Nevin Manimala

Child Care Health Dev. 2023 Nov 11. doi: 10.1111/cch.13201. Online ahead of print.

ABSTRACT

BACKGROUND: Child survival remains a major public health challenge in the sub-Saharan region of Africa, especially Nigeria. The Boko Haram crisis, which has aggravated this, has led to the displacement of many people in the north-eastern region, including children under five. This study investigated the determinants of child survival practice among caregivers in internally displaced persons’ (IDP) camps in Abuja Municipal Area Council (AMAC), Nigeria.

METHODOLOGY: A cross-sectional design was used to collect data on determinants of child survival practice from 312 caregivers in five purposively selected IDP camps in AMAC using the snowball sampling technique. Data were analysed using univariate, bivariate, and multivariate statistics at 5% level of significance.

RESULTS: The mean age of respondents was 29.6 ± 6.72 years. There was a significant (p < 0.05) relationship between the predisposing, reinforcing, enabling and environmental factors studied and child survival practice. Findings also indicated that all factors were significant (p < 0.05) predictors of child survival practice with the reinforcing factor being the major predictor (ß = 0.38; t = 6.08).

CONCLUSION: Attention needs to be paid to all factors, particularly the reinforcing factor of social support in order to promote optimal child survival practice among caregivers in AMAC IDP camps. Collaboration with social work professionals would be an added benefit to enhance social support.

PMID:37950536 | DOI:10.1111/cch.13201

Cytopathology. 2023 Nov 10. doi: 10.1111/cyt.13330. Online ahead of print.

ABSTRACT

INTRODUCTION: Specific diagnosis of endometrial carcinomas on cervical cytology is difficult with few useful cytomorphological clues reported. This study reviews a cohort of cervical cytology to investigate the presence of keratinization in atypical glandular cells (AGC), an undescribed cytomorphological clue for identifying endometrial endometrioid carcinomas on cervical cytology.

METHODS: Cervical cytology slides from patients with a histologic diagnosis of endometrial endometrioid carcinoma were reviewed for the presence of keratinization associated with AGCs. Corresponding histology slides were reviewed for tumour grading and degree of squamous differentiation.

RESULTS: In total, 42 cases of cervical cytology specimens from 41 patients were retrieved, including 7 (16.7%) with keratinization associated with AGCs seen and 35 (83.3%) without. Comparison of histologic grading did not demonstrate an association with the presence of keratinization on cytology (p = 0.565). Corresponding histology slides were available for 37 cases. Cytologic and histologic keratinization were associated statistically (p = 0.002). Frank keratinization was seen on histologic slides of five cases, with four also showing cytologic keratinization. Area of squamous differentiation, including squamous morule formation, did not correlate with keratinization on cytologic preparation (p = 0.185).

CONCLUSION: Histologic and cytologic keratinization are observed in endometrioid endometrial carcinomas. Such is reflected in cervical cytology by the presence of orangeophilic, rigid and acellular fragments within or associated with AGC clusters. Keratinization, when identified with AGCs, should be regarded as a cytologic clue suggestive of an endometroid carcinoma of endometrial origin.

PMID:37950528 | DOI:10.1111/cyt.13330

Nutr Bull. 2023 Nov 10. doi: 10.1111/nbu.12649. Online ahead of print.

ABSTRACT

Nutrition professionals are important stakeholders in sustainable food systems with skills to promote the connection between health, food production, environment, culture and economics. Higher education institutions are increasingly recognising the importance of teaching about sustainability, yet there exists a gap in the literature detailing the awareness of sustainability issues by nutrition students. This study aimed to ascertain the level of knowledge of sustainable diets (SDs), the perceived barriers to their adoption in their own diets, students’ experience of university-based teaching about SDs and their views on the future role of the nutrition profession in relation to SD amongst nutrition students on Association for Nutrition (AfN)-accredited degrees. The study assessed environmental and sustainable food literacy (SFL) through an online questionnaire and explored the issues in more detail in virtual or face-to-face interviews in 2019. Quantitative data were analysed using descriptive statistics (Kruskal-Wallis, Jonckheere-Terpstra, independent t-test, Spearman, Pearson Correlations). Qualitative data were analysed using the Braun and Clark (2006) six-step approach to thematic analysis. The questionnaire responses (n = 51) represented 17 AfN-accredited undergraduate courses (35% of AfN-accredited universities in 2019). The majority (76%) of students had received an introduction, partaken in a module or received teaching on SDs throughout their whole degree. Students were predominantly environmentally literate, yet had a fragmented understanding of SDs, focusing on the environmental aspects of SDs. There was no correlation between SFL and reported sustainability content of university courses, highlighting a need for more effective teaching on sustainability topics. Additionally, no relationship between self-reported diet intake and SFL was found. Students identified a lack of knowledge and education as barriers preventing them from adopting sustainable practices in the present and future. To integrate sustainability into their future practice more consistently and effectively, nutrition students require more structured, holistic sustainability education and knowledge.

