Tag: nevin manimala

J Acquir Immune Defic Syndr. 2023 Mar 27. doi: 10.1097/QAI.0000000000003193. Online ahead of print.

ABSTRACT

BACKGROUND: In Zambia, half of children and adolescents living with HIV (CALWH) on antiretroviral therapy (ART) are virologically unsuppressed. Depressive symptoms are associated with ART non-adherence but have received insufficient attention as mediating factors in the relationship between HIV self-management and household-level adversities. We aimed to quantify theorized pathways from indicators of household adversity to ART adherence, partially mediated by depressive symptoms, among CALWH in two Zambian provinces.

SETTING: In July-September 2017, we enrolled 544 CALWH aged 5-17 years and their adult caregivers into a year-long prospective cohort study.

METHODS: At baseline, CALWH-caregiver dyads completed an interviewer-administered questionnaire, which included validated measures of recent (past 6 months) depressive symptomatology and self-reported past-month ART adherence (never versus sometimes or often missing medication doses). We used structural equation modeling with theta parameterization to identify statistically significant (p<0.05) pathways from household adversities (past-month food insecurity, caregiver self-reported health) to depression (modeled latently), ART adherence, and poor physical health in the past 2 weeks.

RESULTS: Most CALWH (mean age: 11 years, 59% female) exhibited depressive symptomatology (81%). In our structural equation model, food insecurity significantly predicted elevated depressive symptomatology (ß = 0.128), which was associated inversely with daily ART adherence (ß = -0.249) and positively with poor physical health (ß = 0.359). Neither food insecurity nor poor caregiver health were directly associated with ART non-adherence or poor physical health.

CONCLUSIONS: Using structural equation modeling, we found that depressive symptomatology fully mediated the relationship between food insecurity, ART non-adherence, and poor health among CALWH.

PMID:36976552 | DOI:10.1097/QAI.0000000000003193

Med Sci (Basel). 2023 Mar 17;11(1):24. doi: 10.3390/medsci11010024.

ABSTRACT

Persistent pleural effusions (PPEf) represent a known complication of orthotopic liver transplant (OLT). However, their clinical relevance is not well described. We evaluated the clinical, biochemical, and cellular characteristics of post-OLT PPEf and assessed their relationship with longitudinal outcomes. We performed a retrospective cohort study of OLT recipients between 2006 and 2015. Included patients had post-OLT PPEf, defined by effusion persisting >30 days after OLT and available pleural fluid analysis. PPEf were classified as transudates or exudates (Exud^Light) by Light’s criteria. Exudates were subclassified as those with elevated lactate dehydrogenase (Exud^LDH) or elevated protein (Exud^Prot). Cellular composition was classified as neutrophil- or lymphocyte-predominant. Of 1602 OLT patients, 124 (7.7%) had PPEf, of which 90.2% were Exud^Light. Compared to all OLT recipients, PPEf patients had lower two-year survival (HR 1.63; p = 0.002). Among PPEf patients, one-year mortality was associated with pleural fluid RBC count (p = 0.03). While Exud^Light and Exud^Prot showed no association with outcomes, Exud^LDH were associated with increased ventilator dependence (p = 0.03) and postoperative length of stay (p = 0.03). Neutrophil-predominant effusions were associated with increased postoperative ventilator dependence (p = 0.03), vasopressor dependence (p = 0.02), and surgical pleural intervention (p = 0.02). In summary, post-OLT PPEf were associated with increased mortality. Ninety percent of these effusions were exudates by Light’s criteria. Defining exudates using LDH only and incorporating cellular analysis, including neutrophils and RBCs, was useful in predicting morbidity.

PMID:36976532 | DOI:10.3390/medsci11010024

Med Sci (Basel). 2023 Mar 3;11(1):22. doi: 10.3390/medsci11010022.

ABSTRACT

BACKGROUND: Atrial fibrillation is the most common clinically significant cardiac arrhythmia, and it might lead to heart failure, which prolongs the duration of hospitalization and consequently increases the cost of treatment. Thus, diagnosing and treating atrial fibrillation should be the first line of defense against further complications. This study aimed to determine the incidence rate of postoperative atrial fibrillation and correlation with cardiac surgery on heart valves. A specific aim was to determine the relationship between the prevalence of atrial fibrillation and socio-demographic features.

