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Nevin Manimala Statistics

The first SARS-CoV-2 genetic variants of concern (VOC) in Poland: The concept of a comprehensive approach to monitoring and surveillance of emerging variants

Adv Med Sci. 2021 Mar 30;66(2):237-245. doi: 10.1016/j.advms.2021.03.005. Online ahead of print.

ABSTRACT

PURPOSE: We analyzed the SARS-CoV-2 genome using our integrated genome analysis system and present the concept of a comprehensive approach to monitoring and surveillance of emerging variants.

MATERIAL/METHODS: A total of 69 SARS-CoV-2 positive samples (with Ct value ​≤ ​28) were tested. Samples included in this study were selected from 7 areas of eastern Poland. All samples were sequenced on an Illumina MiSeq platform using a 300-cycle MiSeq Reagent Kit v2. BWA was used for reads mapping on the reference SARS-CoV-2 sequence. SAMTools were used for post-processing of reads to genome assembly. Pango lineage and Nexstrain were used to identify variants and amino acid mutations. Statistical analysis was performed with R 4.0.2.

RESULTS: This study shows the first confirmed case of SARS-CoV-2 in Poland with the lineage B.1.351 (known as 501Y.V2 South African variant), as well as another 18 cases with epidemiologically relevant lineage B.1.1.7, known as British variant. Supplementary analysis of SARS-CoV-2 sequences deposited in GISAID shows that the share of a new variant can change rapidly within one month. In addition, we show a complete, integrated concept of a networked system for analyzing the variability of the SARS-CoV-2 genome, which, used in the present study, generated data and a variant report within 6 days.

CONCLUSION: The analyzed viral genomes showed considerable variability with simultaneous clear distinction of local clusters of genomes showing high similarity. Implementing real-time monitoring of new SARS-CoV-2 variants in Poland is urgently needed, and our developed system is available to be implemented on a large scale.

PMID:33827042 | DOI:10.1016/j.advms.2021.03.005

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Tuning ensemble-averaged cargo run length via fractional change in mean kinesin number

Phys Biol. 2021 Apr 7. doi: 10.1088/1478-3975/abf5b3. Online ahead of print.

ABSTRACT

The number of motors carrying cargos in biological cells is not well-defined, instead varying from cargo to cargo about a statistical mean. Predictive understanding of motility in cells therefore requires quantitative insights into mixed ensembles of cargos. Toward this goal, here we employed Monte Carlo simulations to investigate statistical ensembles of cargos carried by a Poisson-distributed number of motors. Focusing on the key microtubule-based motor kinesin-1, our simulations utilized experimentally determined single-kinesin characteristics and alterations in kinesin’s on- and off-rates caused by cellular factors and/or physical load. We found that a fractional increase in mean kinesin number enhances the ensemble-averaged cargo run length and amplifies run-length sensitivity to changes in single-kinesin on-rate and off-rate. These tuning effects can be further enhanced as solution viscosity increases over the range reported for cells. Together, our data indicate that the physiological range of kinesin number sensitively tunes the motility of mixed cargo populations. These effects have rich implications for quantitative and predictive understanding of cellular motility and its regulation.

PMID:33827070 | DOI:10.1088/1478-3975/abf5b3

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Outcomes of Hospitalized COVID-19 Patients Receiving Renin Angiotensin System Blockers and Calcium Channel Blockers

Am J Nephrol. 2021 Apr 7:1-11. doi: 10.1159/000515232. Online ahead of print.

ABSTRACT

INTRODUCTION: Use of certain antihypertensive medications has been an area of interest during the COVID-19 pandemic, and several hypotheses have been developed regarding the effects of renin-angiotensin system blockers as well as calcium channel blockers in those infected with COVID-19. We seek to determine the association between exposure to ACEI, ARB, and CCB and outcomes in those admitted to the hospital with COVID-19 infection.

