Tag: nevin manimala

PLoS One. 2021 Apr 2;16(4):e0248709. doi: 10.1371/journal.pone.0248709. eCollection 2021.

ABSTRACT

INTRODUCTION: Deaths due to non-communicable diseases (NCDs) have surpassed those due to communicable diseases globally and are projected to do so in Africa by 2030. Despite demonstrated effectiveness in high-income country (HIC) settings, the ED is a primary source of NCD care that has been under-prioritized in Africa. In this study, we assess the burden of leading NCDs and NCD risk factors in Kenyan Casualty Department patients to inform interventions targeting patients with NCDs in emergency care settings.

MATERIALS AND METHODS: Using the WHO STEPwise approach to surveillance (STEPS) tool and the Personal Health Questionnaire (PHQ-9), we conducted a survey of 923 adults aged 18 and over at Kenyatta National Hospital Emergency Department (KNH ED) between May-October 2018. Age, income, household size(t-test), sex, education, marital status, work status, and poverty status (chi-squared test or fisher’s exact test) were assessed using descriptive statistics and analyzed using covariate-adjusted logistic analysis.

RESULTS: Over a third of respondents had hypertension (35.8%, n = 225/628), 18.3% had raised blood sugar or diabetes (18.3%, n = 61/333), and 11.7% reported having cardiovascular disease (11.7%, n = 90/769). Having lower levels of education was associated with tobacco use (OR 6.0, 95% CI 2.808-12.618, p < 0.0001), while those with higher levels of education reported increased alcohol use (OR 0.620 (95% CI 0.386-0.994, p = 0. 0472). While a predominant proportion of respondents had had some form of screening for either hypertension (80.3%, n = 630/772), blood sugar (42.6%, n = 334/767) or cholesterol (13.9%, n = 109/766), the proportion of those on treatment was low, with the highest proportion being half of those diagnosed with hypertension reporting taking medication (51.6%, n = 116/225).

CONCLUSIONS: This study establishes the ED as a high-risk population with potential for high impact in East Africa, should targeted interventions be implemented. Comprehension of the unique epidemiology and characteristics of patients presenting to the ED is key to guide care in African populations.

PMID:33798234 | DOI:10.1371/journal.pone.0248709

PLoS One. 2021 Apr 2;16(4):e0249671. doi: 10.1371/journal.pone.0249671. eCollection 2021.

ABSTRACT

The potential ergogenic effects of vitamin D (vitD) in high performing athletes has received considerable attention in the literature and media. However, little is known about non-supplemented university athletes and students residing at a higher latitude. This study aimed to investigate the effects of vitD (biochemical status and dietary intake) on exercise performance in UK university athletes and sedentary students. A total of 34 athletes and 16 sedentary controls were studied during the spring and summer months. Serum vitD status and sunlight exposure were assessed using LC-MS/MS and dosimetry, respectively. Muscular strength of the upper and lower body was assessed using handgrip and knee extensor dynamometry (KE). Countermovement jump (CMJ) and aerobic fitness were measured using an Optojump and VO2max test, respectively. Statistical analysis was performed using paired/ independent t-tests, ANCOVA and Pearson/ Spearman correlations, depending on normality. VitD status increased significantly over the seasons, with athletes measuring higher status both in spring (51.7±20.5 vs. 37.2±18.9 nmol/L, p = 0.03) and summer (66.7±15.8 vs 55.6±18.8 nmol/L, p = 0.04) when compared to controls, respectively. Notably, 22% of the subjects recruited were vitD deficient during the spring term only (<25nmol/L, n 9). Subjects with ‘insufficient’ vitD status (<50nmol/L) elicited significantly lower CMJ when contrasted to the vitD ‘sufficient’ (>50nmol/l) group (p = 0.055) and a lower VO2 max (p = 0.05) in the spring and summer term (p = 0.05 and p = 0.01, respectively). However, an ANCOVA test showed no significant difference detected for either CMJ or VO2max following adjustments for co-variates. In conclusion, we provide novel information on the vitD status, dietary intake, physical fitness and sunlight exposure of UK young adults across two separate seasons, for which there is limited data at present.

