Nevin Manimala

Retrovirology. 2024 Dec 3;21(1):20. doi: 10.1186/s12977-024-00653-y.

ABSTRACT

BACKGROUND: The role of viruses in the development of breast cancer has been a subject of debate and extensive research over the past few decades. Several studies have examined the association between Bovine leukemia virus (BLV) infection and the risk of developing breast cancer; however, their findings have yielded inconsistent results. To address this uncertainty, the purpose of the present study was to conduct a systematic review and meta-analysis to determine any potential association between BLV and breast cancer.

METHODS: The literature search was performed by finding related articles from PubMed, Web of Science, Scopus, EMBASE, and ScienceDirect databases. Statistical analysis was conducted using the meta package in R Studio and Review Manager 5.1. The I² test was used to assess between-study heterogeneity. The Mantel-Haenszel method calculated the pooled odds ratio and its 95% confidence interval. Studies were divided into subgroups for comparison.

RESULTS: The literature search identified a total of 17 studies that were deemed suitable for inclusion in the systematic review. Out of these 17 studies, 12 were used in the subsequent meta-analysis. Combining the data from these eligible studies, we calculated the pooled multi-factor adjusted odds ratio (OR) and a 95% confidence interval (CI). Considering the heterogeneity observed across the studies, the result obtained using the fixed effects model was 2.12 (1.77, 2.54). However, upon removing the six studies that contributed significantly to the heterogeneity, the pooled OR with a 95% CI was recalculated to be 3.92 (2.98, 5.16).

CONCLUSION: The result of this study suggests that BLV infection is statistically associated with Breast cancer.

PMID:39623467 | DOI:10.1186/s12977-024-00653-y

Health Res Policy Syst. 2024 Dec 2;22(1):157. doi: 10.1186/s12961-024-01250-3.

ABSTRACT

BACKGROUND: The phenomenon of growth in drug consumption within the framework of national volume-based procurement (VBP) policy raises speculations about demand release and policy inducing. This study aims to explore the reasons and mechanisms of drug consumption increases following VBP policy from two perspectives.

METHODS: We collected data from the China Drug Supply Information Platform, National Bureau of Statistics and the Joint Procurement Office. Twenty cardiovascular international non-proprietary names (INNs) in the first three VBP batches and 28 observation regions were included, constructing 418 valid INN-region combinations as the unit for analysis. The average monthly consumption volume of VBP cardiovascular drug was assigned as the explained variable. The generalized difference-in-difference method was conducted using the price reduction level and the size of policy assessment task as the policy intensity indicator. Moderating effect model was employed to examine the role of resident’s income level.

RESULTS: Increased cardiovascular drug consumption was observed in 285 (68.18%) INN-region combinations after policy implementation. Under VBP policy, the price reduction level was significantly correlated with drug consumption in total (β = 0.144, p < 0.001), as well as in tertiary hospitals, secondary hospitals and primary healthcare centers (PHCs) (all p-values < 0.05). Resident’s income level negatively moderated the impact of price reduction level on drug consumption in total (β = -0.089, p < 0.001) and in secondary hospitals (β = 0.154, p < 0.001) and PHCs (β = -0.2.9, p < 0.001), rather than in tertiary hospitals (β = -0.079, p > 0.05). The size of policy assessment task was positively associated with drug consumption in total (β = 0.052, p < 0.001), as well as in tertiary hospitals, secondary hospitals and PHCs (all p-values < 0.05).

CONCLUSIONS: Two mechanisms codrive drug consumption increases under VBP policy: first is the improvement of cardiovascular medication access and consumption toward lower-income groups following price reduction, pointing to the fulfillment of unmet needs, and second is policy pressure from supporting assessment measures on hospital drug use, indicating potential overprescribing.

PMID:39623462 | DOI:10.1186/s12961-024-01250-3

BMC Med. 2024 Dec 2;22(1):570. doi: 10.1186/s12916-024-03767-4.

