Tag: nevin manimala

BMJ Open. 2021 Dec 14;11(12):e048022. doi: 10.1136/bmjopen-2020-048022.

ABSTRACT

INTRODUCTION: Undernutrition is considered a marker for poor prognosis among people living with HIV (PLHIV), particularly in sub-Saharan Africa (SSA), where undernutrition and HIV are both highly prevalent. Evidence suggests that undernutrition (body mass index <18.5 kg/m²) is one of the main factors that significantly increases the risk of lost to follow-up (LTFU) in PLHIV. However, primary studies in SSA have reported inconsistent findings on the relationship between undernutrition and LTFU among adults living with HIV. To the best of our knowledge, no systematic review which aimed to summarise the available evidence. Hence, this review aims to determine the pooled effect of undernutrition on LTFU among adults living with HIV in SSA.

METHODS AND ANALYSIS: PubMed, EMBASE, Web of Science, Scopus, and, for grey literature, Google Scholar will be systematically searched to include relevant articles published since 2005. Studies reporting the effect of undernutrition on LTFU in adults living with HIV in SSA will be included. The Newcastle-Ottawa Scale will be used for quality assessment. Data from eligible studies will be extracted using a standardised data extraction tool. Heterogeneity between included studies will be assessed using Cochrane Q-test and I² statistics. The Egger’s and Begg’s tests at a 5% significance level will be used to evaluate publication bias. As heterogeneity is anticipated, the pooled effect size will be estimated using a random-effects model. The final effect size will be reported using the adjusted HR with a 95% CI.

ETHICS AND DISSEMINATION: Ethical approval is not required for a protocol for a systematic review. The results of this systematic review will be published in a peer-reviewed journal and will be publicly available.

PROSPERO REGISTRATION NUMBER: CRD42021277741.

PMID:34907042 | DOI:10.1136/bmjopen-2020-048022

BMJ Open. 2021 Dec 14;11(12):e041270. doi: 10.1136/bmjopen-2020-041270.

ABSTRACT

INTRODUCTION: In 2019, over 70 million people were forcibly displaced worldwide. Women and girls comprise nearly half of this population and are at heightened risk of negative sexual and reproductive health outcomes. With the collapse of health systems, reduced resources and increased vulnerabilities from displacement, there is a need to strengthen current practices and ensure the delivery of comprehensive sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH) services. Recognising the need for consistency in data collection, analysis and use, the WHO developed a list of core SRMNCAH monitoring and evaluation indicators for services and outcomes in humanitarian settings. This research will explore the feasibility of collecting this core set of SRMNCAH indicators in displacement contexts.

METHODS AND ANALYSIS: We will undertake a multimethods qualitative study in seven humanitarian settings: Afghanistan, Albania, Bangladesh, Cameroon, the Democratic Republic of the Congo, Iraq and Jordan. We selected sites that reflect diversity in geographic region, sociocultural characteristics, primary location(s) of displaced persons and nature and phase of the crisis. Our study consists of four components: key informant interviews, facility assessments, observational sessions at select facilities and focus group discussions with front-line healthcare personnel. We will analyse our data using descriptive statistics and for content and themes. We will begin by analysing data from each setting separately and will then combine these data to explore concordant and discordant results, triangulate findings and develop global recommendations.

ETHICS AND DISSEMINATION: The University of Ottawa’s Research Ethics Board and the Research Project Review Panel (RP 2) of the World Health Organization-Department of Sexual and Reproductive Health as well as local IRBs of PIs’ research institutions reviewed and approved this protocol. We intend to disseminate findings through workshops at the WHO country, regional and headquarter levels, as well as through local, national and international conferences, workshops, peer-reviewed publications, and reports.

PMID:34907036 | DOI:10.1136/bmjopen-2020-041270

Z Gastroenterol. 2021 Dec 14. doi: 10.1055/a-1695-3637. Online ahead of print.

ABSTRACT

BACKGROUND: As part of a prospective clinical study, the degree of hepatic fatty degeneration was quantified in a patient population with nonalcoholic fatty liver disease and sonographically diagnosed with hepatic steatosis using attenuation imaging.

