Nevin Manimala

BMC Geriatr. 2022 Jul 13;22(1):575. doi: 10.1186/s12877-022-03262-6.

ABSTRACT

BACKGROUND: The use of psychotropics is high among the older population and may have detrimental effects on their physical and mental health. Cardiorespiratory fitness (CRF) is a strong and modifiable measure of health and declines with age. We aimed to study the association of change in CRF with use of psychotropics in community-dwelling older adults.

METHODS: We analyzed longitudinal data from 1531 older adults from the Generation 100 study, aged 70-77 years at inclusion, and with a permanent address in Trondheim, Norway. Data on objectively measured peak oxygen uptake (VO_2peak) were linked with register data from the Norwegian Prescription Database on prescribed psychotropics. The included psychotropics were antidepressants (N06A), antipsychotics (N05A), anxiolytics (N05B), hypnotics and sedatives (N05C), and N03AE (benzodiazepine derivatives). Analyses were done on any psychotropics as one group, and on the following separate groups: antidepressants (N06A), benzodiazepines (N05BA, N05CD, and N03AE), and z-hypnotics (N05CF). Peak oxygen uptake was measured four times over a five-year period and corresponding medication use was measured as defined daily doses (DDD). A random effects estimator was applied to investigate the association of change in VO_2peak with the use of psychotropics.

RESULTS: We found a statistically significant curvilinear association of change in VO_2peak with use of any psychotropics and antidepressants. For VO_2peak up to ~ 40 ml/kg/min, each 1 ml/kg/min increase was associated by a 3.3 DDD and 2.5 DDD decrease in use of any psychotropics and antidepressants, respectively. A bottoming-out effect was found and increases in VO_2peak above ~ 40 ml/kg/min showed increased use of any psychotropics and antidepressants. However, the association of change in VO_2peak with use was stronger for changes in the lower continuum of VO_2peak levels and decreased with increasing VO_2peak. No statistically significant association of change in VO_2peak with use of benzodiazepines and z-hypnotics were found. However, because of a non-randomized design, we cannot rule out the possibility of confounding by indication.

CONCLUSIONS: The results of this study show a curvilinear association of change in VO_2peak with use of any psychotropics and antidepressants in older adults. This relationship adds a new viewpoint on the adverse effects of psychotropic use and should be considered in interventions and policies aimed at reducing psychotropic medication use among the older population.

PMID:35831807 | DOI:10.1186/s12877-022-03262-6

BMC Genomics. 2022 Jul 12;23(1):506. doi: 10.1186/s12864-022-08736-w.

ABSTRACT

BACKGROUND: The genus Sporothrix belongs to the order Ophiostomatales and contains mainly saprobic soil and plant fungi, although pathogenic species capable of causing human infections are also present. The whole-genomes of disease-causing species have already been sequenced and annotated but no comprehensive genomic resources for environmental Sporothrix species are available, thus limiting our understanding of the evolutionary origin of virulence-related genes and pathogenicity.

RESULT: The genome assembly of four environmental Sporothrix species resulted in genome size of ~ 30.9 Mbp in Sporothrix phasma, ~ 35 Mbp in S. curviconia, ~ 38.7 Mbp in S. protearum, and ~ 39 Mbp in S. variecibatus, with a variable gene content, ranging from 8142 (S. phasma) to 9502 (S. variecibatus). The analysis of mobile genetic elements showed significant differences in the content of transposable elements within the sequenced genomes, with the genome of S. phasma lacking several class I and class II transposons, compared to the other Sporothrix genomes investigated. Moreover, the comparative analysis of orthologous genes shared by clinical and environmental Sporothrix genomes revealed the presence of 3622 orthogroups shared by all species, whereas over 4200 genes were species-specific single-copy gene products. Carbohydrate-active enzyme analysis revealed a total of 2608 protein-coding genes containing single and/or multiple CAZy domains, resulting in no statistically significant differences among pathogenic and environmental species. Nevertheless, some families were not found in clinical species. Furthermore, for each sequenced Sporothrix species, the mitochondrial genomes was assembled in a single circular DNA molecule, ranging from 25,765 bp (S. variecibatus) to 58,395 bp (S. phasma).

CONCLUSION: In this study, we present four annotated genome assemblies generated using PacBio SMRT sequencing data from four environmental species: S. curviconia, S. phasma, S. protearum and S. variecibatus with the aim to provide a starting point for future comparative genome evolution studies addressing species diversification, ecological/host adaptation and origin of pathogenic lineages within the genus Sporothrix.

