Nevin Manimala

PLoS Negl Trop Dis. 2021 Nov 8;15(11):e0009887. doi: 10.1371/journal.pntd.0009887. Online ahead of print.

ABSTRACT

BACKGROUND: Brazil remains endemic for infection by the human immunodeficiency virus (HIV) and leprosy, having a major impact on public health and the life quality of affected patients. Although the relevance of this co-infection is recognized, several aspects, such as the immune response, are not yet fully understood. The objective of this study was to investigate the expression of FOXP3+ Treg cells in leprosy skin lesions and to correlate their clinical forms, laboratory characteristics (CD4, CD8, and CV), and the immune reconstitution syndrome in HIV-leprosy co-infection.

METHODOLOGY/PRINCIPAL FINDINGS: An observational, cross-sectional, and analytical study was carried out comparing four groups of patients: those with concomitant diagnosis of leprosy and HIV infection without a leprosy reaction, those with leprosy and HIV co-infection patients with a reverse reaction (RR), those with leprosy without HIV and without reaction, and those with leprosywithout HIV and with RR. The patients were diagnosed at a dermatology outpatient clinic located in Belém, Pará, Brazil, from 2003 to 2017. In the sample studied, there was a positive correlation between FOXP3+ cell density and viral load, negative correlation with blood CD4+ (not statistically significant), significant positive correlation in CD8 count in patients with leprosy reaction, and positive relationship in patients with IRIS. The density of cells expressing FOXP3 was higher in the BL/LL forms in patients without HIV, although the difference was not statistically significant. However, the cell mean was higher in the TT/BT forms in patients co-infected with leprosy and HIV, showing contradictory results.

CONCLUSIONS/SIGNIFICANCE: These findings support that higher activity of the HIV may stimulate or result in a higher expression of FOXP3-Tregs and that they may be involved in active immunosuppression observed at the infection site at the tissue level. This supports the need to expand studies on FOXP3+ Treg cells in co-infected patients.

PMID:34748560 | DOI:10.1371/journal.pntd.0009887

J Affect Disord. 2021 Oct 29;297:495-501. doi: 10.1016/j.jad.2021.10.120. Online ahead of print.

ABSTRACT

BACKGROUND: The relationship between dyslexia and anxiety/depressive symptoms among children in China is unclear. Besides, the pathways to explain the risks are also undefined.

METHODS: 3993 primary school students from grade 2 to 6 were recruited in this study. The Dyslexia Checklist for Chinese Children and the Pupil Rating Scale-Revised Screening for Learning Disabilities were used to filter the dyslexic children. The Chinese perceived stress scale, the Screen for Child Anxiety Related Emotional Disorders, and the Children’s Depression Inventory-Short Form were used separately to assess stress, anxiety symptoms, and depressive symptoms of the children. Time spent on homework was obtained by asking their parents: “How long does it take the children to complete the homework every day?”. The chain mediation models were examined using SPSS PROCESS macro 3.3 software.

RESULTS: Dyslexic children spend more time on homework (2.61±1.15), and have higher scores for depression (4.75±3.60) and stress (26.55±7.40) compared to normal children (1.87±0.77, 3.25±3.32, and 23.20±8.43, respectively). The differences are statistically significant (all P<0.01). There is no direct association between dyslexia and anxiety symptoms, while dyslexia has a direct link with depressive symptoms. Dyslexia could affect anxiety/depressive symptoms via the independent mediating effect of stress and the chain mediating effect of time spent on homework and stress. The total indirect effect is 0.21 and 0.25, respectively.

LIMITATIONS: The data used in our study is self-reported and this is a cross-sectional study.

CONCLUSIONS: Time spent on homework and stress could mediate the association between dyslexia and anxiety/depressive symptoms.

PMID:34743962 | DOI:10.1016/j.jad.2021.10.120

Int J Biol Macromol. 2021 Oct 29;193(Pt A):915-922. doi: 10.1016/j.ijbiomac.2021.10.155. Online ahead of print.

