Tag: pubmed

PLoS One. 2021 Aug 5;16(8):e0255608. doi: 10.1371/journal.pone.0255608. eCollection 2021.

ABSTRACT

BACKGROUND: The diversity in the clinical course of COVID-19 has been related to differences in innate and adaptative immune response mechanisms. Natural killer (NK) lymphocytes are critical protagonists of human host defense against viral infections. It would seem that reduced circulating levels of these cells have an impact on COVID-19 progression and severity. Their activity is strongly regulated by killer-cell immuno-globulin-like receptors (KIRs) expressed on the NK cell surface. The present study’s focus was to investigate the impact of KIRs and their HLA Class I ligands on SARS-CoV-2 infection.

METHODS: KIR gene frequencies, KIR haplotypes, KIR ligands and combinations of KIRs and their HLA Class I ligands were investigated in 396 Sardinian patients with SARS-CoV-2 infection. Comparisons were made between 2 groups of patients divided according to disease severity: 240 patients were symptomatic or paucisymptomatic (Group A), 156 hospitalized patients had severe disease (Group S). The immunogenetic characteristics of patients were also compared to a population group of 400 individuals from the same geographical areas.

RESULTS: Substantial differences were obtained for KIR genes, KIR haplotypes and KIR-HLA ligand combinations when comparing patients of Group S to those of Group A. Patients in Group S had a statistically significant higher frequency of the KIR A/A haplotype compared to patients in Group A [34.6% vs 23.8%, OR = 1.7 (95% CI 1.1-2.6); P = 0.02, Pc = 0.04]. Moreover, the KIR2DS2/HLA C1 combination was poorly represented in the group of patients with severe symptoms compared to those of the asymptomatic-paucisymptomatic group [33.3% vs 50.0%, OR = 0.5 (95% CI 0.3-0.8), P = 0.001, Pc = 0.002]. Multivariate analysis confirmed that, regardless of the sex and age of the patients, the latter genetic variable correlated with a less severe disease course [ORM = 0.4 (95% CI 0.3-0.7), PM = 0.0005, PMC = 0.005].

CONCLUSIONS: The KIR2DS2/HLA C1 functional unit resulted to have a strong protective effect against the adverse outcomes of COVID-19. Combined to other well known factors such as advanced age, male sex and concomitant autoimmune diseases, this marker could prove to be highly informative of the disease course and thus enable the timely intervention needed to reduce the mortality associated with the severe forms of SARS-CoV-2 infection. However, larger studies in other populations as well as experimental functional studies will be needed to confirm our findings and further pursue the effect of KIR receptors on NK cell immune-mediated response to SARS-Cov-2 infection.

PMID:34352002 | DOI:10.1371/journal.pone.0255608

PLoS One. 2021 Aug 5;16(8):e0255655. doi: 10.1371/journal.pone.0255655. eCollection 2021.

ABSTRACT

BACKGROUND: The relationship between institutional liver transplantation (LT) case volume and clinical outcomes after liver re-transplantation is yet to be determined.

METHODS: Patients who underwent liver re-transplantation between 2007 and 2016 were selected from the Korean National Healthcare Insurance Service database. Liver transplant centers were categorized to either high-volume centers (≥ 64 LTs/year) or low-volume centers (< 64 LTs/year) according to the annual LT case volume. In-hospital and long-term mortality after liver re-transplantation were compared.

RESULTS: A total of 258 liver re-transplantations were performed during the study period: 175 liver re-transplantations were performed in 3 high-volume centers and 83 were performed in 21 low-volume centers. In-hospital mortality after liver re-transplantation in high and low-volume centers were 25% and 36% (P = 0.069), respectively. Adjusted in-hospital mortality was not different between low and high-volume centers. Adjusted 1-year mortality was significantly higher in low-volume centers (OR 2.14, 95% CI 1.05-4.37, P = 0.037) compared to high-volume centers. Long-term survival for up to 9 years was also superior in high-volume centers (P = 0.005). Other risk factors of in-hospital mortality and 1-year mortality included female sex and higher Elixhauser comorbidity index.

