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Nevin Manimala Statistics

Corneal epithelium in keratoconus underexpresses active NRF2 and a subset of oxidative stress-related genes

PLoS One. 2022 Oct 14;17(10):e0273807. doi: 10.1371/journal.pone.0273807. eCollection 2022.

ABSTRACT

Keratoconus (KC) is a multifactorial progressive ectatic disorder characterized by local thinning of the cornea, leading to decreased visual acuity due to irregular astigmatism and opacities. Despite the evolution of advanced imaging methods, the exact etiology of KC remains unknown. Our aim was to investigate the involvement of corneal epithelium in the pathophysiology of the disease. Corneal epithelial samples were collected from 23 controls and from 2 cohorts of patients with KC: 22 undergoing corneal crosslinking (early KC) and 6 patients before penetrating keratoplasty (advanced KC). The expression of genes involved in the epidermal terminal differentiation program and of the oxidative stress pathway was assessed by real time PCR analysis. Presence of some of the differentially expressed transcripts was confirmed at protein level using immunofluorescence on controls and advanced KC additional corneal samples. We found statistically significant under-expression in early KC samples of some genes known to be involved in the mechanical resistance of the epidermis (KRT16, KRT14, SPRR1A, SPRR2A, SPRR3, TGM1 and TGM5) and in oxidative stress pathways (NRF2, HMOX1 and HMOX2), as compared to controls. In advanced KC samples, expression of SPRR2A and HMOX1 was reduced. Decreased expression of keratin (KRT)16 and KRT14 proteins was observed. Moreover, differential localization was noted for involucrin, another protein involved in the epidermis mechanical properties. Finally, we observed an immunofluorescence staining for the active form of NRF2 in control epithelia that was reduced in KC epithelia. These results suggest a defect in the mechanical resistance and the oxidative stress defense possibly mediated via the NRF2 pathway in the corneal keratoconic epithelium.

PMID:36240204 | DOI:10.1371/journal.pone.0273807

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Nevin Manimala Statistics

A measurement invariance analysis of selected Opioid Overdose Knowledge Scale (OOKS) items among bystanders and first responders

PLoS One. 2022 Oct 14;17(10):e0271418. doi: 10.1371/journal.pone.0271418. eCollection 2022.

ABSTRACT

The Opioid Overdose Knowledge Scale (OOKS) is widely used as an adjunct to opioid education and naloxone distribution (OEND) for assessing pre- and post-training knowledge. However, the extent to which the OOKS performs comparably for bystander and first responder groups has not been well determined. We used exploratory structural equation modeling (ESEM) to assess the measurement invariance of an OOKS item subset when used as an OEND training pre-test. We used secondary analysis of pre-test data collected from 446 first responders and 1,349 bystanders (N = 1,795) attending OEND trainings conducted by two county public health departments. Twenty-four items were selected by practitioner/trainer consensus from the original 45-item OOKS instrument with an additional 2 removed owing to low response variation. We used exploratory factor analysis (EFA) followed by ESEM to identify a factor structure, which we assessed for configural, metric, and scalar measurement invariance by participant group using the 22 dichotomous items (correct/incorrect) as factor indicators. EFA identified a 3-factor model consisting of items assessing: basic overdose risk information, signs of an overdose, and rescue procedures/advanced overdose risk information. Model fit by ESEM estimation versus confirmatory factor analysis showed the ESEM model afforded a better fit. Measurement invariance analyses indicated the 3-factor model fit the data across all levels of invariance per standard fit statistic metrics. The reduced set of 22 OOKS items appears to offer comparable measurement of pre-training knowledge on opioid overdose risks, signs of an overdose, and rescue procedures for both bystanders and first responders.

PMID:36240201 | DOI:10.1371/journal.pone.0271418

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Nevin Manimala Statistics

Association of anthropometric indices with the development of multimorbidity in middle-aged and older adults: A retrospective cohort study

PLoS One. 2022 Oct 14;17(10):e0276216. doi: 10.1371/journal.pone.0276216. eCollection 2022.

