Category: Nevin Manimala

PLoS One. 2022 Apr 5;17(4):e0265471. doi: 10.1371/journal.pone.0265471. eCollection 2022.

ABSTRACT

When dealing with longitudinal data, linear mixed-effects models (LMMs) are often used by researchers. However, LMMs are not always the most adequate models, especially if we expect a nonlinear relationship between the outcome and a continuous covariate. To allow for more flexibility, we propose the use of a semiparametric mixed-effects model to evaluate the overall treatment effect on the hemodynamic responses during bone graft healing and build a prediction model for the healing process. The model relies on a closed-form expectation-maximization algorithm, where the unknown nonlinear function is estimated using a Lasso-type procedure. Using this model, we were able to estimate the effect of time for individual mice in each group in a nonparametric fashion and the effect of the treatment while accounting for correlation between observations due to the repeated measurements. The treatment effect was found to be statistically significant, with the autograft group having higher total hemoglobin concentration than the allograft group.

PMID:35381007 | DOI:10.1371/journal.pone.0265471

PLoS One. 2022 Apr 5;17(4):e0266010. doi: 10.1371/journal.pone.0266010. eCollection 2022.

ABSTRACT

Spatial event data is heavily used in contemporary research on political violence. Such data are oftentimes mapped onto grid-cells or administrative regions to draw inference about the determinants of conflict intensity. This setup can identify geographic determinants of violence, but is also prone to methodological issues. Problems resulting from spatial aggregation and dependence have been raised in methodological studies, but are rarely accounted for in applied research. As a consequence, we know little about the empirical relevance of these general problems and the trustworthiness of a popular research design. We address these questions by simulating conflict events based on spatial covariates from seven high-profile conflicts. We find that standard designs fail to deliver reliable inference even under ideal conditions at alarming rates. We also test a set of statistical remedies which strongly improve the results: Controlling for the geographic area of spatial units eliminates an important source of spurious correlation. In time-series analyses, the same result can be achieved with unit-level fixed effects. Under outcome diffusion, spatial lag models with area controls produce most reliable inference. When those are computationally intractable, geographically larger aggregations lead to similar improvements. Generally, all analyses should be performed at two separate levels of geographic aggregation. To facilitate future research into geographic methods, we release the Simple Conflict Event Generator (SCEG) developed for this analysis.

PMID:35381020 | DOI:10.1371/journal.pone.0266010

PLoS One. 2022 Apr 5;17(4):e0264626. doi: 10.1371/journal.pone.0264626. eCollection 2022.

ABSTRACT

BACKGROUND: There was limited data on treatment outcomes among patients with diabetic ketoacidosis (DKA) in Ethiopia.

OBJECTIVE: The aim of the study was to determine the treatment outcomes of DKA patients attending Debre Tabor General Hospital.

METHOD: A retrospective study was conducted at Debre Tabor General Hospital and data were collected from June 1 to June 30 of 2018. Participants included in the study were all diabetic patients with DKA admitted from August 2010 to May 31, 2018. The primary outcomes were the treatment outcomes of DKA including (in-hospital glycemic control, the length of hospital stay and in-hospital mortality). The statistical analysis was carried out using Statistical Package for Social Sciences (SPSS) version 22. Descriptive statistics was presented in the form of means with standard deviation and binary regression was conducted to determine factors that affect length of hospital stay among DKA patients.

RESULT: 387 patients were included in the study. The mean age of patients was 33.30± 14.96 years. The most common precipitating factor of DKA was new onset diabetes mellitus 150(38.8%). The mean length of hospital stay was 4.64(±2.802) days. The mean plasma glucose at admission and discharge was 443.63(±103.33) and 172.94 (±80.60) mg/dL, respectively. The majority 370 (95.60%) of patients improved and discharged whereas 17 (4.40%) patients died in the hospital. Patients with mild and moderate DKA showed short hospital stay; AOR: 0.16 [0.03-0.78] and AOR:0.17[0.03-0.96] compared with severe DKA. Diabetic ketoacidosis precipitated by infection were nearly five times more likely to have long hospital stay than DKA precipitated by other causes; AOR: 4.59 [1.08-19.42]. In addition, serum glucose fluctuation during hospitalization increased the likelihood of long hospital stay, AOR: 2.15[1.76-2.63].

