Nevin Manimala

J Thromb Haemost. 2022 Apr 15. doi: 10.1111/jth.15730. Online ahead of print.

ABSTRACT

BACKGROUND: The ISTH SSC Subcommittee on Pediatric and Neonatal Thrombosis and Hemostasis convened a working group on medication adherence to begin to understand the current state of clinical practice to inform priority areas for efforts to improve adherence for children, and adolescents and young adults (AYA) prescribed anticoagulants.

OBJECTIVES: We sought to survey an international group of clinicians involved in anticoagulation management in children and/or AYA about perceptions of medication on health outcomes, clinical practice related to medication adherence, and barriers to assessing and improving medication adherence.

METHODS: Clinicians involved in anticoagulation management in children and/or AYA were surveyed via REDCap^® . Descriptive statistics were used to summarize demographic and clinical characteristics and responses to multiple choice and Likert-type questions. Free-text answers were coded based on the Behavior Change Technique Taxonomy and the Expert Recommendations for Implement Change project.

RESULTS AND CONCLUSIONS: There were 200 participants, 90% of whom were pediatric hematology/oncology physicians. Based on the results which demonstrate that clinicians are concerned about impact of poor medication adherence and have limited resources to identify and improve adherence, the working group has identified next steps to further understand impact of medication adherence on anticoagulation-related health outcomes, address the need for validated measures to assess medication adherence for all anticoagulants prescribed to this population, and develop an intervention and implementation research agenda to improve outcomes.

PMID:35427434 | DOI:10.1111/jth.15730

PLoS One. 2022 Apr 15;17(4):e0266881. doi: 10.1371/journal.pone.0266881. eCollection 2022.

ABSTRACT

The purpose of this study was to evaluate the strength of the knee flexors and extensors and hip abductor and adductor muscles in young soccer players. Twenty-three male under-19 soccer players participated in this study (age: 17.7 ± 0.2 years; height: 173.0 ± 1.1 cm; body mass: 66.1 ± 1.3 kg). Body composition was measured using a bioelectrical impedance (InBody770), and the dynamometry was performed by an isokinetic dynamometer (Biodex System 3) for knee flexion and extension, and by an isometric dynamometer (Smart Groin Trainer), for hip adduction and abduction. Comparisons were made between dominant members (D) vs. non-dominant members (ND) and adductors vs. abductors (ADD:ABD) using the Wilcoxon test. There were statistically significant differences in the peak torques between the dominant and non-dominant members in the flexion function (Z = -4.198, p < 0.01) and in the extension function (Z = -4.197, p < 0.01) of the knee in concentric muscular action, and the flexion (Z = -4.198, p < 0.01) and in the extension (Z = -4.198, p < 0.01) of the knee in eccentric muscular action. No statistically significant differences were obtained in the conventional ratio (Z = -0.456, p = 0.648) nor the functional ratio (Z = -0.335, p = 0.738) between D and ND members. There were no statistically significant differences between adductors and abductors at the moment of strength for absolute values (N). The reference absolute and normalized to the weight values and the ADD:ABD can be used as a guideline for classifying players in screening and comparison in return tests to sports practice after an injury.

PMID:35427407 | DOI:10.1371/journal.pone.0266881

PLoS One. 2022 Apr 15;17(4):e0267168. doi: 10.1371/journal.pone.0267168. eCollection 2022.

ABSTRACT

Photography and photogrammetry have recently become among the most widespread and preferred visualisation methods for the representation of small objects and artefacts. People want to see the past, not only know about it; and the ability to visualise objects into virtually realistic representations is fundamental for researchers, students and educators. Here, we present two new methods, the ‘Small Object and Artefact Photography’ (‘SOAP’) and the ‘High Resolution “DIY” Photogrammetry’ (‘HRP’) protocols. The ‘SOAP’ protocol involves the photographic application of modern digital techniques for the representation of any small object. The ‘HRP’ protocol involves the photographic capturing, digital reconstruction and three-dimensional representation of small objects. These protocols follow optimised step-by-step explanations for the production of high-resolution two- and three-dimensional object imaging, achievable with minimal practice and access to basic equipment and softwares. These methods were developed to allow anyone to easily and inexpensively produce high-quality images and models for any use, from simple graphic visualisations to complex analytical, statistical and spatial analyses.