METHODS: The study has a prospective cross-sectional design. The questionnaire was anonymous, requesting socio-demographic information as inclusion criteria, and the data were analyzed using descriptive statistics methods.

RESULTS: The sample was 201 patients. χ² test and t-test were performed where we found that the frequency of atrial fibrillation was higher in the groups that have had valve surgery compared to other cardiac surgeries (χ² = 7.695, ss = 2, p = 0.021). Atrial fibrillation increased with the age of the patients, but the prevalence of atrial fibrillation was not correlated with body weight.

CONCLUSION: The results of this this study show that atrial fibrillation was higher in the participants who had valve surgery compared to other cardiac surgeries. There was also an increase in atrial fibrillation in the older participants. The results of this study can help to improve nursing practice and the quality of care for cardiac surgery patients with regard to daily activities, or planning nursing care due to the patient’s condition.

PMID:36976530 | DOI:10.3390/medsci11010022

J Mol Neurosci. 2023 Mar 28. doi: 10.1007/s12031-023-02109-y. Online ahead of print.

ABSTRACT

This study evaluates the range of neurological manifestation in children with COVID-19 (neuro-COVID-19) both with and without the multisystem inflammatory syndrome (MIS-C) and the persistence of symptoms after hospital discharge. The study was conducted as a prospective study of children and adolescents under 18 years of age who were admitted to a children’s hospital for infectious diseases from January 2021 to January 2022. The children had no previous neurological or psychiatric disorders. Out of the 3021 patients evaluated, 232 were confirmed to have COVID-19 and 21 of these patients (9%) showed neurological manifestations associated with the virus. Of these 21 patients, 14 developed MIS-C, and 7 had neurological manifestations unrelated to MIS-C. There was no statistical difference regarding the neurological manifestations during hospitalization and outcomes between patients with neuro-COVID-19 who had or did not have MIS-C, except for seizures that occurred more frequently in patients with neuro-COVID-19 without MIS-C (p-value = 0.0263). One patient died, and 5 patients still had neurological or psychiatric manifestations at discharge, which persisted for up to 7 months. The study highlights that SARS-CoV-2 infection can affect the central and peripheral nervous system, particularly in children and adolescents with MIS-C, and that it is crucial to be vigilant for long-term adverse outcomes, as the neurological and psychiatric effects of COVID-19 in children are emerging during an important stage of brain development.

PMID:36976476 | DOI:10.1007/s12031-023-02109-y

CNS Drugs. 2023 Mar 28. doi: 10.1007/s40263-023-00997-7. Online ahead of print.

ABSTRACT

AIM: To compare safety and functional outcomes of intravenous thrombolysis (IVT) between females and males with acute ischaemic stroke (AIS) in relation to preadmission use of antiplatelets.

METHODS: Multicentre cohort study of patients admitted from 1 January 2014 to 31 January 2020 to hospitals participating in the Swiss Stroke Registry, presenting with AIS and receiving IVT. Primary safety outcome was in-hospital symptomatic intracerebral haemorrhage (sICH). Primary functional outcome was functional independence at 3 months after discharge. Multivariable logistic regression models were fitted to assess the association between sex and each outcome according to preadmission use of antiplatelets.

RESULTS: The study included 4996 patients (42.51 % females, older than males, median age 79 vs 71 years, p < 0.0001). Comparable proportions of females (39.92 %) and males (40.39 %) used antiplatelets before admission (p = 0.74). In total, 3.06 % females and 2.47 % males developed in-hospital sICH (p = 0.19), with similar odds (adjusted odds ratio, [AOR] 0.93, 95 % confidence interval, [CI] 0.63-1.39). No interaction was found between sex and preadmission use of either single or dual antiplatelets in relation to in-hospital sICH (p = 0.94 and p = 0.23). Males had higher odds of functional independence at 3 months (AOR 1.34, 95 % CI 1.09-1.65), regardless of preadmission use of antiplatelets (interaction between sex and preadmission use of either single or dual antiplatelets p = 0.41 and p = 0.58).

