Category: Nevin Manimala

PLoS One. 2021 Jun 21;16(6):e0253011. doi: 10.1371/journal.pone.0253011. eCollection 2021.

ABSTRACT

BACKGROUND: Climate change, as a defining issue of the current time, is causing severe heat-related illness in the context of extremely hot weather conditions. In Japan, the remarkable temperature increase in summer caused by an urban heat island and climate change has become a threat to public health in recent years.

METHODS: This study aimed to determine the potential risk factors for heatstroke by analysing data extracted from the records of emergency transport to the hospital due to heatstroke in Fukuoka City, Japan. In this regard, a negative binomial regression model was used to account for overdispersion in the data. Age-structure analyses of heatstroke patients were also embodied to identify the sub-population of Fukuoka City with the highest susceptibility.

RESULTS: The daily maximum temperature and wet-bulb globe temperature (WBGT), along with differences in both the mean temperature and time-weighted temperature from those of the consecutive past days were detected as significant risk factors for heatstroke. Results indicated that there was a positive association between the resulting risk factors and the probability of heatstroke occurrence. The elderly of Fukuoka City aged 70 years or older were found to be the most vulnerable to heatstroke. Most of the aforementioned risk factors also encountered significant and positive associations with the risk of heatstroke occurrence for the group with highest susceptibility.

CONCLUSION: These results can provide insights for health professionals and stakeholders in designing their strategies to reduce heatstroke patients and to secure the emergency transport systems in summer.

PMID:34153053 | DOI:10.1371/journal.pone.0253011

PLoS One. 2021 Jun 21;16(6):e0252939. doi: 10.1371/journal.pone.0252939. eCollection 2021.

ABSTRACT

BACKGROUND: Coagulopathy and thromboembolic events are among the complications of Corona Virus disease 2019 (COVID-19). Abnormal coagulation parameters in COVID-19 patients are important prognostic factors of disease severity. The aim of this study was to analyze coagulation profiles of hospitalized COVID-19 patients in Addis Ababa, Ethiopia.

METHODS: This prospective cross-sectional study was conducted among 455 Covid-19 patients admitted at Millennium COVID-19 care and treatment center, Addis Ababa, Ethiopia from July 1- October 23, 2020. Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT) and International normalized ratio (INR) were determined on HUMACLOT DUE PLUS® coagulation analyzer (Wiesbaden, Germany). In all statistical analysis of results, p<0.05 was defined as statistically significant.

RESULT: A prolonged prothrombin time was found in 46.8% of study participants with COVID-19 and a prolonged prothrombin time and elevated INR in 53.3% of study subjects with severe and 51% of critically COVID patients. Thrombocytopenia was detected in 22.1% of COVID-19 patients. 50.5% and 51.3% of COVID-19 patients older than 55 years had thrombocytopenia and prolonged APTT respectively.

CONCLUSION: In this study, prolonged prothrombin time and elevated INR were detected in more than 50% of severe and critical COVID-19 patients. Thrombocytopenia and prolonged APTT were dominant in COVID-19 patients older than 55 years. Thus, we recommend emphasis to be given for monitoring of platelet count, PT, APTT and INR in hospitalized and admitted COVID-19 patients.

PMID:34153056 | DOI:10.1371/journal.pone.0252939

Plast Reconstr Surg. 2021 Jun 21. doi: 10.1097/PRS.0000000000008233. Online ahead of print.

ABSTRACT

BACKGROUND: Negative-pressure wound therapy (NPWT) with instillation is a novel wound therapy. The optimal solution is still investigated. Tetrachlorodecaoxygen-anion complex (TCDO) causes increased phagocytosis and oxygenation. The authors’ objective was to investigate the efficacy of NPWT with TCDO instillation (NPWTi) and to compare the results with NPWT alone.

METHODS: A randomized controlled trial was conducted. Inclusion criteria were wound size greater than 4 cm2 and depth greater than 10 mm. Exclusion criteria were malignancy, immunocompromise, and allergy to TCDO. Patients were randomized into NPWT and NPWTi groups. Outcome measurements consisted of wound surface area, depth, volume, tissue culture, and pathologic evaluation.

RESULTS: A total of 24 patients in each group were enrolled. The percentages of wound surface area reduction of NPWTi and NPWT groups were 24.1 ± 6.8 and 28.2 ± 7.6 on day 12, and 19.0 ± 6.6 and 22.7 ± 7.8 on day 15, respectively (p < 0.05). The percentages of wound depth reduction were 16.4 ± 5.3 and 22.5 ± 10.5 on day 12, and 12.0 ± 6.7 and 14.1 ± 8.0 on day 15, respectively (p < 0.05). The percentages of wound volume reduction were 17.9 ± 4.6 and 21.6 ± 5.8 on day 12, and 14.7 ± 6.0 and 17.1 ± 6.6 on day 15, respectively (p < 0.05). No statistically significant difference in microbial reduction was found between the groups. Histopathologic examination showed that more angiogenesis was observed in the NPWTi group than in the NPWT group.

