Tag: nevin manimala

Med Sci Monit. 2023 Sep 18;29:e940948. doi: 10.12659/MSM.940948.

ABSTRACT

BACKGROUND The aim of this study was to analyze the correlation and the accuracy of lower-extremity torsion deformities measured by physical examination, CT scan, and three-dimensional gait analysis in children with CP. MATERIAL AND METHODS The study group included 72 children with CP with lower-extremity torsion deformities. All subjects were assessed by: 1. physical examination: maximum internal rotation (MIR), maximum external rotation (MER) for hip joint torsion, and transmalleolar axis (TMA) for tibial torsion; 2. CT scanning: femoral anteversion (FAV) and tibial torsion (TT); 3. three-dimensional gait analysis kinematic parameters: single-support phase of femoral rotation, double-support phase of femoral rotation, swing phase of femoral rotation and single-support phase of tibial rotation, double-support phase of tibial rotation, and swing phase of tibial rotation. Statistical analysis was performed using the Pearson correlation test. A significance level of P<0.05 was set. RESULTS In femurs, MIR and MER were correlated with FAV, and the correlation of MER was higher, while physical examination and FAV were not correlated with any kinematic data in gait analysis. In tibias, there was no correlation between TMA and TT, but both TMA and TT were correlated with the gait analysis kinematic data, and the correlation of TT was higher. TMA was more correlated with tibial rotation during swing phase, while TT was more correlated with tibial rotation in single-support phase. CONCLUSIONS Three-dimensional gait analysis can analyze the tibial rotation of children with cerebral palsy, which is highly correlated with CT and physical examination. However, femoral rotation was not associated with CT and physical examination.

PMID:37721931 | DOI:10.12659/MSM.940948

PLOS Glob Public Health. 2023 Sep 18;3(9):e0002326. doi: 10.1371/journal.pgph.0002326. eCollection 2023.

ABSTRACT

Voluntary medical male circumcision (VMMC) has primarily been promoted for HIV prevention. Evidence also supports that male circumcision offers protection against other sexually transmitted infections. This analysis assessed the effect of circumcision on syphilis, hepatitis B virus (HBV) infection and HIV. Data from the 2015 to 2019 Population-based HIV Impact Assessments (PHIAs) surveys from Rwanda, Tanzania, Uganda, Zambia, and Zimbabwe were used for the analysis. The PHIA surveys are cross-sectional, nationally representative household surveys that include biomarking testing for HIV, syphilis and HBV infection. This is a secondary data analysis using publicly available PHIA data. Univariate and multivariable logistic regression models were created using pooled PHIA data across the five countries to assess the effect of male circumcision on HIV, active and ever syphilis, and HBV infection among sexually active males aged 15-59 years. Circumcised men had lower odds of syphilis infection, ever or active infection, and HIV, compared to uncircumcised men, after adjusting for covariates (active syphilis infection = 0.67 adjusted odds ratio (aOR), 95% confidence interval (CI), 0.52-0.87, ever having had a syphilis infection = 0.85 aOR, 95% CI, 0.73-0.98, and HIV = 0.53 aOR, 95% CI, 0.47-0.61). No difference between circumcised and uncircumcised men was identified for HBV infection (P = 0.75). Circumcised men have a reduced likelihood for syphilis and HIV compared to uncircumcised men. However, we found no statistically significant difference between circumcised and uncircumcised men for HBV infection.

PMID:37721926 | DOI:10.1371/journal.pgph.0002326

Biomedica. 2023 Aug 31;43(Sp. 1):144-155. doi: 10.7705/biomedica.6852.

ABSTRACT

INTRODUCTION: Drug resistance to azoles is a growing problem in the Candida genus.

OBJECTIVE: To analyze molecularly the genes responsible for fluconazole resistance in Candida tropicalis strains.

MATERIALS AND METHODS: Nineteen strains, with and without exposure to fluconazole, were selected for this study. The expression of MDR1, CDR1, ERG11, and ERG3 genes was analyzed in sensitive, dose-dependent sensitive, and resistant strains exposed to different concentrations of the antifungal drug.