PMID:35831806 | DOI:10.1186/s12864-022-08736-w

BMC Plant Biol. 2022 Jul 13;22(1):337. doi: 10.1186/s12870-022-03712-8.

ABSTRACT

BACKGROUND: Grazing disturbance plays an important role in the desert steppe ecosystem in Inner Mongolia, China. Previous studies found that grazing affected the spatial distribution of species in a community, and showed patchiness characteristics of species under different grazing treatments. Artemisia frigida is the dominant species and semi-shrub in desert steppe, and whether grazing interference will affect the spatial distribution of A. frigida is studied. In this study, geo-statistical methods were mainly used to study the spatial distribution characteristics of A. frigida population in desert steppe of Inner Mongolia at two scales (quadrat size 2.5 m × 2.5 m, 5 m × 5 m) and four stocking rates (control, CK, 0 sheep·ha^-1·month^-1; light grazing, LG, 0.15 sheep·ha^-1·month^-1, moderate grazing, MG, 0.30 sheep·ha^-1·month^-1, heavy grazing, HG, 0.45 sheep·ha^-1·month^-1).

RESULTS: The results showed that the spatial distribution of A. frigida tended to be simplified with the increase of stocking rate, and tended to be banded with increased spatial scale. The density and height of A. frigida increased with increasing scale. With increased stocking rate, the density of A. frigida population decreased linearly, while its height decreased in a step-wise fashion. The spatial distribution of A. frigida was mainly affected by structural factors at different scales and stocking rate. The density of A. frigida was more sensitive to change in stocking rate, and the patchiness distribution of A. frigida was more obvious with increase in scale.

CONCLUSIONS: Stocking rate has a strong regulatory effect on the spatial pattern of A. frigida population in the desert steppe. Heavy grazing reduced the spatial heterogeneity of A. frigida in the desert steppe. The smaller dominant populations are unfavourable for its survival in heavy grazing condition, and affects the stability and productivity of the grassland ecosystem.

PMID:35831803 | DOI:10.1186/s12870-022-03712-8

BMC Psychiatry. 2022 Jul 13;22(1):465. doi: 10.1186/s12888-022-04090-z.

ABSTRACT

BACKGROUND: In low-income nations, suicidal conduct increases within the first year following delivery, ranging from 4 to 17.6%, with a three-fold cause of maternal death. Suicidal behavior was also reported to be 14% among postpartum women in Ethiopia.

OBJECTIVE: To assess the magnitude and associated factors of suicidal behavior among postpartum mothers attending public health centers in Addis Ababa, Ethiopia, 2021.

METHODS: A cross-sectional study was conducted in ten public health facilities of Addis Ababa, Ethiopia with a total sample size of 615 women. The data were entered into Epi data 4.6 and exported to SPSS version 25 for statistical analysis. A logistic regression model with adjusted odds ratio (AOR), 95% confidence interval (CI) and p-value of ≤0.05 was used to identify predictors of the outcome variable.

RESULTS: The magnitude of suicidal behavior among postnatal mothers attending public health centers in Addis Ababa was 41.46% with 95%CI (35.2-44.5%). Being mother’s literate (adjusted odds ratio (AOR) = 0.64, 95% CI: 0.42-0.97), verbal abuses (AOR = 2.18, 95% CI: 1.38-3.44), history of rape (AOR = 3.03, 95% CI 1.14 -8.05), history of depression (AOR = 4.12, 95% CI 1.21-14.03), women’s having sexually unfaithful husband (AOR = 1.42, 95% CI 1.14-6.23) and khat chewing (AOR = 8.48, 95% CI 2.52-28.50) were significantly associated with suicidal behavior.

CONCLUSION: The magnitude of suicidal behavior among postnatal mothers attending public health centers in Addis Ababa was 41.46% and it was found to be associated with being literate, rape, verbal abuse, having a history of depression, having a sexually unfaithful husband and chewing khat. As a result, women should be screened for suicidal behavior during antenatal and postnatal services for early detection and management.

PMID:35831799 | DOI:10.1186/s12888-022-04090-z

Pediatr Crit Care Med. 2022 Jul 14. doi: 10.1097/PCC.0000000000003028. Online ahead of print.

ABSTRACT

OBJECTIVES: Currently, there are no prediction tools available to identify patients at risk of needing high-complexity care following cardiac catheterization for congenital heart disease. We sought to develop a method to predict the likelihood a patient will require intensive care level resources following elective cardiac catheterization.