CONCLUSIONS: New onset type 1 diabetes was the major precipitating factor for DKA. Admitted DKA patients remained in hospital for a duration of approximately five days. About five out of hundred DKA patients ended up with death in the hospital. Infection, serum glucose fluctuations and severity of DKA were determinants of long hospital stay. Early prevention of precipitating factors and adequate management of DAK are warranted to reduce length of hospital stay and mortality.

PMID:35381004 | DOI:10.1371/journal.pone.0264626

J Behav Addict. 2022 Apr 4. doi: 10.1556/2006.2022.00009. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Data regarding the association between ultra-processed food (UPF) consumption and eating disorders (ED) are scarce. Our aim was to investigate whether UPF intake was associated with different ED types in a large population-based study.

METHODS: 43,993 participants (mean age = 51.0 years; 76.1% women) of the French NutriNet-Santé web-cohort who were screened for ED in 2014 via the Sick-Control-One stone-Fat-Food (SCOFF) questionnaire, were included in the analysis. The clinical algorithm Expali TM tool was used to identify four ED types: restrictive, bulimic, binge eating, and other (not otherwise specified). Mean dietary intake was evaluated from at least 2 self-administered 24-h dietary records (2013-2015); categorization of food as ultra-processed or not relied on the NOVA classification. The associations between UPF intake (as percent and reflecting mean daily UPF quantity (g/d) within the dietary intake, %UPF) and ED types were evaluated using polytomous logistic regression models.

RESULTS: 5,967 participants (13.6%) were categorized as likely ED (restrictive n = 444; bulimic n = 1,575; binge eating n = 3,124; other ED n = 824). The fully-adjusted analyses revealed a positive association between UPF intake and bulimic, binge eating, and other ED: ED risk (odds ratio, OR) for an absolute 10-percentage point incremental increase in %UPF intake were 1.08 (1.01-1.14; P = 0.02), 1.21 (1.16-1.26; P < 0.0001), and 1.11 (1.02-1.20; P = 0.02), respectively. No significant association was detected for restrictive ED.

DISCUSSION AND CONCLUSION: This study revealed an association of UPF intake with different ED types among French adults. Future research is needed to elucidate the direction of the observed associations.

PMID:35380986 | DOI:10.1556/2006.2022.00009

Am J Respir Crit Care Med. 2022 Apr 5. doi: 10.1164/rccm.202106-1439OC. Online ahead of print.

ABSTRACT

RATIONALE: Outdoor air pollution is a potential risk factor for lower lung function and chronic obstructive pulmonary disease (COPD). Little is known on how airway abnormalities and lung growth might modify this relationship.

OBJECTIVE: To evaluate the associations of ambient air pollution exposure with lung function and COPD, and to examine possible interactions with dysanapsis.

METHODS: We made use of cross-sectional post-bronchodilator spirometry data from 1452 individuals enrolled in the Canadian Cohort Obstructive Lung Disease (CanCOLD) with linked ambient fine particulate matter (PM2.5) and nitrogen dioxide (NO2) air pollution estimates. Dysanapsis, or the ratio of airway-to-lung volume calculated from thoracic computed tomography images, was used to examine possible interactions.

MEASUREMENTS AND MAIN RESULTS: In adjusted models, 101.7 mL [95% CI: -166.2, -37.2] and 115.0 mL [95% CI: -196.5, -33.4] lower forced expiratory volume in one second (FEV1) were demonstrated per increase of 2.4 ug/m3 PM2.5, and 9.2 ppb NO2, respectively. Interaction between air pollution and dysanapsis was not statistically significant when modelling airway-to-lung ratio as a continuous variable. However, a 109.8 mL [95% CI: -209.0, -10.5] lower FEV1 and an 87% [95% CI: 12%; 213%] higher odds of COPD was observed amongst individuals in the lowest, relative to highest, airway-to-lung ratio, per 2.4 μg/m3 increment of PM2.5.

CONCLUSION: Ambient air pollution exposure was associated with lower lung function, even at relatively low concentrations. Individuals with dysanaptic lung growth might be particularly susceptible to inhaled ambient air pollutants, especially those at the extremes of dysanapsis.

PMID:35380941 | DOI:10.1164/rccm.202106-1439OC

BMJ Open. 2021 Dec 30;11(12):e055013. doi: 10.1136/bmjopen-2021-055013.

ABSTRACT

OBJECTIVES: To examine the associations between self-stigma and diabetes duration in a sample of Japanese people with type 2 diabetes.

DESIGN: A secondary analysis of a cross-sectional study.

SETTING: Two university hospitals, one general hospital and one clinic in Tokyo, Japan.

