Nevin Manimala

Trials. 2022 Sep 8;23(1):762. doi: 10.1186/s13063-022-06708-9.

ABSTRACT

BACKGROUND: The HEALing (Helping to End Addiction Long-term^SM) Communities Study (HCS) is a multi-site parallel group cluster randomized wait-list comparison trial designed to evaluate the effect of the Communities That Heal (CTH) intervention compared to usual care on opioid overdose deaths. Covariate-constrained randomization (CCR) was applied to balance the community-level baseline covariates in the HCS. The purpose of this paper is to evaluate the performance of model-based tests and permutation tests in the HCS setting. We conducted a simulation study to evaluate type I error rates and power for model-based and permutation tests for the multi-site HCS as well as for a subgroup analysis of a single state (Massachusetts). We also investigated whether the maximum degree of imbalance in the CCR design has an impact on the performance of the tests.

METHODS: The primary outcome, the number of opioid overdose deaths, is count data assessed at the community level that will be analyzed using a negative binomial regression model. We conducted a simulation study to evaluate the type I error rates and power for 3 tests: (1) Wald-type t-test with small-sample corrected empirical standard error estimates, (2) Wald-type z-test with model-based standard error estimates, and (3) permutation test with test statistics calculated by the difference in average residuals for the two groups.

RESULTS: Our simulation results demonstrated that Wald-type t-tests with small-sample corrected empirical standard error estimates from the negative binomial regression model maintained proper type I error. Wald-type z-tests with model-based standard error estimates were anti-conservative. Permutation tests preserved type I error rates if the constrained space was not too small. For all tests, the power was high to detect the hypothesized 40% reduction in opioid overdose deaths for the intervention vs. comparison group both for the overall HCS and the subgroup analysis of Massachusetts (MA).

CONCLUSIONS: Based on the results of our simulation study, the Wald-type t-test with small-sample corrected empirical standard error estimates from a negative binomial regression model is a valid and appropriate approach for analyzing cluster-level count data from the HEALing Communities Study.

TRIAL REGISTRATION: ClinicalTrials.gov http://www.

CLINICALTRIALS: gov ; Identifier: NCT04111939.

PMID:36076295 | DOI:10.1186/s13063-022-06708-9

J Transl Med. 2022 Sep 8;20(1):412. doi: 10.1186/s12967-022-03623-0.

ABSTRACT

BACKGROUND: Berberine (BBR), an isoquinoline alkaloid isolated from Rhizoma Coptis, is widely used in the treatment of hyperlipidemia (HLP) in China. At present, the efficacy of BBR against HLP is relatively clear, but there are few researches on its mechanism. The purpose of this study was to evaluate the potentially beneficial role of BBR in HLP hamster models, as well as investigate its possible mechanisms and potential lipid biomarkers in combination with network pharmacology.

METHODS: HLP hamster model was induced by high-fat diet. Hematoxylin-eosin (HE) staining was used to determine the degree of hepatic pathological injury. Liquid chromatography-mass spectrometry was used to analyze lipid metabolism profiles of liver samples, and multiple statistical analysis methods were used to screen and identify lipid biomarkers. The possible molecular mechanism was unraveled by network pharmacology.

RESULTS: The results showed that 13 metabolites, including CE (16:1), HexCer (D18:1/19:0) and LPC (O-22:0) were biomarkers of BBR regulation. CHPT1, PLA2G4A, LCAT and UGCG were predicted as the lipid-linked targets of BBR against HLP, whilst glycerophospholipid and sphingolipid metabolism were the key pathways of BBR against HLP.

CONCLUSIONS: In summary, this study provides new insights into the protective mechanism of BBR against HLP through network pharmacology and lipidomic approaches.

PMID:36076294 | DOI:10.1186/s12967-022-03623-0

Int Breastfeed J. 2022 Sep 8;17(1):68. doi: 10.1186/s13006-022-00507-3.

ABSTRACT

BACKGROUND: Twins and late preterm (LPT) infants are at an increased risk of being breastfed to a lesser extent than term singletons. This study aimed to describe the initiation and duration of any and exclusive breastfeeding at the breast for mothers of LPT twins and term twins during the first 4 months and to explore the breastfeeding experiences of mothers of LPT twins.

