Nevin Manimala

Ann Agric Environ Med. 2022 Mar 21;29(1):63-71. doi: 10.26444/aaem/147277. Epub 2022 Mar 16.

ABSTRACT

INTRODUCTION AND OBJECTIVE: Serological assays for Lyme disease (LD) routinely performed in laboratories often give inconclusive results, thereby making correct diagnosis difficult and delaying treatment. The aim of the study was to assess the usefulness of a commercial Optiplex Borrelia (OB) assay in the serological diagnostics of LD. Based on the results obtained in a previous study on the seroreactivity of the sera of patients with LD to Borrelia spp. antigens using enzyme immunoassays (ELISA) and immunoblotting (IB), the same sera were re-analyzed using the OB assay.

RESULTS: The assays carried out with the use of OB method showed a statistically significant lower number of positive/borderline results for the presence of IgM antibodies, compared to the ELISA assay. Moreover, statistically lower positive/borderline results were obtained for antibodies in the IgG class with use of the OB method, compared to the IB assay and a two-stage diagnostic protocol (ELISA with IB). The specificity analysis showed that in both the IB and OB assays, anti-OspC IgM and anti-p41 antibodies were detected. Additionally, high positive/borderline values were found in the OB assay for native antigens derived from B. afzelii lysate. The IB assay most frequently detected antibodies against OspC, p39 (BmpA) and VlsE proteins in the IgG class. There were fewer positives/borderlines for anti-p41-I B. afzelii antibodies in the OB assay and a higher number for antigens: VlsE-C6, p18 B. afzelii (DbpA), and p39 B. afzelii (BmpA).

CONCLUSIONS: Answering the question whether the OB assay could replace the traditional, two-step method of LD diagnostics, it can be concluded that it could not. It can be used to diagnose LD only as a complementary assay and not as an optimal and dedicated method of Borrelia spp. infection detection.

PMID:35352907 | DOI:10.26444/aaem/147277

J Chem Inf Model. 2022 Mar 30. doi: 10.1021/acs.jcim.1c01438. Online ahead of print.

ABSTRACT

Conformational sampling of protein structures is essential for understanding biochemical functions and for predicting thermodynamic properties such as free energies. Where previous approaches rely on sequential sampling procedures, recent developments in generative deep neural networks rendered possible the parallel, statistically independent sampling of molecular configurations. To be able to accurately generate samples of large molecular systems from a high-dimensional multimodal equilibrium distribution function, we developed a hierarchical approach based on expressive normalizing flows with rational quadratic neural splines and coarse-grained representation. Furthermore, system specific priors and adaptive and property-based controlled learning was designed to diminish the likelihood for the generation of high-energy structures during sampling. Finally, backmapping from a coarse-grained to fully atomistic representation is performed through an equivariant transformer model. We demonstrate the applicability of the method on the one-shot configurational sampling of a protein system with more than a hundred amino acids. The results show enhanced expressivity that diminish the invertibility constraints inherent in the normalizing flow framework. Moreover, the capacity of the hierarchical normalizing flow model was tested on a challenging case study of the folding/unfolding dynamics of the peptide chignolin.

PMID:35352898 | DOI:10.1021/acs.jcim.1c01438

Yonsei Med J. 2022 Apr;63(4):305-316. doi: 10.3349/ymj.2022.63.4.305.

ABSTRACT

This present systematic review examines spine surgery literature supporting augmented reality (AR) technology and summarizes its current status in spinal surgery technology. Database search strategies were retrieved from PubMed, Web of Science, Cochrane Library, Embase, from the earliest records to April 1, 2021. Our review briefly examines the history of AR, and enumerates different device application workflows in a variety of spinal surgeries. We also sort out the pros and cons of current mainstream AR devices and the latest updates. A total of 45 articles are included in our review. The most prevalent surgical applications included are the augmented reality surgical navigation system and head-mounted display. The most popular application of AR is pedicle screw instrumentation in spine surgery, and the primary responsible surgical levels are thoracic and lumbar. AR guidance systems show high potential value in practical clinical applications for the spine. The overall number of cases in AR-related studies is still rare compared to traditional surgical-assisted techniques. These lack long-term clinical efficacy and robust surgical-related statistical data. Changing healthcare laws as well as the increasing prevalence of spinal surgery are generating critical data that determines the value of AR technology.

PMID:35352881 | DOI:10.3349/ymj.2022.63.4.305

Stat Med. 2022 Mar 30. doi: 10.1002/sim.9390. Online ahead of print.

