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Nevin Manimala Statistics

Electronic Method (Pro-Kin) for Improving And Speeding up The Recovery after Ankle Sprain

Endocr Metab Immune Disord Drug Targets. 2022 May 23. doi: 10.2174/1871530322666220523155452. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Ankle sprains, very common injuries occurred especially during sports activities, are mainly caused by indirect trauma, which influences exaggerated stress exceeding the strength of stabilization mechanisms. Up to 85% of such injuries result from a sudden flexion and inversion of the foot. In this study, we analyzed the effectiveness of the platform Pro-kin, an innovative system that has given us the possibility to combine the functionality of the older proprioceptive boards with very accurate software in order to improve and accelerate the recovery after ankle injuries.

METHODS: 30 patients with moderate ankle sprain outcomes in two groups (A and B) were included in this study. Group A was only treated with proprioceptive exercises for 3 weeks, while the group B was trained with the innovative Pro-kin. In both groups, we evaluated VAS scale, the ratio between the number of circumductions performed by the injured foot and the time spent on doing them and the percentage of load among the injured and the healthy foot in statics and dynamics with electronic baropodometry. Our data has been collected at t0 (beginning of study), t1(one week later), t2 (two weeks later), t3 (one month later), t4 (two months later), and then analyzed by the two-way analysis of variance (2-way ANOVA) test.

RESULTS: At t0 no statistical differences of pain in the 2 groups (3.3 and 3.4); the values were similar, as well as at time t1, t2, t3 and t4. Therefore we deduce that Pro-kin treatment is not painful. The number of circumductions performed was definitely better in B group since the first week; for the A group the values considerably increased only at t3 (one month later). Comparing the load percentages on two feet detected by the electronic baropodometer in statics and in dynamics, we deduced that the patients of A group tend to lean mostly on the healthy foot than B group.

CONCLUSIONS: This study demonstrates that new technological resources (such as Pro-kin) may be helpful to improve and speed up the recovery of ankle sprain in athletes.

PMID:35616674 | DOI:10.2174/1871530322666220523155452

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Nevin Manimala Statistics

Assessment of Alternative Medicine Use, Costs, and Predictors of Medication Adherence among Diabetes Mellitus Patients in Palestine

Endocr Metab Immune Disord Drug Targets. 2022 May 23. doi: 10.2174/1871530322666220523114806. Online ahead of print.

ABSTRACT

BACKGROUND: Diabetes Mellitus (DM) is considered the fourth leading cause of death in Palestine, with a prevalence of 9.1% in patients aged 20-79 years, and is predicted to increase to 20.6% by 2020.

AIMS: This study aims to estimate DM costs, compare DM total health care cost among patient characteristics and DM management (e.g. Anti-diabetic medications and alternative medicine), as well as assess MA and its predictors including patient characteristics, DM management, alternative medicine use, and DM costs.

METHODS: A cross-sectional study was conducted for the past one year among 479 diabetic patients, selected by convenience sampling and snowball sampling methods via electronic post of an online questionnaire including a web link to the questionnaire page in a Google Form via email or public social media pages and applications. Data on patients’ socio-demographic and clinical characteristics, medication profile, use of medicinal plants as alternative medicine, costs, and Medication Adherence (MA) were collected. The Statistical Package for Social Sciences (SPSS v. 25) was used to perform a descriptive, Kolmogorov-Smirnov test, univariate analysis, Mann-Whitney or Kruskal-Wallis test, multiple linear regression, binary logistic regression, and multiple logistic regression analysis. A P value < 0.05 was considered statistically significant.

RESULTS: More than half of the participants were male and living in villages (50.7%, 59.1%, respectively). Approximately 51.4% received Oral Hypoglycemic Drugs (OHDs) and only 16.1% received insulin. The participants receiving ≤3 medications daily acquired the highest percentage (55.7%), and less than half received medicinal plants as an alternative medicine for the management of DM. The estimated total DM health care cost per 1 year incurred by patients and family members was Israeli Shekel 988,276 (US Dollar 307,590). More than half of the participants were considered adherent with the Eight-Item Morisky Medication Adherence Scale (MMAS-8) score ≥6. It is noteworthy that the use of alternative medicine was significantly associated with total health care cost and MA. Furthermore, DM duration was significantly associated with MA. These are results worth taking into consideration.

CONCLUSION: This study reflects the need for strengthening the patient-health care professionals’ relationship, and to enhance the role of preventive education, and the importance of awareness about MA, DSCMBs, and the use of alternative medicine based on evidence-based strategies to improve MA, glycemic control, meanwhile reducing the costs incurred by patients and family members.