RESULTS: MDR1, ERG11 and ERG3 genes were significantly overexpressed in the different sensitivity groups. CDR1 gene expression was not statistically significant among the studied groups. Seven of the eight fluconazole-resistant strains showed overexpression of one or more of the analyzed genes. In some dose-dependent sensitive strains, we found overexpression of CDR1, ERG11, and ERG3.

CONCLUSION: The frequency of overexpression of ERG11 and ERG3 genes indicates that they are related to resistance. However, the finding of dose-dependent resistant/sensitive strains without overexpression of these genes suggests that they are not exclusive to this phenomenon. More basic research is needed to study other potentially involved genes in the resistance mechanism to fluconazole.

PMID:37721916 | DOI:10.7705/biomedica.6852

Biomedica. 2023 Aug 31;43(Sp. 1):206-216. doi: 10.7705/biomedica.6872.

ABSTRACT

INTRODUCTION: Fungal infections in patients with COVID-19 was one of the most debated topics during the pandemic.

OBJECTIVES: To analyze the clinical characteristics and evolution of people living with HIV/AIDS and coinfection with cryptococcus and COVID-19 (group A) or without it (group B).

MATERIALS AND METHODS: This is an analytical and retrospective study. We reviewed medical records of patients with meningeal cryptococcosis between April 2020 and May 2021.

RESULTS: We studied 65 people living with HIV/AIDS and with cryptococcosis infection diagnosed from April 2020 to May 2021. Fifteen patients with HIV/AIDS suffered from cryptococcosis and COVID-19, and out of these, 14 presented meningitis (group A), while 28 suffered from meningeal cryptococcosis, but did not have COVID-19 (group B).

CONCLUSIONS: No statistically significant differences were observed between the two groups (A and B) considering: intracranial hypertension, presence of Cryptococcus antigens in cerebrospinal fluid, sensorium deterioration or mortality. The detection of Cryptococcus antigens in serum by lateral flow assay was highly effective to rapidly diagnose cryptococcosis in patients with HIV/AIDS who also developed COVID-19. Patients of both groups consulted for cryptoccocosis sometime after, in comparison with the pre-pandemic cases related to this infection.

PMID:37721913 | DOI:10.7705/biomedica.6872

Biomedica. 2023 Aug 31;43(Sp. 1):255-266. doi: 10.7705/biomedica.7020.

ABSTRACT

INTRODUCTION: Pneumocystis jirovecii is an opportunistic fungus that affects mainly people living with HIV (CD4 cell count lower than 200 cells/ml) and other immunosuppressed patients. Since P. jirovecii does not grow on routine mycological media, diagnosis of P. jirovecii pneumonia relies on indirect evidence of its presence in respiratory samples.

OBJECTIVES: To associate the results of direct immunofluorescence and two molecular methods with a score to predict P. jirovecii pneumonia in patients with AIDS.

MATERIALS AND METHODS: A prospective study was conducted with 40 patients. A respiratory sample collected before treatment was subjected to direct immunofluorescence using the Merifluor kit, to nested PCR targeting the mitochondrial large subunit ribosomal RNA, and to the VIASURE real-time PCR kit.

RESULTS: These three techniques revealed P. jirovecii in 6, 12, and 15 samples, respectively. All positive samples by direct immunofluorescence were positive by nested PCR, and all positive samples by nested PCR amplified by real-time PCR. There was a statistically significant association between the P. jirovecii pneumonia score and the molecular methods. Two patients were early diagnosed and responded well to treatment.

CONCLUSION: Molecular methods, especially real-time PCR, are recommended for early diagnosis of P. jirovecii pneumonia in AIDS patients.

PMID:37721900 | DOI:10.7705/biomedica.7020

IEEE Trans Neural Netw Learn Syst. 2023 Sep 18;PP. doi: 10.1109/TNNLS.2023.3310985. Online ahead of print.

