Nevin Manimala

PLoS One. 2022 Sep 15;17(9):e0273183. doi: 10.1371/journal.pone.0273183. eCollection 2022.

ABSTRACT

INTRODUCTION: Tenofovir Disoproxil Fumarate (TDF) is the most widely used Anti-Retroviral Therapy (ART) drug due to its potency, safety profile and World Health Organization (WHO) recommendation. TDF causes proximal tubular renal dysfunction (PTRD) leading to Fanconi syndrome, acute kidney injury and chronic kidney disease. Modest rates (2-4%) of TDF related toxicity based on estimated Glomerular Filtration Rate (GFR) have been described, while TDF-induced PTRD has been reported to be 22%. TDF toxicity is more likely among African patients, it is reversible and TDF may be renal dosed in patients with dysfunction. The objective of this study was to assess proximal tubular renal dysfunction, global renal function, and their determinants among patients on TDF versus TDF-sparing regimen.

METHODS: This was a cross-sectional study among people living with HIV/AIDS (PLWHA) attending the Academic Model Providing Access to Healthcare (AMPATH) program. The primary outcome of interest in this study was PTRD while the secondary outcome of interest was estimated GFR. PTRD was defined as any two of beta-2 microglobulin in urine, metabolic acidosis, normoglycemic glucosuria and fractional excretion of phosphate. Student’s t-test, chi-square and their non-parametric equivalents were used to test for statistical significance. Univariate and multivariate logistic regression analysis was carried out.

RESULTS: A total of 516 participants were included in the final analysis, 261 on TDF while 255 were on TDF-sparing regimens. The mean (SD) age of all participants was 41.5 (12.6) years with majority being female (60.3%). The proportion of PTRD was 10.0% versus 3.1% in the TDF compared to TDF-sparing group (P<0.001). Mean estimated GFR was 112.8 (21.5) vs 109.7 (21.9) ml/min/1.73mm3 (P = 0.20) for the TDF compared to TDF-sparing group. TDF users were more likely to have PTRD compared to non-TDF users, adjusted Odds Ratio (AOR) 3.0, 95% CI 1.12 to 7.75.

CONCLUSION: There was significant PTRD in the TDF compared to TDF-sparing group without significant difference in estimated GFR. The clinical significance of these findings may not be clear in the short term.

PMID:36108078 | DOI:10.1371/journal.pone.0273183

PLoS One. 2022 Sep 15;17(9):e0274602. doi: 10.1371/journal.pone.0274602. eCollection 2022.

ABSTRACT

Intimate-partner factors have a significant effect on the uptake of services that affect maternal reproductive health outcomes. There is limited research on intimate-partner factors associated with cervical cancer screening. Therefore, this article examines the intimate-partner correlates of cervical cancer screening among married women in Central Uganda. We conducted a cross-sectional survey in Wakiso and Nakasongola districts in Central Uganda. A total of 656 married women aged 25-49 participated in the study. Frequency distributions for descriptive statistics and Pearson chi-squared tests were done to identify the association of selected individual explanatory variables and intimate-partner factors with cervical cancer screening. Finally, multivariable complementary log-log regressions were used to estimate intimate-partner factors associated with women’s cervical cancer screening uptake in Central Uganda. About 2 in 10 (20%) of the participants had been screened for cervical cancer. The following characteristics when examined separately in relation to the uptake of cervical cancer screening service and were significant: woman’s age, education attainment, occupation, wealth index, parity, male partner’s age, and male partner’s emotional support. After adjusting for independent factors, cervical cancer screening was significantly associated with women who had; attained secondary (AOR = 2.19; CI 1.18-4.06) compared to none/ primary education, and received partner’s emotional support (AOR = 30.06; CI 13.44-67.20) compared to those who did not receive partner’s emotional support. In Central Uganda, cervical cancer screening among married women was significantly associated with women’s education, and partner’s emotional support. These factors point to the importance of intimate-partner factors. Therefore, more effort should be directed at encouraging men’s participation. This should be supplemented with empowering women through education to increase uptake of screening services.

PMID:36108074 | DOI:10.1371/journal.pone.0274602

PLoS One. 2022 Sep 15;17(9):e0274641. doi: 10.1371/journal.pone.0274641. eCollection 2022.