PMID:35427405 | DOI:10.1371/journal.pone.0267168

PLoS One. 2022 Apr 15;17(4):e0267182. doi: 10.1371/journal.pone.0267182. eCollection 2022.

ABSTRACT

INTRODUCTION: There is scarcity of data on children with disabilities living in low-and-middle-income countries, including Uganda. This study describes disability prevalence and explores factors associated with different disability categories. It highlights the value of using a standardized, easy-to-use tool to determine disability in children and contextualizing disability in children in light of their developmental needs.

METHODS: A cross-sectional study was conducted between September 2018-January 2019 at the Iganga-Mayuge Health and Demographic Surveillance Site in Uganda. Respondents were caregivers of children between 5-17 years and were administered an in-depth Child Functioning Module (CFM). The outcome variable, disability, was defined as an ordered categorical variable with three categories-mild, moderate, and severe. Generalized ordered logit model was applied to explore factors associated with disability categories.

RESULTS: Out of 1,842 caregivers approached for the study, 1,439 (response: 78.1%) agreed to participate in the study. Out of these 1,439, some level of disability was reported by 67.89% (n = 977) of caregivers. Of these 977 children with disability, 48.01% (n = 692) had mild disability and 15.84% (n = 228) had moderate disability, while 3.96% (n = 57) had severe disability. The mean (SD) score for mild disability was 2.22±1.17, with a median of 2. The mean and median for moderate disability was 5.26±3.28 and 4 (IQR:3-6), and for severe disability was 14.23±9.51 and 12 (IQR:6-22). The most common disabilities reported were depression (54.83%) and anxiety (50.87%). Statistically significant association was found for completion of immunization status and school enrollment when controlled for a child’s age, sex, having a primary caregiver, age of mother at child’s birth, family system, family size and household wealth quintile.

CONCLUSION: This study suggests association between incomplete immunization status and school enrollment for children with disability. These are areas for further exploration to ensure inclusive health and inclusive education of children with disabilities in Uganda.

PMID:35427403 | DOI:10.1371/journal.pone.0267182

PLoS One. 2022 Apr 15;17(4):e0267231. doi: 10.1371/journal.pone.0267231. eCollection 2022.

ABSTRACT

BACKGROUND: Despite it being easily preventable, still diabetes mellitus is found in every population in the world and all regions, with the greatest escalation in low and middle-income countries. Moreover, undiagnosed or poorly controlled diabetes can lead to lower limb amputation, blindness, and kidney disease. However, there is a paucity of information on the magnitude and associated factors among adult populations in rural pastoral areas. Therefore, this study aimed to assess the magnitude of diabetes mellitus and associated factors among Guji Zone Government Civil Servants, Southern Ethiopia.

METHODS: Cross-sectional study was conducted from March 1-14/2018, among 437 randomly selected Government employees of Guji Zone. A self-administered questionnaire was used to collect data. Data were coded and entered using Epi-data version 3.1 and exported to SPSS version 20 for analysis. Multivariable logistic regression analysis was done to identify significant factors associated with the magnitude of DM. P<0.05 was used to declare statistical significance and odds ratio with 95% confidence interval were calculated.

RESULT: The median (±IQR) age of participants was 33 (±14) years of age. Overall, the prevalence of DM in the study population was found to be 16 (3.9%) [95% CI: 2.2-5.6%]. The prevalence of DM among males and females was 3.8% and 4.2% respectively. Age (<35 years) [0.21 (0.04-0.94)], increasing salt amount in dietary feeding [14.31(1.28-159.2)], Consumption of vegetable &fruit once per week [23.38(2.01-269.17)], diagnosed with HTN [21.35(2.28-199.37)], and Family history of DM [9.42(1.72-51.42)] were significantly associated with DM.