PMID:35616669 | DOI:10.2174/1871530322666220523114806

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Nevin Manimala Statistics

The impact of an educational tool in cervix image registration across three imaging modalities

Br J Radiol. 2022 May 26:20211402. doi: 10.1259/bjr.20211402. Online ahead of print.

ABSTRACT

OBJECTIVES: Accurate image registration is vital in cervical cancer where changes in both planning target volume (PTV) and organs at risk (OAR) can make decisions regarding image registration complicated. This work aims to determine the impact of a dedicated educational tool compared with experience gained in MR guided radiotherapy (MRgRT).

METHODS: Ten therapeutic radiographers acted as observers and were split into two groups based on previous experience with MRgRT and Monaco treatment planning system. Three CBCT- CT, three MR-CT and two MR-MR registrations were completed per patient by each observer. Observers recorded translations, time to complete image registration and confidence. Data was collected in two phases; prior to and following the introduction of a cervix registration guide.

RESULTS: No statistically significant differences were noted between imaging modalities. Each group was assessed independently pre and post education, no statistically significant differences were noted in either CBCT-CT or MR-CT imaging. Group one MR-MR imaging showed a statistically significant reduction in inter-observer variability (p=0.04), in group two, the result was not statistically significant (p=0.06). Statistically significant increases in confidence were seen in all three modalities (p≤0.05).

CONCLUSIONS: At our institution radiographers consistently registered images across three different imaging modalities regardless of their previous experience. The implementation of an image registration guide had limited impact on inter and intra-observer variability. Radiographers’ confidence showed statistically significant improvements following the use of the registration manual.

ADVANCES IN KNOWLEDGE: This work helps evaluate training methods for novel roles that are developing in MRgRT.

PMID:35616660 | DOI:10.1259/bjr.20211402

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An integrative approach to predict severity in nonketotic hyperglycinemia

Ann Neurol. 2022 May 26. doi: 10.1002/ana.26423. Online ahead of print.

ABSTRACT

OBJECTIVE: Glycine encephalopathy, also known as nonketotic hyperglycinemia (NKH), is an inherited neurometabolic disorder with variable clinical course and severity, ranging from infantile epileptic encephalopathy to psychiatric disorders. A precise phenotypic characterization and an evaluation of predictive approaches are needed.

METHODS: Longitudinal clinical and biochemical data of 25 individuals with NKH from the patient registry of International Working Group on Neurotransmitter related Disorders were studied with in silico analyses, pathogenicity scores and molecular modeling of GLDC and AMT variants.

RESULTS: Symptom onset (p<0· 01) and diagnosis occur earlier in life in severe NKH (p<0· 01). Presenting symptoms affect the age at diagnosis. Psychiatric problems occur predominantly in attenuated NKH. Onset-age ≥3 months (66% specificity, 100% sensitivity, AUC = 0·87) and cerebrospinal fluid (CSF)/plasma glycine ratio ≤0· 09 (57% specificity, 100% sensitivity, AUC = 0·88) are sensitive indicators for attenuated NKH while CSF glycine concentration ≥116· 5 μmol/L (100% specificity, 93% sensitivity, AUC = 0·97) and CSF/plasma glycine ratio ≥0· 15 (100% specificity, 64% sensitivity, AUC = 0·88) are specific for severe forms. A ratio threshold of 0· 128 discriminates the overlapping range. We present ten new GLDC variants. Two mild variants resulted in attenuated, while two severe variants or one mild and one severe variant lead to severe phenotype. Based on clinical, biochemical and genetic parameter we propose a severity prediction model.

INTERPRETATION: This study widens the phenotypic spectrum of attenuated NKH and expands the number of pathogenic variants. The multiparametric approach provides a promising tool to predict disease severity, helping to improve clinical management strategies. This article is protected by copyright. All rights reserved.

PMID:35616651 | DOI:10.1002/ana.26423

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Nevin Manimala Statistics

Intracellular Aβ42 Aggregation Leads to Cellular Thermogenesis

J Am Chem Soc. 2022 May 26. doi: 10.1021/jacs.2c03599. Online ahead of print.