METHODS: A total of 113 patients with hepatic steatosis were examined, of whom 35 showed focal fatty sparing. Patients with the condition after right nephrectomy, other known liver diseases, and relevant alcohol consumption were excluded from the evaluation. B-scan sonography and sonographic quantification of steatosis content using attenuation imaging (Aplio i800 Canon Medical Systems) were performed. Attenuation imaging is a new ultrasound-based measurement technique that allows objective detection and quantification of hepatic steatosis.

RESULTS: The prevalence of focal fatty sparing was 31.0% in the patient population examined. Patients with focal fatty sparing showed a statistically significantly higher attenuation coefficient in contrast to patients without focal fatty sparing (0.79 ± 0.10 vs. 0.66 ± 0.09 dB/cm/MHz, p < 0.0001).

CONCLUSION: Detection of focal fatty sparing is associated with an increased attenuation coefficient and is thus an expression of higher-grade hepatic fatty degeneration. Patients with focal fatty sparing are more often male and have a higher BMI and a larger liver than patients with nonalcoholic fatty liver disease without focal fatty sparing.

PMID:34905800 | DOI:10.1055/a-1695-3637

Eur J Dent. 2021 Dec 14. doi: 10.1055/s-0041-1735932. Online ahead of print.

ABSTRACT

OBJECTIVES: Due to time-consuming curricular and extracurricular activities, students in dentistry and medicine can profit from efficient learning strategies. One strategy could be the preparation with individually designed educational software that embed different multimedia sources. The aim of this study was to determine the efficiency of such a program compared with an e-book similar to a traditional textbook.

MATERIALS AND METHODS: Dentistry students of the Johannes Gutenberg-University of Mainz passed an entrance multiple-choice test on the topic of odontogenic tumors and were then randomized into two groups. Afterward, both groups had 14 days to study on the topic of odontogenic tumors either with a learning software or an e-book. A final exam was then taken and the two groups were compared.

STATISTICAL ANALYSIS: A least significant difference post hoc analysis comparing the group average values was performed. The level of significance was p <0.05.

RESULTS: Seventy-one students took part in the study. While students from the first and second clinical semester showed significantly better results and improvements with the e-book, an opposite effect was observed in students from the third and fifth clinical semester with significantly better results and improvements with the software.

CONCLUSION: Depending on the clinical experience and knowledge, a multimedia educational software can help students in dentistry to enhance efficiency in the preparation for exams.

PMID:34905779 | DOI:10.1055/s-0041-1735932

Neuropediatrics. 2021 Dec 14. doi: 10.1055/s-0041-1740550. Online ahead of print.

ABSTRACT

BACKGROUND: More than half of children and adolescents have experienced headache within the last 3 months. Several risk factors for headache have been identified, including obesity and lack of sleep. The association between screen time and headache in children and adolescents is sparsely investigated. The aim of this study was to assess this association and evaluate if it varied according to headache diagnosis.

METHOD: This cross-sectional study was performed at the tertiary pediatric outpatient clinic for headache at Herlev University Hospital. A total of 139 participants who answered a questionnaire on lifestyle factors and their daily living were included. Diagnoses of migraine and tension-type headache (TTH) were made according to the International Classification of Headache Disorders-3. Children with both migraine and TTH were allocated to a mixed headache group. We differentiated between total, leisure, and school-related screen time.

RESULTS: The mean age was 13.20 ± 3.38 years and 53.2% were girls. Note that 25.2% were diagnosed with migraine without aura, 23.0% migraine with aura, 28.1% TTH, 15.8% mixed headache, and 7.9% had an unclassified headache diagnosis at the time of inclusion. There was no statistically significant difference in screen time across the five headache groups. An association between screen time and headache frequency was found in children with migraine with aura.

CONCLUSION: In this study, we investigated the association between screen time and headache in children and adolescents. More screen time was associated with more frequent headaches in children with migraine with aura. Future prospective studies are needed to determine the causality of this association.