PMID:37950523 | DOI:10.1111/nbu.12649

Ophthalmic Physiol Opt. 2023 Nov 10. doi: 10.1111/opo.13244. Online ahead of print.

ABSTRACT

Peripheral refraction is believed to be involved in the development of myopia. The aim of this study was to compare the relative peripheral refraction (RPR) at four different levels of illuminance, ranging from photopic conditions to complete darkness, using an open-field autorefraction method. The RPR was calculated for each eccentricity by subtracting central from peripheral autorefraction measurements. The study included 114 myopic eyes from 114 subjects (mean age of 21.81 ± 1.91 years) and the mean difference in RPR between scotopic and photopic conditions (0 and 300 lux, respectively) was +0.32 D at 30° temporal and +0.37 D at 30° in the nasal visual field (NVF). Statistically significant differences were observed between 0 and 300 lux at 30° in the temporal visual field and at 30° and 20° in the NVF. Our results revealed a significant increase in relative peripheral hyperopia with increasing visual field eccentricity along the horizontal visual field in myopic eyes of young adults. Furthermore, this relative peripheral hyperopia increased as illumination decreased. These findings suggest that an increase in peripheral illuminance may protect against myopic eye growth.

PMID:37950504 | DOI:10.1111/opo.13244

Eur J Clin Invest. 2023 Nov 10:e14127. doi: 10.1111/eci.14127. Online ahead of print.

ABSTRACT

INTRODUCTION: This cross-sectional study aimed to investigate the association between myocardial mechano-energetic efficiency (MEE) and whole blood viscosity (WBV) in nondiabetic adults participating in the CATAnzaro MEtabolic RIsk factors (CATAMERI) study.

METHODS: 1143 participants underwent an oral glucose tolerance test and an echocardiogram for myocardial MEE per gram of left ventricular mass (MEEi) measurement. WBV was measured as: [0.12 × h] + [0.17 × (p-2.07)], where h is haematocrit and p is plasma protein levels.

RESULTS: Study population includes 595 males and 548 females with a mean age of 46 ± 12 years and a mean BMI of 30.0 ± 6.2 kg/m² . Individuals with normal glucose tolerance were 63%, while those with impaired fasting glucose, impaired glucose tolerance and or the combination of both were 14.3%, 13% and 9.7%, respectively. A univariate analysis showed that MEEi was significantly associated with sex, age, smoking, BMI, waist circumference, total cholesterol, HDL, triglycerides, fasting glucose, fasting insulin, HOMA-IR index, glucose tolerance, C-reactive protein, haematocrit, haemoglobin, plasma protein and WBV. In a multivariable regression model including variables that were significantly associated with MEEi in univariate analysis, MEEi was associated with HOMA-IR (β = -0.144, p < .001), age (β = -0.140, p < .001), WBV (β = -0.129, p < .001) and glucose tolerance (β = -0.064, p = .04). The independent association between WBV and MEEi remained statistically significant (β = -0.122, p < .001) when antihypertensive therapy and lipid-lowering therapy were included in the model.

CONCLUSION: WBV is associated with decreased myocardial MEE independently of other cardiovascular risk factors.

PMID:37950492 | DOI:10.1111/eci.14127

J Gerontol A Biol Sci Med Sci. 2023 Nov 9:glad258. doi: 10.1093/gerona/glad258. Online ahead of print.

ABSTRACT

BACKGROUND: Having multiple sleep problems is common in adulthood. Yet, most studies have assessed single sleep variables at one timepoint, potentially misinterpreting health consequences of co-occurring sleep problems that may change over time. We investigated the relationship between multidimensional sleep health across adulthood and mortality.

METHOD: Participants from the Midlife in the United States Study reported sleep characteristics in 2004-2006 (MIDUS-2; M2) and in 2013-2016 (MIDUS-3; M3). We calculated a composite score of sleep health problems across five dimensions: Regularity, Satisfaction, Alertness, Efficiency, and Duration (higher=more problems). Two separate models for baseline sleep health (n=5,140; median follow-up time=15.3 years) and change in sleep health (n=2,991; median follow-up time=6.4 years) to mortality were conducted. Cox regression models controlled for sociodemographics and key health risk factors (body mass index, smoking, depressive symptoms, diabetes, hypertension).