PARTICIPANTS: Outpatients with type 2 diabetes aged 20-74 years and receiving treatment from diabetes specialist physicians (n=209) completed a self-administered questionnaire.

PRIMARY AND SECONDARY OUTCOME MEASURES: Self-stigma was measured as the primary outcome. Patient Activation Measure, body mass index and haemoglobin A1c were measured as secondary outcomes.

RESULTS: One-way analysis of covariance showed significant differences in self-stigma levels between the five groups of diabetes duration (≤5 years, 6-10 years, 11-15 years, 16-21 years and 22 years or more) after controlling for age, gender, education, marital status, diabetes treatment (insulin use) and diabetes-related complications, F(4,198)=2.83, p=0.026. Multiple comparisons using Bonferroni correction showed statistically significant differences in self-stigma levels between the groups with ≤5 years (95% CI 59.63 to 69.73) and 11-15 years with diabetes (95% CI 71.12 to 80.82; p=0.020). The highest mean level of self-stigma was observed in the group having diabetes for 11-15 years.

CONCLUSIONS: Self-stigma was associated with diabetes duration and was lowest after diagnosis and gradually increased, with its highest levels being observed in those having diabetes for 11-15 years. Self-stigma takes time to develop and gradually increases in individuals as it is learnt through direct experiences of diabetes-related stigma after self-administering treatment in everyday social situations.

PMID:35380981 | DOI:10.1136/bmjopen-2021-055013

Am J Respir Cell Mol Biol. 2022 Apr 5. doi: 10.1165/rcmb.2021-0346OC. Online ahead of print.

ABSTRACT

Chronic alcohol drinking is associated with increased susceptibility to viral and bacterial respiratory pathogens. In this study, we utilize a rhesus macaque model of voluntary ethanol self-administration to study the effects of long-term alcohol drinking on the immunological landscape of the lung. We report heightened inflammatory state in alveolar macrophages (AM) obtained from ethanol (EtOH) drinking animals that is accompanied by increased chromatin accessibility in intergenic regions that regulate inflammatory genes and contain binding motifs for transcription factors AP-1, IRF8, and NFKB p-65. In line with these transcriptional and epigenetic changes at basal state, AM from EtOH drinking animals generate elevated inflammatory mediator responses to LPS and respiratory syncytial virus (RSV). However, transcriptional analysis revealed an inefficient induction of interferon stimulated genes with EtOH in response to RSV, suggesting disruption of anti-microbial defenses. Correspondingly, AM from EtOH drinking animals exhibited transcriptional shifts indicative of increased oxidative stress and oxidative phosphorylation which was coupled with higher cytosolic reactive oxygen species (ROS) and mitochondrial potential. This heightened oxidative stress state was accompanied by decreased ability to phagocytose bacteria. Bulk RNA and ATAC sequencing data further revealed reduced expression and chromatin accessibility of loci associated with tissue repair and maintenance with chronic EtOH drinking. Similarly, analysis of scRNA-Seq data revealed shifts in cell states from tissue maintenance to inflammatory responses with EtOH. Collectively, these data provide novel insight into mechanisms by which chronic EtOH drinking increases susceptibility to infection in patients with alcohol use disorders.

PMID:35380939 | DOI:10.1165/rcmb.2021-0346OC

Environ Sci Pollut Res Int. 2022 Apr 5. doi: 10.1007/s11356-022-19730-w. Online ahead of print.

ABSTRACT

We researched China’s climate and sustainable development goal with relevant and susceptible instruments capable of inducing and mitigating carbon emissions. Amidst the contributor to the global carbon emissions, China is caught in between mitigating its carbon emission and aiming towards placing its national contribution of emissions to the acceptable levels of 1.5 °C and below 2 °C. Following the intricacies surrounding China’s sustainable development as it contains its economic and environmental performance, we adopt China’s data of 1980 and 2018 with different scientific approaches (nonlinear autoregressive distributed lag (NARDL), dynamic ordinary least square test, and bootstrap Granger causality) with different instruments (such as economic growth, financial development, renewable energy, and innovation policies) to research China’s sustainable development. For clear exposition and insight into our findings with policies attached, we draw a conclusion from the outcomes of the mentioned approaches. From NARDL and dynamic ordinary least squares (DOLS), we find that economic growth through economic activities is statistically significant in determining the trend (increase) of carbon emissions in China in both periods (short run and long run). However, other selected instruments (financial, renewable, and innovation policies) tend towards controlling and moderating the carbon emissions in China. Thus, China has good prospects to mitigate its carbon emissions if considered tailoring its policies towards favorable instruments. From bootstrap Granger causality, we find similar inferential results that support previous findings thereby confirming the positive implication of the selected instruments to China’s sustainable development. Hence, the nexus that is established among the selected instruments clearly show the importance of technological innovation and renewable energy in mitigating carbon emissions.