ABSTRACT

This article presents a comprehensive evaluation of instance segmentation models with respect to real-world image corruptions as well as out-of-domain image collections, e.g., images captured by a different set-up than the training dataset. The out-of-domain image evaluation shows the generalization capability of models, an essential aspect of real-world applications, and an extensively studied topic of domain adaptation. These presented robustness and generalization evaluations are important when designing instance segmentation models for real-world applications and picking an off-the-shelf pretrained model to directly use for the task at hand. Specifically, this benchmark study includes state-of-the-art network architectures, network backbones, normalization layers, models trained starting from scratch versus pretrained networks, and the effect of multitask training on robustness and generalization. Through this study, we gain several insights. For example, we find that group normalization (GN) enhances the robustness of networks across corruptions where the image contents stay the same but corruptions are added on top. On the other hand, batch normalization (BN) improves the generalization of the models across different datasets where statistics of image features change. We also find that single-stage detectors do not generalize well to larger image resolutions than their training size. On the other hand, multistage detectors can easily be used on images of different sizes. We hope that our comprehensive study will motivate the development of more robust and reliable instance segmentation models.

PMID:37721888 | DOI:10.1109/TNNLS.2023.3310985

IEEE Trans Neural Syst Rehabil Eng. 2023 Sep 18;PP. doi: 10.1109/TNSRE.2023.3316749. Online ahead of print.

ABSTRACT

Understanding the lower-limb coordination of individuals with unilateral transfemoral amputation (uTFA) while walking is essential to understand their gait mechanisms. Continuous relative phase (CRP) analysis provides insights into gait coordination patterns of the neuromusculoskeletal system based on movement kinematics. Fourteen individuals with uTFA and their age-matched able-bodied individuals participated in this study. Kinematic data of the lower limbs of the participants were collected during walking. The joint angles, segment angles, and CRP values of the thigh-shank and shank-foot couplings were investigated. The curves among the lower limbs of the participants were compared using a statistical parametric mapping test. Compensatory strategies were found in the lower limbs from coordination patterns. In thigh-shank coupling, although distinct coordination traits in stance and swing phases among the lower limbs were found, the lower limbs in both groups were discovered to remain in a similar coordination pattern during gait. For individuals with uTFA, in shank-foot coupling, intact limbs demonstrated a short period of foot-leading pattern which was significantly different from that of the other limbs during mid-stance to compensate for the weaker force generation by prosthetic limbs. The findings offer normative coordination patterns on the walking of individuals with uTFA, which could benefit prosthetic gait rehabilitation and development.

PMID:37721878 | DOI:10.1109/TNSRE.2023.3316749

Phys Rev Lett. 2023 Sep 1;131(9):091802. doi: 10.1103/PhysRevLett.131.091802.

ABSTRACT

The time-integrated CP asymmetry in the Cabibbo-suppressed decay D^{0}→K^{-}K^{+} is measured using proton-proton collision data, corresponding to an integrated luminosity of 5.7 fb^{-1} collected at a center-of-mass energy of 13 TeV with the LHCb detector. The D^{0} mesons are required to originate from promptly produced D^{*+}→D^{0}π^{+} decays, and the charge of the companion pion is used to determine the flavor of the charm meson at production. The time-integrated CP asymmetry is measured to be A_{CP}(K^{-}K^{+})=[6.8±5.4±1.6]×10^{-4} where the first uncertainty is statistical and the second systematic. The direct CP asymmetries in D^{0}→K^{-}K^{+} and D^{0}→π^{-}π^{+} decays, a_{K^{-}K^{+}}^{d} and a_{π^{-}π^{+}}^{d}, are derived by combining A_{CP}(K^{-}K^{+}) with the time-integrated CP asymmetry difference, ΔA_{CP}=A_{CP}(K^{-}K^{+})-A_{CP}(π^{-}π^{+}), and other inputs, giving a_{K^{-}K^{+}}^{d}=(7.7±5.7)×10^{-4},a_{π^{-}π^{+}}^{d}=(23.2±6.1)×10^{-4},with a correlation coefficient corresponding to ρ=0.88. The compatibility of these results with CP symmetry is 1.4 and 3.8 standard deviations for D^{0}→K^{-}K^{+} and D^{0}→π^{-}π^{+} decays, respectively. This is the first evidence for direct CP violation in a specific D^{0} decay.