PMID:34905787 | DOI:10.1055/s-0041-1740550

Menopause. 2021 Dec 12. doi: 10.1097/GME.0000000000001901. Online ahead of print.

ABSTRACT

OBJECTIVES: To examine the efficacy and acceptability of decision aids (DAs) in counseling urogynecology patients with prolapse, stress urinary incontinence, or refractory overactive bladder.

METHODS: This pilot study enrolled 33 patients into a control group that underwent usual care without a DA, followed by 33 patients into an intervention group where providers utilized a DA for counseling. Postvisit patient surveys assessed differences in treatment preference, knowledge, and in patient-physician collaboration using SURE, CollaboRATE, and Shared Decision Making (SDM) Process scales. Postvisit provider surveys assessed their perception of the usefulness and the difficulty of using a DA and visit length. Independent t tests were used for continuous variables (Knowledge and SDM Process scores) and Chi-Square for categorical variables (treatment preference, SURE, and CollaboRATE).

RESULTS: The majority of eligible patients 66/71 (93%) completed the survey. The intervention group trended toward higher knowledge scores (72% vs 60%, P = 0.06), clearer treatment preferences (85% vs 67%, P = 0.08), higher rates of top SURE scale scores (91% vs 73%, P = 0.11), and top CollaboRATE scores (75% vs 52%, P = 0.07). SDM process scores were similar across groups (3.2 vs 3.2, P = 0.96). Providers used the DA in 73% of intervention group visits and rated the visit length as “normal” in both groups (70% vs 76%, P = 0.78).

CONCLUSIONS: There were no statistically significant differences between the control group and the intervention group. The use of DAs was acceptable to providers and indicated a trend toward increased patient knowledge, treatment preference, and satisfaction. A larger study is warranted to examine the impact of DAs on decision making and patient experience.

Video Summary:http://links.lww.com/MENO/A856.

PMID:34905749 | DOI:10.1097/GME.0000000000001901

Brief Bioinform. 2021 Dec 15:bbab521. doi: 10.1093/bib/bbab521. Online ahead of print.

ABSTRACT

Proteins with intrinsically disordered regions (IDRs) are common among eukaryotes. Many IDRs interact with nucleic acids and proteins. Annotation of these interactions is supported by computational predictors, but to date, only one tool that predicts interactions with nucleic acids was released, and recent assessments demonstrate that current predictors offer modest levels of accuracy. We have developed DeepDISOBind, an innovative deep multi-task architecture that accurately predicts deoxyribonucleic acid (DNA)-, ribonucleic acid (RNA)- and protein-binding IDRs from protein sequences. DeepDISOBind relies on an information-rich sequence profile that is processed by an innovative multi-task deep neural network, where subsequent layers are gradually specialized to predict interactions with specific partner types. The common input layer links to a layer that differentiates protein- and nucleic acid-binding, which further links to layers that discriminate between DNA and RNA interactions. Empirical tests show that this multi-task design provides statistically significant gains in predictive quality across the three partner types when compared to a single-task design and a representative selection of the existing methods that cover both disorder- and structure-trained tools. Analysis of the predictions on the human proteome reveals that DeepDISOBind predictions can be encoded into protein-level propensities that accurately predict DNA- and RNA-binding proteins and protein hubs. DeepDISOBind is available at https://www.csuligroup.com/DeepDISOBind/.

PMID:34905768 | DOI:10.1093/bib/bbab521

J Am Coll Health. 2021 Dec 14:1-11. doi: 10.1080/07448481.2021.2013237. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective was to examine mental health of undergraduate researchers (UGRs) during the COVID-19 pandemic.

PARTICIPANTS: We surveyed 962 UGRs who were conducting research in Spring 2020 at over 100 US universities.

METHODS: We conducted an online survey in July 2020. We analyzed data using descriptive statistics and multivariable generalized estimating equations.

RESULTS: 63% reported at least mild anxiety and 73% reported at least mild depression based on GAD-7 and PHQ-9 scores; 15.2% reported severe anxiety (score ≥ 15) and 23.4% reported severe depression (score ≥ 15). More COVID-19-related adverse event experiences were associated with more severe anxiety and depression, as were first-generation status, woman gender, and LGBQ status. Greater social support was protective, and significantly more so for men (vs. women) and continuing generation (vs. first generation) students.