PMID:35380330 | DOI:10.1007/s11356-022-19730-w

J Neurooncol. 2022 Apr 5. doi: 10.1007/s11060-022-03996-8. Online ahead of print.

ABSTRACT

INTRODUCTION: Glioblastoma (GBM) is the most aggressive central nervous system (CNS) tumor with astrocytic differentiation. The growth pattern of GBM mimics that of the precursor cell migration during the fetal development of the brain. Diaphanous homolog (Diaph3) has been established to play a role in both CNS maturation and cancer progression as it is required both for cell migration and division. Furthermore, Diaph3 has been shown to play a role in malignant disease progression through hyperactivation of the EGFR/MEK/ERK in loss of expression and its overexpression correlating to hyperactivity of the mTOR pathway, both of which are with a well-established role in GBM. Herein, we aimed at establishing the diagnostic role of Diaph3 immunohistochemistry expression patterns in GBM and their possible implications for molecular response to different therapies.

MATERIALS AND METHODS: The study utilized a retrospective nonclinical approach. Results of Diaph3 immunohistochemical expression were compared to healthy controls and reactive gliosis and statistically analyzed for correlation with neuroradiological tumor parameters and patient survival.

RESULTS: Healthy controls showed individual weakly positive cells, while reactive gliosis controls showed a strong expression in astrocytic projections. GBM samples showed a heterogeneous positive reaction to Diaph3, mean number of positive cells 62.66%, median 61.5, range 12-96%. Areas of migrating cells showed a strong diffuse cytoplasmic reaction. Cells located in the tumor core and those in areas of submeningeal aggregation had no antibody expression. Statistical analysis revealed no correlation with tumor size or patient survival.

CONCLUSION: The different expression pattern of Diaph3 in healthy controls, reactive gliosis and GBM shows promise as a clinical differentiating marker. Despite Diaph3 expression not correlating with survival and tumor size in GBM, there is an accumulating body of evidence that Diaph3 correlates with mTOR activity and can thus be used as a predictor for response to rapamycin and taxanes, clinical studies of which have shown promising, if mixed results in GBM.

PMID:35380294 | DOI:10.1007/s11060-022-03996-8

Wien Klin Wochenschr. 2022 Apr 5. doi: 10.1007/s00508-022-02026-x. Online ahead of print.

ABSTRACT

BACKGROUND: There are conflicting results concerning sex-specific differences in the post-cardiac arrest period. We investigated the sex distribution of patients after successful cardiopulmonary resuscitation (CPR), differences in treatment, complications, outcome and sex-specific performance of biomarkers for prognostication of neurological outcome.

METHODS: Prospective observational study including cardiac-arrest (CA) patients treated with mild therapeutic hypothermia (MTH) at 33 °C for 24 h or normothermia. We investigated common complications including pneumonia and acute kidney injury (AKI) and neuron-specific enolase, secretoneurin and tau protein as biomarkers of neurological outcome, which was assessed with the cerebral performance categories score at hospital discharge.

RESULTS: Out of 134 patients 26% were female. Women were significantly older (73 years, interquartile range (IQR) 56-79 years vs. 62 years, IQR 53-70 years; p = 0.038), whereas men showed a significantly higher rate of pneumonia (29% vs. 6%; p = 0.004) and a trend towards higher rates of AKI (62% vs. 45%; p = 0.091). Frequency of MTH treatment was not significantly different (48% vs. 31%; p = 0.081). Female sex was not associated with neurological outcome in multivariable analysis (p = 0.524). There was no significant interaction of sex with prognostication of neurological outcome at 24, 48 and 72 h after CPR. At the respective time intervals p_interaction for neuron-specific enolase was 0.524, 0.221 and 0.519, for secretoneurin 0.893, 0.573 and 0.545 and for tau protein 0.270, 0.635, and 0.110.

CONCLUSION: The proportion of female patients was low. Women presented with higher age but had fewer complications during the post-CA period. Female sex was not associated with better neurological outcome. The performance of biomarkers is not affected by sex.

PMID:35380262 | DOI:10.1007/s00508-022-02026-x