DESIGN: Prospective single-center study capturing important patient and procedural characteristics for predicting discharge to the ICU. Characteristics significant at the 0.10 level in the derivation dataset (July 1, 2017 to December 31, 2019) were considered for inclusion in the final multivariable logistic regression model. The model was validated in the testing dataset (January 1, 2020 to December 31, 2020). The novel pre-procedure cardiac status (PCS) feature, collection started in January 2019, was assessed separately in the final model using the 2019 through 2020 dataset.

SETTING: Tertiary pediatric heart center.

PATIENTS: All elective cases coming from home or non-ICU who underwent a cardiac catheterization from July 2017 to December 2020.

INTERVENTIONS: None.

MEASUREMENTS AND MAIN RESULTS: A total of 2,192 cases were recorded in the derivation dataset, of which 11% of patients (n = 245) were admitted to the ICU, while 64% (n = 1,413) were admitted to a medical unit and 24% (n = 534) were discharged home. In multivariable analysis, the following predictors were identified: 1) weight less than 5 kg and 5-9.9 kg, 2) presence of systemic illness, 3) recent cardiac intervention less than 90 days, and 4) ICU Admission Tool for Congenital Heart Catheterization case type risk categories (1-5), with C-statistics of 0.79 and 0.76 in the derivation and testing cohorts, respectively. The addition of the PCS feature fit into the final model resulted in a C-statistic of 0.79.

CONCLUSIONS: The creation of a validated pre-procedural risk prediction model for ICU admission following congenital cardiac catheterization using a large volume, single-center, academic institution will improve resource allocation and prediction of capacity needs for this complex patient population.

PMID:35830709 | DOI:10.1097/PCC.0000000000003028

Am J Public Health. 2022 Aug;112(8):1151-1160. doi: 10.2105/AJPH.2022.306805.

ABSTRACT

Life expectancy figures for countries and population segments are increasingly being reported to more decimal places and used as indicators of the strengths or failings of countries’ health and social systems. Reports seldom quantify their intrinsic statistical imprecision or the age-specific numbers of deaths that determine them. The SE formulas available to compute imprecision are all model based. This note adds a more intuitive data-based SE method and extends the jackknife to the analysis of event rates more generally. It also describes the relationships between the magnitude of the SE and the numbers of person-years and deaths on which it is based. These relationships can help quantify the statistical noise present in published year-to-year differences in life expectancies, as well as in same-year differences between or within countries. Agencies and investigators are encouraged to use one of these SEs to report the imprecision of life expectancy numbers and to tailor the number of decimal places accordingly. (Am J Public Health. 2022;112(8):1151-1160. https://doi.org/10.2105/AJPH.2022.306805).

PMID:35830672 | DOI:10.2105/AJPH.2022.306805

Sex Transm Dis. 2022 Jul 14. doi: 10.1097/OLQ.0000000000001675. Online ahead of print.

ABSTRACT

BACKGROUND: The COVID-19 pandemic has coincided with an explosion of on-line platforms for sexually transmitted infections (STIs) testing using self-collected, mail-in specimens. Reports on the effect of COVID-19-associated restrictions on sexual behaviors have been mixed, but STI transmissions have continued during the pandemic. We sought to understand the pandemic impact on sexual habits associated with STIs among IWantTheKit (IWTK) users.

METHODS: Users of IWTK, a free, on-line STI testing platform, were invited to complete an anonymous questionnaire. Descriptive statistics were used to describe survey responses. Associations with reports of new sex partnerships were explored as a marker of STI risk. Descriptive statistics, univariate and multivariate logistic regression models were used to analyze individual characteristics and reported behaviors associated with self-reported new sexual partnerships during the first two COVID-19 pandemic waves.

RESULTS: Of the 3,462 users of the on-line STI testing platform between June 2020 and February 2021, 1,088 (31.4%) completed the on-line survey; 705 (66.2%) of 1,065 reported a new sex partner. One-quarter met their sex partners using Apps. Overall, 10% were symptomatic and almost 18% were concerned that their partner had an STI. White race in males (OR 1.81 [95%CI:1.04, 3.16]), female age < 25 years (OR 1.85 [95%CI:1.09, 3.14]), and increased condom use in both men and women were significantly associated with reports of new sexual partnerships in adjusted analysis.

CONCLUSIONS: Despite pandemic restrictions on social gatherings, new sexual partnerships were common in this population, associated with common risk factors, and may help to explain ongoing STI transmission.

PMID:35830655 | DOI:10.1097/OLQ.0000000000001675

J Clin Pediatr Dent. 2022 May 1;46(3):211-218. doi: 10.17796/1053-4625-46.3.7.

ABSTRACT

OBJECTIVES: With the recent improvements in technology, the expectation of minimal invasion and maximal comfort in caries removal techniques is increasing. This study aims to examine the effectiveness of six caries removal methods in primary teeth.