ABSTRACT

BACKGROUND: Understanding the prevalence of diseases and where it is detected and recorded in healthcare settings is important for planning effective prevention and care provision. We examined inequalities in the prevalence of 205 chronic conditions and in the care setting where the related diagnoses were recorded in the English National Health Service.

METHODS: We used data from the Clinical Practice Research Datalink Aurum linked with Hospital Episode Statistics for 12.8 million patients registered with 1406 general practices in 2018. We mapped diagnoses recorded in primary and secondary care in the previous 12 years. We used linear regressions to assess associations of ethnicity, deprivation, and general practice with a diagnosis being recorded in primary care only, secondary care only, or both settings.

RESULTS: 72.65% of patients had at least one diagnosis recorded in any care setting. Most diagnoses were reported only in primary care (62.56%) and a minority only in secondary care (15.24%) or in both settings (22.18%). Black (- 0.08 percentage points (pp)), Asian (- 0.08 pp), mixed (- 0.13 pp), and other ethnicity patients (- 0.31 pp) were less likely than White patients to have a condition recorded. Patients in most deprived areas were 0.27 pp more likely to have a condition recorded (+ 0.07 pp in secondary care only, + 0.10 pp in both primary and secondary care, and + 0.10 pp in primary care only). Differences in prevalence by ethnicity were driven by diagnostic recording in primary care. Higher recording of diagnoses in more deprived areas was consistent across care settings. There were large differences in prevalence and diagnostic recording between general practices after adjusting for patient characteristics.

CONCLUSIONS: Linked primary and secondary care records support the identification of disease prevalence more comprehensively. There are inequalities in the prevalence and setting of diagnostic recording by ethnicity, deprivation, and providers on average across conditions. Further research should examine inequalities for each specific condition and whether they reflect also differences in access or recording as well as disease burden. Improving recording where needed and making national linked records accessible for research are key to understanding and reducing inequalities in disease prevention and management.

PMID:39623457 | DOI:10.1186/s12916-024-03767-4

Eur J Med Res. 2024 Dec 3;29(1):575. doi: 10.1186/s40001-024-02174-y.

ABSTRACT

BACKGROUND: The risks of obesity and epigenetic age acceleration (EAA) have drawn widespread attention. Lipid accumulation product (LAP) is a simple and reliable indicator of obesity; however, the relationship between LAP and EAA remains unclear.

METHODS: Data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2002 were used. The EAA was assessed using a self-administered questionnaire in the database. LAP was calculated based on triglycerides and waist circumference. The association between LAP and EAA was analyzed using logistic regression models, subgroup analysis, and smooth curve fitting.

RESULTS: A total of 1796 participants were included in the study, of whom 1055 had EAA. After adjusting for relevant covariates, participants with EAA generally had higher LAP levels than those without EAA (258.1 vs. 244.6). Logistic regression analysis showed that individuals in the highest LAP quartile (Q4) were more likely to have EAA than those in the lowest quartile (Q1) (OR = 1.77; 95% CI 1.31-2.39; P < 0.001). The area under the curve of the adjusted logistic regression analysis was 0.706.

CONCLUSION: This research indicates that elevated LAP levels are independently linked to an increased risk of EAA, and early intervention to reduce high LAP levels is necessary to mitigate the progression of EAA.

PMID:39623450 | DOI:10.1186/s40001-024-02174-y

BMC Psychol. 2024 Dec 3;12(1):716. doi: 10.1186/s40359-024-02185-8.