ABSTRACT

Mediation models are a set of statistical techniques that investigate the mechanisms that produce an observed relationship between an exposure variable and an outcome variable in order to deduce the extent to which the relationship is influenced by intermediate mediator variables. For a case-control study, the most common mediation analysis strategy employs a counterfactual framework that permits estimation of indirect and direct effects on the odds ratio scale for dichotomous outcomes, assuming either binary or continuous mediators. While this framework has become an important tool for mediation analysis, we demonstrate that we can embed this approach in a unified likelihood framework for mediation analysis in case-control studies that leverages more features of the data (in particular, the relationship between exposure and mediator) to improve efficiency of indirect effect estimates. One important feature of our likelihood approach is that it naturally incorporates cases within the exposure-mediator model to improve efficiency. Our approach does not require knowledge of disease prevalence and can model confounders and exposure-mediator interactions, and is straightforward to implement in standard statistical software. We illustrate our approach using both simulated data and real data from a case-control genetic study of lung cancer.

PMID:35352841 | DOI:10.1002/sim.9390

Laryngoscope. 2022 Mar 30. doi: 10.1002/lary.30117. Online ahead of print.

ABSTRACT

OBJECTIVE: In 2021 the U.S. FDA issued a Class 1 safety recall notice for specific devices due to a risk of carcinogen exposure. The objective of this study was to evaluate reports of cancer linked to CPAP devices to understand implications for the field of sleep medicine.

METHODS: Cases of cancer involving CPAP devices were retrieved from the MAUDE database from 2014 to 2021 and analyzed with descriptive statistics.

RESULTS: A total of 2571 patient injuries were associated with CPAP. Reports of cancer (n = 209; 4.62%) were the second most commonly documented patient problem associated with CPAP, although 1950 (43.13%) patients had a device problem without an associated injury. Of the 209 cancer cases associated with CPAP, 200 (95.7%) of the adverse event reports were received by the FDA in 2021. There were 174 (9.15%) descriptions of the CPAP polyurethane sound abatement foam degrading in association with a cancer diagnosis, but degradation was more commonly not associated with malignancy (n = 1728; 90.85%). Other frequently documented CPAP device problems included broken devices (n = 279; 6.92%), fire (n = 182; 4.51%), and patient-device incompatibility (n = 144; 3.57%).

CONCLUSION: Malignancy associated with CPAP devices has been reported; however, future studies are required to establish causation. Given 95.7% of those documented cases were reported in 2021, otolaryngologists should be prepared to discuss the risks of carcinogenesis associated with CPAP. The otolaryngology community should also be aware of the potential bandwagon effect and the implications for CPAP compliance.

LEVEL OF EVIDENCE: 4 Laryngoscope, 2022.

PMID:35352830 | DOI:10.1002/lary.30117

Biometrics. 2022 Mar 30. doi: 10.1111/biom.13651. Online ahead of print.

NO ABSTRACT

PMID:35352823 | DOI:10.1111/biom.13651

Mil Med. 2022 Mar 30:usac080. doi: 10.1093/milmed/usac080. Online ahead of print.

ABSTRACT

INTRODUCTION: Color vision deficiency (CVD) is a disqualifying condition for military special duty occupations. Color vision testing and standards vary slightly among the U.S. military branches. Paper-based pseudoisochromatic plates (PIPs) remain a screening tool. Computer-based color vision tests (CVTs), i.e., the Cone Contrast Test (CCT), the Colour Assessment and Diagnosis (CAD) test, and the Waggoner Computerized Color Vision Test (WCCVT), are now replacing the Farnsworth Lantern Test (FALANT) and its variants to serve as a primary or secondary test in the U.S. Armed Forces. To maintain consistency in recruitment, performance, and safety, the study objectives were to examine military color vision testing, passing criteria, and color discrimination performance.

METHODS: Study participants were 191 (17% female) students, faculty, and staff of the U.S. Air Force Academy and the Naval Aerospace Medical Institute. All subjects performed six CVTs, and 141 participants completed two additional military relevant color discrimination tasks. Friedman non-parametric test and Wilcoxon signed-rank post hoc test with Bonferroni adjusted P values were used to compare CVTs and standards. Analysis of variance and Bonferroni adjusted post hoc test were used to describe effects on color discrimination performance.

