Tag: nevin manimala

J Int Assoc Provid AIDS Care. 2022 Jan-Dec;21:23259582221121096. doi: 10.1177/23259582221121096.

ABSTRACT

Background: Drug adherence is the most significant in the progression of diseases. Thus, this study aimed to assess adherence and associated factors among seropositive people received treatment. Methods: Facility-based cross-sectional study was conducted in Jimma town public health facility from March to April 2019 on 385 selected participants. Systematic sampling technique was used to select study participants. The data were entered using Epi-data version 4.1 and analyzed by SPSS version 20 software. Variables with p-value of less than 0.25 in binary logistic regression were entered into the multivariable logistic regression to control cofounding A significance level of less than 0.05 was used in the final model to judge statistical significance. Results: The magnitude of adherence to antiretroviral treatment was 69.4%. Food security (AOR = 1.75 (95% CI;(1.01-3.0), substance abuse (AOR = 0.55 (95% CI;(0.32-0.96), Didn’t take other medications (AOR = 2.11(95%CI;(1.15-3.87), Good relationship with providers (AOR = 3.35(95%CI;(1.55-7.2), and irregular appointment (AOR = 0.19(95%CI; (0.11-0.34) were significantly associated. Conclusion: The magnitude of adherence to Anti-retroviral therapy was low compare to WHO. Food security, substance abuse, use of other medication, relationship with the health care providers, and irregular appointment were the factors associated. Treatment. Therefore, it is recommended that patients and health care workers enhance Antiretroviral Treatment adherence.

PMID:35975573 | DOI:10.1177/23259582221121096

Plant Genome. 2022 Aug 17:e20253. doi: 10.1002/tpg2.20253. Online ahead of print.

ABSTRACT

The growing demand for food and feed crops in the world because of growing population and more extreme weather events requires high-yielding and resilient crops. Many agriculturally important traits are polygenic, controlled by multiple regulatory layers, and with a strong interaction with the environment. In this study, 120 F₂ families of perennial ryegrass (Lolium perenne L.) were grown across a water gradient in a semifield facility with subsoil irrigation. Genomic (single-nucleotide polymorphism [SNP]), transcriptomic (gene expression [GE]), and DNA methylomic (MET) data were integrated with feed quality trait data collected from control and drought sections in the semifield facility, providing a treatment effect. Deep root length (DRL) below 110 cm was assessed with convolutional neural network image analysis. Bayesian prediction models were used to partition phenotypic variance into its components and evaluated the proportion of phenotypic variance in all traits captured by different regulatory layers (SNP, GE, and MET). The spatial effects and effects of SNP, GE, MET, the interaction between GE and MET (GE × MET) and GE × treatment (GE_Control and GE_Drought ) interaction were investigated. Gene expression explained a substantial part of the genetic and spatial variance for all the investigated phenotypes, whereas MET explained residual variance not accounted for by SNPs or GE. For DRL, MET also contributed to explaining spatial variance. The study provides a statistically elegant analytical paradigm that integrates genomic, transcriptomic, and MET information to understand the regulatory mechanisms of polygenic effects for complex traits.

PMID:35975565 | DOI:10.1002/tpg2.20253

J Clin Sleep Med. 2022 Aug 17. doi: 10.5664/jcsm.10240. Online ahead of print.

ABSTRACT

STUDY OBJECTIVES: This study evaluated sleep quality in relation to pain and pain-related impairment in adolescents and young adults (AYAs) with sickle cell disease (SCD). The purpose of this work was to examine whether increased age was associated with poorer sleep quality and pain and to examine the sleep quality-pain association in this age group.

METHODS: Eighty-nine AYAs with SCD between the ages of 13 and 25 completed ratings of sleep quality, overall pain, and two measures of pain-related impairment (pain impact and pain burden) as part of their clinical care. Retrospective chart reviews were completed to match ratings to demographic and medical characteristics. Correlations and multiple regression were used to examine associations between age, sleep quality, and pain variables, including an exploratory analysis of the sleep-pain association by age.

RESULTS: Increased age was associated with poorer sleep quality, worse overall pain, and higher pain burden. Poorer sleep quality was also associated with worse overall pain and pain burden. Using multiple regression, a small, but not statistically significant trend was observed for the interaction of increased age and strengthening of the sleep quality-pain burden association.