CONCLUSION: Comparably lower prevalence of previously undiagnosed DM was found by this study. Being old, excess salt consumption, intake of vegetables & fruit once per week, hypertension, and family history of DM were significantly associated with DM. Therefore, the zonal Health department should enhance and strengthen the provision of health education programs and counseling about nutrition, weight control, and appropriate physical activity and advised the communities for mass screening for diabetes.

PMID:35427392 | DOI:10.1371/journal.pone.0267231

PLoS One. 2022 Apr 15;17(4):e0266999. doi: 10.1371/journal.pone.0266999. eCollection 2022.

ABSTRACT

OBJECTIVES: This study was an in-depth exploration of unique data from a nationally representative sample of adults living in the United States to identify biomarkers associated with musculoskeletal pain.

METHODS: We performed secondary analyses of 2003-2004 NHANES data. After a first screening of 187 markers, analyses of 31 biomarkers were conducted on participants aged ≥20 years identified in all counties using the 2000 Census Bureau data (n = 4,742). To assess the association of each biomarker with each pain outcome (acute, subacute and chronic low back, neck, and shoulder pain), analyses were carried out using multivariable logistic regression with adjustments for sex, age and body mass index. Biomarkers were considered as continuous variables and categorized at the median of their distributions.

RESULTS: Pain at any site for ≥24 hours during the past month was reported by 1,214 participants. Of these, 779 mentioned that the pain had lasted for ≥3 months (“chronic pain”). α-carotene, ascorbic acid, β-carotene, mercury and total protein had a statistically significant, inverse association with ≥2 chronic pain sites. Acrylamide, alkaline phosphatase, cadmium, cotinine, glycidamide, homocysteine, retinol, triglycerides and white blood cell count were positively associated with ≥2 chronic pain sites. Few biological markers were associated with acute and subacute pain.

CONCLUSIONS: This study identified some biomarkers that were strongly and consistently associated with musculoskeletal pain. These results raise new hypotheses and could have tremendous implications for advancing knowledge in the field. Research on musculoskeletal pain needs to put more effort on the biological dimension of the biopsychosocial model of pain.

PMID:35427389 | DOI:10.1371/journal.pone.0266999

PLoS One. 2022 Apr 15;17(4):e0266952. doi: 10.1371/journal.pone.0266952. eCollection 2022.

ABSTRACT

The clinicopathological features of early gastric cancer (EGC) with mixed-type histology (differentiated and undifferentiated) are incompletely understood, and the capacity of endoscopic submucosal dissection (ESD) to treat mixed-type cancer remains controversial. This systematic review analyzed the rate of lymph node metastasis (LNM) in mixed-type EGC. We gathered articles published up to February 21, 2021, that analyzed the relationship between LNM and mixed-type EGC from Embase, PubMed, and Web of Science. The primary outcome was the LNM rate associated with different histological types of EGC, and the secondary outcomes were the odds ratios (ORs) for LNM risk factors among EGC patients. From the 24 studies included in this meta-analysis, the overall rate of LNM in predominantly differentiated mixed-type (MD) EGC was 12%, whereas the LNM rate in predominantly undifferentiated mixed-type (MU) EGC was 22%. We further divided these studies into 2 groups according to the depth of invasion. In mixed-type mucosal EGC, the pooled LNM rate was 15%; in submucosal EGC, the rate was 33% for MU, which was higher than the rates for pure types (pure differentiated type, 13%; pure undifferentiated type, 21%; p<0.05). The LNM rate of MD was 20%, it was higher than those of the pure differentiated type and nearly the same as pure undifferentiated type. Other pooled statistics showed that submucosal invasion, pure undifferentiated EGC, and mixed-type EGC were independent risk factors for LNM. This meta-analysis showed that MD submucosal EGC has a high rate of LNM and is highly correlated with LNM; thus, the management of MD EGC as purely differentiated EGC according to the indications for ESD is inappropriate, and the mixed type should be added as a parameter in these indications.

PMID:35427370 | DOI:10.1371/journal.pone.0266952

PLoS One. 2022 Apr 15;17(4):e0265384. doi: 10.1371/journal.pone.0265384. eCollection 2022.