RESULTS: On average, 88% of the sample reported having one or more sleep health problems at M2. Each additional sleep health problem at M2 was associated with 12% greater risk of all-cause mortality (hazard ratio [HR]=1.12, 95% confidence interval [CI]=1.04-1.21), but not heart disease related mortality (HR=1.14, 95% CI=0.99-1.31). An increase in sleep health problems from M2 to M3 was associated with 27% greater risk of all-cause mortality (HR=1.27, 95% CI=1.005-1.59), and 153% greater risk of heart disease mortality (HR=2.53, 95% CI=1.37-4.68).

CONCLUSIONS: More sleep health problems may increase the risk of early mortality. Sleep health in middle and older adulthood is a vital sign that can be assessed at medical check-ups to identify those at greater risk.

PMID:37950462 | DOI:10.1093/gerona/glad258

Glycobiology. 2023 Nov 9:cwad090. doi: 10.1093/glycob/cwad090. Online ahead of print.

ABSTRACT

Several risk factors have been associated with SARS-CoV-2 infections and severity of COVID-19 disease it causes. This study investigated whether variations in histo-blood group antigen (HBGA) expression can predispose individuals to SARS-CoV-2 infections and severity of the disease. Nasopharyngeal swabs, randomly selected from SARS-CoV-2 positive and SARS-CoV-2 negative individuals, were tested for Lewis and H-type 1 HBGA phenotypes by ELISA using monoclonal antibodies specific to Lewis a, Lewis b and H type 1 antigens. The most common Lewis HBGA phenotype among all study participants was Lewis a-b+ (46%), followed by Lewis a-b- (24%), Lewis a+b- and Lewis a+b+ (15% each), while 55% of the study participants were H-type 1. Although SARS-CoV-2 negative individuals had a lower likelihood of having a Lewis a-b- phenotype compared to their SARS-CoV-2 positives counterparts (OR: 0.53, 95% C.I: 0.255-1.113), it did not reach statistical significance (P = 0.055). The frequency of Lewis a+b+, Lewis a+B-, Lewis a-b+, H type 1 positive and H type 1 negative were consistent between SARS-CoV-2 positive and SARS-CoV-2 negative individuals. When stratified according to severity of the disease, individuals with Lewis a+b- phenotype had a higher likelihood of developing mild COVID-19 symptoms (OR: 3.27, 95% CI; 0.9604-11.1), but was not statistically significant (P = 0.055), while Lewis a-b- phenotype was predictive of severe COVID-19 symptoms (OR: 4.3, 95% CI: 1.274-14.81), P = 0.016. In conclusion, individuals with Lewis a-b- phenotype were less likely to be infected by SARS-CoV-2, but when infected, they were at risk of severe COVID-19.

PMID:37950443 | DOI:10.1093/glycob/cwad090

Med Sci Monit. 2023 Nov 11;29:e941229. doi: 10.12659/MSM.941229.

ABSTRACT

BACKGROUND The clinical course of respiratory syncytial virus (RSV), SARS-CoV-2, and influenza infections comprises many non-specific symptoms, which makes diagnosis difficult. The aim of this study was to retrospectively analyze the symptomatology of these infections in children and to search for correlations between them. MATERIAL AND METHODS A total of 121 children with a positive RSV (n=61), influenza (n=31), or SARS-CoV-2 (n=29) antigen test were enrolled in this retrospective analysis. Children were aged up to 71 months (median, 8 months). The collected data were collated by performing statistical analysis using the chi-square test and comparing the results using OR (odds ratio) and 95%CI (confidence interval). RESULTS There was a higher risk of fever in children with influenza than in those with RSV. Patients infected with RSV had a higher risk of nasal blockage than those with SARS-CoV-2. Dyspnea was more common in RSV infection than in influenza. Severe, sleep-awakening cough was more frequent in children with RSV than in those with COVID-19. Influenza was more prevalent in children aged >24 months than in those aged 7-24 months. RSV-infected children had a higher risk of numerous auscultatory changes compared to those with SARS-CoV-2. In the case of RSV infection, symptoms requiring hospitalization occurred later than in SARS-CoV-2 infection. CONCLUSIONS Children aged >24 months were at higher risk of contracting influenza. Numerous auscultatory changes, nasal blockage, and dyspnea were more common in children with RSV. There was a higher risk of dyspnea in children with RSV. Fever was more frequent in children with influenza. However, none of the symptoms clearly indicated the etiology of the infection.

PMID:37950434 | DOI:10.12659/MSM.941229

J Magn Reson Imaging. 2023 Nov 10. doi: 10.1002/jmri.29130. Online ahead of print.

ABSTRACT

BACKGROUND: Late gadolinium enhancement (LGE) cardiac MRI is the method of choice in revealing the presence of myocardial scarring, but its availability remains limited in clinical practice.

PURPOSE: To assess myocardial scarring in patients with autoimmune rheumatic diseases (ARDs) using contrast-free cardiac MRI with a radiomics model.

