Tag: nevin manimala

BMC Public Health. 2022 May 25;22(1):1043. doi: 10.1186/s12889-022-13385-5.

ABSTRACT

BACKGROUND: Diarrhoeal diseases are important causes of disability and mortality being one of the main causes of mortality in the Democratic Republic of Congo (DRC). One of the largest and wealthiest African countries, DRC has been for long subjected to continuous political and economic instability, conflicts and disease outbreaks. This study aimed to address the knowledge gap in understanding how prevalence, mortality and burden of diseases in DRC changed over time and examine the influence of specific factors in these disease-related outcomes.

METHODS: A time-series analysis of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 estimates was performed to describe prevalence, years lived with disabilities (YLDs) and mortality due to diarrhoeal diseases, by age-group and sex, between 1990-2019 in DRC. The contribution of water, sanitation and hygiene (WASH) and child malnutrition risk factors to these outcomes was also analysed. Piecewise regression analysis was used to assess trends over time.

RESULTS: The overall age-standardised prevalence of diarrhoeal diseases for both sexes in DRC was 1350.84 (UI:1240.16-1461.62) cases per 100,000 people in 1990. The prevalence increased until 2019, also fuelled by the movement of Rwandan refugees to DRC and First/Second Congo wars between 1996-2003. Age-standardised prevalence and mortality were consistently higher in males, compared to females, decreasing by 42% and 54%, respectively, between 1990 and 2019. Overall prevalence was also usually higher in over 70 years old, except between 1998-2003 when mortality in under five years old was the highest. Unsafe water sources and child wasting among under five years old were the main contributors to YLDs and deaths associated to diarrhoeal diseases in DRC.

CONCLUSION: Diarrhoeal diseases are important and preventable causes of disability and mortality in DRC. National measures of surveillance and cost-effective interventions targeting the identified risk groups could be effective in reducing its prevalence and associated burden.

PMID:35614436 | DOI:10.1186/s12889-022-13385-5

BMC Health Serv Res. 2022 May 25;22(1):701. doi: 10.1186/s12913-022-08017-y.

ABSTRACT

BACKGROUND: Existing studies have illustrated how the onset of physical disability or dementia negatively impacts economic wellbeing and increases out of pocket costs. However, little is known about this relationship in older individuals. Consequently, this study aimed to identify how the onset of physical disability or dementia in older adults affects economic wellbeing and out of pocket costs, and to explore the impact of gender in the context of Australia.

METHODS: The data was collected from a large, randomized clinical study, ASPirin in Reducing Events in the Elderly (ASPREE). Two generalized linear models (with and without interaction effects) of total out of pocket costs for those who did and did not develop physical disability or dementia were generated, with adjustment for sociodemographic characteristics at baseline.

RESULTS: We included 8,568 older Australian individuals with a mean age of 74.8 years and 53.2% being females. After adjustment for the baseline sociodemographic characteristics, the onset of physical disability did statistically significantly raise out of pocket costs (cost ratio = 1.25) and costs among females were 13.1% higher than males.

CONCLUSIONS: This study highlights that classifying different types of health conditions to identify the drivers of out of pocket costs and to explore the gender differences in a long-term follow-up is of importance to examine the financial impact on the older population. These negative financial impacts and gender disparities of physical disability and dementia must be considered by policymakers.

PMID:35614437 | DOI:10.1186/s12913-022-08017-y

BMC Ophthalmol. 2022 May 25;22(1):235. doi: 10.1186/s12886-022-02460-5.

ABSTRACT

BACKGROUND: Evaluate outcomes and identify prognostic factors in congenital aniridia.

METHODS: Retrospective interventional case series of patients with congenital aniridia treated between 2012-2020. Ocular examination and surgical details were collected. Surgical failure was defined as disease progression or need for additional surgery for same/related indication. Kaplan-Meier survival curves, Wilcoxon test, and univariate and multivariate linear regression analyses were performed.