CONCLUSIONS: Sleep quality and pain are important challenges for AYAs with SCD that may persist or worsen with increased age. Early identification of these difficulties in pediatric populations as well as continued screening and intervention as adolescents transition into adult care is important. Additional longitudinal research is needed to better understand the progression of the sleep-pain relationship over time.

PMID:35975556 | DOI:10.5664/jcsm.10240

J Clin Sleep Med. 2022 Aug 17. doi: 10.5664/jcsm.10250. Online ahead of print.

ABSTRACT

STUDY OBJECTIVE: Obstructive sleep apnea (OSA) is a common and serious sleep disorder whose treatment remains challenging due to lack of adherence to approved therapies. Previous pharmacological studies addressing sleep-related upper airway muscle hypotonia suggested that the combination of atomoxetine and oxybutynin is effective in treating OSA. The current study is with aroxybutynin (AD109), a new enantiomerically pure form of oxybutynin with better safety profile compared to racemic oxybutynin.

METHODS: This was a randomized, double-blind, placebo-controlled, crossover study in patients with mild to moderate OSA. Each received low-dose AD109 (37.5/2.5mg), high-dose (75/2.5mg), and placebo at bedtime across three overnight periods in a randomized order. Adverse events were collected by telephone contact with participants during each washout period. The primary endpoint was change in Hypoxic Burden (HB) and secondary endpoint was apnea-hypopnea index (AHI).

RESULTS: Patients treated with both the high and low doses of AD109 had a statistically significant and clinically meaningful difference from placebo in HB. Median[IQR] HB for participants on placebo was 13.9[4.5-21.9]%min/h vs 2.3[0.1-10.5]%min/h for patients on the high dose (p<0.001) and to 7.3[2-12.5]%min/h on the low dose (p<0.01). AHI went from a median of 13.2[8.0-19.1] events/h on placebo reduced to 5.5[2.2 to 9.6] events/h on the high dose (p<0.001) and to 7.8[4-13.7] on the low dose (p<0.05). AD109 demonstrated a favorable safety profile.

CONCLUSIONS: This study provides further support that a pharmacological intervention for OSA, namely the combination of atomoxetine and aroxybutynin, offers promising results. Additional development of this compound and others is warranted.

CLINICAL TRIAL REGISTRATION: Registry: ClinicalTrials.gov; Identifier: NCT04631107; Title: AD109 Dose Finding in Mild to Moderate OSA; URL: https://clinicaltrials.gov/ct2/show/NCT04631107.

PMID:35975547 | DOI:10.5664/jcsm.10250

Clin Lab. 2022 Jul 1;68(7). doi: 10.7754/Clin.Lab.2021.211110.

ABSTRACT

BACKGROUND: Excessive inflammatory immune response during SARS-CoV-2 infection contributes to severe disease in COVID-19 patients. Recently, some researchers hypothesized that dysregulation of the bradykinin (BK) system may also play a role in the pathogenesis of severe disease. Des-Arg(9)-bradykinin (DABK), an active metabolite of BK, is responsible for vasodilatation and increased permeability in the lungs and regulated by angiotensin converting enzyme 2 (ACE-2). Viral inhibition of ACE-2 by SARS-CoV-2 increases DABK levels. Serum levels of this metabolite may be linked to disease severity in COVID-19 patients. In this study, it is aimed to investigate the prognostic value of serial measurement of serum DABK levels in severe COVID-19 patients.

METHODS: This prospective cohort study was conducted in hospitalized severe COVID-19 patients. Serum DABK levels of patients were serially measured on day 0, day 3 and day 5. Patients were categorized as cases with poor or good prognosis and critical or non-critical cases. Serum DABK levels of these patient groups were compared with paired sample t-test. Serum DABK levels on different days in the same patients were compared with repeated measures ANOVA tests.

RESULTS: There was no statistically significant difference in serum DABK levels measured at day 0, day 3, and day 5 between good and poor prognosis groups. DABK levels in critical and non-critical COVID-19 patients also did not show any significant difference.

CONCLUSIONS: According to our results serially measured serum DABK levels did not correlate with outcome of severe COVID-19 and do not have prognostic value in severe COVID-19 patients.

PMID:35975542 | DOI:10.7754/Clin.Lab.2021.211110

Clin Lab. 2022 Jul 1;68(7). doi: 10.7754/Clin.Lab.2021.210910.

ABSTRACT

BACKGROUND: Candida auris is an opportunistic pathogen with multiple drug resistance. Therefore, researchers conducted a meta-analysis to review PCR’s ability to diagnose Candida auris to promote the development of accurate Candida auris diagnosis.