PMID:37721849 | DOI:10.1103/PhysRevLett.131.091802

Phys Rev Lett. 2023 Sep 1;131(9):091903. doi: 10.1103/PhysRevLett.131.091903.

ABSTRACT

A search for the rare η→μ^{+}μ^{-}μ^{+}μ^{-} double-Dalitz decay is performed using a sample of proton-proton collisions, collected by the CMS experiment at the CERN LHC with high-rate muon triggers during 2017 and 2018 and corresponding to an integrated luminosity of 101 fb^{-1}. A signal having a statistical significance well in excess of 5 standard deviations is observed. Using the η→μ^{+}μ^{-} decay as normalization, the branching fraction B(η→μ^{+}μ^{-}μ^{+}μ^{-})=[5.0±0.8(stat)±0.7(syst)±0.7(B_{2μ})]×10^{-9} is measured, where the last term is the uncertainty in the normalization channel branching fraction. This work achieves an improved precision of over 5 orders of magnitude compared to previous results, leading to the first measurement of this branching fraction, which is found to agree with theoretical predictions.

PMID:37721839 | DOI:10.1103/PhysRevLett.131.091903

JMIR Form Res. 2023 Sep 18;7:e45490. doi: 10.2196/45490.

ABSTRACT

BACKGROUND: Type 2 diabetes (T2D) is a growing global health concern, including in Singapore. Diabetes education programs have been shown to be effective in improving health outcomes and diabetes self-management skills. Mobile health apps have emerged as useful tools for diabetes education; however, their use and acceptance by the target population remain inconsistent. Therefore, end-user participation in the design and development of a mobile health app is crucial for designing an acceptable app that can improve outcomes for populations with a chronic disease.

OBJECTIVE: The objective of this study was to apply an end-user participatory approach to co-design a diabetes education app prototype for people living with T2D by exploring their perceptions, acceptance, and usability of an app prototype, as well as their diabetes experience and perspectives on digital diabetes education.

METHODS: A total of 8 people with T2D, who were recruited from diabetes management Facebook groups, participated in 4 web-based surveys via Qualtrics and 2 structured interviews via Zoom (Zoom Video Communications, Inc) between August 20, 2021, and January 28, 2022. Descriptive statistics and thematic analyses of the discussion and iterative feedback on the app prototype were used to assess the participants’ perceptions of living with T2D, attitudes toward digital diabetes education, and acceptance of the prototype.

RESULTS: Analyses of the surveys and interview data revealed 3 themes: challenges of living with T2D; validation, acceptability, and usability of the diabetes education app prototype; and perspectives on digital diabetes education. In the first theme, participants highlighted the importance of solitary accountability, translating knowledge into practice, and developing pragmatic self-consciousness. The second theme indicated that the diabetes education app prototype was acceptable, with information and appearance being key; revealed ambivalent and polarized opinions toward the chatbot; and confirmed potential impact of the app on diabetes self-management skills and practice. The third theme comprised the necessity of using a variety of information-seeking strategies and recommendations for desired content and app qualities, including accessibility, adaptability, autonomy, evidence-based design and content, gamification, guidance, integration, personalization, and up-to-date content. The findings were used to reiterate the app design.

CONCLUSIONS: Despite a small sample size, the study demonstrated the feasibility of engaging and empowering people living with T2D to consider digital therapeutics for diabetes self-management skills and practice. Participants gave rather positive feedback on the design and content of the app prototype, with some recommendations for improvements. The findings suggest that incorporating end-user feedback into app design can lead to the creation of feasible and acceptable tools for diabetes education, potentially improving outcomes for populations with a chronic disease. Further research is needed to test the impact of the refined diabetes education app prototype on diabetes self-management skills and practice and quality of life.

PMID:37721799 | DOI:10.2196/45490