CONCLUSION: Centers with higher case volume (≥ 64 LTs/year) showed lower in-hospital and overall mortality after liver re-transplantation compared to low-volume centers.

PMID:34351979 | DOI:10.1371/journal.pone.0255655

PLoS One. 2021 Aug 5;16(8):e0255545. doi: 10.1371/journal.pone.0255545. eCollection 2021.

ABSTRACT

INTRODUCTION: 2021 Global Initiative for Chronic Obstructive Lung Disease (GOLD) Reports recommends that patients with clinically significant symptoms and exacerbations of chronic obstructive pulmonary disease (COPD) should escalate to triple therapy, a combined use of inhaled corticosteroids (ICS), long-acting muscarinic antagonists (LAMA) and long-acting b2-agonists (LABA)(ICS/LAMA/LABA). Triple therapy in fixed-dose combinations (FDCs), i.e., combining ICS, LABA with LAMA and administrating by a single inhalation device, has appeared in recent years. This study aims to compare the efficacy of triple therapy in FDCs in treating patients with moderate to severe COPD.

METHODS AND ANALYSES: Literature search will be conducted on PubMed, Embase and Web of science, according to pre-specified and corresponding search strategies, for relevant reports published since the inception dates of the databases. Randomised controlled trials (RCT) which compared the triple therapy in FDCs with other pharmacological therapies will be included. The Cochrane risk of bias assessment tool (RoB 2) will be used to assess the RCT quality. The outcomes will be analyzed as rate ratios and mean differences under a random-effects model in a frequentist network meta-analysis (NMA). Additional statistical analyses including subgroup analysis, sensitivity analysis, and publication bias analysis will be performed to assess the evidential heterogeneity and robustness. The strength of evidence from the NMA will be evaluated with the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) methods.

ETHICS AND DISSEMINATION: No ethics approval is required as this systematic review and network meta-analysis do not collect confidential personal data and do not carry out interventions in treating patients.

PROTOCOL REGISTRATION NUMBER: CRD42021240823.

PMID:34351996 | DOI:10.1371/journal.pone.0255545

PLoS One. 2021 Aug 5;16(8):e0255195. doi: 10.1371/journal.pone.0255195. eCollection 2021.

ABSTRACT

INTRODUCTION: Urinary excretion of calcium (Ca), magnesium (Mg), phosphorus (P), iodine and fluoride is used to assess their statuses and/or the existence of metabolic abnormalities. In the United Arab Emirates (UAE), the urinary concentration of these minerals among children have not been documented.

MATERIALS AND METHODS: A cross-sectional study, including 593 subjects (232 boys and 361 girls), was conducted among healthy 6 to 11-year-old Emirati children living in Dubai. Non-fasting morning urine samples and anthropometrical measurements were collected and analyzed. Results were expressed as per mg of creatinine (Cr).

RESULTS: On average, estimated Cr excretion was 17.88±3.12 mg/kg/d. Mean urinary Ca/Cr, Mg/Cr and P/Cr excretions were 0.08±0.07 mg/mg, 0.09±0.04 mg/mg, and 0.57±0.26 mg/mg respectively. Urinary excretion of Ca, Mg and P were found to decrease as age increased. Urinary excretion and predicted intake of fluoride were lower than 0.05 mg/kg body weight per day. Surprisingly, more than 50% of the children were found to have urinary iodine excretion level above adequate.

CONCLUSION: The Emirati schoolchildren had comparable levels of urinary Ca, Mg and P excretion to other countries. The 95% percentile allows the use of the current data as a reference value for the detection of mineral abnormalities. Fluoride excretion implies that Emirati children are at low risk of fluorosis. The level of urinary iodine excretion is slightly higher than recommended and requires close monitoring of the process of salt iodization to avoid the harmful impact of iodine overconsumption.

