Category: Nevin Manimala

J Eur Acad Dermatol Venereol. 2021 Apr 29. doi: 10.1111/jdv.17315. Online ahead of print.

ABSTRACT

BACKGROUND: In a European study on contact allergy in the general population, it has been hypothesized that the combination of contact allergy to a fragrance together with a history indicating dermatitis at exposure and thereafter subsequent avoidance of scented products implied a diagnosis of allergic contact dermatitis.

OBJECTIVES: The primary aim of this study was to validate this hypothesis/algorithm. The secondary aim was to investigate whether there was any association between the outcome of the ROAT and the patch test reactivity.

METHODS: 109 subjects with and without contact allergy to fragrance mix II (FM II) were recruited. Volunteers from 6 European dermatology clinics participated in the study including a patch test and a ROAT.

RESULTS: 24 positive ROAT reactions were noted in total including 20 of those 32 with contact allergy to FM II. None of the volunteers reacted to the vehicle (p<0.001). More individuals with a positive algorithm had positive ROATs when compared with those with a negative algorithm. However, the difference was not statistically significant (p=0.12). The lower the patch test concentration eliciting a positive test reaction, the more likely was a positive ROAT and the more likely that the positive ROAT appeared early during the investigative period.

CONCLUSIONS: The algorithm used in this study was not validated but it was indicated in this ROAT setup. The stronger the patch test reactivity the more likely was a positive ROAT and the more likely it was that the positive ROAT appeared early during the application period.

PMID:33914959 | DOI:10.1111/jdv.17315

J Eur Acad Dermatol Venereol. 2021 Apr 29. doi: 10.1111/jdv.17312. Online ahead of print.

ABSTRACT

BACKGROUND: Aquagenic Wrinkling of the Palms (AWP) is an excessive and early palmar wrinkling occurring after Brief Immersion to Water (BIW), and has been reported as a frequent finding among Cystic Fibrosis (CF) patients.

OBJECTIVES: To evaluate and assess the diagnostic performance of BIW test as an initial screening tool for CF diagnosis.

METHODS: We measured AWP in CF patients, CF-heterozygotes (CF-het) and normal controls. The AWP parameters of palmar wrinkling, oedema, papules, pruritus and pain were assessed at 3, 7, 11 mins after a BIW test was performed for all the participants. Statistical analyses explored the progression of AWP in time for the three groups and assessed the diagnostic performance of BIW test as a diagnostic screening tool for CF.

RESULTS: A total of 250 individuals (100 CF patients, their 50 CF-het parents, 100 healthy controls) were included in the analysis. The average age in years (mean±SD) was 10.4 ± 4.0 for CF, 35.9 ± 6.1 for CF-het and 10.5 ± 4.0 for Controls. The rate of positives for AWP at 3 minutes among CF patients, CF-het and controls was 68%, 8% and 0% respectively (p< 0.01). Kaplan Meier analysis showed a clear trend towards earlier appearance of all five parameters in the direction Controls < hetCF < CF (p values < 0.01). The best diagnostic performance in detecting between CF patients and non-CF was achieved by the presence of papules and wrinkling at 7 min (sensitivity/specificity: 94.0%/98.3% and 100.0%/92.0%, respectively).

CONCLUSIONS: A strong association between AWP and CF was detected. AWP after BIW could be elicited easily and possibly can be used as an initial screening tool to assess if an individual with symptoms and signs that raise the likelihood of CF is a CF patient.

PMID:33914973 | DOI:10.1111/jdv.17312

J Eur Acad Dermatol Venereol. 2021 Apr 29. doi: 10.1111/jdv.17324. Online ahead of print.

ABSTRACT

BACKGROUND: In the era of precision medicine, identification of possible predictive factors of clinical response to treatment is fundamental. This need is particularly strong for anogenital warts (AGW), because there are several treatment modalities with different clearance and recurrence rates. However, data regarding the effect of mental health parameters on response to treatment in patients with AGW are lacking.

OBJECTIVES: The purpose of the present study was to evaluate the association between patients’ mental health parameters and AGW treatment outcomes.