METHODS: A sequential two-sample quantitative-qualitative explanatory mixed-methods design was used. The quantitative data were derived from a longitudinal cohort study in which 22 mothers of LPT twins and 41 mothers of term twins answered questionnaires at one and four months after birth (2015-2017). The qualitative data were obtained from semi-structured interviews with 14 mothers of LPT twins (2020-2021), based on results from the quantitative study and literature. Analysis included descriptive statistics of quantitative data and deductive content analysis of the qualitative data, followed by condensation and synthesis.

RESULTS: All mothers of LPT twins (100%) and most mothers of term twins (96%) initiated breastfeeding. There was no difference in any breastfeeding during the first week at home (98% versus 95%) and at 1 month (88% versus 85%). However, at 4 months, the difference was significant (44% versus 75%). The qualitative data highlighted that mothers of LPT twins experienced breastfeeding as complex and strenuous. Key factors influencing mothers’ experiences and decisions were their infants’ immature breastfeeding behaviors requiring them to express breast milk alongside breastfeeding, the burden of following task-oriented feeding regimes, and the lack of guidance from healthcare professionals. As a result, mothers started to question the worth of their breastfeeding efforts, leading to changes in breastfeeding management with diverse results. Support from fathers and grandparents positively influenced sustained breastfeeding.

CONCLUSIONS: Mothers of LPT twins want to breastfeed, but they face many challenges in breastfeeding during the first month, leading to more LPT twins’ mothers than term twins’ mothers ceasing breastfeeding during the following months. To promote and safeguard breastfeeding in this vulnerable group, care must be differentiated from routine term infant services, and healthcare professionals need to receive proper education and training.

PMID:36076279 | DOI:10.1186/s13006-022-00507-3

Int J Behav Nutr Phys Act. 2022 Sep 8;19(1):117. doi: 10.1186/s12966-022-01350-9.

ABSTRACT

BACKGROUND: Standardized validation indices (i.e., accuracy, bias, and precision) provide a comprehensive comparison of step counting wearable technologies.

PURPOSE: To expand a previously published child/youth catalog of validity indices to include adults (21-40, 41-60 and 61-85 years of age) assessed across a range of treadmill speeds (slow [0.8-3.2 km/h], normal [4.0-6.4 km/h], fast [7.2-8.0 km/h]) and device wear locations (ankle, thigh, waist, and wrist).

METHODS: Two hundred fifty-eight adults (52.5 ± 18.7 years, 49.6% female) participated in this laboratory-based study and performed a series of 5-min treadmill bouts while wearing multiple devices; 21 devices in total were evaluated over the course of this multi-year cross-sectional study (2015-2019). The criterion measure was directly observed steps. Computed validity indices included accuracy (mean absolute percentage error, MAPE), bias (mean percentage error, MPE), and precision (correlation coefficient, r; standard deviation, SD; coefficient of variation, CoV).

RESULTS: Over the range of normal speeds, 15 devices (Actical, waist-worn ActiGraph GT9X, activPAL, Apple Watch Series 1, Fitbit Ionic, Fitbit One, Fitbit Zip, Garmin vivoactive 3, Garmin vivofit 3, waist-worn GENEActiv, NL-1000, PiezoRx, Samsung Gear Fit2, Samsung Gear Fit2 Pro, and StepWatch) performed at < 5% MAPE. The wrist-worn ActiGraph GT9X displayed the worst accuracy across normal speeds (MAPE = 52%). On average, accuracy was compromised across slow walking speeds for all wearable technologies (MAPE = 40%) while all performed best across normal speeds (MAPE = 7%). When analyzing the data by wear locations, the ankle and thigh demonstrated the best accuracy (both MAPE = 1%), followed by the waist (3%) and the wrist (15%) across normal speeds. There were significant effects of speed, wear location, and age group on accuracy and bias (both p < 0.001) and precision (p ≤ 0.045).

CONCLUSIONS: Standardized validation indices cataloged by speed, wear location, and age group across the adult lifespan facilitate selecting, evaluating, or comparing performance of step counting wearable technologies. Speed, wear location, and age displayed a significant effect on accuracy, bias, and precision. Overall, reduced performance was associated with very slow walking speeds (0.8 to 3.2 km/h). Ankle- and thigh-located devices logged the highest accuracy, while those located at the wrist reported the worst accuracy.

TRIAL REGISTRATION: Clinicaltrials.gov NCT02650258. Registered 24 December 2015.

PMID:36076265 | DOI:10.1186/s12966-022-01350-9

BMC Nutr. 2022 Sep 8;8(1):99. doi: 10.1186/s40795-022-00597-6.