ABSTRACT

Frontline medical workers (FMWs) faced high stress levels in frontline clinics during the COVID-19 pandemic. This study aims to alleviate FMWs’ psychological stress by enhancing protection measures, which includes refining the selection process, improving protective measures for their work in frontline clinics, and determining the appropriate time for evacuation. A Chinese-language-version stress questionnaire, covering stress-related issues and sociodemographic characteristics, was administered to FMWs in Shanghai during the COVID-19 pandemic in 2022, yielding 107 valid responses. The questionnaire’s reliability and validity were subsequently confirmed. Exploratory factor analysis (EFA) was applied to the stress-related questions, with the KMO and Bartlett’s test values of 0.886, 877.8522 (df = 120, p < 0.0001), respectively. Structure equation modeling (SEM) was used to confirm the factors and measure the relationships among the stress-related questions, factors and sociodemographic characteristics. The parameters of SEM named SOFAIDC were significant with SRMSR, RMSEA, AGFI, NFI, and PNFI being 0.0422, 0.0507, 0.9946, 0.9958, and 0.7615, respectively. Paired sample t-tests revealed the significant decrease in FMWs’ stress score of the current week and the previous week, with all t-values being negative and significant (p < 0.01). A latent growth model (LGM) named LGM30 verified the overall decreasing stress trend over the weeks, with high R-squares (> 0.80), significant positive linear and negative quadratic time parameters. Based on the trajectory analysis, a stress scorecard with an AUC of 0.856 was developed. This study found that there are four factors for FMWs’ psychological stress (anxiety about infection, exhaustion, lack of cognition for infection, and hesitant feeling), and improving targeted hospital protection could alleviate FMWs’ psychological stress through SOFAIDC, as all the total effect of factors or items from the feeling of being protected by hospital were negative. Meanwhile, although overall FMWs’ stress trend has decreased, 22.43% of FMWs have maintained or experienced a high stress trend, and the stress might increase over weeks in frontline clinics. To perfect hospital protection to alleviate FMWs’ psychological stress, the scorecard could be used to select FMWs with low-stress trends, LGM30 could be used to determine the withdrawal time (such as week 8), and targeted hospital protections could be designed based on the relationships between feeling of being protected by the hospital and factors in SOFAIDC, such as providing adequate protective equipment, improving the rationality of FMWs’ work schedules, recruiting personnel with higher education levels, and paying adequate monetary compensation.

PMID:39623436 | DOI:10.1186/s40359-024-02185-8

Nutr J. 2024 Dec 2;23(1):153. doi: 10.1186/s12937-024-01058-5.

ABSTRACT

AIMS: This study aims to ascertain whether abdominal fat accumulation evaluated by waist circumference increases the risk of hypertension using the nationwide population.

METHODS: We enrolled 47,037 participants from the China Health and Nutrition Survey (CHNS), China Health and Retirement Longitudinal Study (CHARLS), and National Health, and Nutrition Examination Survey (NHANES). The adjusted logistic regression model was used to examine the relationship between waist circumference and prevalent hypertension. 9445 participants without baseline hypertension from the CHNS and CHARLS were followed up to investigate the association between waist circumference and onset hypertension. The association was evaluated using a Cox regression model and restricted cubic spline. Furthermore, Mendelian randomization was employed to explore causal inferences.

RESULTS: In the baseline survey, waist circumference demonstrated a notable correlation with hypertension, presenting an odds ratio (with 95% confidence intervals) of 1.34 (1.28 ~ 1.40). After a mean follow-up of 3.8 years for participants without baseline hypertension, 2,592 (27.5%) developed hypertension. In the pooled analysis, the Cox regression showed that every 10 cm increase in waist circumference was associated with 20% (95% CI: 13% ~ 27%) elevated risk of new-onset hypertension. Restricted cubic splines indicated a pronounced linear dose-response relationship. A subgroup analysis affirmed the persisting association between waist circumference and hypertension onset even in those with normal BMI. The Mendelian randomization method revealed a significant causative association between waist circumference and hypertension.

CONCLUSION: Elevated waist circumference stands as an independent risk factor for hypertension, even in those with normal BMI. Our results provide evidence supporting the routine measure for waist circumference.

PMID:39623430 | DOI:10.1186/s12937-024-01058-5

BMC Nurs. 2024 Dec 2;23(1):876. doi: 10.1186/s12912-024-02533-4.