CONCLUSION: Faculty have an important role in the mental health of their mentees. Additional interventions are needed to better support women and first-generation students.

Supplemental data for this article can be accessed online at.

PMID:34905697 | DOI:10.1080/07448481.2021.2013237

PLoS One. 2021 Dec 14;16(12):e0261432. doi: 10.1371/journal.pone.0261432. eCollection 2021.

ABSTRACT

INTRODUCTION: Coronavirus disease 2019 (COVID-19) is the ongoing pandemic with multitude of manifestations and association of ABO blood group in South-East Asian population needs to be explored.

METHODS: It was a retrospective study of patients with COVID-19. Blood group A, B, O, and AB were identified in every participant, irrespective of their RH type and allotted groups 1, 2,3, and 4, respectively. Correlation between blood group and lab parameters was presented as histogram distributed among the four groups. Multivariate regression and logistic regression were used for inferential statistics.

RESULTS: The cohort included 1067 patients: 521 (48.8%) participants had blood group O as the prevalent blood type. Overall, 10.6% COVID-19-related mortality was observed at our center. Mortality was 13.9% in blood group A, 9.5% in group B, 10% in group C, and 10.2% in AB blood group (p = 0.412). IL-6 was elevated in blood group A (median [IQR]: 23.6 [17.5,43.8]), Procalcitonin in blood group B (median [IQR]: 0.54 [0.3,0.7]), D-dimers and CRP in group AB (median [IQR]: 21.5 [9,34]; 24 [9,49], respectively). Regarding severity of COVID-19 disease, no statistical difference was seen between the blood groups. Alteration of the acute phase reactants was not positively associated with any specific blood type.

CONCLUSION: In conclusion, this investigation did not show significant association of blood groups with severity and of COVID-19 disease and COVID-19-associated mortality.

PMID:34905588 | DOI:10.1371/journal.pone.0261432

Prostate. 2021 Dec 14. doi: 10.1002/pros.24283. Online ahead of print.

ABSTRACT

BACKGROUND: Smaller prostates have been linked to unfavorable clinical characteristics and poor short-term outcomes following radical prostatectomy (RP). We examined the relation between prostate weight at RP and prostate cancer (PC) outcomes post-RP.

METHODS: Men in the SEARCH cohort undergoing RP between 1988 and 2017 (N = 6242) were studied for PC-specific mortality (PCSM) as the primary outcome, and for biochemical recurrence (BCR), castration-resistant PC (CRPC) and metastasis as secondary outcomes. Hazard ratios (HR) and 95% confidence intervals (CI) were determined for associations between prostate weight and outcomes using Fine-Gray competing risk regression multivariable analyses. Sensitivity analyses were also carried out following exclusion of: (i) men with extreme prostate weights (<20 g and ≥100 g); and (ii) men with elevated prostate specific antigen (PSA) levels.

RESULTS: Median values for age, pre-RP PSA and prostate weight were 63 years, 6.6 ng/ml, and 42.0 g, respectively. During a median follow-up of 7.9 years, 153 (3%) died from PC, 2103 (34%) had BCR, 203 (3%) developed CRPC, and 289 (5%) developed metastases. Prostate weight was not associated with PCSM in the main analyses (multivariable HR = 1.43; 95% CI: 0.87-2.34) or in sensitivity analyses. Prostate weight was inversely associated with BCR in the main analyses (multivariable HR = 0.70; 95%CI: 0.61-0.79) which was unchanged in sensitivity analyses. HRs for prostate weight and CRPC and metastasis were elevated but statistical significance was not attained. Similar results were observed in sensitivity analyses.

CONCLUSIONS: Inconsistent results for prostate weight and short-term vs longer-term outcomes highlight the need to better understand the complex biology leading to prostate size and the relevance of prostate size as a predictor of PC outcomes.

PMID:34905632 | DOI:10.1002/pros.24283