Tag: pubmed

BMC Public Health. 2021 Jun 14;21(1):1136. doi: 10.1186/s12889-021-11155-3.

ABSTRACT

BACKGROUND: Nepal recorded 5754 suicides in 2018-19 – a high number for a relatively small country. Over 24% of these suicides were by poisoning, most by ingestion of highly concentrated agricultural pesticides. Nepal has actively regulated pesticides to reduce their health impacts since 2001. We aimed to analyse Nepal’s history of pesticide regulation, pesticides responsible for poisonings, and relate them to national suicide rates.

METHODS: Information on pesticide regulation was collected from the Plant Quarantine and Pesticide Management Centre of the Ministry of Agriculture and Livestock Development. National data on suicides from 1980 to 2019 were obtained from the National Statistical Bureau and Nepal Police. Data on the pesticides responsible for self-poisoning and pesticide suicides over time were obtained from a systematic literature review.

RESULTS: As of June 2020, 171 pesticides were registered for use in Nepal, of which one was extremely hazardous (WHO Class Ia), one other highly hazardous (WHO Class Ib), and 71 moderately hazardous (WHO Class II). Twenty-four pesticides have been banned since 2001, with eight (including five WHO Class I compounds) banned in 2019. Although the suicide rate has increased more than twelve-fold since 1980, particularly for hanging (15-fold increase from 1980 to 2018), fatal pesticide self-poisoning has increased by 13-fold. Methyl-parathion is reported to be the key pesticide responsible for pesticide self-poisoning in Nepal, despite being banned in 2006.

CONCLUSION: The full effect of the recent pesticide policy reform in Nepal remains to be seen. Our analysis shows a continuing increase in suicide numbers, despite bans of the most important pesticide in 2006. This may indicate smuggling across the border and the use of the brand name (Metacid) for pesticides in general making it difficult to identify the responsible pesticide. More information is required from forensic toxicology labs that identify the individual compounds found. The effect of recent bans of common suicide pesticides needs to be monitored over the coming years. Evidence from other Asian countries suggests that HHPs bans will lead to a marked reduction in suicides, as well as fewer cases of occupational poisoning.

PMID:34120596 | DOI:10.1186/s12889-021-11155-3

Virulence. 2021 Dec;12(1):1527-1537. doi: 10.1080/21505594.2021.1936769.

ABSTRACT

We prospectively investigated the neurological development in infants born from mothers treated with telbivudine (LdT) in the third trimester for prevention of hepatitis B virus (HBV) mother-to-infant transmission. Mothers with high HBV load were assigned to either the LdT group (n = 81, 600 mg of LdT each day from gestational week 28 to delivery) or the Control group (n = 39, untreated). Their infants were followed for 36 months to assess physical and neurological developments with Gesell Developmental Schedule tools. At 12 months after birth, the mean scores in the LdT group for gross motor, fine motor, adaptive, linguistic, and personal social domains were similar to those in the Control group. At 36 months, infants in the LdT group had higher mean scores for gross motor than the Control group (98.42 ± 9.69 vs. 94.54 ± 7.48, P = 0.03). In the LdT group, the rates of normal development were higher for gross motor (96.30% vs. 82.05% P = 0.01) and lower for adaptive (74.07% vs. 92.31% P = 0.02). Multivariate regression analyses showed that exposure to LdT during pregnancy was independently associated with infant’s development in gross motor (OR 6.49, 95% CI 1.37-30.20, P = 0.02) and adaptive (OR 0.18, 95% CI 0.05-0.71, P = 0.01) at 36 months. These results suggest that prenatal LdT exposure might affect neurological development in long-term observation.Abbreviations: LdT: telbivudine; HBV: hepatitis B virus; HBsAg: hepatitis B surface antigen; HBeAg: hepatitis Be antigen; HbsAb: hepatitis B surface antibody; ALT: alanine aminotransferase; NA: nucleoside/nucleotide analog; LAM: lamivudine; MTCT: mother-to-child transmission; GDS: Gesell Developmental Schedule; OR: odds ratio; CI: confidence interval; DQ: developmental quotient; RMB: renminbi; BMI: body mass Index; HBIG: hepatitis B immunoglobulin.

PMID:34120564 | DOI:10.1080/21505594.2021.1936769

BMC Bioinformatics. 2021 Jun 13;22(1):322. doi: 10.1186/s12859-021-04240-2.

ABSTRACT

BACKGROUND: Assessing the nucleosome-forming potential of specific DNA sequences is important for understanding complex chromatin organization. Methods for predicting nucleosome positioning include bioinformatics and biophysical approaches. An advantage of bioinformatics methods, which are based on in vivo nucleosome maps, is the use of natural sequences that may contain previously unknown elements involved in nucleosome positioning in vivo. The accuracy of such prediction attempts reflects the genomic coordinate resolution of the nucleosome maps applied. Nucleosome maps are constructed using micrococcal nuclease digestion followed by high-throughput sequencing (MNase-seq). However, as MNase has a strong preference for A/T-rich sequences, MNase-seq may not be appropriate for this purpose. In addition to MNase-seq-based maps, base pair-resolution chemical maps of in vivo nucleosomes from three different species (budding and fission yeasts, and mice) are currently available. However, these chemical maps have yet to be integrated into publicly available computational methods.