ABSTRACT

Agave lechuguilla Torr., of the family Agavaceae, is distributed from southwestern United States to southern Mexico and is one of the most representative species of arid and semiarid regions. Its fiber is extracted for multiple purposes. The objective of this study was to generate a robust model to predict dry fiber yield (Dfw) rapidly, simply, and inexpensively. We used a power model in its linear form and bioclimatic areas as dummy variables. Training, generation (80%) and validation (20%) of the model was performed using machine learning with the package ‘caret’ of R. Using canonical correlation analysis (CCA), we evaluated the relationship of Dwf to bioclimatic variables. The principal components analysis (PCA) generated two bioclimatic zones, each with different A. lechuguilla productivities. We evaluated 499 individuals in four states of Mexico. The crown diameter (Cd) of this species adequately predicts its fiber dry weight (R2 = 0.6327; p < 0.05). The intercept (β0), slope [lnCd (β1)], zone [(β2)] and interaction [lnCd:Zona (β3)] of the dummy model was statistically significant (p < 0.05), giving origin to an equation for each bioclimatic zone. The CCA indicates a positive correlation between minimum temperature of the coldest month (Bio 6) and Dwf (r = 0.84 and p < 0.05). In conclusion, because of the decrease in Bio 6 of more than 0.5°C by 2050, the species could be vulnerable to climate change, and A. lechuguilla fiber production could be affected gradually in the coming years.

PMID:36108072 | DOI:10.1371/journal.pone.0274641

PLoS One. 2022 Sep 15;17(9):e0274684. doi: 10.1371/journal.pone.0274684. eCollection 2022.

ABSTRACT

BACKGROUND: The aim of the study was to estimate the prevalence of insomnia symptoms and to examine the associations of body mass index (BMI), chronic diseases, and lifestyle factors with self-reported insomnia symptoms among older people in India.

METHODS: We conducted a cross-sectional study using data from the baseline wave of the Longitudinal Ageing Study in India (LASI) that was collected during 2017-18. A sample of 31,358 older adults aged 60 and above was included in the analyses. Descriptive statistics and bivariate and multivariable analyses were performed to obtain the results.

RESULTS: In this study, insomnia symptoms were reported by around 36 percent of older adults aged 60 and above. After controlling for socio-demographic factors, insomnia symptoms were positively associated with the risk of being underweight [AOR: 1.289, CI: 1.211-1.372] and negatively associated with obesity/overweight [AOR: 0.928, CI: 0.872-0.990] as compared to older adults with normal BMI. The odds of insomnia symptoms were higher among those who reported the following chronic conditions, i.e., hypertension [AOR:1.356, CI:1.278-1.438], diabetes [AOR:1.160, CI:1.074-1.254], chronic lung diseases [AOR:1.485, CI:1.351-1.632], bone-related diseases [AOR:1.561, CI:1.458-1.670] and any psychiatric disorders [AOR:1.761, CI:1.495-2.074]. In addition, older adults who were physically active [AOR: 0.850, CI:0.804-0.900] were less likely to report insomnia symptoms.

CONCLUSIONS: The study suggests a high prevalence of insomnia symptoms among the older population in India. Early identification of the signs of insomnia in older population is crucial, as is timely treatment for any kind of sleep problems. In addition, nutrition-based interventions and individual disease-specific management programs may help minimize the stressful situations in later life and develop a good night’s sleep for the older population.

PMID:36108066 | DOI:10.1371/journal.pone.0274684

Adv Physiol Educ. 2022 Sep 15. doi: 10.1152/advan.00017.2022. Online ahead of print.