CONCLUSIONS: NPWT with TCDO instillation statistically significantly accelerated wound healing, but it did not show significant microbial reduction. The authors’ results suggest that TCDO instillation may be an adjunctive treatment in NPWT.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.

PMID:34153022 | DOI:10.1097/PRS.0000000000008233

PLoS Comput Biol. 2021 Jun 21;17(6):e1009072. doi: 10.1371/journal.pcbi.1009072. Online ahead of print.

ABSTRACT

Epstein-Barr virus (EBV) is transmitted by saliva and is a major cause of cancer, particularly in people living with HIV/AIDS. Here, we describe the frequency and quantity of EBV detection in the saliva of Ugandan adults with and without HIV-1 infection and use these data to develop a novel mathematical model of EBV infection in the tonsils. Eligible cohort participants were not taking antiviral medications, and those with HIV-1 infection had a CD4 count >200 cells/mm3. Over a 4-week period, participants provided daily oral swabs that we analysed for the presence and quantity of EBV. Compared with HIV-1 uninfected participants, HIV-1 coinfected participants had an increased risk of EBV detection in their saliva (IRR = 1.27, 95% CI = 1.10-1.47) and higher viral loads in positive samples. We used these data to develop a stochastic, mechanistic mathematical model that describes the dynamics of EBV, infected cells, and immune response within the tonsillar epithelium to analyse potential factors that may cause EBV infection to be more severe in HIV-1 coinfected participants. The model, fit using Approximate Bayesian Computation, showed high fidelity to daily oral shedding data and matched key summary statistics. When evaluating how model parameters differed among participants with and without HIV-1 coinfection, results suggest HIV-1 coinfected individuals have higher rates of B cell reactivation, which can seed new infection in the tonsils and lower rates of an EBV-specific immune response. Subsequently, both these traits may explain higher and more frequent EBV detection in the saliva of HIV-1 coinfected individuals.

PMID:34153032 | DOI:10.1371/journal.pcbi.1009072

PLoS One. 2021 Jun 21;16(6):e0251194. doi: 10.1371/journal.pone.0251194. eCollection 2021.

ABSTRACT

Computational reproducibility is a corner stone for sound and credible research. Especially in complex statistical analyses-such as the analysis of longitudinal data-reproducing results is far from simple, especially if no source code is available. In this work we aimed to reproduce analyses of longitudinal data of 11 articles published in PLOS ONE. Inclusion criteria were the availability of data and author consent. We investigated the types of methods and software used and whether we were able to reproduce the data analysis using open source software. Most articles provided overview tables and simple visualisations. Generalised Estimating Equations (GEEs) were the most popular statistical models among the selected articles. Only one article used open source software and only one published part of the analysis code. Replication was difficult in most cases and required reverse engineering of results or contacting the authors. For three articles we were not able to reproduce the results, for another two only parts of them. For all but two articles we had to contact the authors to be able to reproduce the results. Our main learning is that reproducing papers is difficult if no code is supplied and leads to a high burden for those conducting the reproductions. Open data policies in journals are good, but to truly boost reproducibility we suggest adding open code policies.

PMID:34153038 | DOI:10.1371/journal.pone.0251194

J Acquir Immune Defic Syndr. 2021 Aug 1;87(4):1086-1092. doi: 10.1097/QAI.0000000000002694.

ABSTRACT

BACKGROUND: Consistent with the global trend, youth with HIV (YWH) in Nigeria have high rates of viral nonsuppression. Hence, novel interventions are needed.

SETTING: Infectious Diseases Institute, College of Medicine, University of Ibadan, Nigeria.

METHODS: In a single-arm trial, participants aged 15-24 years received 48 weeks of a combination intervention, comprising daily 2-way text message medication reminders plus peer navigation. The primary outcome measure was viral suppression less than 200 copies/mL. The secondary outcome measures included self-reported adherence on a visual analog scale and medication possession ratio, each dichotomized as ≥90% (good) or <90% (poor) adherence. The outcomes were analyzed using McNemar test. Retention in care, intervention feasibility and acceptability, and participants’ satisfaction were also assessed.

RESULTS: Forty YWH (50% male participants) were enrolled: mean age 19.9 years (SD = 2.5), 55% perinatally infected, and 35% virologically suppressed at baseline. Compared with baseline, the odds of virologic suppression was higher at 24 weeks (odds ratio = 14.00, P < 0.001) and 48 weeks (odds ratio = 6.00, P = 0.013). Self-reported adherence (≥90%) increased from baseline at 24 weeks (63%, P = 0.008) and 48 weeks (68%, P = 0.031). Medication possession ratio ≥90% increased at weeks 24 and 48 (85% and 80%, respectively), achieving statistical significance at 24 weeks alone (P = 0.022). Retention in care at 48 weeks was 87.5%. All (37/37) participants at week 48 were fully or mostly satisfied with the intervention.

CONCLUSION: Daily 2-way text message reminders plus peer navigation is a promising combination intervention to improve viral suppression among YWH in Nigeria.

PMID:34153015 | DOI:10.1097/QAI.0000000000002694

Plast Reconstr Surg. 2021 Jun 21. doi: 10.1097/PRS.0000000000008191. Online ahead of print.