RESULTS: Ninety-four patients with congenital aniridia presented at median 19.0 years. Two-thirds of patients underwent ≥ 1intraocular surgery, with average of 1.7 ± 2.3 surgeries/eye. At final follow-up (median 4.0 years), 45% of eyes had undergone lensectomy. Aphakic eyes showed worse visual acuity (VA) than phakic or pseudophakic eyes. Glaucoma affected 52% of eyes, of which half required IOP-lowering surgery. Glaucoma drainage devices showed the highest success rate (71%) at 14.2 ± 15.4 years of follow-up. Keratopathy affected 65% of eyes and one-third underwent corneal surgery. Keratoprosthesis had the longest survival rates at 10-years (64% with 95% CI [32,84]). LogMAR VA at presentation and final follow-up were not statistically different. Half of patients were legally blind at final follow-up. Final VA was associated with presenting VA, glaucoma diagnosis, and cataract or keratopathy at presentation. Penetrating keratoplasty and keratoprosthesis implantation correlated with worse BCVA.

CONCLUSIONS: Most aniridic patients in this large US-based cohort underwent at least 1 intraocular surgery. Cataract, glaucoma, and keratopathy were associated with worse VA and are important prognostic factors to consider when managing congenital aniridia.

PMID:35614435 | DOI:10.1186/s12886-022-02460-5

BMC Ecol Evol. 2022 May 25;22(1):70. doi: 10.1186/s12862-022-02024-7.

ABSTRACT

BACKGROUND: Inter-regional relationships between landscape factors and biological responses in natural conditions are important but difficult to predict because of the differences in each landscape context and local environment. To examine the inter-regional variability in relation to landscape factors and the biological response of an insect pest of rice, Stenotus rubrovittatus, we extrapolated a damage prediction model (the ‘original model’ of our previous study) for rice using land-use data. The ‘original model’ comprised as fixed factors the area of source habitat (i.e. pastures and graminoid-dominated fallow fields), soybean fields, and rice paddies within 300-m radii with research years as the random intercept. We hypothesized that the original model would be applicable to new regions, but the predictive accuracy would be reduced. We predicted that fitting a new extended model, adjusting the parameter coefficients of identical fixed factors of the ‘original model,’ and adding regional random intercepts would improve model performance (the ‘extended model’). A field experiment was conducted in two regions that had a similar landscape context with the original region, each in a different year of four years in total. The proportion of rice damage and surrounding land use within a 300-m radius was investigated, and the data were applied to the models and the applicability and accuracy of the models were examined.

RESULTS: When the ‘original model’ was assigned to the combined data from the original and extrapolated regions, the relationship between the observed and the predicted values was statistically significant, suggesting that there was an inter-regional common relationship. The relationship was not statistically significant if the model was applied only to the new regions. The extended model accuracy improved by 14% compared with the original model and was applicable for unknown data within the examined regions as demonstrated by three-fold cross validation.

CONCLUSIONS: These results imply that in this pest-crop system, there is likely to be a common inter-regional biological response of arthropods because of landscape factors, although we need to consider local environmental factors. We should be able to apply such relationships to identify or prevent pest hazards by offering region-wide management options.

PMID:35614432 | DOI:10.1186/s12862-022-02024-7

BMC Oral Health. 2022 May 25;22(1):203. doi: 10.1186/s12903-022-02233-y.

ABSTRACT

OBJECTIVE: The present study was designed to explore endurable pressure intensity of different paranasal sinus mucosa in goats.

METHOD: Mucosa commonly involved in maxillary sinus augmentation, including mucosa from maxillary sinus crest, maxillary sinus floor, and frontal sinus, were harvested in a computed tomography-guided manner. The obtained mucosa was then sectioned into square and irregular ones for maximum endurable pressure intensity determination and morphological observation, respectively.

RESULTS: Thickness of paranasal sinus mucosa, as determined under morphological staining by an optical microscope with a graduated eyepiece, were calculated. And the results showed that the average thickness of maxillary sinus crest mucosa, floor mucosa, and frontal sinus mucosa in goats were 410.03 ± 65.97 μm, 461.33 ± 91.37 μm and 216.90 ± 46.47 μm, respectively. Significant differences between maxillary sinus crest and frontal sinus, maxillary sinus floor, and frontal sinus were observed (P < 0.05). Maximum endurable pressure intensity was determined by utilizing a self-made clamp device and the results revealed maximum endurable pressure intensity of maxillary sinus crest mucosa, floor mucosa and frontal sinus mucosa in goats were 260.08 ± 80.12Kpa, 306.90 ± 94.37Kpa and 121.72 ± 31.72Kpa, respectively. Also, a statistically significant difference was observed when comparing the endurable pressure intensity between maxillary sinus crest and frontal sinus, maxillary sinus floor, and frontal sinus (P < 0.05). Further correlation analysis also revealed a positive correlation between the thickness of mucosa of the maxillary sinus and frontal sinus and maximum endurable pressure intensity (P < 0.05).