STUDY TYPE: Retrospective.

POPULATION: One hundred ninety-two patients (mean age, 41 years ± 15, 62 men) with or without ARDs, grouped into a training set of 153 patients and a testing set of 39 patients.

FIELD STRENGTH/SEQUENCE: 3.0 T/ cine imaging with a balanced steady-state free precession sequence, T1 mapping with a modified Look-Locker inversion recovery sequence, and LGE imaging with a phase-sensitive inversion recovery gradient echo sequence.

ASSESSMENT: LGE assessment was the reference standard for identifying myocardial scarring. Based on motion features extracted from cine images and tissue characterization features extracted from native T1 maps, a fully automated radiomics model with T1, cine MRI, or combined inputs was developed.

STATISTICAL TESTS: Logistic regression model was used to detect myocardial scarring using contrast-free cardiac MRI parameters. Receiver operating characteristic curves were analyzed to assess the accuracy, sensitivity, and specificity in detecting myocardial scarring. Sensitivities of the models were further assessed in patients with various myocardial scarring proportions. Z-statistic and dice coefficient were assessed to compare the performance. P-values <0.05 were considered significant.

RESULTS: The multivariable regression model exhibited an accuracy of 85.3%, a sensitivity of 93.5%, and a specificity of 50.0%. The radiomics model with T1 and cine MRI input exhibited an accuracy of 75.7%, a sensitivity of 60.9%, and a specificity of 85.5%. Moreover, the radiomics model showed a sensitivity of 90.9% among patients with >25% myocardial scarring.

DATA CONCLUSIONS: The proposed radiomics model allowed for the identification of myocardial scarring similar to LGE, but on contrast-free cardiac MRI in patients with ARDs.

EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 1.

PMID:37950412 | DOI:10.1002/jmri.29130

J Magn Reson Imaging. 2023 Nov 10. doi: 10.1002/jmri.29124. Online ahead of print.

ABSTRACT

BACKGROUND: The widely used magnetization-prepared rapid gradient-echo (MPRAGE) sequence makes enhancing lesions and blood vessels appear bright after gadolinium administration. However, dark blood imaging using T1-weighted Sampling Perfection with Application optimized Contrast using different flip angle Evolution (T1 SPACE) can be advantageous since it improves the conspicuity of small metastases and leptomeningeal disease. As a potential alternative to T1 SPACE, we evaluated a new dark blood sequence called echo-uT₁ RESS (unbalanced T1 Relaxation-Enhanced Steady-State).

PURPOSE: We compared the performance of echo-uT₁ RESS with Dixon fid-uT₁ RESS, MPRAGE, and T1 SPACE.

STUDY TYPE: Retrospective, IRB approved.

SUBJECTS/PHANTOM: Phantom to assess flow properties of echo-uT₁ RESS. Twenty-one patients (14 female, age range 35-82 years) with primary and secondary brain tumors.

FIELD STRENGTH/SEQUENCES: 3 Tesla/MPRAGE, T1 SPACE, Dixon fid-uT₁ RESS, echo-uT₁ RESS.

ASSESSMENT: Flow phantom signal vs. velocity as a function of flip angle and sequence. Qualitative image assessment on 4-point scale. Quantitative evaluation of tumor-to-brain contrast, apparent contrast-to-noise ratio (aCNR), and vessel-to-brain aCNR.

STATISTICAL TESTS: Friedman and Mann-Whitney U tests. A P value <0.05 was considered statistically significant.

RESULTS: In the phantom, echo-uT₁ RESS showed greater flow-dependent signal loss than fid-uT₁ RESS. In patients, blood vessels appeared bright with MPRAGE, gray with fid-uT₁ RESS, and dark with T1 SPACE and echo-uT₁ RESS. For MPRAGE, Dixon fid-uT₁ RESS, echo-uT₁ RESS, and T1 SPACE, respective tumor-to-brain contrast values were 0.6 ± 0.3, 1.3 ± 0.5, 1.0 ± 0.4, and 0.6 ± 0.4, while normalized aCNR values were 68.9 ± 50.9, 128.4 ± 59.2, 74.2 ± 42.1, and 99.4 ± 73.9.

DATA CONCLUSION: Volumetric dark blood contrast-enhanced brain MRI is feasible using echo-uT₁ RESS. The dark blood effect was improved vs. fid-uT₁ RESS, while both uT₁ RESS versions provided better tumor-to-brain contrast than MPRAGE. Whereas T1 SPACE provided better tumor aSNR, echo-uT₁ RESS provided better Weber contrast, lesion sharpness and a more consistent dark blood effect.

EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 1.

PMID:37950398 | DOI:10.1002/jmri.29124