METHODS: This retrospective cohort study included 841 adult patients hospitalized with COVID-19 infection at the University of Chicago Medical Center between March 25 and June 22, 2020. Out of these 841, 453 patients had a personal history of hypertension. For the first part, we evaluated primary outcomes of in-hospital mortality and ICU admission in hospitalized COVID-19 patients based on their exposure to particular medications regardless of a personal history of hypertension and compared them with those who were not on these medications. For the second part, we evaluated the aforementioned outcomes in 453 patients with a personal history of hypertension based on their medication exposure. Secondary outcomes of length of stay, readmission rate, and new-onset dialysis requirement were also compared across the study groups.

RESULTS: Out of 841 patients, 111 (13.19%) were on ACEI/ARB (median age: 66.1, SD 15.4; 52.25% females) and 730 (86.80%) were not on them (median age: 56.6, SD 20.3; 50.14% females), while 277 (32.93%) used CCB (median age: 64.6, SD 15.2; 57.04% females) and 564 (67.06%) did not use CCB (median age: 54.6, SD 21.2; 47.16% females). After adjusting for demographics and covariates, neither ACEI/ARB nor CCB exposure was associated with any effect on mortality, but ACEI/ARB exposure was associated with 42% reduction in risk of ICU admissions (OR 0.58, 95% CI [0.35, 0.95], p value 0.03). In addition, combined use of ACEI/ARB and CCB was associated with statistically significant (45%) reduction in ICU admission (OR 0.55, 95% CI [0.32, 0.94], p value 0.029). Out of 453 patients with a personal history of hypertension, 85 (18.76%) were taking ACEI/ARB (median age 65, SD 15.6; 56.47% females) and 368 (81.24%) were not on ACEI/ARB (median age 62.8, SD 16.4; 54.89% females), while 208 (45.92%) out of 453 were on CCB (median age 65; SD 14.8; 60.1% females) and 245 (54.08%) were not on CCB (median age 61.7, SD 17.3; 51.02% females). In the fully adjusted model in this group, ACEI use was associated with 71% reduction in in-house mortality (OR 0.29, 95% CI [0.09, 0.93], p value 0.03).

DISCUSSION/CONCLUSION: Among all hospitalized patients with COVID-19 infection, exposure to ACEI/ARB, as well as combined exposure to ACEI/ARB and CCB, were associated with reduced incidence of ICU admissions. In those admitted patients who had a personal history of hypertension, there was a trend towards reduced in-hospital mortality in those exposed to ACEI.

PMID:33827074 | DOI:10.1159/000515232

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Rituximab-containing immuno-chemotherapy regimens are effective for the elimination of EBV for EBV-HLH with only and mainly B lymphocytes of EBV infection

Int Immunopharmacol. 2021 Apr 4;96:107606. doi: 10.1016/j.intimp.2021.107606. Online ahead of print.

ABSTRACT

Patients with Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) have a poor prognosis. This study investigated the efficacy of rituximab-containing immuno-chemotherapy regimens for EBV-HLH. In this study, 15 patients were treated with rituximab-containing regimens. The treatment efficacy and adverse events were evaluated. In 10 patients, EBV DNA became negative after the first course of treatment. The lymphocyte types infected by EBV in the 10 patients were only infected with B cells and mainly infected with B cells. In the other 5 patients, the EBV DNA of peripheral blood mononuclear cells (PBMC) before and after treatment with the regimens had no statistical difference (P = 0.111). In addition, in these 5 patients, EBV mainly infected T and NK cells. Among the 5 patients without a significant decline in EBV DNA of PBMC, 2 patients received allogeneic hematopoietic stem cell transplantation and turned negative for EBV DNA. This study suggests that rituximab-containing regimens are effective therapy for EBV-HLH with only and mainly B lymphocytes infected by EBV, especially for eliminating EBV.

PMID:33826999 | DOI:10.1016/j.intimp.2021.107606

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Delineating the impact of urbanization on the hydrochemistry and quality of groundwater wells in Aba, Nigeria

J Contam Hydrol. 2021 Mar 2;240:103792. doi: 10.1016/j.jconhyd.2021.103792. Online ahead of print.