PMID:34351961 | DOI:10.1371/journal.pone.0255195

PLoS One. 2021 Aug 5;16(8):e0255233. doi: 10.1371/journal.pone.0255233. eCollection 2021.

ABSTRACT

Due to the complexity of socio-economic-related issues, people thought of housing market as a chaotic nucleus situated at the intersection of neighboring sciences. It has been known that the dependence of house features on the residential property value can be estimated employing the well-established hedonic regression analysis method in teams of location characteristic, neighborhood characteristic and structure characteristic. However, to further assess the roles of urban infrastructures in housing markets, we proposed a new kind of volatility measure for house prices utilizing the Lie symmetry analysis of quantum theory based on Schrödinger equation, mainly focusing on the effects of transportation systems and public parks on residential property values. Based on the municipal open government data regularly collected for four cities, including Boston, Milwaukee, Taipei and Tokyo, and all spatial sampling sites were featured by United States Geological Survey (USGS) National Map, transportation and park were modelled as perturbations to the quantum states generated by the feature space in response to the environmental amenities with different spatial extents. In an attempt to ascertain the intrinsic impact of the location-dependent price information obtained, the similarity functions associated with the Schrödinger equation were considered to facilitate revealing the city amenities capitalizing into house prices. By examining the spatial spillover phenomena of house prices in the four cities investigated, it was found that the mass transit systems and the public green lands possessed the infinitesimal generators of Lie point symmetries Y2 and Y5, respectively. Compared statistically with the common performance criteria, including mean absolute error (MAE), mean squared error (MSE) and, root mean squared error (RMSE) obtained by hedonic pricing model, the Lie symmetry analysis of the Schrödinger equation approach developed herein was successfully carried out. The invariant-theoretical characterizations of economics-related phenomena are consonant with the observed residential property values of the cities internationally, ultimately leading to develop a new perspective in the global financial architecture.

PMID:34351968 | DOI:10.1371/journal.pone.0255233

J Public Health Res. 2021 Aug 5. doi: 10.4081/jphr.2021.2307. Online ahead of print.

ABSTRACT

BACKGROUND: Firefighting is a hazardous occupation, and the firefighters’ fitness for duty is affected by their knowledge of and attitudes toward their health and their relationship in the development of cardiovascular disease (CVD). The aim of this study was to assess knowledge and attitude toward health and CVD risk factors among firefighters in South Africa.

DESIGN AND METHODS: The study used a cross-sectional research design. A sample of 110 firefighters, males and females, aged 18 to 65 years were conveniently sampled from the City of Cape Town Fire and Rescue Service. A researcher-generated self-administered questionnaire was completed online to obtain data from firefighters. A p-value of less than 0.05 indicated statistical significance.

RESULTS: The results showed that 52.8% of firefighters had a poor knowledge of health, and 47.2% had a good knowledge of health, while 10% reported a negative attitude towards health and 90.0% had a positive attitude towards health. There was a significant difference between firefighters’ knowledge of health and their attitudes toward health (p<0.05), particularly related to marital status, age, years of experience and in those with CVD risk factors (p<0.05). Significant correlations were found between knowledge of CVD and knowledge of health-risk behaviors (p<0.05).

CONCLUSION: Significant differences in health knowledge and attitudes toward health were present in married, aged and hypertensive firefighters. Overall health knowledge and health-risk behaviours were significant predictors of attitudes toward health.

PMID:34351095 | DOI:10.4081/jphr.2021.2307

J Public Health Res. 2021 Aug 4. doi: 10.4081/jphr.2021.2434. Online ahead of print.