RESULTS: The Heidelberg Multicolor-Moreland and Rayleigh (HMC-MR) anomaloscope diagnosed 58 CVD (30.4%). There were no statistically significant differences in identifying red-green CVD by the HMC-MR, CCT, CAD, WCCVT, and PIP tests (P = .18), or classifying deutan, protan, and normal color vision (CVN) by the HMC-MR and the CVT (P = .25). Classification of tritan CVD was significantly different depending on which CVT was used (P < .001). Second, overall passing rates were 79.1% on the CAD (≤6 standard normal unit (SNU)), 78.5% on the combined PIP/FALANT, 78.0% on the CCT (≥55%), and 75.4% on the WCCVT (mild) military standards. The CVTs and the PIP/FALANT standards were not significantly different in number of personnel selected, but CAD and CCT passed significantly more individuals than WCCVT (P = .011 and P = .004, respectively). The previous U.S. Air Force standard (CCT score ≥75%) passed significantly fewer individuals relative the U.S. Navy pre-2017 PIP/FALANT or the current CVT standards (P ≤ .001). Furthermore, for those who failed the PIP (<12/14), the FALANT (9/9 or ≥16/18) agreed with the CVTs on passing the same CVN (n = 5); however, it also passed moderate-to-severe CVD who did not pass WCCVT (n = 6), CCT (n = 3), and CAD (n = 1). Lastly, moderate/severe CVD were significantly slower and less accurate than the “mild” CVD or CVN in the two color discrimination tasks (P < .001). In comparison to CVN in the in-cockpit display color discrimination task, mild CVD (CCT ≥55% and <75%) were significantly slower by 1,424 ± 290 milliseconds in reaction time (P < .001) while maintaining accuracy.

CONCLUSIONS: CVTs are superior to paper-based PIP in diagnosing, classifying, and grading CVD. Relative to the PIP/FALANT standard in personnel selection, the current U.S. military CVT passing criteria offer comparable passing rates but are more accurate in selecting mild CVD. Nevertheless, military commanders should also consider specific operational requirements in selecting mild CVD for duty as reduced job performance may occur in a complex color critical environment.

PMID:35352814 | DOI:10.1093/milmed/usac080

Rev Bras Enferm. 2022 Mar 30;75(4):e20210522. doi: 10.1590/0034-7167-2021-0522. eCollection 2022.

ABSTRACT

OBJECTIVES: to demonstrate the effectiveness of educational interventions in knowledge, attitude and practice for preventing respiratory infections in adults and older adults.

METHODS: this is a systematic review carried out in 11 databases. Primary studies, without language and time restrictions, of the randomized, non-randomized and before-and-after clinical trial type, were selected. The risk of bias was assessed by two independent researchers, and the methodological quality was generated by the Grading of Recommendations, Assessment, Development and Evaluation.

RESULTS: the intervention effectiveness was evidenced in seven studies. The results of the random effects meta-analysis show that there is a statistically significant difference between knowledge about preventing respiratory diseases, with an OR of 2.82 (95%CI 1.70 to 4.69) for the occurrence of events represented by improved knowledge.

CONCLUSIONS: most studies show the effectiveness of educational interventions, which was determined through the Knowledge, Attitude and Practice survey.

PMID:35352787 | DOI:10.1590/0034-7167-2021-0522

Rev Bras Enferm. 2022 Mar 30;75(4):e20210500. doi: 10.1590/0034-7167-2021-0500. eCollection 2022.

ABSTRACT

OBJECTIVES: to analyze the influence of privatization and geographic inequalities in the distribution and expansion of higher education in nursing in Brazil.

METHODS: a cross-sectional study, with online data of 1,244 courses and 190,610 nursing vacancies, started between 1890 and 2019. Proportions were estimated and differences were verified with statistical tests (α=5%), vacancy rate per 10,000 inhabitants and private ratio/public.

RESULTS: there was an accelerated, disorderly and heterogeneous growth in the number of courses and vacancies for nursing over 129 years, with strong private influence, favoring their concentration in large urban centers, capitals and richer states.

CONCLUSIONS: the significant expansion of higher education in nursing in Brazil occurred with excessive private supply and unequal distribution between its locations, indicating the need for state regulation in the opening of new courses and vacancies, which can minimize the negative repercussions on the quality of education, health care and workforce imbalances.

PMID:35352786 | DOI:10.1590/0034-7167-2021-0500

Rev Bras Enferm. 2022 Mar 30;75(4):e20210278. doi: 10.1590/0034-7167-2021-0278. eCollection 2022.

ABSTRACT

OBJECTIVES: to identify cardiovascular risk and cardiovascular risk factors in adolescents and verify correlations between these variables and biochemical markers, and between blood pressure percentiles, Body Mass Index, and biochemical markers.

METHODS: a cross-sectional study, conducted at a Brazilian school, from August to September 2019, including 205 participants who were interviewed. After the interview, anthropometric assessments, including weight, height, arm circumference, blood pressure checking, and blood collection for laboratory tests were performed. Descriptive and inferential analysis using the chi-square test was conducted.

RESULTS: a total of 18.5% had blood pressure percentiles >95%, 25.4% were overweight, and 25.9% were at very high cardiovascular risk. Statistically significant associations were found between cardiovascular risk and sex, Body Mass Index and blood pressure percentiles, and between blood pressure percentiles and triglycerides.

CONCLUSIONS: high prevalence of risk factors among school adolescents reinforces the need for interventions for cardiovascular risk reduction in this population.

PMID:35352781 | DOI:10.1590/0034-7167-2021-0278