ABSTRACT

Groundwater samples from 61 randomly selected tube-wells in densely residential (DR) and sparse residential (SR) parts of Aba, Nigeria were analysed to elucidate the influence of urban land-use on the quality and characterize the hydrochemistry of the groundwater. Twelve water quality indicators: temperature, pH, EC, and TDS (physicochemical), as well as HCO3, Cl, SO4, NO3, Na, K, Ca, and Mg (major ions) were analysed for each well. The results of the analyses were grouped based on the influence of land-use on the wells. The descriptive statistics, Piper, Chadha’s, and bivariate scattered plots, as well as index of base ion-exchange, and Friedman nonparametric statistical test were used to delineate and ascertain the significance of the urban impact on the quality of the groundwater wells. The results showed that the groundwater pH is acidic (3.7-5.6), and the mineralization low, with TDS ranging between 6.5 mg/l – 365 mg/l. The statistical mean and standard deviation (x¯±S.D) of the remaining quality indicators were found within the limits set by WHO in all the wells. The Piper and Chadha’s plots revealed four dominant water-types with spatial differentiation in the area. Though there are several mixed water-types in the SR area, the Na-HCO3 water-type is dominant and represents the background hydrochemistry of the groundwater in the area. Whereas, Mg, Ca-Cl, water-types predominates in the DR wells. Other dominant water-types found between the SR and DR areas are Na-Cl and Ca-HCO3 types. The rapid compositional change and local alteration in the hydrochemistry of the groundwater were impacted by some identified urban land-use practices, which introduce additional major ions in the groundwater solution. The mixed water-types found in the SR wells were influenced by factors such as the direction of flow and mixing of the groundwater reservoirs impacted by the hydrochemistry of the DR groundwater, which were upstream to the SR wells. The results of indicators such as EC, TDS, Cl, and NO3, when compared showed observable local deterioration moving from wells in the SR to wells in the DR area. This was supported by the Friedman statistical test which revealed statistical significance of some urban practices on the quality of the groundwater. These results highlight the current quality status and harmonize the reports of previous studies which have characterized the hydrochemistry of the groundwater in the study area.

PMID:33827000 | DOI:10.1016/j.jconhyd.2021.103792

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WebFRIS: An efficient web-based decision support tool to disseminate end-to-end risk information for flood management

J Environ Manage. 2021 Mar 31;288:112456. doi: 10.1016/j.jenvman.2021.112456. Online ahead of print.

ABSTRACT

The present study describes the development of a web-based flood risk information system ‘WebFRIS’ for Jagatsinghpur district, a severely flood-prone region in Eastern India. The WebFRIS is designed by using various readily available open-source web tools and packages such as Google Map, PHP, MySQL, and JSON. Special emphasis is directed towards designing the layout and architecture, to be easily accessible by any end-user irrespective of any technical know-how. The WebFRIS illustrates spatial maps of flood hazard, socio-economic vulnerability, and flood risk at the village level for two-time scenarios. While analyzing a set of graphical statistics depicting the changes in flood risk components, a significant increase in high and very-high categories of both flood hazard (~140%) and socio-economically vulnerable villages (~68%) is noticed during Scenario-I. The number of villages facing compound risk (contributed equally by flood hazard and socio-economic vulnerability) nearly doubled in Scenario-I. A spatial analysis of diametric changes in flood risk shows that a large proportion of villages in Balikuda, Ersama, and Tirtol tehsils have undergone radical changes. Following these observations, a set of possible engineering, social, and policy measures are proposed, whose implementation in the near future is expected to reinforce flood management in the study area. The WebFRIS architecture is flexible, easy-to-use; it is expected to provide crucial lessons to the local bodies, town-planners, water professionals, flood experts, and also the citizens, a precious knowledge on flood risk management. The WebFRIS may be considered as a precious cartographic product for environmental management. The proposed web platform is generic, as it can be applied to study other inter-related systems such as environmental protection, land-use planning, coastal habitat restoration, and community resilience building.