PMID:33798240 | DOI:10.1371/journal.pone.0249671

PLoS One. 2021 Apr 2;16(4):e0248386. doi: 10.1371/journal.pone.0248386. eCollection 2021.

ABSTRACT

BACKGROUND: The interaction between smoking and the use of antiplatelet agents on the prognosis of vasospastic angina (VA) is rarely investigated.

METHODS: VA-Korea is a nation-wide multi-center registry with prospective design (n = 1812). The primary endpoint was the composite occurrence of acute coronary syndrome (ACS), symptomatic arrhythmia, and cardiac death. Log-rank test and Cox proportional hazard model were for statistical analysis. Also, we conducted interaction analysis in both additive and multiplicative scales between smoking and antiplatelet agents among VA patients. For additive scale interaction, relative excess risk due to interaction (RERI) was calculated and for multiplicative scale interaction, the ratio of hazard ratio (HR) was calculated. All statistical analysis conducted by Stata Ver 16.1.

RESULTS: Patients who were smoking and using antiplatelet agents had the highest incidence rate in the primary composite outcome. The incidence rate was 3.49 per 1,000 person-month (95% CI: 2.30-5.30, log-rank test for primary outcome p = 0.017) and HR of smoking and using antiplatelet agents was 1.66 (95%CI: 0.98-2.81). The adjusted RERI of smoking and using antiplatelet agents was 1.10 (p = 0.009), and the adjusted ratio of HR of smoking and using antiplatelet agents was 3.32 (p = 0.019). The current study observed the interaction between smoking and using antiplatelet agents in both additive and multiplicative scales.

CONCLUSIONS: Smoking was associated with higher rates of unfavorable clinical outcomes among VA patients taking antiplatelet agents. This suggested that VA patients, especially those using antiplatelet agents should quit smoking.

PMID:33798225 | DOI:10.1371/journal.pone.0248386

PLoS One. 2021 Apr 2;16(4):e0249514. doi: 10.1371/journal.pone.0249514. eCollection 2021.

ABSTRACT

BACKGROUND: Little evidence exists about parental satisfaction and their influence on referral to paediatric Outpatient Parenteral Antimicrobial Therapy (OPAT).

AIM: This study aimed to examine the experiences of parents, children and clinicians of OPAT at a large tertiary children’s hospital.

METHOD: A prospective e-survey, using closed and open questions, of parents (n = 33) of 33 children who had received OPAT (3 children completed a survey), and clinicians (n = 31) involved in OPAT at a tertiary hospital. Data were collected September 2016 to July 2018.

RESULTS: Data were analysed using simple descriptive statistics. The results show that OPAT offered benefits (less stress, re-establishment of family life) compared to hospital-based treatment for parents and children, although some were anxious. Clinicians’ referral judgements were based on child, home, and clinical factors. Some clinicians found the process of referral complex.

CONCLUSION: Most parents and children were satisfied with the OPAT service and preferred the option of home-based treatment as it promoted the child’s comfort and recovery and supported family routines.

PMID:33798226 | DOI:10.1371/journal.pone.0249514

PLoS One. 2021 Apr 2;16(4):e0249028. doi: 10.1371/journal.pone.0249028. eCollection 2021.

ABSTRACT

The two-parameter of exponentiated Gumbel distribution is an important lifetime distribution in survival analysis. This paper investigates the estimation of the parameters of this distribution by using lower records values. The maximum likelihood estimator (MLE) procedure of the parameters is considered, and the Fisher information matrix of the unknown parameters is used to construct asymptotic confidence intervals. Bayes estimator of the parameters and the corresponding credible intervals are obtained by using the Gibbs sampling technique. Two real data set is provided to illustrate the proposed methods.

PMID:33798228 | DOI:10.1371/journal.pone.0249028

PLoS One. 2021 Apr 2;16(4):e0245898. doi: 10.1371/journal.pone.0245898. eCollection 2021.