ABSTRACT

BACKGROUND: Previous studies have explored the relationship between body mass index (BMI) and multimorbidity. However, the relationship between other obesity indicators and their dynamic changes and multimorbidity has not been systematically estimated. Therefore, we aimed to investigate the association of BMI and other obesity indicators, including waist circumference (WC), waist-to-height ratio (WHtR), waist divided by height0.5 (WHT.5R), and body roundness index (BRI) and their changes and the risk of multimorbidity in middle-aged and older adults through a retrospective cohort study.

METHODS: Data collected from annual health examination dataset in the Jinshui during 2017 and 2021. Cox regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) to evaluate the effect of baseline and dynamic changes in the anthropometric indices on the risk of multimorbidity.

RESULTS: A total of 75,028 individuals were included in the study, and 5,886 participants developed multimorbidity during the follow-up. Multivariate Cox regression analysis revealed a progressive increase in the risk of multimorbidity with increasing anthropometric indicators (BMI, WC, WHtR, WHT.5R, and BRI) (all P<0.001). Regardless of general obesity status at baseline, increased WC was associated with a high risk of multimorbidity. Compared to the subjects with baseline BMI<24 kg/m2 and WC<90 (men)/80 (women), the HRs (95% CI) of the baseline BMI<24 kg/m2 and WC≥90 (men)/80 (women) group and BMI≥24 kg/m2 and WC≥90 (men)/80 (women) group were 1.31 (1.08, 1.61) and 1.82 (1.68, 1.97), respectively. In addition, the dynamics of WC could reflect the risk of multimorbidity. When subjects with baseline WC<90 (men)/80 (women) progressed to WC≥90 (men)/80 (women) during follow-up, the risk of multimorbidity significantly increased (HR = 1.78; 95% CI, 1.64, 1.95), while the risk of multimorbidity tended to decrease when people with abnormal WC at baseline reversed to normal at follow-up (HR = 1.40; 95% CI, 1.26, 1.54) compared to those who still exhibited abnormal WC at follow-up (HR = 2.00; 95% CI, 1.82, 2.18).

CONCLUSIONS: Central obesity is an independent and alterable risk factor for the occurrence of multimorbidity in middle-aged and elderly populations. In addition to the clinical measurement of BMI, the measurement of the central obesity index WC may provide additional benefits for the identification of multimorbidity in the Chinese middle-aged and elderly populations.

PMID:36240163 | DOI:10.1371/journal.pone.0276216

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Nevin Manimala Statistics

A systemic review and network meta-analysis of accuracy of intraocular lens power calculation formulas in primary angle-closure conditions

PLoS One. 2022 Oct 14;17(10):e0276286. doi: 10.1371/journal.pone.0276286. eCollection 2022.

ABSTRACT

BACKGROUND: For primary angle-closure and angle-closure glaucoma, the fact that refractive error sometimes deviates from predictions after intraocular lens (IOL) implantation is familiar to cataract surgeons. Since controversy remains in the accuracy of IOL power calculation formulas, both traditional and network meta-analysis on formula accuracy were conducted in patients with primary angle-closure conditions.

METHODS: A comprehensive literature search was conducted through Aug 2022, focusing on studies on intraocular lens power calculation in primary angle-closure (PAC) and primary angle-closure glaucoma (PACG). A systemic review and network meta-analysis was performed. Quality of studies were assessed. Primary outcomes were the mean absolute errors (MAE) and the percentages of eyes with a prediction error within ±0.50 diopiters (D) or ±1.00 D (% ±0.50/1.00 D) by different formulas.

RESULTS: Six retrospective studies involving 419 eyes and 8 formulas (Barrett Universal II, Kane, SRK/T, Hoffer Q, Haigis, Holladay I, RBF 3.0 and LSF) were included. SRK/T was used as a reference as it had been investigated in all the studies included. Direct comparison showed that none of the involved formula outperformed or was defeated by SRK/T significantly in terms of either MAE or % ±0.50/1.00 D (all P>0.05). Network comparison and ranking possibilities disclosed BUII, Kane, RBF 3.0 with statistically insignificant advantage. No significant publication bias was detected by network funnel plot.