CONCLUSION: Mucosal thickness and maximum endurable pressure intensity of maxillary sinus crest and floor were larger than that of frontal sinus mucosa and a positive correlation between the thickness of mucosa and endurable pressure intensity was observed. Our results thus might provide an experimental basis and guidance for mucosa-related problems involved maxillary sinus augmentation.

PMID:35614431 | DOI:10.1186/s12903-022-02233-y

BMC Pulm Med. 2022 May 25;22(1):207. doi: 10.1186/s12890-022-01967-3.

ABSTRACT

BACKGROUND: Asbestosis and fibrotic hypersensitivity pneumonitis (FHP) share the pathogenetic mechanisms induced bronchiolocentric fibrotic process secondary to inhalation exposure. Under the occupational and environmental mixed exposures, asbestosis and FHP are needed to make the differential diagnoses on high-resolution computed tomography (HRCT), especially in the countries still using asbestos. The study aimed to analyze the HRCT features of asbestosis versus FHP.

METHODS: The patients with asbestosis or with HP were sequentially recruited in this comparative study at Beijing Chaoyang Hospital between January 2006 and December 2016. Patients’ clinical data were obtained from a predesigned charts. The international classification of HRCT for occupational and environmental respiratory diseases was used to categorize chest imaging findings in patients. The calculation of test statistics was used to compare the imaging features of asbestosis and FHP.

RESULTS: 341 patients with asbestosis and 158 patients with HP were sequentially recruited, among which 204 patients with asbestosis and 74 patients with FHP were eligible for data analysis. Patients with asbestosis were older and had a longer latent period until disease manifestation than those with FHP. Asbestosis was characterized by irregular and/or linear opacities, with lower lung preponderance, accompanied by ground-glass opacities and mosaic attenuation. Notably, 98.5% of patients with asbestosis showed benign pleural abnormalities, and 39.7% of these patients had diffuse pleural thickening with parenchymal bands and/or rounded atelectasis. Abnormalities of the mediastinal and diaphragmatic pleura were observed only in cases of asbestosis, and this finding showed high specificity for the diagnosis for asbestosis compared with that for FHP. Subpleural dots or diaphragmatic pleural abnormalities showed moderate sensitivity and high specificity for diagnosis of asbestosis compared with that for FHP. Interobserver reliability was good for evaluation of imaging findings including honeycombing, pleural calcification, lymphadenectasis, and lymph node calcification.

CONCLUSIONS: HRCT-based imaging findings can distinguish between asbestosis and FHP to a certain extent, particularly with regard to subpleural dots and diaphragmatic pleural abnormalities that characterize the former.

PMID:35614422 | DOI:10.1186/s12890-022-01967-3

J Am Chem Soc. 2022 May 25. doi: 10.1021/jacs.2c02836. Online ahead of print.

ABSTRACT

In this work, we synthesized an acrylamide-based terpolymer that is a block copolymer composed of an AB alternating copolymer and a C homopolymer. The key to the unprecedented achievement is rational design of an acrylate-acrylamide divinyl monomer carrying CF₃-substituted salicylic acid ester bonds (AAm-CF₃) to realize the efficient and selective cyclopolymerization as well as the quantitative transformation of the resultant cyclorepeating units. The selectivity in the cyclopolymerization and the pendant transformation ability were evaluated through reactivity ratios of the corresponding model monomers and quantitative aminolysis reactions of the model compound. The cyclopolymerization via the photoinduced electron transfer-reversible addition-fragmentation chain transfer (PET-RAFT) process with a macrochain-transfer agent and subsequent aminolysis reaction afforded the homopolymer-block-alternating copolymer. The sequence-controlled terpolymer exhibited a very unique thermal response behavior in water that was strikingly different from the corresponding sequence-uncontrolled terpolymers, such as homopolymer-block-statistical copolymers and all statistical terpolymers, despite the fact that the structure cannot be distinguished by ¹H NMR.