PMID:33827018 | DOI:10.1016/j.jenvman.2021.112456

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Association of Metformin and Abdominal Aortic Aneurysm Repair Outcomes

Ann Vasc Surg. 2021 Apr 4:S0890-5096(21)00279-X. doi: 10.1016/j.avsg.2021.02.048. Online ahead of print.

ABSTRACT

INTRODUCTION: . Metformin is a commonly used drug in diabetes mellitus treatment. Recently it has been suggested that the use of metformin on diabetes mellitus patients may lower the prevalence and slow the progression of AAA (abdominal aortic aneurysm) as well as the risk of rupture related mortality. The aim of this study was to investigate the impact of metformin treatment on the risk of AAA repair related mortality and surgical complications.

METHODS: . In this retrospective study, the clinical data of 306 patients, including 77 patients with diabetes mellitus, who underwent abdominal aortic aneurysm repair has been analysed. Treatment outcomes have been investigated. The diabetes and metformin prescription status has been obtained from the medical history. Patients were divided into three groups: diabetes-free individuals, diabetics treated with metformin and diabetics treated with other glucose lowering drugs. The association between metformin treatment and AAA diameter, surgical complications and mortality were assessed using chi-square independence test and odds ratio analysis. In order to assess which factors are influencing AAA repair related complications and mortality a multi-variables analysis has been performed.

RESULTS: . A significant protective effect of metformin treatment towards AAA repair related mortality (p=0.019) and complications (p=0.032) among patients suffering from diabetes mellitus was revealed. These findings were statistically insignificant when considering all groups of patients (diabetes-free individuals, diabetics treated with metformin and diabetics treated with other glucose lowering drugs).

CONCLUSION: . Metformin may lower the risk of AAA repair related mortality and surgical complications among patients with diabetes.

PMID:33826959 | DOI:10.1016/j.avsg.2021.02.048

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A Systematic Review and Meta-analysis of Ligation Versus Repair of Inferior Vena Cava Injuries

Ann Vasc Surg. 2021 Apr 4:S0890-5096(21)00251-X. doi: 10.1016/j.avsg.2021.02.032. Online ahead of print.

ABSTRACT

OBJECTIVE: Inferior vena cava (IVC) injuries have a high mortality rate that may be related to the location of injury and type of repair. Previous studies have been either single center series or database studies lacking granular detail. These have reported conflicting results. We aimed to perform a systematic review and meta-analysis of published literature evaluating ligation versus repair.

METHODS: Studies published in English on MEDLINE or EMBASE from 1946 through October 2018 were examined to evaluate mortality among patients treated with ligation versus repair of IVC injuries. Studies were included if they provided mortality associated with ligation versus repair and reported IVC injury by level. Risk of bias was assessed regarding incomplete and selective outcome reporting with Newcastle-Ottawa score of 7 or higher to evaluate study quality. We used a random-effects model with restricted maximum likelihood estimation method in R using the Metafor package to evaluate outcomes.

RESULTS: Our systematic review identified 26 studies, of which 14 studies, including 855 patients, met our inclusion criteria for meta-analysis. IVC ligation was associated with higher mortality than IVC repair (OR: 3.12, p<0.01, I2=49%). Ligation of infrarenal IVC injuries was not statistically associated with mortality (OR: 3.13, p=0.09). Suprarenal injury location compared to infrarenal (OR 3.11, p<0.01, I2=28%) and blunt mechanism compared to penetrating (OR: 1.91, p=0.02, I2=0%) were also associated with higher mortality.

CONCLUSIONS: In this meta-analysis, ligation of IVC injuries was associated with increased mortality compared to repair, but not specifically for infrarenal IVC injuries. Suprarenal IVC injury, and blunt mechanism was associated with increased mortality compared to infrarenal IVC injury and penetrating mechanism, respectively. Data are limited regarding acute renal injury and venous thromboembolic events after IVC ligation and may warrant multicenter studies. Standardized reporting of IVC injury data has not been well established and is needed in order to enable comparison of outcomes across institutions. In particular, reporting of injury location, severity, and repair type should be standardized. A contemporary prospective, multicenter study is needed in order to definitively compare surgical technique.