ABSTRACT

PURPOSE: This study assessed robot-enhanced healthcare in practical settings for the purpose of community diabetes care.

METHODS: A mixed method evaluation collected quantitative and qualitative data on diabetes patients over 45 (N = 30) and community pharmacists (N = 10). It took 15-20 min for the diabetes patients to interact with the robot. Before and after the interaction, questionnaires including a diabetes knowledge test, self-efficacy for diabetes, and feasibility of use of the robot was administered. In-depth interviews with both pharmacists and patients were also conducted.

RESULTS: After interacting with the robot, a statistically significant improvement in diabetes knowledge (p < .001) and feasibility of the robot (p = .012) was found, but self-efficacy (p = .171) was not significantly improved. Five themes emerged from interviewing the diabetes patients: Theme 1: meets the needs of self-directed learning for the elderly; Theme 2: reduces alertness and creates comfortable interaction; Theme 3: vividness and richness enhance interaction opportunities; Theme 4: Robots are not without disadvantages, and Theme 5: Every person has unique tastes. Three themes emerged from interviewing pharmacists: Theme 1: Technology must meet the real needs of the patient; Theme 2: creates new services, and Theme 3: The use of robots must conform to real-life situations.

CONCLUSIONS: Both the diabetes patients and the pharmacist reported more positive feedback on the robot-enhanced diabetes care than concerns. Self-directed learning, comfortable interaction, and vividness were the most focuses when using robot to enhance self-management for the patients. Pharmacists were most receptive to fit conforming with reality and creating new services.

PMID:35427359 | DOI:10.1371/journal.pone.0265384

PLoS One. 2022 Apr 15;17(4):e0264705. doi: 10.1371/journal.pone.0264705. eCollection 2022.

ABSTRACT

OBJECTIVE: To systematically evaluate the prognostic factors for mortality in bullous pemphigoid.

METHODS: PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, China Biology Medicine disc and Wanfang Database were searched to collect literature on the prognostic factors for mortality in bullous pemphigoid. The quality of studies was assessed by Newcastle-Ottawa Quality Assessment Scale. Two researchers extracted relevant data and scored study quality independently. The hazard ratio (HR) was calculated using the random effects model. Study heterogeneity was assessed using both Cochran’s Q test and I2 statistics. The causes of heterogeneity were assessed by subgroup analysis and/ or sensitivity analysis when heterogeneity was significant. When ten or more studies were included as outcome indicators, publication bias was evaluated by funnel plot and Egger’s test.

RESULTS: Out of a total of 1,546 articles retrieved, 15 studies involving 2,435 patients were included. The meta-analysis showed that the mortality of patients with bullous pemphigoid increased with positive bullous pemphigoid 180 antibody (HR = 1.85, 95%CI: 1.25~2.75, P = 0.002); concomitant dementia (HR = 2.26, 95%CI: 1.43~3.59, P<0.001); stroke (HR = 2.09, 95% CI: 1.23-3.55, P = 0.007); heart disease (HR = 1.96, 95% CI: 1.41-2.73, P<0.001) and diabetes mellitus (HR = 2.39, 95% CI: 1.55-3.69, P<0.001). Sex, positive indirect immunofluorescence and hypertension were not associated with prognosis.

CONCLUSION: Positive bullous pemphigoid 180 antibody, dementia, stroke, heart disease and diabetes mellitus were the prognostic factors for mortality in bullous pemphigoid.

PMID:35427358 | DOI:10.1371/journal.pone.0264705

Opt Lett. 2022 Apr 15;47(8):2000-2003. doi: 10.1364/OL.451725.

ABSTRACT

A computationally efficient radiative transport model is presented that predicts a camera measurement and accounts for the light reflected and blocked by an object in a scattering medium. The model is in good agreement with experimental data acquired at the Sandia National Laboratory Fog Chamber Facility (SNLFC). The model is applicable in computational imaging to detect, localize, and image objects hidden in scattering media. Here, a statistical approach was implemented to study object detection limits in fog.

PMID:35427321 | DOI:10.1364/OL.451725