ABSTRACT

BACKGROUND: Mesenchymal stem cells have the potential to produce neurotrophic growth factors and establish a supportive microenvironment for neural regeneration. The purpose of this study was to determine the effect of undifferentiated and differentiated mesenchymal stem cells dynamically seeded onto decellularized nerve allografts on functional outcomes when used in peripheral nerve repair.

METHODS: In 80 Lewis rats, a 10-mm sciatic nerve defect was reconstructed with (1) autograft, (2) decellularized allograft, (3) decellularized allograft seeded with undifferentiated mesenchymal stem cells, or (4) decellularized allograft seeded with mesenchymal stem cells differentiated into Schwann cell-like cells. Nerve regeneration was evaluated over time by cross-sectional tibial muscle ultrasound measurements, and at 12 and 16 weeks by isometric tetanic force measurements, compound muscle action potentials, muscle mass, histology, and immunofluorescence analyses.

RESULTS: At 12 weeks, undifferentiated mesenchymal stem cells significantly improved isometric tetanic force measurement and compound muscle action potential outcomes compared to decellularized allograft alone, whereas differentiated mesenchymal stem cells significantly improved compound muscle action potential outcomes. The autografts outperformed both stem cell groups histologically at 12 weeks. At 16 weeks, functional outcomes normalized between groups. At both time points, the effect of undifferentiated versus differentiated mesenchymal stem cells was not significantly different.

CONCLUSIONS: Undifferentiated and differentiated mesenchymal stem cells significantly improved functional outcomes of decellularized allografts at 12 weeks and were similar to autograft results in the majority of measurements. At 16 weeks, outcomes normalized as expected. Although differences between both cell types were not statistically significant, undifferentiated mesenchymal stem cells improved functional outcomes of decellularized nerve allografts to a greater extent and had practical benefits for clinical translation by limiting preparation time and costs.

PMID:34153019 | DOI:10.1097/PRS.0000000000008191

Cutan Ocul Toxicol. 2021 Jun 21:1-6. doi: 10.1080/15569527.2021.1940194. Online ahead of print.

ABSTRACT

PURPOSE: Hand-foot syndrome (HFS) is a frequent dose-limiting adverse reaction of fluoropyrimidine drugs like capecitabine and 5-flourouracil (5-FU) in breast and gastrointestinal cancers. It has been shown that conventional application of Lawsonia inermis L. (Henna) is effective in ameliorating of the skin lesions. To increase the patient compliance, in this study we formulated a standardized topical hydrogel (H.gel) containing the hydroalcoholic extract (10%) of Henna and evaluated its clinical efficacy for the management of fluorouracil associated HFS.

MATERIAL AND METHODS: The topical dosage form was standardized based on its Lawsone content. Eighteen patients suffering from HFS were randomized to receive H.gel and the placebo four times a day for 2 weeks. At the baseline and at the end of the trial, HFS grades were determined.

RESULTS AND CONCLUSIONS: Allergic reactions following administration of H.gel were observed in one patient, while no serious adverse events occurred in the others. No statistically significant differences between two arms were observed at the baseline (p-value = 0.133), after treatment (p-value = 0.590) and grade differences (p-value = 0.193). The applied hydrogel showed less efficacy compared to the traditional method of using Henna, meaning that Lawsone may not be a good indicator for standardizing the topical dosage form.

PMID:34152880 | DOI:10.1080/15569527.2021.1940194

Psychol Rep. 2021 Jun 21:332941211025269. doi: 10.1177/00332941211025269. Online ahead of print.

ABSTRACT

The aim of this study was to investigate the potential role of three COVID-19-related variables (i.e., risk perception, knowledge, and behaviour) on four indices of pandemic-related mental health (i.e., anxiety, depression, loneliness, and hopelessness). In total, 337 participants completed four self-report questionnaires: selected subscales of the World Health Organisation’s COVID-19 Behavioural Insights Tool, UCLA Loneliness Scale, State-Trait Anxiety Inventory-Trait Scale, Center for Epidemiologic Studies Depression Scale, and Beck Hopelessness Scale. In addition to descriptive statistics and intercorrelations, structural equation modelling was used to compare three models of the potential role (predictor or moderator/mediator) that the three abovementioned COVID-19-related variables could play in psychological wellbeing. The results showed high levels of psychological distress among the current sample. Generally, better knowledge of COVID-19 and engaging in protective behaviours were found to be related to lower levels of psychological distress, whereas increased risk perception was found to be associated with increased feelings of loneliness, anxiety, and depression. It was also found that behaviour mediated the effect of knowledge on psychological wellbeing, suggesting that while publicising information about COVID-19 remains necessary, providing the public with a means to engage in protective behaviours is central for promoting psychological wellbeing.

PMID:34152883 | DOI:10.1177/00332941211025269

J Med Internet Res. 2021 Jun 21;23(6):e31253. doi: 10.2196/31253.

ABSTRACT

[This corrects the article DOI: 10.2196/27348.].

PMID:34152993 | DOI:10.2196/31253