PMID:33826960 | DOI:10.1016/j.avsg.2021.02.032

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Associations of childhood executive control with adolescent cigarette and E-cigarette use: Tests of moderation by poverty level

Addict Behav. 2021 Mar 26;119:106923. doi: 10.1016/j.addbeh.2021.106923. Online ahead of print.

ABSTRACT

BACKGROUND: Adolescent cigarette smoking has continued to decline, whereas electronic cigarette (e-cigarette) use has increased dramatically among youth. Nicotine use in any form, even at low levels, during adolescence can have adverse consequences, particularly for low-income individuals. To elucidate potential early intervention targets, this study examined childhood executive control (EC), a set of cognitive processes for directing attention and behavior, in relation to adolescent cigarette and e-cigarette onset, testing for differential prediction by poverty level.

METHOD: Participants were 313 children (51% female, 64% European American) recruited in a small city in the Midwestern United States beginning in 2006 and then followed into adolescence between ages 14 and 16 years. EC was measured in the laboratory with performance-based tasks when children were age 5 years, 3 months. Self-reports of cigarette onset and e-cigarette onset were obtained in adolescence (Mage = 15.65 years). Overall, 24% of the sample was at or below the poverty line.

RESULTS: Cigarette onset was higher in the poverty group (17%) than in the non-poverty (8%) group, but e-cigarette onset did not differ by poverty level (36% poverty versus 38% non-poverty). Multiple group structural equation modeling revealed a statistically significant group difference such that EC ability was a significant negative predictor of e-cigarette onset for poverty but not for non-poverty youth. A similar group difference was evident as a trend for cigarette onset.

CONCLUSIONS: Because EC has been shown to be modifiable, early interventions to improve EC for children living in poverty might help prevent adolescent e-cigarette onset.

PMID:33826966 | DOI:10.1016/j.addbeh.2021.106923

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Association Between Breast Arterial Calcification on Mammography and Coronary Artery Disease: A Systematic Review and Meta-Analysis

J Womens Health (Larchmt). 2021 Apr 7. doi: 10.1089/jwh.2020.8733. Online ahead of print.

ABSTRACT

Background: Breast arterial calcification (BAC), which may be detected during screening mammography, is hypothesized to be a noninvasive imaging marker that may enhance cardiovascular risk assessment. Materials and Methods: In this systematic review and meta-analysis, we sought to assess the association between BAC and coronary artery disease (CAD) by conducting a meta-analysis. We conducted a literature search of PubMed, Scopus, Cochrane library, ClinicalTrials.gov, and conference proceedings, from inception through December 24, 2019. The outcome of interest was the presence of CAD in patients with BAC. This was reported as crude and adjusted odds ratio (OR). Results: A total of 18 studies comprising 33,494 women (mean age of 60.8 ± 3.7 years, 25% with diabetes, 57% with hypertension, and 21% with history of tobacco smoking) were included in the current meta-analysis. The prevalence of BAC among study participants was 10%. There was a statistically significant association between BAC and CAD (unadjusted OR 2.14; 95% confidence interval [CI] 1.63-2.81, p < 0.001, I2 = 76.5%). Moreover, adjusted estimates were available from 10 studies and BAC was an independent predictor of CAD (OR 2.39; 95% CI 1.68-3.41, p < 0.001, I2 = 61.7%). In the meta-regression analysis, covariates included year of publication, age, hypertension, diabetes mellitus, and history of tobacco smoking. None of these study covariates explained the heterogeneity across studies. Conclusions: BAC detected as part of screening mammography is a promising noninvasive imaging marker that may enhance CAD risk prediction in women. The clinical value of BAC for cardiovascular risk stratification merits further evaluation in large prospective studies.

PMID:33826862 | DOI:10.1089/jwh.2020.8733