METHODS: This was a single-centre, prospective study that included newly diagnosed male patients with AGW. At their initial visit, all patients completed the State-Trait Anxiety Inventory (STAI), the Symptom Checklist-90-Revised (SCL-90-R), and the Eysenck Personality Questionnaire (EPQ) questionnaires, which evaluate anxiety, psychopathological manifestations, and personality traits, respectively. All patients received cryotherapy until clearance of lesions and were followed up for 18 months for detection of recurrences.

RESULTS: The study included 167 male patients. The mean number of days for AGW clearance was 89+/-65. During the 18-month follow up, 28 % of participants showed a recurrence, after a mean number of 150+/-132 days. No statistically significant association was detected between questionnaires scores and a) time needed for AGW clearance, b) time until 1^st recurrence, and c) number of recurrences.

CONCLUSION: If confirmed, our findings indicate that we may not need to modify our AGW treatment plan according to a patient’s mental health profile.

PMID:33914981 | DOI:10.1111/jdv.17324

Genome Biol Evol. 2021 Apr 29:evab089. doi: 10.1093/gbe/evab089. Online ahead of print.

ABSTRACT

Codon bias is common to all organisms and is the result of mutation, drift, and selection. Selection for the efficiency and accuracy of translation is well recognized as a factor shaping the codon usage. In contrast, fewer studies report the control of the rate of translation as an additional selective pressure influencing the codon usage of an organism. Experimental molecular evolution using RNA virus populations is a powerful tool for the identification of mechanisms underlying the codon bias. Indeed, the role of deoptimized codons on the co-translational folding has been proven in the capsids of two fecal-orally transmitted picornaviruses, poliovirus and the hepatitis A virus, emphasizing the role of the frequency of codons in determining the phenotype. However, most studies on virus codon usage rely only on computational analyses, and experimental studies should be encouraged to clearly define the role of selection on codon evolution.

PMID:33914886 | DOI:10.1093/gbe/evab089

Biometrics. 2021 Apr 29. doi: 10.1111/biom.13483. Online ahead of print.

ABSTRACT

A prominent threat to causal inference about peer effects in social science studies is the presence of homophily bias, that is, social influence between friends and families is entangled with common characteristics or underlying similarities that form close connections. Analysis of social study data has suggested that certain health conditions such as obesity and psychological states including happiness and loneliness can spread between friends and relatives. However, such analyses of peer effects or contagion effects have come under criticism because homophily bias may compromise the causal statement. We develop a regression-based approach which leverages a negative control exposure for identification and estimation of contagion effects on additive or multiplicative scales, in the presence of homophily bias. We apply our methods to evaluate the peer effect of obesity in Framingham Offspring Study. This article is protected by copyright. All rights reserved.

PMID:33914905 | DOI:10.1111/biom.13483

J Oral Rehabil. 2021 Apr 29. doi: 10.1111/joor.13177. Online ahead of print.

ABSTRACT

BACKGROUND: Discomfort encountered during oral processing may cause food avoidance and increase the risk of malnutrition in older adults. The aim of the present survey was to explore the relationships between oral health and the oral discomfort experienced while eating in senior people.

MATERIALS AND METHODS: In a cross-sectional study, oral discomfort was assessed in a sample of 119 independently-living participants aged between 35 and 81 years. Statistical analyses were used to identify categorical variables associated with food-related oral discomfort, including age, oral health-related quality of life (OHQoL), saliva secretion, occluding support, oral diseases, and denture use.

RESULTS: Food-related oral discomfort concerned 28.5% of the participants. Within the sample study, the risk of experiencing food-related oral discomfort was increased for participants perceiving average (OR= 7.968, CI95%= 2.603-24.381, p=0.000) or poor OHQoL (OR= 17.109, CI95%= 4.398-66.552, p=0.000), and presenting strictly fewer than 7 occlusal functional units (OFUs) (OR=3.396, CI95%= 1.206-9.561, p=0.020). Textured foods including fibrous (66.6%), heterogenous (60.6%) and grainy foods (42.4%) were mostly cited as food-related oral discomfort trigger factors. Within the 66-80 years group, participants having 0-6 OFUs were four times more likely to experience oral discomfort related to fibrous foods than participants having more than 7 OFUs (OR=4.812, CI95%=1.192-19.415, p=0.024). Within this group, participants having their teeth replaced by denture were also four times more likely to develop oral discomfort related to foods with heterogeneous textures (OR=4.714, CI95%=1.030-21.562, p=0.045) and grainy foods (OR=7.285, CI95%=1.308-40.568, p=0.023) than non-denture wearers.