ABSTRACT

This research work is a contribution to understand the olfaction mechanism at a molecular level of vanillin, ethyl vanillin, coumarin and quinoline molecules using a modeling of a putative adsorption process by analytical model established by statistical physics formalism. A statistical physics modeling using the monolayer model with identical and independent binding sites of the responses of the two human olfactory receptors OR10G4 and OR2B11 showed that vanillin and quinoline were adsorbed with a mixed non-parallel and parallel orientation on OR10G4 and on OR2B11, respectively. However, ethyl vanillin and coumarin were anchored with a total non-parallel orientation. The adsorption energy values collected from data analysis, which were ranged from 12.51 to 20.91 kJ/mol, confirmed that the adsorption of vanillin and ethyl vanillin on OR10G4 and the adsorption of coumarin and quinoline on OR2B11were exothermic and were based on physical interactions. Furthermore, the dose-olfactory response curves of vanillin, ethyl vanillin, coumarin and quinoline provided access to OR10G4 and OR2B11 steric characterization via the calculation of the studied olfactory receptors site size distributions (RSDs). Indeed, vanillin, ethyl vanillin, coumarin and quinoline RSDs are spread from 0.3 to 12 nm, from 0.5 to 12 nm, from 0.40 to 12 nm and from 0.14 to 12 nm, respectively, with a maximum at 1.55 nm, 2.11 nm, 2.50 and 1.13 nm, respectively. Lastly, the physico-chemical model parameters can be used for the energetic characterization to confirm the physical nature of the vanillin/ethyl vanillin-OR10G4 and the coumarin/quinoline-OR2B11 interactions and to determine an olfactory band of order of 12 kJ/mol [11-23 kJ/mol], 10 kJ/mol [14-24 kJ/mol], 7 kJ/mol [9-16 kJ/mol], 15 kJ/mol [13-28 kJ/mol] for vanillin, ethyl vanillin, coumarin and quinoline, respectively, through the determination of the adsorption energy distributions (AEDs).

PMID:34743943 | DOI:10.1016/j.ijbiomac.2021.10.155

Indian Heart J. 2021 Oct 29:S0019-4832(21)00231-5. doi: 10.1016/j.ihj.2021.10.012. Online ahead of print.

ABSTRACT

BACKGROUND: Over the last 20 years various techniques have been developed striving for safer and more durable pulmonary vein isolation (PVI). The three most commonly used tools are pulmonary vein ablation catheter (PVAC) and cryoballoon (‘single-shot’ techniques), and point-by-point (PBP) radiofrequency ablation using 3D electroanatomical mapping (EAM).

OBJECTIVE: Evaluate the safety and efficacy of the different techniques in an unselected population undergoing de-novo ablation for persistent or paroxysmal atrial fibrillation (AF) at Royal Papworth Hospital (RPH).

METHOD: Retrospective, single-centre study of consecutive AF ablations at RPH between March 2017 and April 2018. Demographic, procedural and outcome data were analysed.

RESULTS: Over the study period 329 first-time PVI procedures were performed. 37.4% were performed using PBP, 39.8% using cryoballoon and 22.8% using PVAC. There was no significant difference in age or sex between different ablation technique groups. 238 procedures were performed for paroxysmal AF and 91 for persistent AF. A higher proportion of the persistent cases were performed using point-by-point techniques compared to paroxysmal cases (58.2% vs 29.0%, p < 0.05). Procedural times were significantly longer in the group undergoing PBP ablation compared to cryoballoon or PVAC. However, there was no statistically significant difference in 12-month freedom from symptomatic AF or procedural complications between the groups.

CONCLUSIONS: PBP, PVAC and cryoballoon AF ablation all appeared equally efficacious in an unselected population, though PVAC and cryoballoon procedures were shorter. All procedures were associated with a low adverse event rate. Prospective examination is required to substantiate this finding.

PMID:34743897 | DOI:10.1016/j.ihj.2021.10.012

Clin Chim Acta. 2021 Oct 28:S0009-8981(21)00378-8. doi: 10.1016/j.cca.2021.10.034. Online ahead of print.

NO ABSTRACT

PMID:34743811 | DOI:10.1016/j.cca.2021.10.034

Clin Chim Acta. 2021 Oct 29:S0009-8981(21)00380-6. doi: 10.1016/j.cca.2021.10.036. Online ahead of print.

NO ABSTRACT

PMID:34743810 | DOI:10.1016/j.cca.2021.10.036

J Clin Sleep Med. 2021 Sep 1;17(9):1895-1945. doi: 10.5664/jcsm.9326.

ABSTRACT

INTRODUCTION: This systematic review provides supporting evidence for the accompanying clinical practice guideline on the treatment of central disorders of hypersomnolence in adults and children. The review focuses on prescription medications with U.S. Food & Drug Administration approval and nonpharmacologic interventions studied for the treatment of symptoms caused by central disorders of hypersomnolence.

METHODS: The American Academy of Sleep Medicine commissioned a task force of experts in sleep medicine to perform a systematic review. Randomized controlled trials and observational studies addressing pharmacological and nonpharmacological interventions for central disorders of hypersomnolence were identified. Statistical analyses were performed to determine the clinical significance of all outcomes. Finally, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) process was used to assess the evidence for the purpose of making specific treatment recommendations.