ABSTRACT

Misalignment in teaching pedagogies between secondary schools and tertiary institutions have exacerbated educational disparities amongst students from different backgrounds. Given the variation in students’ educational background and competencies there was a need to develop an Anatomy and Physiology (A&P) Foundational Knowledge Assessment to establish the levels of preparedness of first-year medical students. Previous work that focused on the development of the assessment showed it to be effective in measuring students’ foundational knowledge in human anatomy and physiology. ​The aim of this study is to assess the validity of the A&P Foundational Knowledge Assessment in determining students’ prior knowledge and predicting academic performance of first-year students in their anatomy and physiology studies. Three hundred and seventy first-year students, across two cohort years 2017 and 2018, completed the A&P Foundational Knowledge Assessment. Data was analysed using descriptive statistics, analysis of variance, and Pearson’s correlation. Results show that for both cohorts, approximately 30% of students scored less than or equal to 55% and were potentially at risk of performing poorly in their anatomy and physiology studies. Pearson’s correlation showed a significant relationship between students’ performance on the foundational knowledge assessment and their anatomy and physiology assessments. For both cohorts more than 10% of students identified by the A&P Foundational Knowledge Assessment were either at risk of failing the course, entering an extended degree programme, or being excluded from the programme. Results indicate that the assessment is a good predictor for differentiating medical students’ performance in first-year anatomy and physiology.

PMID:36108059 | DOI:10.1152/advan.00017.2022

Science. 2022 Sep 16;377(6612):1304-1310. doi: 10.1126/science.abl4476. Epub 2022 Sep 15.

ABSTRACT

The authors analyzed data from multiple large-scale randomized experiments on LinkedIn’s People You May Know algorithm, which recommends new connections to LinkedIn members, to test the extent to which weak ties increased job mobility in the world’s largest professional social network. The experiments randomly varied the prevalence of weak ties in the networks of over 20 million people over a 5-year period, during which 2 billion new ties and 600,000 new jobs were created. The results provided experimental causal evidence supporting the strength of weak ties and suggested three revisions to the theory. First, the strength of weak ties was nonlinear. Statistical analysis found an inverted U-shaped relationship between tie strength and job transmission such that weaker ties increased job transmission but only to a point, after which there were diminishing marginal returns to tie weakness. Second, weak ties measured by interaction intensity and the number of mutual connections displayed varying effects. Moderately weak ties (measured by mutual connections) and the weakest ties (measured by interaction intensity) created the most job mobility. Third, the strength of weak ties varied by industry. Whereas weak ties increased job mobility in more digital industries, strong ties increased job mobility in less digital industries.

PMID:36107999 | DOI:10.1126/science.abl4476

PLoS One. 2022 Sep 15;17(9):e0273666. doi: 10.1371/journal.pone.0273666. eCollection 2022.

ABSTRACT

BACKGROUND: Paediatric early warning systems (PEWS) are a means of tracking physiological state and alerting healthcare professionals about signs of deterioration, triggering a clinical review and/or escalation of care of children. A proactive end-to-end deterioration solution (the DETECT surveillance system) with an embedded e-PEWS that included sepsis screening was introduced across a tertiary children’s hospital. One component of the implementation programme was a sub-study to determine an understanding of the DETECT e-PEWS in terms of its clinical utility and its acceptability.

AIM: This study aimed to examine how parents and health professionals view and engage with the DETECT e-PEWS apps, with a particular focus on its clinical utility and its acceptability.

METHOD: A prospective, closed (tick box or sliding scale) and open (text based) question, e-survey of parents (n = 137) and health professionals (n = 151) with experience of DETECT e-PEWS. Data were collected between February 2020 and February 2021.

RESULTS: Quantitative data were analysed using descriptive and inferential statistics and qualitative data with generic thematic analysis. Overall, both clinical utility and acceptability (across seven constructs) were high across both stakeholder groups although some challenges to utility (e.g., sensitivity of triggers within specific patient populations) and acceptability (e.g., burden related to having to carry extra technology) were identified.

CONCLUSION: Despite the multifaceted nature of the intervention and the complexity of implementation across a hospital, the system demonstrated clinical utility and acceptability across two key groups of stakeholders: parents and health professionals.

PMID:36107953 | DOI:10.1371/journal.pone.0273666

PLoS One. 2022 Sep 15;17(9):e0273734. doi: 10.1371/journal.pone.0273734. eCollection 2022.

ABSTRACT

BACKGROUND: Anticipated stigma related to chronic illness patients undermines diagnosis, treatment, and successful health outcomes. The study aimed to assess the magnitude and factors associated with anticipated stigma among patients with chronic illness attending follow-up clinics in Amhara Region Referral Hospitals, Ethiopia.