ABSTRACT

BACKGROUND: Growth monitoring and promotion (GMP) is one of the health care priorities to assess and follow the growth pattern of children under 2 years old. Appropriate GMP services enable health care workers to control growth faltering early and child mortality. However, there is limited information showing the practice and associated factors of GMP service among health care workers in Ethiopia. Therefore, this study aimed to assess the practice and identify associated factors of GMP service among health care workers at public health facilities of the South Wollo Zone, northeast Ethiopia.

METHODS: A facility-based cross-sectional study was conducted on 397 randomly selected health care workers in the South Wollo Zone, northeast Ethiopia, from May 25 to July 7, 2020. A pretested self-administered questionnaire and in-depth interview were used to collect the quantitative and qualitative data, respectively. Quantitative data were entered using Epi data Version 3.1 and exported to statistical software for social sciences (SPSS) version 20.0 software for further analysis. Binary logistic regression analyses were used to identify factors associated with GMP practice. Statistical tests at a P value < 0.05 with a 95% confidence interval were taken as a cutoff point to determine the statistical significance. Qualitative data were analyzed by using thematic analysis.

RESULTS: In this study, the proportion of GMP practice among health care workers was 58.4% (95% CI: 54.0-63.0). Being a holder of first degree (AOR = 2.25; 95% CI: 1.01, 5.05), being a holder of a diploma (AOR = 3.52; 95% CI: 2.04, 6.09), work experience with GMP (AOR = 3.13; 95% CI: 1.58, 6.20), receiving GMP training (AOR = 4.83; 95% CI: 2.89, 8.06), availability of GMP equipment (AOR = 2.75; 95% CI: 1.64, 4.58) and having a positive attitude toward GMP (AOR = 3.70; 95% CI: 2.23, 6.17) were factors significantly associated with GMP practice.

CONCLUSIONS AND RECOMMENDATIONS: The proportion of GMP practice among health care workers was still low. Educational level, work experience with GMP, GMP training, GMP equipment and attitude toward GMP were positively associated with GMP practice. Availability of GMP equipment brings positive attitudes toward GMP, and GMP training for health care workers with less experience should be strengthened to improve GMP practice.

PMID:36076259 | DOI:10.1186/s40795-022-00597-6

Acta Vet Scand. 2022 Sep 8;64(1):25. doi: 10.1186/s13028-022-00643-0.

ABSTRACT

BACKGROUND: Computed tomography (CT) scanning of the lung is known to be a valuable tool when investigating lung pathology of the dog. During CT-scan the dog needs to be immobilized and general anesthesia has historically been considered as gold standard although being a more expensive and time-consuming alternative to sedation. Today, modern high speed multidetector CT-scanners offer new possibilities for sedation as an alternative. Both anesthesia and sedation can cause lung atelectasis, and this can be problematic when reading the CT-images since it potentially can masque or mimic lung pathology leading to misdiagnosis. The objective of this prospective analytic study was to investigate the prevalence of lung atelectasis and changes in lung attenuation over time in dogs that receive intravenous sedation and positioned in sternal recumbency.

RESULTS: 20 dogs without known lung pathology underwent three consecutive CT-scans of the lung; the first scan was initiated as soon as the dog was sufficiently sedated, the second scan approximately 5 min after the first one and the last scan after the dog’s orthopaedic scan was completed. The dogs received intravenous sedation in a combination of dexmedetomidine and butorphanol and were kept positioned in a strict sternal recumbency during sedation and exam. Each lung lobe was individually examined in an axial plane and measurements of dorsal, ventral, and mean lung attenuation were made. Atelectasis or areas with poorly aerated lung tissue were not detected as all parts of the lobes were normally aerated at all three scans. A statistically significant increase in lung attenuation between the first and the second scan (P = 0.03) and between the first and the third scan (P = 0.0004) was seen in the ventral part of the lobes.

CONCLUSIONS: This study indicates that CT-examination of the lungs can be performed on sedated dogs that are kept in a sternal recumbency without development of atelectasis. It also suggests that there is an early correlation between time and increase in lung attenuation.

PMID:36076254 | DOI:10.1186/s13028-022-00643-0

Biotechnol Biofuels Bioprod. 2022 Sep 9;15(1):92. doi: 10.1186/s13068-022-02191-1.

ABSTRACT

BACKGROUND: The yield and quality of soybean oil are determined by seed oil-related traits, and metabolites/lipids act as bridges between genes and traits. Although there are many studies on the mode of inheritance of metabolites or traits, studies on multi-dimensional genetic network (MDGN) are limited.