ABSTRACT

BACKGROUND: Pressure injuries (PIs) remain a significant public health concern due to their high prevalence among critically ill patients admitted to intensive care units (ICUs). Despite advancements in science and technology related to PI prevention, the prevalence continues to rise. A key factor contributing to this rise is inadequate knowledge and limited use of evidence-based practices by nurses, resulting in prolonged hospital stays and poor patient outcomes. This study aimed to determine the knowledge of intensive care nurses regarding pressure injury prevention.

METHODS: A descriptive cross-sectional design was used to collect data from 101 nurses working in four ICUs at an academic hospital in Gauteng Province, South Africa. The revised Pressure Ulcer Knowledge Assessment Tool (PUKAT 2.0) was utilized to gather data from a convenience sample of intensive care nurses. Descriptive and inferential statistics were employed to analyze the data, with statistical tests including the Shapiro-Wilk test, univariate and multivariate linear regression, and Cronbach’s alpha coefficient tests. A p-value of less than 0.05 was considered statistically significant.

RESULTS: The mean knowledge score of the nurses (N = 101) was 42.16% (SD 12.09), indicating poor knowledge of PI prevention. The lowest scores were observed in the areas of “prevention of pressure injuries” (25%) and “classification and observation” (39.5%). Higher levels of education (14.00; 95% CI 2.90-25.11; p = 0.014), seniority (15.58; 95% CI 2.92-28.24; p = 0.016), and years of experience (6.38; 95% CI 9.70-5.45; p = 0.039) were statistically significant predictors of better prevention and management of PI.

CONCLUSION: The findings of this study demonstrate that intensive care nurses have poor knowledge of prevention measures, classification, and observation of stages. This may hinder their ability to effectively utilize risk assessment tools in clinical practice. Improving training and providing intensive care nurses with adequate information about evidence-based practices to prevent PI could strengthen their contribution to patient safety. These findings underscore the need for continuous, mandatory training programs for intensive care nurses to stay updated with the latest evidence and practices in PI prevention.

PMID:39623421 | DOI:10.1186/s12912-024-02533-4

BMC Public Health. 2024 Dec 2;24(1):3351. doi: 10.1186/s12889-024-20883-1.

ABSTRACT

BACKGROUND: Pneumonia is a major cause responsible for mortality and morbidity among children around the world. The present study aimed to determine the age distribution, and contributing risk factors for mortality among children who died from pneumonia.

METHOD: This study was a cross-sectional study conducted at Teaching Hospital Peradeniya and Sirimavo Bandaranaike Specialized Children’s Hospital (SBSCH) which is one of the two specialised children’s hospitals in the country. Demographic details, clinical details, laboratory and radiological findings of the children who died due to pneumonia from 2017 to 2022 were collected from record rooms of the two hospitals. The targeted study cohort consists of children between 0 and 14 years of age who died with an established diagnosis of pneumonia. Data was analysed using SPSS version 24. Percentages were calculated to determine the demographic details. The association between different risk factors with childhood pneumonia deaths was calculated.

RESULTS: Fifty-six (56) children in the age category of 0-14 years who died due to an established diagnosis of pneumonia from 2017 to 2022 were included in this study. Fourteen (25%) of them died in the acute medical ward and the remainder in the ICU. From the total study cohort, 51.8% (29) were males and 48.2% (27) were females. The highest number of children (39.3%) was in the age category of 3-12 months. Forty-two children, 75% of the study cohort were children younger than 1 year. Among 56 total, 41 children (73.2%) were identified as underweight for age according to the WHO weight for age charts and 14 (25%) children had not completed the immunisation to the age according to the National Programme of Immunisation (NPI) of Sri Lanka. In the present study cohort, 51.8% (29) of children were diagnosed with CHD and 28.6% (16) of the study cohort had a past medical history of LRTI. Number of patients with underlying respiratory diseases and cerebral palsy were 6 (10.7%) and 5 (8.9%) respectively. There was a significant correlation between the death of children due to pneumonia and the younger age (p = 0.004), duration of the hospital stay (P = 0.011), cerebral palsy (p = 0.004) and history of LRTI (p = 0.001).