METHODS: Researchers systematically retrieved relevant articles from PubMed, Cochrane Library, Embase, and Web of Science. Then, researchers extracted the key data required for the study from the selected articles. Meta-DiSc 1.4 was used for the statistical analysis. RevMan 5.3 was employed to assess the quality of the included literature. A funnel plot can appraise whether the included articles have publication bias.

RESULTS: Five articles were included in the study. The results suggest that the pooled sensitivity and pooled specificity were 0.94 (95% CI: 0.92 – 0.95) and 0.99 (95% CI: 0.99 – 0.99), respectively. The positive and negative likelyhood ratios were 100.94 (95% CI: 47.51 – 214.47) and 0.07 (95% CI: 0.05 – 0.10), respectively. The diagnostic odds ratio was 1,814.70 (95% CI: 717.30 – 4,591.04), and the area under the SROC curve was 0.9935. Deek’s funnel plot indicated that there was no publication bias.

CONCLUSIONS: The results of the analysis indicate that PCR can become a valuable technique for the clinical diagnosis of Candida auris due to its excellent performance.

PMID:35975540 | DOI:10.7754/Clin.Lab.2021.210910

Clin Lab. 2022 Jul 1;68(7). doi: 10.7754/Clin.Lab.2021.210833.

ABSTRACT

BACKGROUND: Serum TSH reference intervals (RIs) are methodology, population, and age specific. However, the ethical and practical challenges restrict the establishment of pediatric RIs using conventional approaches and advocates the use of indirect data mining-based algorithms. This study was carried out to estimate the reference interval of neonatal serum TSH in Pakistani population using an indirect approach.

METHODS: A data mining of serum TSH results of neonates (≤ 1 month of age) from 2013 – 2018 was done. Two subgroups on the basis of age from birth to 5 days and 6 – 30 days were assessed. The German study group’s pre-validated indirect algorithm ‘KOSMIC’ was utilized for the statistical analysis.

RESULTS: A total of non-duplicate 82,299 neonatal serum TSH tests were retrieved over a period of 6 years, including 88% (n = 70,788) aged 0 – 5 days and 12% (n = 11,511) ranging from 6 days to 1 month. The estimated RIs for the first age partition was 0.7 (90% CI 0.6 – 0.8) to 15.5 (90% CI 12.9 – 16.2) and for the second group 0.7 (90% CI 0.5 – 0.9) to 7.8 (90% CI 6.1 – 9.9) µIU/mL.

CONCLUSIONS: This study revealed age related trends in serum TSH. The study advocates the need for population specific RIs owing to the significant variations noted on comparison with previously published literature. Precise RIs become vital particularly when serum TSH is undertaken as a confirmatory test for presumptive positive results on newborn screening for congenital hypothyroidism.

PMID:35975518 | DOI:10.7754/Clin.Lab.2021.210833

Clin Lab. 2022 Aug 1;68(8). doi: 10.7754/Clin.Lab.2022.220362.

ABSTRACT

BACKGROUND: Identifying the distribution and pattern of specific aeroallergens in Sichuan, China, after the corona-virus disease (COVID-19) epidemic and to provide a basis for future prevention and clinical treatment.

METHODS: Serological tests for 10 types of aeroallergens were performed on 10,036 participants attending the West China Second University Hospital from January 2020 to January 2021. SPSS23.0 was used to statistically analyze their specific immunoglobulin E (sIgE) grades in different genders, various age groups, and different diseases.

RESULTS: Of the 10,036 participants, 4,578 (45.62%) were allergic to at least one allergen. House dust had the highest sensitization rate (2,974, 29.63%), followed by Dermatophagoides farina (2,717, 27.07%) and Dermatophagoides pteronyssinus (2,611, 26.02%). Male and female participants had no significant difference in overall sensitization distributions. The prevalence differences between 0 – 3, 4 – 6, 7 – 9, 10 – 12, 13 – 15, and over 16-year-old age groups were statistically significant (p < 0.05), and the highest incidence age for children to be sensitive to aeroallergens was 4 – 6 years, respectively. Sensitization to D. pteronyssinus, D. farina, house dust, dog epithelium, and Alternaria alternata was more common in patients with rhinitis and asthma compared with bronchitis.

CONCLUSIONS: Aeroallergens are important causes of respiratory-related allergic diseases, and the characteristics of allergen sensitization discovered in this study could help with inhalant allergy disease prevention, diagnosis, and management in the post-epidemic era.