STUDY DESIGN: Sixty primary molars (10 teeth in each groups) were used. The groups were: Group I (Tungsten Carbide Bur), Group II (Sono abrasion), Group III (Air abrasion), Group IV (Carisolv), Group V (Er:YAG Laser), Group VI (ART). In micro-CT scanning, mineral density at the cavity floor was examined before and after caries removal. After caries removal, the patency of the dentinal tubules was examined in two teeth from each group on SEM images. Statistical analyses were performed using Kruskal-Wallis, Wilcoxon tests.

RESULTS: For six different caries removal methods, tooth mineral (inorganic, total) densities at cavity floors were compared among the groups after the procedures, and no statistically significant difference was found (p>0.05). On the SEM images, it was seen that the dentinal tubules were exposed and no smear layer was formed in the Carisolv group. Significant rough surfaces were exposed in the laser group.

CONCLUSION: It was observed that alternative caries removal methods are at least as effective as the traditional method in primary teeth for clinical applications.

PMID:35830639 | DOI:10.17796/1053-4625-46.3.7

Haemophilia. 2022 Jul 13. doi: 10.1111/hae.14624. Online ahead of print.

ABSTRACT

INTRODUCTION: Measurement of physical activity (PA) using commercial activity trackers such as Fitbit devices has become increasingly popular, also for people with haemophilia (PWH). The accuracy of the Fitbit model Charge 3 has not yet been examined.

AIMS: To compare the Fitbit Charge 3 against the research-grade accelerometer ActiGraph GT3X-BT in measuring average daily steps and minutes spent in different PA intensities.

METHODS: Twenty-four young PWH wore a wrist-worn Fitbit Charge 3 and hip-worn ActiGraph GT3X-BT simultaneously for seven consecutive days in free-living conditions. Correlation of and differences between the devices for daily averages of PA parameters were assessed using Pearson’s correlation coefficient and paired t-test, respectively. Agreement between devices was assessed using Bland-Altman plots.

RESULTS: Twenty participants (mean age 21.8) were included in the analyses. We found moderate to high correlations between Fitbit and ActiGraph measured daily averages for all PA variables, but statistically significant differences between devices for all variables except daily minutes of moderate PA. Fitbit overestimated average daily steps, minutes of light, vigorous and moderate-to-vigorous PA. Bland-Altman plots showed a measurement bias between devices for all parameters with increasing overestimation by the Fitbit for higher volumes of PA.

CONCLUSION: The Fitbit Charge 3 overestimated steps and minutes of light, moderate and moderate-to-vigorous PA as compared to the ActiGraph GT3X-BT, and this bias increased with PA volume. The Fitbit should therefore be used with caution in research, and we advise users of the device to be cognizant of this overestimation.

PMID:35830613 | DOI:10.1111/hae.14624

Perfusion. 2022 Jul 13:2676591221115267. doi: 10.1177/02676591221115267. Online ahead of print.

ABSTRACT

BACKGROUND: Extracorporeal Membrane Oxygenation (ECMO) therapy for respiratory failure is an increasingly popular modality of support. Patient selection is an important aspect of outcome success. This review assesses the efficacy of the popular prognostic tools Respiratory ECMO Survival Prediction Score (RESP) and Predicting Death for Severe ARDS on VV-ECMO score (PRESERVE) for ECMO patient selection.

METHODS: A literature search was performed. Six publications were found to match the specified selection criteria. These publications were assessed and compared using the area under the receiver operating characteristic (AUROC) curve statistical method to ascertain the discriminatory ability of the models to predict treatment outcome.

RESULTS: Six articles were included in this review from 306 screened, of which all were retrospective cohort studies. Data was generated over a period of 3-9 years from 13 referring hospitals. Studies consisted of 467 male and 221 female (30 unknown) participants in total with a high heterogeneity. The PRESERVE prognostic model was found to have a higher AUROC score than the RESP model, however both models were found to be sub-optimal in their discriminatory ability. A high chance of bias was seen across all included studies.

CONCLUSION: It was the findings of this review, indicated by analysis using the AUROC measures, that the prognostic model PRESERVE performed better than RESP for predicting post ECMO therapy outcomes, for patients presenting with Acute Respiratory Distress Syndrome within their respective validated time frames, i.e., RESP at Intensive care unit (ICU) discharge and PRESERVE at 6 months post ICU discharge. However, It was recognized that comparator groups were small thereby introducing bias into the study. Further prospective, randomized studies would be necessary to effectively assess the utility of these predictive survival scores.

PMID:35830605 | DOI:10.1177/02676591221115267