PMID:35613460 | DOI:10.1021/jacs.2c02836

Sud Med Ekspert. 2022;65(3):5-9. doi: 10.17116/sudmed2022650315.

ABSTRACT

The purpose of the study is to study the prevalence and frequency of sudden death (SD) from cardiovascular diseases (CVD) in the structure of non-violent death, taking into account the socio-economic development of the constituent entities of the Russian Federation. We analyzed the frequency of this indicator, compared it with the data of the Federal State Statistics Service, and determined the overall dynamics. We conducted a non-parametric analysis of the initial data, carried out clustering and visualization based on the following parameters of the initial sample: «CVD mortality in the structure of non-violent death», «morbidity» and «per capita income level». Correlation dependences of the level of mortality from CVD according to the form 42 on the indicated indicators of the socio-economic condition of the subject were determined. Identified subjects of the Russian Federation with an increase in mortality from CVD; established the dependence of the level of VS on CVD and a number of medical and economic indicators.

PMID:35613439 | DOI:10.17116/sudmed2022650315

JMIR Form Res. 2022 May 9. doi: 10.2196/35717. Online ahead of print.

ABSTRACT

BACKGROUND: To provide effective care for COVID-19 inpatients, clinical practitioners need systems that monitor patient health and subsequently allow for risk scoring. Existing approaches for risk scoring in COVID-19 patients focus primarily on intensive care units with specialized medical measurement devices, but not on hospital general wards.

OBJECTIVE: In this paper, we aim to develop a risk score for COVID-19 inpatients in general wards based on consumer-grade wearables (smartwatches).

METHODS: Patients wore consumer-grade wearables to record physiological measurements such as heart rate, heart rate variability, and respiration frequency. Based on Bayesian survival analysis, we validate the association between these measurements and the patient outcomes (i.e., discharge or intensive care unit admission). To build our risk score, we generate a low-dimensional representation of the physiological features. Subsequently, a pooled ordinal regression with time-dependent covariates infers the probability of either hospital discharge or intensive care unit (ICU) admission.

RESULTS: We evaluate the predictive performance of our developed system for risk scoring in a single-center, prospective study based on N = 40 inpatients with COVID-19 in a general ward of a tertiary referral center in Switzerland. First, the Bayesian survival analysis shows that physiological measurements from consumer-grade wearables are significantly associated with the patient outcomes (i.e., discharge or intensive care unit admission). Second, our risk score achieves a time-dependent area under the receiver operating characteristic curve of 0.73 to 0.90 based on leave-one-subject-out cross-validation.

CONCLUSIONS: Our results demonstrate the effectiveness of consumer-grade wearables for risk scoring in COVID-19 inpatients. Due to their low cost and ease of use, consumer-grade wearables could enable a scalable monitoring system.

CLINICALTRIAL: The study Wearable-based COVID-19 Markers for Prediction of Clinical Trajectories (WAVE) is registered at https://clinicaltrials.gov (Identifier: NCT04357834). The study followed the Declaration of Helsinki, the guidelines of good clinical practice, the Swiss health laws, and the ordinance on clinical research. The study was approved by the local ethics committee Bern, Switzerland (ID 2020-00874). Each patient gave informed written consent before any study-related procedure.

PMID:35613417 | DOI:10.2196/35717

J Clin Oncol. 2022 May 25:JCO2102558. doi: 10.1200/JCO.21.02558. Online ahead of print.

ABSTRACT

The approval of tisagenlecleucel and axicabtagene ciloleucel in 2017 marked a milestone in the development of oncology therapies. Since 2017, the breakthrough in treatment or even cure of previously intractable diseases represented by this new class of cancer treatments has continued with subsequent chimeric antigen receptor T (CAR T)-cell approvals. To date, the US Food and Drug Administration has approved five autologous CAR T-cell products for seven indications. A feature of autologous CAR T-cell products that differentiates them from traditional oncology drugs is that they need to be manufactured specifically for each patient. This feature has implications in study design, statistical analyses, and interpretation of study results. In this article, we share our experiences in the statistical review of CAR T-cell products and provide considerations for the design and statistical analyses of CAR T-cell trials. We also describe how the newly adopted estimand framework for clinical trials can help clarify nuanced issues in CAR T-cell trial design.

PMID:35613410 | DOI:10.1200/JCO.21.02558