ABSTRACT

BACKGROUND: We aimed to compare the performance of the recent CASTLE score to J-CTO, CL and PROGRESS CTO scores in a comprehensive database of percutaneous coronary intervention of chronic total occlusion procedures.

METHODS: Scores were calculated using raw data from 1,342 chronic total occlusion procedures included in REBECO Registry that includes learning and expert operators. Calibration, discrimination and reclassification were evaluated and compared.

RESULTS: Mean score values were: CASTLE 1.60±1.10, J-CTO 2.15±1.24, PROGRESS 1.68±0.94 and CL 2.52±1.52 points. The overall percutaneous coronary intervention success rate was 77.8%. Calibration was good for CASTLE and CL, but not for J-CTO or PROGRESS scores. Discrimination: the area under the curve (AUC) of CASTLE (0.633) was significantly higher than PROGRESS (0.557) and similar to J-CTO (0.628) and CL (0.652). Reclassification: CASTLE, as assessed by integrated discrimination improvement, was superior to PROGRESS (integrated discrimination improvement +0.036, p<0.001), similar to J-CTO and slightly inferior to CL score (- 0.011, p = 0.004). Regarding net reclassification improvement, CASTLE reclassified better than PROGRESS (overall continuous net reclassification improvement 0.379, p<0.001) in roughly 20% of cases.

CONCLUSION: Procedural percutaneous coronary intervention difficulty is not consistently depicted by available chronic total occlusion scores and is influenced by the characteristics of each chronic total occlusion cohort. In our study population, including expert and learning operators, the CASTLE score had slightly better overall performance along with CL score. However, we found only intermediate performance in the c-statistic predicting chronic total occlusion success among all scores.

PMID:33798205 | DOI:10.1371/journal.pone.0245898

PLoS One. 2021 Apr 2;16(4):e0249464. doi: 10.1371/journal.pone.0249464. eCollection 2021.

ABSTRACT

Along with other countries in America, plague reached Brazil through the sea routes during the third pandemic. A brief ports phase was followed by an urban phase that took place in smaller inland cities and finally, it attained the rural area and established several foci where the ecological conditions were suitable for its continued existence. However, the geographic dispersion of plague in Brazil is still poorly studied. To better understand the disease dynamics, we accessed satellite-based data to trace the spatial occurrence and distribution of human plague cases in Pernambuco, Northeastern Brazil and using the municipality of Exu as study case area. Along with the satellite data, a historical survey using the Plague Control Program files was applied to characterize the spatial and temporal dispersion of cases in the period of 1945-1976. Kernel density estimation, spatial and temporal clusters with statistical significance and maximum entropy modeling were used for spatial data analysis, by means of the spatial analysis software packages. The use of geostatistical tools allowed evidencing the shift of the infection from the urban to the wild-sylvatic areas and the reemergence of cases after a period of quiescence, independent of the reintroduction from other plague areas.

PMID:33798208 | DOI:10.1371/journal.pone.0249464

PLoS One. 2021 Apr 2;16(4):e0248732. doi: 10.1371/journal.pone.0248732. eCollection 2021.

ABSTRACT

Spinner dolphins on Hawai’i Island’s west coast (Stenella longirostris longirostris) rest by day in protected bays that are increasingly popular for recreation. Because more frequent interactions of people with these dolphins is likely to reduce rest for dolphins and to explain recent decline in dolphin abundance, the National Oceanic and Atmospheric Administration (NOAA) proposed stricter rules regarding interactions with spinner dolphins near the main Hawaiian Islands and plans to increase enforcement. Simultaneous investment in public education about both interaction rules and their biological rationale has been and is likely to be relatively low. To test the hypothesis that more educational signage will reduce human-generated disturbance of dolphins, a paper questionnaire was distributed to 351 land-based, mostly unguided visitors at three dolphin resting bays on Hawai’i Island’s west coast. Responses indicated that visitors wanted to see dolphins, were ignorant of interaction rules, were likely to read signs explaining rules and their biological rationales, and were likely to follow known rules. Therefore, investment in effective educational signage at dolphin resting bays is recommended as one way to support conservation of spinner dolphins on Hawai’i Island’s west coast and similar sites in the Hawaiian archipelago.