ABSTRACT

BACKGROUND: The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) included Internet Gaming Disorder (IGD) as a tentative diagnosis and inquires for additional research. The research on gaming is inconsistent regarding measurement approach and diagnostic cut-offs. Some scholars suggest the core approach, accentuating some of the diagnostic criteria to avoid pathologizing harmless behavior. Also, the co-occurrence of gaming and other addictions, gambling in specifically, is frequently reported but poorly understood. The present study aimed to explore gaming within a population of online gamblers in order to evaluate the core approach but also to investigate the possible co-occurrence of different addictions.

DESIGN AND METHODS: The present study is derived from material collected for a study on online gambling. The study addressed 1007 adult individuals from the general population who had gambled for money on an online casino site or an online betting site, on at least 10 occasions during the past 12 months.

RESULTS: Both the level of distress and problem gambling increased as the severity of gaming increased. The co-occurrence of problems with alcohol, illicit drug use/prescription sedatives/strong painkillers and gambling was roughly 50% among the addictive gamers.

CONCLUSION: The present study suggests that the core approach manages to distinguish in severity of gaming in regards to interference and comorbidity. We also brought light to the occurrence of gaming within a population of gamblers and our results indicate that this specific group of addicted gamers are particularly burdened by co-occurrent addictive behaviors and severe distress.

PMID:34351102 | DOI:10.4081/jphr.2021.2434

ESC Heart Fail. 2020 Dec;7(6):3383-3391. doi: 10.1002/ehf2.13125.

ABSTRACT

AIMS: Functional mitral regurgitation (MR) (FMR) is common in heart failure with reduced ejection fraction and worsens morbidity and mortality, even when mild. The CARILLON® mitral contour system (Cardiac Dimensions, Kirkland, WA, USA), a mitral annuloplasty device delivered percutaneously to the coronary sinus, is designed to reduce the mitral annular dimension by virtue of the close anatomic relationship between the coronary sinus and the posterior mitral annulus. We performed a comprehensive individual patient data meta-analysis of all studies that used CARILLON® device vs. control that have measured mitral regurgitation severity, left ventricular (LV) remodelling, functional status, and heart failure-related outcomes in heart failure with reduced ejection fraction patients.

METHODS AND RESULTS: The Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE were searched in July 2020. Primary outcomes of interest were measures of MR severity, LV remodelling, New York Heart Association functional class and heart failure-related outcomes [mortality and heart failure hospitalization (HFH) during follow up]. All data were received as individual patient and individual time point data-points. Mean differences and 95% confidence intervals (CIs) were calculated for continuous data using a fixed-effects model. Three studies (REDUCE FMR, TITAN and TITAN II) enrolling 209 participants were identified and included. Pooled analysis showed that, compared with control, CARILLON® device significantly improved both MR volume (mean difference MD -9.20, 95% C.I. -16.11 to -2.29 mL, P = 0.009) and MR grade (MD -1.12, 95% CI -1.36 to -0.88, P < 0.00001) and this was associated with a significant reduction in LA volume, MD -7.54 mL, 95% CI -14.90 to – 0.18, P = 0.04. Significant LV reverse remodelling was also seen in terms of EDV (MD -16.53, 95% CI -28.61 to -44.4 mL, P = 0.007), and a trend in ESV (MD -8.68, 95% CI -18.69 to -1.34 mL, P = 0.09) but no significant effect on LVEF (MD 0.88, 95% CI -1.52% to 2.38%, P = 0.47), due presumably to the greater residual MR in the control patients falsely elevating the LVEF. In addition, the CARILLON® device significantly improved New York Heart Association functional Class (MD -0.22, 95% CI -0.24 to -0.16, P < 0.00001), associated with a lower rate of HFH compared with controls (45.3% vs. 64%, respectively, P = 0.04). As a sensitivity analysis we also restricted the analyses to those patients with Class 3+/4+ MR at baseline. In this cohort, the echocardiographic results were similar, and the reduction in HFH rates was even more marked (43.9% vs. 82.9%, respectively, P = 0.04).