CONCLUSIONS: No absolute advantage was disclosed among the formulas involved in this study for PAC/PACG eyes. Further carefully designed studies are warranted to evaluate IOL calculation formulae in this target population.

TRAIL REGISTRATION: Registration: PROSEPRO ID: CRD42022326541.

PMID:36240196 | DOI:10.1371/journal.pone.0276286

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Nevin Manimala Statistics

Commitment to protective measures during the COVID-19 pandemic in Syria: A nationwide cross-sectional study

PLoS One. 2022 Oct 14;17(10):e0275669. doi: 10.1371/journal.pone.0275669. eCollection 2022.

ABSTRACT

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 continues to impose itself on all populations of the world. Given the slow pace of vaccination in the developing world and the absence of effective treatments, adherence to precautionary infection control measures remains the best way to prevent the COVID-19 pandemic from spiraling out of control. In this study, we aim to evaluate the extent to which the Syrian population adheres to these measures and analyze the relationship between demographic variables and adherence.

METHODS: This cross-sectional study took place in Syria between January 17 and March 17, 2021. A structured self-administered questionnaire was used to collect the data. The questionnaire was distributed in both electronic and printed versions. Our sample consisted of 7531 individuals. Collected data were analyzed using SPSS v.25. The chi-square test was used to address the correlation between adherence and demographic variables.

RESULTS: Of the 10083 reached out, only 8083 responded, and 7531 included in the final analysis with an effective response rate of 74.7%. Of them, 4026 (53.5%) were women, 3984 (52.9%) were single, and 1908 (25.3%) had earned university degrees. 5286 (70.25) were in the high level of adherence category to protective measures. Statistically significant differences were documented when investigating the correlation between commitment to preventive measures and age, sex, marital status, financial status, employment, and educational attainment. Furthermore, those who believed that COVID-19 poses a major risk to them, or society were more committed to preventive measures than those who did not.

CONCLUSION: The participants in this study generally showed a high level of adherence to the preventive measures compared to participants in other studies from around the world, with some concerns regarding the sources of information they depend on. Nationwide awareness campaigns should be conducted and focus on maintaining, if not expanding, this level of commitment, which would mitigate the pandemic’s impact on Syrian society.

PMID:36240156 | DOI:10.1371/journal.pone.0275669

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Nevin Manimala Statistics

Cross-cultural investigation from nine countries on the associations of antisocial traits and the WHO’s containment measures for the COVID-19 pandemic

Scand J Psychol. 2022 Oct 14. doi: 10.1111/sjop.12869. Online ahead of print.

ABSTRACT

Personality traits play a role in prosocial behavior in relation to containment measures intended to tackle the COVID-19 pandemic. Empirical findings indicated that individuals high in socially aversive traits such as callousness are less compliant with containment measures. This study aimed to add cross-cultural data on the relationship between antisocial traits and adherence to COVID-19 containment measures. The sample consisted of 4,538 adults recruited by convenience in nine countries (Australia, Brazil, England, Iraq, Iran, Italy, Jordan, Saudi Arabia, and the United States). Statistical analyses indicated two latent profiles from our sample, empathic and antisocial, and six COVID-19 containment-measure-related factors using measures covering antisocial traits (PID-5), empathy (ACME), global personality pathology (LPFS-BF), and COVID-19 behaviors and beliefs. Through MANCOVA, the antisocial profile consistently showed less compliance and concern about the COVID-19 containment measures, even when controlling for demographics and local pandemic covariables. The network analysis indicated a lack of empathy and callousness as crucial traits of the predisposition to non-compliant behavior. In elaborating on prosocial campaigns in community emergencies, our cross-cultural findings would need to consider personality traits that focus on antisociality, anticipating similar associations and potential impacts in future disease outbreaks.

