Tag: nevin manimala

J Orthop Trauma. 2023 Mar 23. doi: 10.1097/BOT.0000000000002602. Online ahead of print.

ABSTRACT

OBJECTIVES: To determine the infection and non-union rates for open tibia fracture treatment over the last four decades since the introduction of the Gustilo-Anderson (GA) open fracture classification.

DATA SOURCES: PubMed, Scopus, CINAHL, and Cochrane databases were reviewed using the PRISMA checklist for articles between 1977 and September 2018.

STUDY SELECTION: 161 articles meeting the following inclusion criteria: English language, published between 1977-2018, reported infection rates, reported nonunion rates and fractures classified by the GA open fracture criteria were selected.

DATA EXTRACTION: All articles were thoroughly evaluated to extract infection and nonunion data for open tibia fractures.Data Synthesis Due to variability in the data reviewed, statistical evaluation could not be reliably done.

RESULTS: 11,326 open tibia fractures were reported with 17% type I, 25.2% type II, 25.3% type IIIA, and 32.5% type IIIB/C. The average infection rate over four decades was 18.3%, with 24.3% superficial, 61% deep, and 14.7% pin tract. The infection rate by decade was: 14% for 1977-1986, 16.2% for 1987-1996, 20.5% for 1997-2006, and 18.1% from 2007-2017. The overall non-union rate was 14.1%. The non-union rate was 13% for 1977-1986, 17% for 1987-1996, 12.8% for 1997-2006, and 12.3% for 2007-2017.

CONCLUSIONS: This in-depth summary has demonstrated that the percentage rate for infections and nonunion has remained similar over the past forty years.

LEVEL OF EVIDENCE: Level IV. See Instructions for Authors for a complete description of levels of evidence.

PMID:36952593 | DOI:10.1097/BOT.0000000000002602

PLoS Comput Biol. 2023 Mar 23;19(3):e1010953. doi: 10.1371/journal.pcbi.1010953. Online ahead of print.

ABSTRACT

Mitochondria are highly dynamic organelles, containing vital populations of mitochondrial DNA (mtDNA) distributed throughout the cell. Mitochondria form diverse physical structures in different cells, from cell-wide reticulated networks to fragmented individual organelles. These physical structures are known to influence the genetic makeup of mtDNA populations between cell divisions, but their influence on the inheritance of mtDNA at divisions remains less understood. Here, we use statistical and computational models of mtDNA content inside and outside the reticulated network to quantify how mitochondrial network structure can control the variances of inherited mtDNA copy number and mutant load. We assess the use of moment-based approximations to describe heteroplasmy variance and identify several cases where such an approach has shortcomings. We show that biased inclusion of one mtDNA type in the network can substantially increase heteroplasmy variance (acting as a genetic bottleneck), and controlled distribution of network mass and mtDNA through the cell can conversely reduce heteroplasmy variance below a binomial inheritance picture. Network structure also allows the generation of heteroplasmy variance while controlling copy number inheritance to sub-binomial levels, reconciling several observations from the experimental literature. Overall, different network structures and mtDNA arrangements within them can control the variances of key variables to suit a palette of different inheritance priorities.

PMID:36952562 | DOI:10.1371/journal.pcbi.1010953

PLoS One. 2023 Mar 23;18(3):e0276673. doi: 10.1371/journal.pone.0276673. eCollection 2023.

ABSTRACT

Poverty is a big threat to prosperity in developing countries like Pakistan. Alleviating poverty needs concerted efforts including how to measure and analyze poverty. Therefore, this paper employs synthetic panel technique and uses repeated cross-sections household survey dataset (Household Integrated and Economic Survey (HIES)) of Pakistan for 2010-11 and 2015-16, to derive poverty bounds for Pakistan. The findings of the paper suggest that 17% of population still remains in poverty in 2015-16 as they were in 2010-11. They don’t move in or out of poverty. In the same periods 19% population affected by poverty. The 2.5% poor’s of 2010-11 moves out of poverty in 2015-16. This constitutes the first attempt to provide an insight into poverty dynamics in Pakistan using the available survey data.

PMID:36952554 | DOI:10.1371/journal.pone.0276673

PLoS One. 2023 Mar 23;18(3):e0283334. doi: 10.1371/journal.pone.0283334. eCollection 2023.