ABSTRACT

The aggregation of Aβ42 is a hallmark of Alzheimer’s disease. It is still not known what the biochemical changes are inside a cell which will eventually lead to Aβ42 aggregation. Thermogenesis has been associated with cellular stress, the latter of which may promote aggregation. We perform intracellular thermometry measurements using fluorescent polymeric thermometers to show that Aβ42 aggregation in live cells leads to an increase in cell-averaged temperatures. This rise in temperature is mitigated upon treatment with an aggregation inhibitor of Aβ42 and is independent of mitochondrial damage that can otherwise lead to thermogenesis. With this, we present a diagnostic assay which could be used to screen small-molecule inhibitors to amyloid proteins in physiologically relevant settings. To interpret our experimental observations and motivate the development of future models, we perform classical molecular dynamics of model Aβ peptides to examine the factors that hinder thermal dissipation. We observe that this is controlled by the presence of ions in its surrounding environment, the morphology of the amyloid peptides, and the extent of its hydrogen-bonding interactions with water. We show that aggregation and heat retention by Aβ peptides are favored under intracellular-mimicking ionic conditions, which could potentially promote thermogenesis. The latter will, in turn, trigger further nucleation events that accelerate disease progression.

PMID:35616634 | DOI:10.1021/jacs.2c03599

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Nevin Manimala Statistics

Remittances and Food Security in Bangladesh: An Empirical Country-level Analysis

Public Health Nutr. 2022 May 26:1-27. doi: 10.1017/S1368980022001252. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine the association between remittances and food security in Bangladesh, controlling for other key factors.

DESIGN: The secondary data analysis was performed on the most recent (2016) nationally representative Household Income and Expenditure Survey. We used logistic regression models to measure the association between food security of the household and remittances received. The household food security was measured based on expenditure on food items and the energy intake of the household members. The key explanatory variables included the receipt of remittances by the household and household-level socioeconomic characteristics.

SETTING: Bangladesh.

PARTICIPANTS: 45,977 households across 7 divisions of Bangladesh.

RESULTS: Findings suggested that remittances have a significant positive effect on food security. Further, the households with female heads were significantly more likely to be food insecure. The wealth status and geographical locations were significantly associated with food security status in Bangladesh.

CONCLUSIONS: The findings highlight the importance of considering remittance as one of the key factors while stakeholders implement nutritional interventions in Bangladesh and other low-income settings. Future research should consider this as an important determinant while further examining food security in such settings.

PMID:35616088 | DOI:10.1017/S1368980022001252

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Nevin Manimala Statistics

Gender differences in psychosocial characteristics and diabetes self-management among inner-city African Americans

Nurs Open. 2022 May 26. doi: 10.1002/nop2.1259. Online ahead of print.

ABSTRACT

AIMS: To characterize differences in psychosocial variables between inner-city African American men and women with type 2 diabetes, and to test if the relationships between psychosocial variables and diabetes self-management behaviours differ by gender.

DESIGN: Secondary analysis.

METHODS: We used baseline data from participants enrolled in the Prevention through Lifestyle Intervention and Numeracy 4 Success-Diabetes study (N = 37). Differences in psychosocial variables between genders were compared using chi-square tests. A two-way analysis of variance was then used to compare self-management scores by different psychosocial characteristics and gender.

RESULTS: There was no statistically significant difference in psychosocial characteristics between genders. High diabetes knowledge and self-efficacy were associated with better self-management behaviours in African American women but not in men. In contrast, high numeracy was associated with better diabetes self-management only in men. Low depression, high health literacy, and high social support were associated with better self-management practices in both genders.

PMID:35616066 | DOI:10.1002/nop2.1259

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Nevin Manimala Statistics

Serological markers of intestinal barrier impairment do not correlate with duration of diabetes and glycated hemoglobin in adult patients with type 1 and type 2 diabetes mellitus

Physiol Res. 2022 May 26. Online ahead of print.

ABSTRACT

Growing evidence suggests that diabetes mellitus is associated with impairment of the intestinal barrier. However, it is not clear so far if the impairment of the intestinal barrier is a consequence of prolonged hyperglycemia or the consequence of external factors influencing the gut microbiota and intestinal mucosa integrity. Aim of the study was to perform an estimation of relationship between serological markers of impairment of the intestinal barrier: intestinal fatty acid-binding protein (I-FABP), cytokeratin 18 caspase-cleaved fragment (cCK-18), and soluble CD14 (sCD14) and markers of prolonged hyperglycemia, such as the duration of diabetes mellitus and glycated hemoglobin (HbA1c) via a correlation analysis in patients with diabetes mellitus. In 40 adult patients with type 1 diabetes mellitus and 30 adult patients with type 2 diabetes mellitus the estimation has been performed. Statistically significant positive correlation was found between cCK-18 and HbA1c (r=0.5047, p=0.0275) in patients with type 1 diabetes mellitus with fading insulitis (T1D). In patients with type 1 diabetes mellitus with ongoing insulitis (T1D/INS) and in patients with type 2 diabetes mellitus (T2D), no statistically significant positive correlations were found between serological markers of intestinal barrier impairment (I-FABP, cCK-18, sCD14) and duration of diabetes or levels of HbA1c. Similarly, in cumulative cohort of patients with T1D/INS and patients with T1D we revealed statistically positive correlation only between HbA1c and cCK-18 (r=0.3414, p=0.0311). Surprisingly, we found statistically significant negative correlation between the duration of diabetes mellitus and cCK-18 (r=-0.3050, p=0.0313) only in cumulative group of diabetic patients (T1D, T1D/INS, and T2D). Based on our results, we hypothesize that the actual condition of the intestinal barrier in diabetic patients is much more dependent on variable interactions between host genetic factors, gut microbiota, and environmental factors rather than effects of long-standing hyperglycemia (assessed by duration of diabetes mellitus or HbA1c).