CONCLUSION: Poor oral health conditions may generate oral discomfort with foods in the elderly especially with fibrous, heterogenous and grainy textures, and thus affect mealtime experience.

PMID:33914929 | DOI:10.1111/joor.13177

PLoS One. 2021 Apr 29;16(4):e0250872. doi: 10.1371/journal.pone.0250872. eCollection 2021.

ABSTRACT

BACKGROUND: Risk communication is a key component of public health interventions during an outbreak. As the coronavirus pandemic unfolded in late 2019, the World Health Organization (WHO) was at the forefront in the development of risk communication strategies. The WHO introduced a range of activities with the purpose of enabling the public to avail verified and timely information on COVID-19 prevention behaviors. Given the various WHO activities to protect the public health during COVID-19, it is important to investigate the extent of familiarity and uptake of the WHO recommendations among the public during the first wave of the pandemic.

METHODS: To do this, we conducted a large-scale Pan-European survey covering around 7500 individuals that are representative of populations from seven European countries, collected online during April 2-April 15, 2020. We use descriptive statistics including proportions and correlations and graphical representations such as bar charts to analyze and display the data.

RESULTS: Our findings suggest that information from the WHO in the context of COVID-19 is well trusted and acted upon by the public. Overall familiarity and adherence were quite high in most countries. Adherence was higher for social distancing recommendations compared to hygiene measures. Familiarity and adherence were higher among older, female, and highly educated respondents. However, country level heterogeneities were observed in the level of trust in information from the WHO, with countries severely affected by the pandemic reporting lower levels of trust.

CONCLUSION: Our findings call for efforts from health authorities to get regular feedback from the public on their familiarity and compliance with recommendations for preventive measures at all stages of the pandemic, to further develop and adapt risk communication as the pandemic evolves.

PMID:33914814 | DOI:10.1371/journal.pone.0250872

PLoS One. 2021 Apr 29;16(4):e0251000. doi: 10.1371/journal.pone.0251000. eCollection 2021.

ABSTRACT

BACKGROUND: The burden to fight with Corona Virus Disease-19 (COVID-19) pandemic has lied to frontline health care workers that are putting themselves at a higher risk in the battle against the disease. This study aimed to assess the exposure health risks of COVID-19 among frontline healthcare workers in the Amhara region, Ethiopia.

METHOD: A web-based cross-sectional study was conducted on public health workers from May to August 2020. Data were collected using a structured questionnaire via email and telegram services. Both descriptive statistics and bivariate followed by multivariable logistic regression analyses were conducted to identify distribution patterns and factors associated with exposure risks to COVID-19. Odds ratio with 95% Confidence Interval (CI), and a P-value of <0.05 was used to determine statistical significance.

RESULT: A total of 418 health care workers participated in the study with a response rate of 99.1%. The majority of the study participants 310(74.2%), were males, and 163(39%) were nurses/ midwives respectively. More than half of the respondents 237(56.7%), had reported that they didn`t have face-to-face contact with a confirmed COVID-19 patient. Among the respondents, 173(41.4%), 147(35.2%), 63(15.1%), and 65(15.6%) of the health professionals had always used gloves, medical masks, face shield, or goggles/protective glasses, and disposable gown, respectively. In this study, age between 25-34 years (AOR = 0.20), age between 35-44 years (AOR = 0.13), family size of >6 (AOR = 3.77), work experience of 21-30 years (AOR = 0.01), and good handwashing habit (AOR = 0.44) were the protective factors against COVID-19. On the other hand, perception of non-exposure to COVD 19 (AOR = 9.56), and poor habit of decontamination of high touch areas (AOR = 2.52) were the risk factors associated with confirmed COVID 19 cases among health care workers.

CONCLUSION: Poor adherence to personal protective equipment use and aseptic practices during and after health care interactions with patients were identified. Strategies should be implemented to institute effective and sustainable infection control measures that protect the health care workers from COVID-19 infection.

PMID:33914826 | DOI:10.1371/journal.pone.0251000

PLoS One. 2021 Apr 29;16(4):e0250814. doi: 10.1371/journal.pone.0250814. eCollection 2021.