CONCLUSION: No sex differences were observed in the safety of IVT regarding preadmission use of antiplatelets. Males showed more favourable 3-month functional independence than females; however, this sex difference was apparently not explained by a sex-specific mechanism related to preadmission use of antiplatelets.

PMID:36976463 | DOI:10.1007/s40263-023-00997-7

Angew Chem Int Ed Engl. 2023 Mar 28:e202303339. doi: 10.1002/anie.202303339. Online ahead of print.

ABSTRACT

This invited Team Profile was created by the Tiwary group, University of Maryland, College Park (USA) and the Seeliger group, Stony Brook University, New York (USA). They recently published an article on the previously made observation through in-cell screening that the blockbuster cancer drug Gleevec has the same binding affinity, yet different dissociation kinetics against wild-type and N368S-mutated Abl kinase. Through all-atom enhanced molecular dynamics simulations guided by statistical mechanics and information theory, they were able to explain the mechanistic basis of this perplexing observation. Their work has ramifications for how pharmaceutical drugs might experience kinetic resistance due to mutations. “Protein Flexibility and Dissociation Pathway Differentiation Can Explain Onset of Resistance Mutations in Kinases”, M. Shekhar, Z. Smith, M. A. Seeliger, P. Tiwary, Angew. Chem. Int. Ed. 2022, e202200983; Angew. Chem. 2022, e202200983.

PMID:36976457 | DOI:10.1002/anie.202303339

Drug Saf. 2023 Mar 28. doi: 10.1007/s40264-023-01291-7. Online ahead of print.

ABSTRACT

INTRODUCTION AND OBJECTIVE: The risks and benefits of medication use in pregnancy are typically established through post-marketing observational studies. As there is currently no standardised or systematic approach to the post-marketing assessment of medication safety in pregnancy, data generated through pregnancy pharmacovigilance (PregPV) research can be heterogenous and difficult to interpret. The aim of this article is to describe the development of a reference framework of core data elements (CDEs) for collection in primary source PregPV studies that can be used to standardise data collection procedures and, thereby, improve data harmonisation and evidence synthesis capabilities.

METHODS: This CDE reference framework was developed within the Innovative Medicines Initiative (IMI) ConcePTION project by experts in pharmacovigilance, pharmacoepidemiology, medical statistics, risk-benefit communication, clinical teratology, reproductive toxicology, genetics, obstetrics, paediatrics, and child psychology. The framework was produced through a scoping review of data collection systems used by established PregPV datasets, followed by extensive discussion and debate around the value, definition, and derivation of each data item identified from these systems.

RESULTS: The finalised listing of CDEs comprises 98 individual data elements, arranged into 14 tables of related fields. These data elements are openly available on the European Network of Teratology Information Services (ENTIS) website ( http://www.entis-org.eu/cde ).

DISCUSSION: With this set of recommendations, we aim to standardise PregPV primary source data collection processes to improve the speed at which high-quality evidence-based statements can be provided about the safety of medication use in pregnancy.

PMID:36976447 | DOI:10.1007/s40264-023-01291-7

Acta Parasitol. 2023 Mar 28. doi: 10.1007/s11686-023-00670-5. Online ahead of print.

ABSTRACT

PURPOSE: Pastoralists regularly come in contact with ticks as they herd their animals and are exposed to pathogens that cause zoonotic diseases. No study has been conducted in Nigeria to evaluate the knowledge, attitudes, and practices (KAP) of these Pastoralists towards ticks, tick bite, and tick control, and thus this research.

METHODS: A KAP survey of pastoralists (n = 119) was conducted in Plateau State, Nigeria. Data generated were analysed using Statistical Package for Social Sciences (SPSS).