ABSTRACT

An in-depth analysis of the epidemiological patterns of TB/HIV co-infection is essential since it helps to target high-risk areas with effective control measures. The main objective of this study was to assess the spatial clustering of TB/HIV co-infection prevalence in Ethiopia for the year 2018 using district-level aggregated TB and HIV data obtained from the Ethiopian Federal Ministry of Health. The global Moran’s index, Getis-Ord [Formula: see text] local statistic, and Bayesian spatial modeling techniques were applied to analyse the data. The result of the study shows that TB among people living with HIV (PLHIV) and HIV among TB patients prevalence were geographically heterogeneous. The highest prevalence of TB among PLHIV in 2018 was reported in the Gambella region (1.44%). The overall prevalence of TB among PLHIV in Ethiopia in the same year was 0.38% while the prevalence of HIV among TB patients was 6.88%. Both district-level prevalences of HIV among TB patients and TB among PLHIV were positively spatially autocorrelated, but the latter was not statistically significant. The local indicators of spatial analysis using the Getis-Ord statistic also identified hot-spots districts for both types of TB/HIV co-infection data. The results of Bayesian spatial logistic regression with spatially structured and unstructured random effects using the Besag, York, and Mollié prior showed that not all the heterogeneities in the prevalence of HIV among TB patients and TB among PLHIV were explained by the spatially structured random effects. This study expanded knowledge about the spatial clustering of TB among PLHIV and HIV among TB patients in Ethiopia at the district level in 2018. The findings provide information to health policymakers in the country to plan geographically targeted and integrated interventions to jointly control TB and HIV.

PMID:36952538 | DOI:10.1371/journal.pone.0283334

PLoS One. 2023 Mar 23;18(3):e0283593. doi: 10.1371/journal.pone.0283593. eCollection 2023.

ABSTRACT

Early proper nutritional support is important to critically ill patients. Nutritional support is also associated with clinical outcomes of neurocritically ill patients. We investigate whether early nutrition is associated with clinical outcomes in neurocritically ill patients. This was a retrospective, single-center, observational study including neurosurgical patients who were admitted to the intensive care unit (ICU) from January 2013 to December 2019. Patients who started enteral nutrition or parenteral nutrition within 72 hours after ICU admission were defined as the early nutrition group. The primary endpoint was in-hospital mortality. The secondary endpoint was an infectious complication. Propensity score matching (PSM) and propensity score weighting overlap weights (PSOW) were used to control selection bias and confounding factors. Among 1,353 patients, early nutrition was performed in 384 (28.4%) patients: 152 (11.2%) early enteral nutrition (EEN) and 232 (17.1%) early parenteral nutrition (EPN). In the overall study population, the rate of in-hospital mortality was higher in patients with late nutrition than in those with early nutrition (P<0.001). However, there was no significant difference in in-hospital mortality and infectious complications incidence between the late and the early nutrition groups in the PSM and PSOW adjusted population (all P>0.05). In the overall study population, EEN patients had a low rate of in-hospital mortality and infectious complications compared with those with EPN and late nutrition (P<0.001 and P = 0.001, respectively). In the multivariable analysis of the overall, PSM adjusted, and PSOW adjusted population, there was no significant association between early nutrition and in-hospital mortality and infectious complications (all P>0.05), but EEN was significantly associated with in-hospital mortality and infectious complications (all P<0.05). Eventually, early enteral nutrition may reduce the risk of in-hospital mortality and infectious complications in neurocritically ill patients.

PMID:36952527 | DOI:10.1371/journal.pone.0283593

PLoS One. 2023 Mar 23;18(3):e0282634. doi: 10.1371/journal.pone.0282634. eCollection 2023.

ABSTRACT

INTRODUCTION: 3D Non-Contact surface scanning (3DSS) is used in both biomechanical and clinical studies to capture accurate 3D images of the human torso, and to better understand the shape and posture of the spine-both healthy and pathological. This study sought to determine the efficacy and accuracy of using 3DSS of the posterior torso, to determine the curvature of the spinal column in the lateral lying position.

METHODS: A cohort of 50 healthy adults underwent 3DSS and Magnetic Resonance Imaging (MRI) to correlate the contours of the external spine surface with the internal spinal column. The correlation analysis was composed of two phases: (1) MRI vertebral points vs MRI external spine surface markers; and (2) MRI external spine surface markers vs 3DSS external spine surface markers. The first phase compared the profiles of fiducial markers (vitamin capsules) adhered to the skin surface over the spinous processes against the coordinates of the spinous processes-assessing the linear distance between the profiles, and similarity of curvature, in the sagittal and coronal planes. The second phase compared 3DSS external spine surface markers with the MRI external spine surface markers in both planes, with further qualitative assessment for postural changes.