RESULTS: In this study, six seed oil-related traits, 59 metabolites, and 107 lipids in 398 recombinant inbred lines, along with their candidate genes and miRNAs, were used to construct an MDGN in soybean. Around 175 quantitative trait loci (QTLs), 36 QTL-by-environment interactions, and 302 metabolic QTL clusters, 70 and 181 candidate genes, including 46 and 70 known homologs, were previously reported to be associated with the traits and metabolites, respectively. Gene regulatory networks were constructed using co-expression, protein-protein interaction, and transcription factor binding site and miRNA target predictions between candidate genes and 26 key miRNAs. Using modern statistical methods, 463 metabolite-lipid, 62 trait-metabolite, and 89 trait-lipid associations were found to be significant. Integrating these associations into the above networks, an MDGN was constructed, and 128 sub-networks were extracted. Among these sub-networks, the gene-trait or gene-metabolite relationships in 38 sub-networks were in agreement with previous studies, e.g., oleic acid (trait)-GmSEI-GmDGAT1a-triacylglycerol (16:0/18:2/18:3), gene and metabolite in each of 64 sub-networks were predicted to be in the same pathway, e.g., oleic acid (trait)-GmPHS-D-glucose, and others were new, e.g., triacylglycerol (16:0/18:1/18:2)-GmbZIP123-GmHD-ZIPIII-10-miR166s-oil content.

CONCLUSIONS: This study showed the advantages of MGDN in dissecting the genetic relationships between complex traits and metabolites. Using sub-networks in MGDN, 3D genetic sub-networks including pyruvate/threonine/citric acid revealed genetic relationships between carbohydrates, oil, and protein content, and 4D genetic sub-networks including PLDs revealed the relationships between oil-related traits and phospholipid metabolism likely influenced by the environment. This study will be helpful in soybean quality improvement and molecular biological research.

PMID:36076247 | DOI:10.1186/s13068-022-02191-1

Pilot Feasibility Stud. 2022 Sep 8;8(1):200. doi: 10.1186/s40814-022-01157-2.

ABSTRACT

BACKGROUND: Many workers performing manual handling tasks suffer from musculoskeletal disorders (MSD). Previous research has identified several loading aspects associated with manual handling, but it is still unknown if lifting on an unstable surface is associated with increased biomechanical loading of different body parts.

AIM: This proof-of-concept study aims to study what kinematic and kinetic movement parameters, such as movement time, joint angles, torque, and muscle activity are feasible and of importance when studying the effect of lifting on surfaces with varying degrees of stability in an experimental set-up.

METHODS: Measurements were taken during three different surface conditions: stable, slightly unstable, and unstable. The participants were instructed to lift a box from the floor and place it on a table in front of them. The weight of the box varied from 0.5 to 15.5 kg. By using a motion capture system (VICON) with 28 reflective markers placed on the participants and one on the box, one Kistler force plate for measuring force levels and center of pressure movements (CoP), and four electromyographic transmitters (EMG), we analyzed the downward and upward phases of the lifting movement, using the Friedman’s test for repeated measures.

RESULTS: Statistically significant results with less joint movements in the lower and upper back were seen with increased instability during both the downward and upward phases. The decrease in trunk movements with increased instability resulted in a somewhat more flexed knee position during the movement, a lower torque in the lower back, and a decrease in CoP movements, but no differences in movement time or muscle activity in back and knee muscles.

CONCLUSION: Lifting while standing on unstable surfaces resulted in an alteration of both kinematics and kinetics parameters; however, further studies regarding whether this is an additional risk factor for developing lower back pain are needed. Muscle activity levels were not altered due to instability and due to the complexity of the measurement, and we suggest not including EMG measures in future experiments of this type.

PMID:36076246 | DOI:10.1186/s40814-022-01157-2

Parasit Vectors. 2022 Sep 8;15(1):320. doi: 10.1186/s13071-022-05444-y.

ABSTRACT

BACKGROUND: Polyarthritis has been associated with canine visceral leishmaniasis (CanVL), and co-infection with Ehrlichia canis is common and may alter clinical manifestations.

METHODS: A total of 89 dogs presenting CanVL were subdivided into two groups: (1) G1, consisting of 46 dogs seronegative to Ehrlichia spp., and (ii) G2, consisting of 43 dogs seropositive to Ehrlichia spp. Eight joints (carpal, tarsal, stifles and elbows) from each dog were evaluated by radiography and synovial fluid (SF) cytologic analysis.