PMID:35975513 | DOI:10.7754/Clin.Lab.2022.220362

Clin Lab. 2022 Aug 1;68(8). doi: 10.7754/Clin.Lab.2021.211042.

ABSTRACT

BACKGROUND: The aim was to investigate the early diagnostic value of serum glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase (UCH-L1) levels in adults with minor head trauma (MHT) and whether it could be an alternative diagnostic method to computed tomography (CT). This is the first study with the combination of GFAP and UCH-L1 in the first 3 hours of MHT.

METHODS: The study comprised 88 patients, 60 patients and 28 controls, who were evaluated as having MHT, were admitted to the emergency department of our hospital within the first 3 hours of the trauma and met the inclusion criteria. CT was performed on all patients. Serum GFAP and UCH-L1 levels were measured within the first 3 hours of the trauma.

RESULTS: The median serum GFAP level was 1.07 ng/mL in the group with pathology on CT and 0.42 ng/mL in the group with no pathology on CT. The median serum UCH-L1 level was 0.40 ng/mL in the group with pathology on CT and 0.39 ng/mL in the group with no pathology on CT. A statistically significant difference was found between the serum GFAP levels of the CT (+) group and the CT (-) group (p = 0.021). GFAP levels were compared according to the CT (+) and CT (-) groups with a cutoff value of ≥ 1.56 ng/mL for GFAP, which had 50% sensitivity and 97.5% specificity. This was statistically significant (p = 0.008). It was found that the UCH-L1 level of the control group was lower than the UCH-L1 levels of the CT (+) and CT (-) groups, and this difference was found to be statistically significant (p = 0.003 and p = 0.018, respectively).

CONCLUSIONS: GFAP was found to be more specific than UCH-L1 in demonstrating the presence of intracranial pathology in patients with head trauma who were admitted to the emergency department in the first 3 hours after trauma.

PMID:35975499 | DOI:10.7754/Clin.Lab.2021.211042

Clin Lab. 2022 Aug 1;68(8). doi: 10.7754/Clin.Lab.2021.211030.

ABSTRACT

BACKGROUND: The aim was to explore the correlations of leukotriene B4 (LTB4) and 25-hydroxyvitamin D3 [25(OH)D3] levels with disease severity in children with Henoch-Schonlein purpura (HSP).

METHODS: A total of 260 HSP children admitted from January 2017 to December 2018 were selected, and 60 healthy children physically examined in the same period were enrolled as controls. The results of general laboratory tests and expression levels of leukotriene B4 (LTB4) and 25-hydroxyvitamin D3 [25(OH)D3] were compared. The correlations of LTB4 and 25(OH)D3 with immunoglobulin A (IgA) were statistically analyzed, and the expression levels of LTB4 and 25(OH)D3 were compared between Henoch-Schonlein purpura nephritis (HSPN) group and non-Henoch-Schonlein purpura nephritis (NHSPN) group. The optimal cutoff values of LTB4 and 25(OH)D3 to predict HSP were analyzed by receiver operating characteristic (ROC) curves, based on which they were divided into low-, intermediate-, and high-risk groups. The length of hospital stay and recurrence rate within 6 months were compared.

RESULTS: The levels of white blood cell count, platelets, C-reactive protein, IgA, IgM, IgE, complement C3, and LTB4 were significantly higher and 25(OH)D3 was lower in HSP group than those in control group (p < 0.05). IgA, LTB4, and 25(OH)D3 levels were independent risk factors for HSP (p < 0.05). LTB4 was positively correlated with IgA (p < 0.05), and 25(OH)D3 was negatively correlated with IgA (p < 0.05). LTB4 level was significantly higher and 25(OH)D3 level was lower in HSPN group than those in NHSPN group (p < 0.05). The optimal cutoff values of LTB4 and 25(OH)D3 were 27.82 pg/mL and 22.10 ng/mL, respectively, the length of hospital stay gradually increased in low-, intermediate-, and high-risk groups, and the recurrence rates within 6 months were 14.2%, 31.5%, and 39.6%, respectively (p < 0.05).

CONCLUSIONS: LTB4 level increases and 25(OH)D3 level decreases in children with HSP, and the expression levels are significantly correlated with disease severity, suggesting predictive values for prognosis.

PMID:35975496 | DOI:10.7754/Clin.Lab.2021.211030