RESULTS: The majority of the pastoralists (99.2%) had knowledge of ticks, with 79% of them being aware that ticks attach and bite humans, whereas only 30.3% believed that ticks transmit diseases to humans. Eighty-four per cent of the pastoralists do not wear protective clothing while herding their animals and 81.5% indicated to having been bitten by ticks, whereas hospital visit after tick bite was low (7.6%). Statistically significant variables were observed when knowledge of the respondents were compared in relation to the ability of ticks to cause diseases (Χ² = 9.980, P = 0.007); hospital visit after a bite (Χ² = 11.453, P = 0.003); and the use of protective clothing for herding (Χ² = 22.596, P = 0). The main tick control measure was hand picking (58.8%).

CONCLUSIONS: The pastoralists were unaware of the ability of ticks to transmit zoonotic pathogens. Preventive practices were insufficient to reduce tick bites, and thus were constantly exposed to tick-borne diseases. This study hopes to provide important insights for the development of educational awareness programmes for the pastoralists and serve as a guide for the health workers in designing future preventive programmes against tick-borne zoonoses in Nigeria.

PMID:36976439 | DOI:10.1007/s11686-023-00670-5

Neuroinformatics. 2023 Mar 28. doi: 10.1007/s12021-023-09626-6. Online ahead of print.

ABSTRACT

Activation likelihood estimation (ALE) is among the most used algorithms to perform neuroimaging meta-analysis. Since its first implementation, several thresholding procedures had been proposed, all referred to the frequentist framework, returning a rejection criterion for the null hypothesis according to the critical p-value selected. However, this is not informative in terms of probabilities of the validity of the hypotheses. Here, we describe an innovative thresholding procedure based on the concept of minimum Bayes factor (mBF). The use of the Bayesian framework allows to consider different levels of probability, each of these being equally significant. In order to simplify the translation between the common ALE practice and the proposed approach, we analised six task-fMRI/VBM datasets and determined the mBF values equivalent to the currently recommended frequentist thresholds based on Family Wise Error (FWE). Sensitivity and robustness toward spurious findings were also analyzed. Results showed that the cutoff log₁₀(mBF) = 5 is equivalent to the FWE threshold, often referred as voxel-level threshold, while the cutoff log₁₀(mBF) = 2 is equivalent to the cluster-level FWE (c-FWE) threshold. However, only in the latter case voxels spatially far from the blobs of effect in the c-FWE ALE map survived. Therefore, when using the Bayesian thresholding the cutoff log₁₀(mBF) = 5 should be preferred. However, being in the Bayesian framework, lower values are all equally significant, while suggesting weaker level of force for that hypothesis. Hence, results obtained through less conservative thresholds can be legitimately discussed without losing statistical rigor. The proposed technique adds therefore a powerful tool to the human-brain-mapping field.

PMID:36976430 | DOI:10.1007/s12021-023-09626-6

Environ Monit Assess. 2023 Mar 28;195(4):517. doi: 10.1007/s10661-023-11143-7.

ABSTRACT

Considering the importance of limited natural resources, accurately recording and evaluating temperature data is critical. The daily average temperature values obtained for the years 2019-2021 of eight highly correlated meteorological stations, characterized by mountainous and cold climate features in the northeast of Turkey, were analyzed by an artificial neural network (ANN), support vector regression (SVR), and regression tree (RT) methods. Output values produced by different machine learning methods compared with different statistical evaluation criteria and the Taylor diagram. ANN6, ANN12, medium gaussian SVR, and linear SVR were chosen as the most suitable methods, especially due to their success in estimating data at high (> 15 ℃) and low (< 0 ℃) temperatures. All the methodologies and network architectures used produced successful results (NSE-R² > 0.90). Some deviations have been observed in the estimation results due to the decrease in the amount of heat emitted from the ground due to fresh snow, especially in the -1 ~ 5 ℃ range, where snowfall begins, in the mountainous areas characterized by heavy snowfall. In models with low neuron numbers (ANN1,2,3) in ANN architecture, the increase in the number of layers does not affect the results. However, the increase in the number of layers in models with high neuron counts positively affects the accuracy of the estimation.

PMID:36976414 | DOI:10.1007/s10661-023-11143-7