CONCLUSIONS: This comprehensive meta-analysis of individual patient data has shown that CARILLON® device provides statistically significant and clinically meaningful benefits on MR severity, LA and LV volumes, and remodelling and rates of subsequent heart failure hospitalization.

PMID:34351074 | DOI:10.1002/ehf2.13125

Pol Arch Intern Med. 2021 Aug 5. doi: 10.20452/pamw.16071. Online ahead of print.

ABSTRACT

Introduction Cardio-vascular mortality in end-stage renal disease patients remains high despite advancement in dialysis techniques. This can be attributed to a number of traditional and non-traditional risk factors. Overhydration seems to be one of the promising non-traditional cardio-vascular risk factors to target in order to improve the survival. Objectives The aim of this study was to assess the influence of chronic overhydration and its dynamic changes on cardio-vascular and all-cause morbidity and mortality in the group of hemodialyzed patients. Patients and methods The study has been conducted on a total number of 511 patients. Hydration was assessed with whole-body bioimpedance spectroscopy. The entire cohort has been divided into 4 subgroups according to initial hydration value. Additionally, patients with at least 2 observation visits (n = 277) have been assigned to 4 subgroups created with respect to hydration change-over-time. Results Statistical analysis showed that male gender (P <0.001), diabetes (P <0.001), heart insufficiency (P < 0.001), smoking (P = 0.049) and cerebrovascular incidents (P = 0.007) were significant risk factors for overhydration. Cardiovascular toxicity of overhydration was reflected with elevated levels of NT-proBNP (P <0.001) and cTnT (P <0.001). Albumin and total cholesterol values were the lowest in highly overhydrated subgroups (P <0.001) showing the prevalence of malnutrition. Mortality rate was significantly lower in groups of normal hydration and mild overhydration (P <0.001), as well as of patients with stable low or descending overhydration levels (P = 0.002). Conclusion We can state that the degree of overhydration of hemodialyzed patients is significantly associated with the incidence of cardiovascular complications and affects the prognosis in end-stage renal disease.

PMID:34351089 | DOI:10.20452/pamw.16071

Orthop Surg. 2021 Aug 5. doi: 10.1111/os.13039. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the predictive values of femoral proximal medullary morphology for the use of subtrochanteric osteotomy (STO) in unilateral Crowe IV developmental dysplasia of the hip (DDH).

METHODS: Ninety four patients with unilateral Crowe type IV DDH (59 hips in STO group and 35 hips in the non-STO group) between April 2008 and June 2019 were enrolled. All patients underwent THA using the Pinnacle acetabular shell, ceramic liner and femoral head, the S-ROM stem with proximal sleeve. Three parameters on the standard anteroposterior hip radiographs were measured: the widths of medullary canals at 20 mm above the center of lesser trochanter (CLT)，20 mm below the CLT and the isthmus. Canal flare index (CFI), metaphyseal canal flare index (MCFI), diaphyseal canal flare index (DCFI) were calculated. A S-ROM femoral stem was used in all patients during total hip arthroplasty (THA).

RESULTS: The CFI and DCFI in the STO group were lower than those in the non-STO group. However, there was no statistical difference in MCFI between the two groups. The receiver operating characteristic (ROC) curves shown that DCFI had the highest area under the curve (AUC), at 0.885. This was followed by the CFI, which had an AUC of 0.847. The AUC of MCFI was 0.579. The optimal threshold for DCFI was 1.44, which lead to a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 0.771, 0.898, 0.869, and 0.818, respectively. For CFI, the optimal threshold was 3.28, resulting in a sensitivity, specificity, PPV, and NPV of 0.829, 0.729, 0.878, and 0.644, respectively.

CONCLUSIONS: The DCFI and CFI may be potent indicators in predicting the use of STO in unilateral Crowe IV DDH. The optimal threshold for CFI and DCFI were 3.28 and 1.44 and had good sensitivity and specificity for predicting the use of STO during THA.

PMID:34351063 | DOI:10.1111/os.13039