PMID:35616045

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Nevin Manimala Statistics

The fatty acid composition of serum phospholipids in adolescents is associated with body composition in early adulthoods: an eight-year follow-up study

Physiol Res. 2022 May 26. Online ahead of print.

ABSTRACT

The fatty acid composition is associated with obesity. Omega 3 polyunsaturated fatty acid (PUFA) could have a beneficial role in the prevention and treatment of many disorders, including cardiometabolic diseases. A cohort of 84 men and 131 women were examined in adolescence and after 8 years. Body weight (BW) and fat mass (FM) were measured. The composition of fatty acids (FAs) of serum phospholipids was assessed using gas chromatography. Statistics: PLS method. Aim: to determine the relationships between FAs in adolescence and FM (explanatoryvariable 1, EV1) and BW (explanatory variable 2, EV2) in adulthood. In the predictive models, a cluster of FAs in boys explained 47.2 % of EV1 and a cluster of 6 FAs in girls explained 32.3 % of EV1 measured in adulthood. FAs measured in adolescents explained 23.7 % of EV2 in early adults regardless of gender. A significant negative association was found between 18:1n-9c and EV1 in males and EV2 in both genders. We found a significant negative association between 18:2n-6 and 20:0 and both EV1 and EV2. In all analyses, we found a significant negative association of 20:1n-9 and 18:3n-3 with EV1-2 in both genders. A significant positive association was found in 20:3n-6 with EV1 and EV2 in males. 20:4n-6 was positively associated with EV1 in females and EV2 in both genders. A positive association between FM and very long chain n- 6 PUFAs was also observed. It is concluded that serum MUFAs and essential PUFAs in adolescence are associated with lower BW and FM in adulthood.

PMID:35616037

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Nevin Manimala Statistics

The impact of COVID-19 on a high-volume incident learning system: A retrospective analysis

J Appl Clin Med Phys. 2022 May 26:e13653. doi: 10.1002/acm2.13653. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this work was to assess how the coronavirus disease 2019 (COVID-19) pandemic impacted our incident learning system data and communicate the impact of a major exogenous event on radiation oncology clinical practice.

METHODS: Trends in our electronic incident reporting system were analyzed to ascertain the impact of the COVID-19 pandemic, including any direct clinical changes. Incident reports submitted in the 18 months prior to the pandemic (September 14, 2018 to March 13, 2020) and reports submitted during the first 18 months of the pandemic (March 14, 2020 to September 13, 2021) were compared. The incident reports include several data elements that were evaluated for trends between the two time periods, and statistical analysis was performed to compare the proportions of reports.

RESULTS: In the 18 months prior to COVID-19, 192 reports were submitted per 1000 planning tasks (n = 832 total). In the first 18 months of the pandemic, 147 reports per 1000 planning tasks were submitted (n = 601 total), a decrease of 23.4%. Statistical analysis revealed that there were no significant changes among the data elements between the pre- and during COVID-19 time periods. An analysis of the free-text narratives in the reports found that phrases related to pretreatment imaging were common before COVID-19 but not during. Conversely, phrases related to intravenous contrast, consent for computed tomography, and adaptive radiotherapy became common during COVID-19.

CONCLUSIONS: The data elements captured by our incident learning system were stable after the onset of the COVID-19 pandemic, with no statistically significant findings after correction for multiple comparisons. A trend toward fewer reports submitted for low-risk issues was observed. The methods used in the work can be generalized to events with a large-scale impact on the clinic or to monitor an incident learning system to drive future improvement activities.

PMID:35616007 | DOI:10.1002/acm2.13653