RESULTS: Overall, 74 of the 89 (83.1%) dogs presented joint abnormalities suggestive of osteoarthritis by radiography (G1: 40/46 [86.9%]; G2: 34/43 [79.0%]), with no statistically significant between-group difference. All dogs with abnormal joint X-ray images presented radiographic lesions bilaterally, independent of the characteristics of the lesion. Soft tissue swelling around the joint and joint space narrowing were more commonly observed in G1 than in G2 dogs. There was no significant between-group difference in terms of other radiographic abnormalities suggestive of osteoarthritis (evident trabecular pattern, subchondral bone sclerosis, osteolysis, osteolytic-proliferative lesions or bone proliferation). SF from 174/315 (55.2%) and 152/307 (49.5%) joints from G1 and G2 dogs, respectively, presented an inflammatory infiltrate, but there was no significant association between the presence of inflammatory infiltrate and group. There was also no statistical difference between groups in either of the evaluated joints in terms of the percentage of neutrophils or mononuclear cells. Leishmania spp. amastigotes were found in 69/315 (21.9%) joints from G1 dogs and in 100/307 (32.5%) joints from G2 dogs (Fisher’s exact test, P = 0.002, odds ratio = 0.5, 95% confidence interval = 0.4-0.8). The neutrophilic infiltrate was significantly higher in joints with amastigote forms in both G1 (Mann-Whitney U-test, U₍₁₈₎ = 817, Z = -3.76, P = 0.0001) and G2 dogs (Mann-Whitney U-test, U₍₁₈₎ = 6543, Z = – 5.06, P < 0.0001).

CONCLUSIONS: A high prevalence of arthritis in dogs with CanVL was found, and all dogs presented involvement in multiple joints. Although no difference was observed between groups in terms of the number of dogs with polyarthritis and the presence of an inflammatory infiltrate in SF, Leishmania spp. amastigotes were found more frequently in joints from G2 dogs. Further studies evaluating SF in dogs co-infected with L. infantum and E. canis should be performed to evaluate this finding.

PMID:36076242 | DOI:10.1186/s13071-022-05444-y

BMC Vet Res. 2022 Sep 8;18(1):338. doi: 10.1186/s12917-022-03433-y.

ABSTRACT

BACKGROUND: The conventional feeding management of horses is still characterized by high starch and low fibre diets, which can negatively affect horse’s gastrointestinal health. Thus, the aim of this study was to compare the effects of a high-starch (HS) vs. a high-fibre (HF) diet on gut health in horses. A total of 19 Bardigiano horses destined for slaughter and aged 14.3 ± 0.7 months were randomly allotted to two dietary groups: HS (5 fillies and 4 colts,) and HF group (7 fillies and 3 colts). They received the same first-cut meadow hay but different complementary feeds for 72 days: HS group was fed 8 kg/animal/day of a starch-rich complementary feed while HF group was fed 3.5 kg/animal/day of a fibre-rich complementary feed. At slaughter, stomachs were separated and washed for the evaluation of the glandular and squamous regions. Also, duodenum, jejunum, ileum, apex of the caecum, sternal flexure, pelvic flexure, right dorsal colon, rectum and liver were excised and submitted to histomorphometrical evaluation.

RESULTS: The glandular region of HS group presented more severe gastric mucosa lesions compared to the HF group (P = 0.006). Moreover, a statistical tendency (P = 0.060) was found for the squamous region, presenting a higher score in HS than HF diet. Regarding morphometry, in jejunum villus height to crypt depth (Cd) ratio was influenced by sex, being greater in males than in females (P = 0.037) while in ileum Cd depended on interaction between sex and diet, being greater in males of HS group (P = 0.029). Moreover, in the duodenum and right dorsal colon the severity of the inflammation depended on sex (P = 0.024 and 0.050), being greater in females than in males. On the contrary, in the jejunum and in the pelvic flexure, inflammation was influenced by diet, being more severe in HS than in HF group (P = 0.024 and 0.052).

CONCLUSIONS: These results suggested that HS diet provoked more severe mucosa lesions in the glandular region of the stomach and a higher inflammation both in the jejunum and pelvic flexure. The present study can represent a starting point for further investigations on gut health in horses.

PMID:36076239 | DOI:10.1186/s12917-022-03433-y