PMID:33798220 | DOI:10.1371/journal.pone.0248732

PLoS One. 2021 Apr 2;16(4):e0249376. doi: 10.1371/journal.pone.0249376. eCollection 2021.

ABSTRACT

Quantification of HIV-1 RNA is essential for clinical management of HIV patients. The limited throughput and significant hands-on time required by most HIV Viral load (VL) tests makes it challenging for laboratories with high test volume, to turn around patient results quickly. The Hologic Aptima HIV-1 Quant Dx Assay (Aptima), has the potential to alleviate this burden as it is high throughput and fully automated. This assay is validated for both plasma and dried blood spots (DBS), which are commonly used in resource limited settings. The objective of this study was to compare the performance of Aptima to Abbott RealTime HIV-1 Assay (Abbott RT), which was used as reference. This was a cross-sectional prospective study where HIV VL in finger stick (FS) DBS, venous blood (VB) DBS and plasma, collected from 258 consenting adults visiting 5 medical facilities in Kenya, Africa were tested in Aptima. The results were compared to plasma VL in Abbott RT at the medical decision point (MDP) of 1000 copies/mL and across Aptima assay range. The total agreement at MDP between plasma HIV VL in Abbott RT and plasma, FS and VB DBS tested in Aptima were 97.7%, 92.2% and 95.3% respectively with kappa statistic of 0.95, 0.84 and 0.90. The positive and negative agreement for all 3 sample types were >92%. Regression analysis between VL in Abbott RT plasma and various sample types tested in Aptima had a Pearson’s correlation coefficient ≥0.91 with systematic bias of < 0.20 log copies/mL on Bland-Altman analysis. The high level of agreement in Aptima HIV VL results for all 3 sample types with Abbott RT plasma VL along with the high throughput, complete automation, and ease of use of the Panther platform makes Aptima a good option for HIV VL monitoring for busy laboratories with high volume of testing.

PMID:33798221 | DOI:10.1371/journal.pone.0249376

PLoS Comput Biol. 2021 Apr 2;17(4):e1008890. doi: 10.1371/journal.pcbi.1008890. Online ahead of print.

ABSTRACT

Protein-protein interaction networks are one of the most effective representations of cellular behavior. In order to build these models, high-throughput techniques are required. Next-generation interaction screening (NGIS) protocols that combine yeast two-hybrid (Y2H) with deep sequencing are promising approaches to generate interactome networks in any organism. However, challenges remain to mining reliable information from these screens and thus, limit its broader implementation. Here, we present a computational framework, designated Y2H-SCORES, for analyzing high-throughput Y2H screens. Y2H-SCORES considers key aspects of NGIS experimental design and important characteristics of the resulting data that distinguish it from RNA-seq expression datasets. Three quantitative ranking scores were implemented to identify interacting partners, comprising: 1) significant enrichment under selection for positive interactions, 2) degree of interaction specificity among multi-bait comparisons, and 3) selection of in-frame interactors. Using simulation and an empirical dataset, we provide a quantitative assessment to predict interacting partners under a wide range of experimental scenarios, facilitating independent confirmation by one-to-one bait-prey tests. Simulation of Y2H-NGIS enabled us to identify conditions that maximize detection of true interactors, which can be achieved with protocols such as prey library normalization, maintenance of larger culture volumes and replication of experimental treatments. Y2H-SCORES can be implemented in different yeast-based interaction screenings, with an equivalent or superior performance than existing methods. Proof-of-concept was demonstrated by discovery and validation of novel interactions between the barley nucleotide-binding leucine-rich repeat (NLR) immune receptor MLA6, and fourteen proteins, including those that function in signaling, transcriptional regulation, and intracellular trafficking.

PMID:33798202 | DOI:10.1371/journal.pcbi.1008890