PMID:36240143 | DOI:10.1111/sjop.12869

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Nevin Manimala Statistics

Evaluating Genetic Modifiers of Duchenne Muscular Dystrophy Disease Progression Using Modeling and MRI

Neurology. 2022 Sep 2:10.1212/WNL.0000000000201163. doi: 10.1212/WNL.0000000000201163. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Duchenne muscular dystrophy (DMD) is a progressive muscle degenerative disorder with a well-characterized disease phenotype but considerable interindividual heterogeneity that is not well understood. The aim of the study was to evaluate the effects of dystrophin mutations and genetic modifiers of DMD on rate and age of muscle replacement by fat.

METHODS: 175 corticosteroid treated participants from the ImagingDMD natural history study underwent repeated magnetic resonance spectroscopy (MRS) of the vastus lateralis (VL) and soleus (SOL) to determine muscle fat fraction. MRS was performed annually in the majority of instances; however, some individuals had additional visits at 3 or 6 month intervals. Fat fraction changes over time were modeled using nonlinear mixed effects to estimate disease trajectories based on the age that the VL or SOL reached half-maximum change in fat fraction (mu) and the time required for fat fraction change (sigma). Computed mu and sigma values were evaluated for dystrophin mutations that have demonstrated the ability to lead to a mild phenotype as well as compared between different genetic polymorphism groups.

RESULTS: Participants with dystrophin gene deletions amenable to exon 8 skipping (n=4) had minimal increases in SOL fat fraction and had an increase in VL mu value by 4.4 years compared to a reference cohort (p=0.039). Participants with nonsense mutations within exons that may produce milder phenotypes (n=11) also had minimal increases in SOL and VL fat fractions. No differences in estimated fat fraction trajectories were seen for individuals amenable to exon 44 skipping (n=10). Modeling of the SPP1, LTBP4, and THBS1 genetic modifiers did not result in significant differences in muscle fat fraction trajectories between genotype groups (p>0.05); however, trends were noted for the polymorphisms associated with long-range regulation of LTBP4 and THBS1 that deserve further follow-up.

DISCUSSION: The results of this study link the historically mild phenotypes seen in individuals amenable to exon 8 skipping and with certain nonsense mutations with alterations in trajectories of lower extremity muscle replacement by fat.

PMID:36240102 | DOI:10.1212/WNL.0000000000201163

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Nevin Manimala Statistics

Pea (Pisum sativum L.) pod powder as a potential enhancer of probiotic Enterococcus faecium M74 in ice cream and its physicochemical, structural, and sensory effects

J Sci Food Agric. 2022 Oct 14. doi: 10.1002/jsfa.12276. Online ahead of print.

ABSTRACT

BACKGROUND: In this study, pea (Pisum sativum L.) pod powder (PPP) was incorporated (1 and 3% w/w) into a probiotic ice cream formulation containing Enterococcus faecium M74 to investigate the potential effect of PPP on the probiotic survivability in the ice cream throughout 60 days of frozen storage. Moreover, the produced symbiotic ice creams were evaluated for the physiochemical properties, stability, and sensory acceptability.

RESULTS: Incorporation of PPP in ice cream caused significantly (p<0.05) increased protein and ash content and lower pH values. Besides that, the addition of PPP resulted in ice creams with higher hardness and lower overrun. A significant diminishing was observed in the melting rates of the ice creams as increased the percentage of PPP and progressed storage time. Ice cream with PPP presented lower lightness and higher greenness and yellowness compared with control. All ice creams had viable counts of E. faecium M74 of ≥6 log cfu g-1 during storage and provided the number of viable cells that the probiotic product should contain. On day 60, the viability of E. faecium M74 in ice cream containing 1% PPP (7.64±0.02) was higher than the control (7.28±0.00). Sensory analyzes revealed that there was no statistical difference in ice cream with 1%PPP and the control without PPP in terms of general acceptability.

CONCLUSION: These results suggest that the pea pod, which is a waste product of the pea industry and obtained at zero cost, could be used as a potential prebiotic and an agent to improve technological properties of dairy products. This article is protected by copyright. All rights reserved.

