at 30 min (P=0.042) and 60 min (P=0.005) postprandial. The glucose area under the curve (AUC) showed a similar trend (P=0.000). There were no statistically significant differences in the AUC of insulin and C-peptide, except C-peptide AUC at 0 to 60 min (P=0.027). CONCLUSIONS Compared with a white rice-based breakfast, a bean-based diet significantly reduced postprandial glucose levels and promoted insulin secretion. These results support a dietary approach to reduce postprandial hyperglycemia.

PMID:33785707 | DOI:10.12659/MSM.930349