RESULTS: The literature search identified 678 studies; 144 met the inclusion criteria and 108 provided data suitable for statistical analyses. Evidence for the following interventions is presented: armodafinil, clarithromycin, clomipramine, dextroamphetamine, flumazenil, intravenous immune globulin (IVIG), light therapy, lithium, l-carnitine, liraglutide, methylphenidate, methylprednisolone, modafinil, naps, pitolisant, selegiline, sodium oxybate, solriamfetol, and triazolam. The task force provided a detailed summary of the evidence along with the quality of evidence, the balance of benefits and harms, patient values and preferences, and resource use considerations.

CITATION: Maski K, Trotti LM, Kotagal S, et al. Treatment of central disorders of hypersomnolence: an American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. J Clin Sleep Med. 2021;17(9):1895-1945.

PMID:34743790 | DOI:10.5664/jcsm.9326

Can J Aging. 2021 Nov 8:1-17. doi: 10.1017/S0714980821000349. Online ahead of print.

ABSTRACT

A palliative approach to care aims to meet the needs of patients and caregivers throughout a chronic disease trajectory and can be delivered by non-palliative specialists. There is an important gap in understanding the perspectives and experiences of primary care providers on an integrated palliative approach in dementia care and the impact of existing programs and models to this end. To address these, we undertook a scoping review. We searched five databases; and used descriptive numerical summary and narrative synthesizing approaches for data analysis. We found that: (1) difficulty with prognostication and a lack of interdisciplinary and intersectoral collaboration are obstacles to using a palliative approach in primary care; and (2) a palliative approach results in statistically and clinically significant impacts on community-dwelling individuals, specifically those with later stages of dementia. There is a need for high-quality research studies examining the integrated palliative approach models and initiation of these models sooner in the care trajectory for persons living with mild and moderate stages of dementia in the community.

PMID:34743774 | DOI:10.1017/S0714980821000349

Br J Nutr. 2021 Oct 7:1-8. doi: 10.1017/S0007114521004049. Online ahead of print.

ABSTRACT

This study aims to evaluate the interaction effect of socio-economic environment (SEE) in the relationship between the eating location (EL) and diet quality, in children and adolescents. Data included Portuguese children and adolescents (3-17 years) from a National Dietary Survey Sample (IAN-AF 2015/2016, n 987). Dietary intake was obtained by 2-d food diaries (children) or 2-24-h-recall (adolescents). Participants were classified into four groups of EL: ‘Home’, ‘Other homes’, ‘School’ and ‘Restaurants’. Diet quality was measured as a higher adherence to a healthy eating pattern. A previous developed socio-economic classification was used, and participants were grouped as belonging to a low socio-economic environment (LSE) or middle-high socio-economic environment (MHSE). Linear regression models were used to evaluate the association between EL and diet quality, stratified by the SEE. A statistically significant interaction effect was found (P < 0·01) for the SEE in the association between EL and diet quality. After adjustment for potential confounders, in LSE, participants belonging to ‘Other homes’ (β = -2·07; 95 % CI:-3·70, -0·44) and ‘Restaurants’ (β = -3·31; 95 % CI: -5·08, -1·54) had lower scores in the diet quality score, comparing to ‘Home’. In MHSE, comparing with ‘Home’, ‘Restaurants’ showed lower diet quality (β = -1·56; 95 % CI:-2·65, -0·48), while the ‘School’ had better diet quality (β = 0·90; 95 % CI: 0·16, 1·64). The SEE influences the association between EL and diet quality and, belonging to more disadvantaged SEE, might represent a higher risk of unhealthy eating habits when eating out-of-home.

PMID:34743770 | DOI:10.1017/S0007114521004049

Trials. 2021 Nov 7;22(1):780. doi: 10.1186/s13063-021-05755-y.

ABSTRACT

Non-pharmaceutical interventions (NPI) for infectious diseases such as COVID-19 are particularly challenging given the complexities of what is both practical and ethical to randomize. We are often faced with the difficult decision between having weak trials or not having a trial at all. In a recent article, Dr. Atle Fretheim argues that statistically underpowered studies are still valuable, particularly in conjunction with other similar studies in meta-analysis in the context of the DANMASK-19 trial, asking “Surely, some trial evidence must be better than no trial evidence?” However, informative trials are not always feasible, and feasible trials are not always informative. In some cases, even a well-conducted but weakly designed and/or underpowered trial such as DANMASK-19 may be uninformative or worse, both individually and in a body of literature. Meta-analysis, for example, can only resolve issues of statistical power if there is a reasonable expectation of compatible well-designed trials. Uninformative designs may also invite misinformation. Here, we make the case that-when considering informativeness, ethics, and opportunity costs in addition to statistical power-“nothing” is often the better choice.

PMID:34743755 | DOI:10.1186/s13063-021-05755-y