CONCLUSION: Younger age of less than one year, cerebral palsy and a history of lower respiratory tract infections were significantly associated with children dying due to pneumonia. Nearly half of the children who died from pneumonia had a congenital heart disease although it is not statistically significant. A substantial number of deaths occurring in general wards needs further evaluation.

PMID:39623419 | DOI:10.1186/s12889-024-20883-1

BMC Nurs. 2024 Dec 2;23(1):871. doi: 10.1186/s12912-024-02549-w.

ABSTRACT

BACKGROUND: Managing hemodynamic instability in critically ill patients due to cardiovascular disease or, in particular, coronary artery disease requires an integrated and responsive approach. The complexity lies in simultaneously addressing the underlying cardiovascular pathology and managing its systemic effects. The complexity described above involves a careful balance of interventions, including fluid and electrolyte management, pharmacological support, and, in some cases, mechanical circulatory support. The dynamic nature of hemodynamic instability necessitates constant vigilance and rapid adaptation of treatment strategies to align with the evolving clinical picture. So, this study aims to investigate the knowledge, attitude, and practice of Palestinian critical care nurses about hemodynamic instability in patients with cardiovascular diseases.

METHOD: A cross-sectional design was conducted on 300 nurses in 30 hospitals in the West Bank and East Jerusalem of Palestine. Data were collected using a self-administered questionnaire composed of four sections covering the socio-demographics, knowledge, attitudes, and practices of the sample. Quantitative statistical analysis was done using Statistical Package for Social Sciences (SPSS) software.

RESULTS: The nurses demonstrated an almost low overall level of knowledge about hemodynamic instability, with a mean score of 2.7 on a 7-points scale. Additionally, nurses generally expressed a high positive attitude toward their practice, with a mean score of 3.8 on a 5-point scale. Although; Palestinian nurses showed a low level of knowledge about hemodynamic instability but expressed positive attitudes toward their practice. The practice level was also moderate with a mean score of 2.3 on a 5-point scale. Significant differences were found with a higher attitude of male nurses and higher knowledge with bachelor or higher educational levels. Other variables showed non-significant differences.

CONCLUSIONS: Several challenges were identified, including lack of training and resources, within this study context. Educational interventions and improved access to resources could improve nurses’ knowledge and practice in managing hemodynamic instability.

PMID:39623413 | DOI:10.1186/s12912-024-02549-w

Arthritis Res Ther. 2024 Dec 2;26(1):207. doi: 10.1186/s13075-024-03445-z.

ABSTRACT

BACKGROUND: This study investigates the causal role of metabolites mediating immune cells in rheumatoid arthritis (RA) and ankylosing spondylitis (AS) through a Mendelian randomization (MR) study.

METHODS: The two-sample and two-step MR methods were used for the current analysis: (1) causal effects of immune cells on RA and AS; (2) mediation effects of metabolites. Inverse variance weighted (IVW) is the main method to analyze causality, and MR results are verified by several sensitive analyses.

RESULTS: This study first identified the immune cells and metabolites that are causally associated with RA and AS, respectively. Subsequent mediation analyses revealed that of the 61 metabolic factors that were causally associated with RA, 6 were identified as mediators of the relationship between immune cells and RA, including 4-cholesten-3-one levels (mediation ratio: 8.91%), N-lactoyl isoleucine levels (13%), 3- phosphoglycerate to glycerate ratio (12.9%, 2.31%, respectively), Gamma-glutamyl histidine levels (9.54%), and Citrulline to phosphate ratio (15.6%). Among the 52 metabolic factors that were causally associated with AS, 2 were identified as mediators of the relationship between immune cells and AS, including salicylate levels (10.4%) and Glucose to N-palmitoyl-sphingosine (d18:1 to 16:0) ratio (8.72%). These results performed well in sensitivity analysis.

CONCLUSIONS: Genetic predictions show causal relationships between immune cells and autoimmune diseases, and that these causal relationships can be mediated by certain metabolites as mediators.

PMID:39623398 | DOI:10.1186/s13075-024-03445-z