ABSTRACT

BACKGROUND: Unsafe disposal of children’s stool makes children susceptible to fecal-oral diseases and children remain vulnerable till the stools of all children are disposed of safely. There is a paucity of data on spatial distribution and factors associated with unsafe child stool disposal in Ethiopia. Previous estimates, however, do not include information regarding individual and community-level factors associated with unsafe child stool disposal. Hence, the current study aimed (i) to explore the spatial distribution and (ii) to identify factors associated with unsafe child stool disposal in Ethiopia.

METHODS: A secondary data analysis was conducted using the recent 2016 Ethiopian demographic and health survey data. A total of 4145 children aged 0-23 months with their mother were included in this analysis. The Getis-Ord spatial statistical tool was used to identify high and low hotspots areas of unsafe child stool disposal. The Bernoulli model was applied using Kilduff SaTScan version 9.6 software to identify significant spatial clusters. A multilevel multivariable logistic regression model was fitted to identify factors associated with unsafe child stool disposal.

RESULTS: Unsafe child stool disposal was spatially clustered in Ethiopia (Moran’s Index = 0.211, p-value< 0.0001), and significant spatial SaTScan clusters of areas with a high rate of unsafe child stool disposal were detected. The most likely primary SaTScan cluster was detected in Tigray, Amhara, Afar (north), and Benishangul-Gumuz (north) regions (LLR: 41.62, p<0.0001). Unsafe child stool disposal is more prevalent among households that had unimproved toilet facility (AOR = 1.54, 95%CI: 1.17-2.02) and those with high community poorer level (AOR: 1.74, 95%CI: 1.23-2.46). Higher prevalence of unsafe child stool disposal was also found in households with poor wealth quintiles. Children belong to agrarian regions (AOR: 0.62, 95%CI 0.42-0.91), children 6-11 months of age (AOR: 0.65, 95%CI: 0.52-0.83), 12-17 months of age (AOR: 0.68, 95%CI: 0.54-0.86), and 18-23 months of age (AOR: 0.58, 95%CI: 0.45-0.75) had lower odds of unsafe child stool disposal.

CONCLUSIONS: Unsafe child stool disposal was spatially clustered. Higher odds of unsafe child stool disposal were found in households with high community poverty level, poor, unimproved toilet facility, and with the youngest children. Hence, the health authorities could tailor effective child stool management programs to mitigate the inequalities identified in this study. It is also better to consider child stool management intervention in existing sanitation activities considering the identified factors.

PMID:33914836 | DOI:10.1371/journal.pone.0250814

PLoS One. 2021 Apr 29;16(4):e0250778. doi: 10.1371/journal.pone.0250778. eCollection 2021.

ABSTRACT

INTRODUCTION: Pooling (or combining) and analysing observational, longitudinal data at the individual level facilitates inference through increased sample sizes, allowing for joint estimation of study- and individual-level exposure variables, and better enabling the assessment of rare exposures and diseases. Empirical studies leveraging such methods when randomization is unethical or impractical have grown in the health sciences in recent years. The adoption of so-called “causal” methods to account for both/either measured and/or unmeasured confounders is an important addition to the methodological toolkit for understanding the distribution, progression, and consequences of infectious diseases (IDs) and interventions on IDs. In the face of the Covid-19 pandemic and in the absence of systematic randomization of exposures or interventions, the value of these methods is even more apparent. Yet to our knowledge, no studies have assessed how causal methods involving pooling individual-level, observational, longitudinal data are being applied in ID-related research. In this systematic review, we assess how these methods are used and reported in ID-related research over the last 10 years. Findings will facilitate evaluation of trends of causal methods for ID research and lead to concrete recommendations for how to apply these methods where gaps in methodological rigor are identified.

METHODS AND ANALYSIS: We will apply MeSH and text terms to identify relevant studies from EBSCO (Academic Search Complete, Business Source Premier, CINAHL, EconLit with Full Text, PsychINFO), EMBASE, PubMed, and Web of Science. Eligible studies are those that apply causal methods to account for confounding when assessing the effects of an intervention or exposure on an ID-related outcome using pooled, individual-level data from 2 or more longitudinal, observational studies. Titles, abstracts, and full-text articles, will be independently screened by two reviewers using Covidence software. Discrepancies will be resolved by a third reviewer. This systematic review protocol has been registered with PROSPERO (CRD42020204104).

PMID:33914795 | DOI:10.1371/journal.pone.0250778