RESULTS: The distance between the MRI vertebral points and MRI external spine surface markers showed strong statistically significant correlation with BMI in both sagittal and coronal planes. Kolmogorov-Smirnov (KS) tests showed similar no significant difference in curvature, k, in almost all participants on both planes. In the second phase, the coronal 3DSS external spine surface profiles were statistically different to the MRI external spine surface markers in 44% of participants. Qualitative assessment showed postural changes between MRI and 3DSS measurements in these participants.

CONCLUSION: These study findings demonstrate the utility and accuracy of using anatomical landmarks overlaid on the spinous processes, to identify the position of the spinal bones using 3DSS. Using this method, it will be possible to predict the internal spinal curvature from surface topography, provided that the thickness of the overlaying subcutaneous adipose layer is considered, thus enabling postural analysis of spinal shape and curvature to be carried out in biomechanical and clinical studies without the need for radiographic imaging.

PMID:36952526 | DOI:10.1371/journal.pone.0282634

PLoS One. 2023 Mar 23;18(3):e0283462. doi: 10.1371/journal.pone.0283462. eCollection 2023.

ABSTRACT

BACKGROUND: The COVID-19 pandemic has brought significant changes worldwide, and due to the strict “Social Distancing Plan” including school closures, Korean adolescents have experienced unprecedented changes in their lives. Considering the peer effect on adolescents’ health behavior impacted due to the changes brought about by the pandemic, it would be interesting to explore differences in substance use in Korean adolescents. This study examines how these risk behaviors among Korean adolescents have changed before and during the COVID-19 pandemic.

METHODS: Korea Youth Risk Behavior Web-based Survey of 87,532 adolescents was used to collect the data for the period 2019, 2020, and 2021. The KYRBWS is conducted by a national institution which uses a stratified two-stage cluster sampling, and the data is statistically reliable and representative of the population. The Cochran-Armitage and Chi-squared test for linear and non-linear time trends, respectively, were calculated to assess the difference across the period (2019, 2020, 2021). Also, the odds ratios (ORs) with 95% CIs for current smoking status and current alcohol use status among 2020 and 2021 participants were compared with those of the 2019 participants using multiple logistic regression analysis.

RESULTS: The degree of current smoking status was lower in 2020 and 2021 participants than in the 2019 participants (2020: OR = 0.66, 95% CI = 0.61-0.71; 2021: OR = 0.66, 95% CI = 0.61-0.71). On the same token, current alcohol use status was also lower in the participants during the pandemic than those before the pandemic (2020: OR = 0.70, 95% CI = 0.66-0.73; 2021: OR = 0.70, 95% CI = 0.66-0.73).

CONCLUSION: This study found that alcohol and tobacco use were reduced among Korean adolescents during the COVID-19 pandemic. Despite the decrease, future research on the potential effects of the COVID-19 pandemic on adolescents is warranted.

PMID:36952498 | DOI:10.1371/journal.pone.0283462

PLoS One. 2023 Mar 23;18(3):e0283146. doi: 10.1371/journal.pone.0283146. eCollection 2023.

ABSTRACT

INTRODUCTION: Heart failure is a growing public health concern around the world. People with heart failure have a high symptom burden, such as depression, which affects health-related quality of life (HRQoL). The objective of this systematic review and meta-analysis was to estimate the pooled prevalence of depression and evaluate its association with HRQoL among people with heart failure in low- and middle-income countries (LMICs).

METHODS: This systematic review was conducted in accordance with the JBI methodology. Electronic databases such as MEDLINE, PsycINFO, EMBASE, CINAHL, Web of Science, Scopus and JBI EBP were searched to identify relevant studies published from January 2012 to August 2022. The methodological quality of each article was assessed using relevant JBI critical appraisal instruments. A random-effects model was employed to estimate the pooled prevalence of depression. Heterogeneity across the studies was investigated using Cochrane’s Q test and I2 statistic. The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines 2020 were followed for reporting the results. All statistical analyses were performed using STATA version 17 software.

RESULTS: After screening, a total of 21 eligible articles with 5074 participants with heart failure were included in this review. The pooled prevalence of depression among people with heart failure in LMICs was 51.5% (95% CI = 39.7, 63.3%, I2 = 99.00%). Subgroup analysis revealed, the highest prevalence in studies whose participants were in-patients, and from the Middle East and North Africa, and studies utilizing Becks Depression Inventory (BDI). Depression was positively associated with HRQoL.