PMID:36240011 | DOI:10.1002/jsfa.12276

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Current concepts in the management of radial head fractures: a national survey and review of the literature

Ann R Coll Surg Engl. 2022 Oct 14. doi: 10.1308/rcsann.2022.0109. Online ahead of print.

ABSTRACT

INTRODUCTION: This study aims to report on current practice in the management of radial head fractures (RHFs) in the United Kingdom and to review the literature to identify areas for future investigation.

METHODS: A 12-question online survey was sent to 500 surgeon members of the British Elbow and Shoulder Society in 2021. Questions focused on clinical assessment, indications for surgical treatment and willingness to participate in future studies. Descriptive statistical analysis summarised the responses.

RESULTS: The response rate was 20.4% (n = 102). For minimally displaced RHFs, non-operative management with immediate mobilisation was reported by 90.2% (n = 92) as opposed to 9.8% (n = 10) for initial immobilisation in plaster or brace. The most cited indication for radial head arthroplasty as opposed to fixation was increased patient age or low functional demand in 69.9% of responses (n = 71). In total, 41.2% (n = 42) indicated the need for a future randomised controlled trial (RCT) concerning the management of RHF. Only five RCTs were returned by the literature review.

DISCUSSION: There is considerable variability in the management of RHF among an experienced cohort of surgeons. With the interest declared by the participating surgeons, there is a call for a well-designed sufficiently powered RCT.

PMID:36239976 | DOI:10.1308/rcsann.2022.0109

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Nevin Manimala Statistics

Optic Nerve Head Myelin-Related Protein, GFAP, and Iba1 Alterations in Non-Human Primates With Early to Moderate Experimental Glaucoma

Invest Ophthalmol Vis Sci. 2022 Oct 3;63(11):9. doi: 10.1167/iovs.63.11.9.

ABSTRACT

PURPOSE: The purpose of this study was to test if optic nerve head (ONH) myelin basic protein (MBP), 2′,3′-cyclic nucleotide 3′-phosphodiesterase (CNPase), glial fibrillary acidic protein (GFAP), and ionized calcium binding adaptor molecule 1 (Iba1) proteins are altered in non-human primate (NHP) early/moderate experimental glaucoma (EG).

METHODS: Following paraformaldehyde perfusion, control and EG eye ONH tissues from four NHPs were paraffin embedded and serially (5 µm) vertically sectioned. Anti-MBP, CNPase, GFAP, Iba1, and nuclear dye-stained sections were imaged using sub-saturating light intensities. Whole-section images were segmented creating anatomically consistent laminar (L) and retrolaminar (RL) regions/sub-regions. EG versus control eye intensity/pixel-cluster density data within L and two RL regions (RL1 [1-250 µm]/RL2 [251-500 µm] from L) were compared using random effects models within the statistical program “R.”

RESULTS: EG eye retinal nerve fiber loss ranged from 0% to 20%. EG eyes’ MBP and CNPase intensity were decreased within the RL1 (MBP = 31.4%, P < 0.001; CNPase =62.3%, P < 0.001) and RL2 (MBP = 19.6%, P < 0.001; CNPase = 56.1%, P = 0.0004) regions. EG eye GFAP intensity was decreased in the L (41.6%, P < 0.001) and RL regions (26.7% for RL1, and 28.4% for RL2, both P < 0.001). Iba1+ and NucBlue pixel-cluster density were increased in the laminar (28.2%, P = 0.03 and 16.6%, P = 0.008) and both RL regions (RL1 = 37.3%, P = 0.01 and 23.7%, P = 0.0002; RL2 = 53.7%, P = 0.002 and 33.2%, P < 0.001).

CONCLUSIONS: Retrolaminar myelin disruption occurs early in NHP EG and may be accompanied by laminar and retrolaminar decreases in astrocyte process labeling and increases in microglial/ macrophage density. The mechanistic and therapeutic implications of these findings warrant further study.

PMID:36239974 | DOI:10.1167/iovs.63.11.9