METHODS: A cross-sectional institution-based study was conducted in Amhara Region Referral Hospitals from 01 March to 15 April 2021. A simple random sampling technique was used to select the three Referral Hospitals in the region and study subjects. Data were collected using a pre-tested interview-based questionnaire. Data were entered and cleaned with Epi-Info version 6 and exported for analysis STATA version 14. Multiple linear regression was used to show the association between anticipated stigma and potential factors. Associations were measured using ß coefficients and were considered statistically significant if the p-value > 0.05.

RESULTS: A total of 779 patients were included for analysis with a response rate of 97%. Their mean (Standard deviation) of anticipated stigma was estimated at 1.86 and 0.5, respectively. After running an assumption test for multiple linear regression; educational status, cigarette smoking, psychological distress, medication adherence, alcohol consumption, and social part of the quality of life were statically significantly associated with anticipated stigma.

CONCLUSION AND RECOMMENDATION: The result showed a high level of anticipated stigma reported among the participants. Emphasizing improving their social part of the quality of life, avoiding risky behaviors like alcohol consumption and cigarette smoking, access to health education for chronically ill patients, integrating mental health in all types of chronic disease, and developing strategies and protocols which will help to improve patient medication adherence to their prescribed medication will be crucial. This can provide a foundation for government andnon-governmental organizations, and researchers implementing evidence-based interventions and strategies on chronic care to address factors related to anticipated stigma.

PMID:36107943 | DOI:10.1371/journal.pone.0273734

Prep Biochem Biotechnol. 2022 Sep 15:1-6. doi: 10.1080/10826068.2022.2119573. Online ahead of print.

ABSTRACT

Experiments were carried out to illustrate the effect of UV light on the course of the enzymatic reaction of the coumarin derivative. Only the pulsating light of the UV diode gives the correct results for the determination of the kinetic constants of the enzymatic reaction. The enzyme concentration limit was found where the description of the M-M model breaks. It was shown that the system determines the kinetic parameters of enzymatic reactions: V_max-the maximum rate of reaction and K_M–the Michaelis constant. This method produces kinetic constants calculated from the changes in enzyme product concentration using the Michaelis-Menten model. To verify the results, we used a statistical analysis that checks the correctness of the model used.

PMID:36107636 | DOI:10.1080/10826068.2022.2119573

Medicine (Baltimore). 2022 Sep 2;101(35):e30121. doi: 10.1097/MD.0000000000030121.

ABSTRACT

BACKGROUND: Activation of venous flow has been shown with different types of electrical stimulation. The aim of this study is to compare the hemodynamic effects of transcutaneous electrical nerve stimulation (TENS), neuromuscular electrical stimulation (NMES), and sham stimulation on healthy young people.

METHODS: This randomized crossover study was conducted during June 2018 in the Faculty of Physical Therapy of A Coruña (Spain). Twenty-four university students (50% male) received in a randomized order 5 Hz-TENS, NMES, and sham stimulation on soleus muscle. Flow volume (FV) and peak velocity (PV) from popliteal vein were recorded via Doppler ultrasound, and relative changes from baseline were determined. Discomfort among the 3 stimulations was also compared.

RESULTS: The differences among the 3 stimulations were assessed using the ANOVA for repeated measured, the Friedman test and the Kendall tau test, according to the type of measurement to be compared. FV (mL/min) and PV (cm/s) increased significantly after NMES (percentual increase 37.2 ± 62.0%, P = .002; 264.4 ± 152.2%, P < .001, respectively) and TENS (226.2 ± 190.3%, P < .001; 202.7 ± 144.6%, P < .001, respectively). These percentual changes from basal level in hemodynamics were statistically different to those after placebo, which was ineffective enhancing hemodynamics. The improvements in FV were statistically higher with TENS than with NMES (P < .001), but there was no statistical difference in PV (P = .531). Despite NMES was applied at a significantly lower amplitude than TENS (P < .001), NMES protocol was the worst tolerated, though the differences in discomfort were not statistically significant.

CONCLUSION: Both active electrical protocols but not sham stimulation increased hemodynamics in healthy people. TENS obtained higher flow volume increase from baseline than NMES, considered globally at not only in its on-time.

PMID:36107611 | DOI:10.1097/MD.0000000000030121