CONCLUSION: This review revealed that almost half of all people with heart failure in low- and middle-income countries have comorbid depression. People with heart failure and depressive symptoms had poor HRQoL. Therefore, early screening of depression is critical for improving HRQoL in this population. Systematic review registration: PROSPERO CRD42022361759.

PMID:36952483 | DOI:10.1371/journal.pone.0283146

PLoS One. 2023 Mar 23;18(3):e0283156. doi: 10.1371/journal.pone.0283156. eCollection 2023.

ABSTRACT

BACKGROUND: Primary healthcare (PHC) systems attain improved health outcomes and fairness and are affordable. However, the proportion of PHC spending to Total Current Health Expenditure in Kenya reduced from 63.4% in 2016/17 to 53.9% in 2020/21 while external funding reduced from 28.3% (Ksh 69.4 billion) to 23.9% (Ksh 68.2 billion) over the same period. This reduction in PHC spending negatively affects PHC performance and the overall health system goals.

METHODS: We conducted a cost-benefit analysis and computed costs against the economic benefits of a PHC scale-up. Activity-Based Costing (ABC) on the provider perspective was employed to estimate the incremental costs. The OneHealth Tool was used to estimate the health impact of operationalizing PHC over five years. Finally, we quantified Return on Investment (ROI) by estimating monetized DALYs based on a constant value per statistical life year (VSLY) derived from a VSL estimate.

RESULTS: The total projected cost of PHC interventions in the Kenya was Ksh 1.65 trillion (USD 15,581.91 billion). Human resource was the main cost driver accounting for 75% of the total cost. PHC investments avert 64,430,316 Disability Adjusted Life-Years (DALYs) and generate cost savings of Ksh. 21.5 trillion (USD 204.4 Billion) over five years. Shifting services from high-level facilities to PHC facilities generates Ksh 198.2 billion (USD 1.9 billion) and yields a benefit-cost ratio of 16:1 in 5 years. Thus, every $1 invested in PHC interventions saves up to $16 in spending on conditions like stunting, NCDs, anaemia, TB, Malaria, and maternal and child health morbidity.

CONCLUSIONS: Evidence of the economic benefits of continued prioritization of funding for PHC can strengthen the advocacy argument for increased domestic and external financing of PHC in Kenya. A well-resourced and functional PHC system translates to substantial health benefits with positive economic benefits. Therefore, governments and stakeholders should increase investments in PHC to accelerate economic growth.

PMID:36952482 | DOI:10.1371/journal.pone.0283156

PLoS One. 2023 Mar 23;18(3):e0280248. doi: 10.1371/journal.pone.0280248. eCollection 2023.

ABSTRACT

BACKGROUND: Socioeconomic status (SES) is an important determinant of screen time (ST) in children and adolescents, however, the association between SES and ST is not fully understood in China. This study aimed to investigate the association between SES and ST (operationalized as meeting the ST guidelines; no more than 2 hours per day) in Chinese children and adolescents.

METHODS: Cross-sectional data of 2,955 Chinese children and adolescents aged 8 to 17(53.4% girls) were used. SES was measured using indicators of parental education and perceived family wealth. ST was assessed with detailed items from the Health Behaviour School-aged Children survey questionnaires. Descriptive statistics and a Chi-square test were used to report the sample characteristics and analyse ST differences across different sociodemographic groups. A binary logistic regression was then applied to analyse the association of SES indicators with ST in children and adolescents.

RESULTS: Overall, 25.3% of children and adolescents met the ST guidelines. Children and adolescents with higher parental education levels were 1.84 [95% CI 1.31-2.57; father] and 1.42 [95% CI 1.02-1.98; mother] times more likely to meet the ST guidelines than those with lower parental education levels. Associations between SES and ST varied across sex and grade groups. Moreover, the associations of SES with ST on weekdays and weekends were different.

CONCLUSIONS: This study demonstrated the association between SES and ST in children and adolescents, highlighting the importance of targeting children and adolescents with low SES levels as an intervention priority. Based on our findings, specific interventions can be tailored to effectively reduce ST. Future studies are encouraged to use longitudinal or interventional designs to further determine the association between SES and ST.

PMID:36952470 | DOI:10.1371/journal.pone.0280248