RESULTS: We developed a Bioconductor package (named nuCpos) to demonstrate the superiority of chemical maps in predicting nucleosome positioning. The accuracy of chemical map-based prediction in rotational settings was higher than that of the previously developed MNase-seq-based approach. With our method, predicted nucleosome occupancy reasonably matched in vivo observations and was not affected by A/T nucleotide frequency. Effects of genetic alterations on nucleosome positioning that had been observed in living yeast cells could also be predicted. nuCpos calculates individual histone binding affinity (HBA) scores for given 147-bp sequences to examine their suitability for nucleosome formation. We also established local HBA as a new parameter to predict nucleosome formation, which was calculated for 13 overlapping nucleosomal DNA subsequences. HBA and local HBA scores for various sequences agreed well with previous in vitro and in vivo studies. Furthermore, our results suggest that nucleosomal subsegments that are disfavored in different rotational settings contribute to the defined positioning of nucleosomes.

CONCLUSIONS: Our results demonstrate that chemical map-based statistical models are beneficial for studying nucleosomal DNA features. Studies employing nuCpos software can enhance understanding of chromatin regulation and the interpretation of genetic alterations and facilitate the design of artificial sequences.

PMID:34120589 | DOI:10.1186/s12859-021-04240-2

Scand J Public Health. 2021 Jun 14:14034948211019798. doi: 10.1177/14034948211019798. Online ahead of print.

ABSTRACT

BACKGROUND: Health literacy (HL) is an important determinant for maintaining and improving health throughout the lifespan. This underlines the need to monitor HL, including among adolescents, and to understand the factors explaining HL, with a view to decreasing differences in HL. The aim of this study was to objectively measure HL, and the relationship between HL and socio-demographic factors (gender, language of instruction, pupils’ educational aspirations, parents’ educational background and pupils’ school achievement) among pupils (n = 3652) at the end of basic education in Finland.

METHODS: A nationally representative assessment, which included 55 items on HL, was conducted as a traditional paper-and-pencil test in schools. The data were analysed via descriptive statistics and a two-level hierarchical linear model to determine how the socio-demographic factors affected HL.

RESULTS: The pupils’ average score on the HL test items was 58.9%, indicating a satisfactory HL level. A two-level hierarchical linear model showed that the variables (gender, language of instruction, pupils’ educational aspirations, parents’ educational background and pupils’ school achievement) predicting the HL level had statistically significant effects.

CONCLUSIONS: Among ninth graders (15-16 years old), almost one third of the boys and 8% of the girls exhibited an unsatisfactory HL level. The study also confirmed the importance of school-related factors in explaining HL differences. Since low HL has been linked to several unfavourable health indicators and has been viewed as an underestimated problem in times of pandemic and other health crises, the findings suggest that the HL level of Finnish ninth graders is a clear public-health issue.

PMID:34120530 | DOI:10.1177/14034948211019798

Ther Adv Cardiovasc Dis. 2021 Jan-Dec;15:17539447211012803. doi: 10.1177/17539447211012803.

ABSTRACT

BACKGROUND: Rates of obesity continue to rise worldwide as evidenced in the 2017 Centers for Disease Control and Prevention (CDC) report that indicated over 35% of United States (US) citizens are obese, with Louisiana ranked as the fifth most obese state in America. Since large clinical trials tend to exclude obese patients, health care providers are faced with concerns of under- or overdosing these patients on warfarin.

METHODS: This retrospective chart review evaluated patients who reported to a community anticoagulation clinic for warfarin management between 1 June 2017 and 30 September 2017. Along with baseline demographics, chronic use of drugs that have clinically significant interactions with warfarin, social activity such as tobacco use and alcohol consumption, were collected. Body mass indexes (BMI) were collected and categorized according to the World Health Organization definitions as follows: Normal (BMI 18-24.9 kg/m²), Overweight (25-29.9 kg/m²), Obesity Class I (30-34.9 kg/m²), Obesity Class II (35-39.9 kg/m²), Obesity Class III (⩾40 kg/m²). The primary outcome was the mean 90-day warfarin dose required to maintain “intermediate control” or “good control” of international normalized ratio (INR), stratified by BMI classifications. The secondary outcome was the time in therapeutic range (TTR) stratified by BMI classifications.

RESULTS: A total of 433 patient encounters were included in this study. There was a total of 43 encounters in the Normal BMI category, 111 Overweight encounters, 135 Obesity Class I encounters, 45 Obesity Class II encounters, and 99 Obesity Class III encounters. Approximately 63% of the study population were male, and over 90% the patients were African American. The Obesity Class I and Obesity Class II class required an average of 11.47 mg and 17.10 mg more warfarin, respectively, to maintain a therapeutic INR when compared with the Normal BMI category. These findings were statistically significant with p values of 0.007 and <0.001, respectively. Additionally, upon comparing the Overweight BMI category with the Obesity Class II category, there was a mean warfarin dose difference of 11.22 mg (p = 0.010) more in Obesity Class II encounters to maintain a therapeutic INR. In the secondary analysis of TTR, Overweight category encounters had the highest TTR, whereas encounters in the Normal BMI category had the lowest TTR.

CONCLUSION: As BMI increases, there is an increased chronic warfarin requirement to maintain “intermediate control” or “good control” of INR between 2 and 3 in an ambulatory care setting.

PMID:34120532 | DOI:10.1177/17539447211012803

Int J Audiol. 2021 Jun 13:1-10. doi: 10.1080/14992027.2021.1928304. Online ahead of print.

ABSTRACT

OBJECTIVE: To canvas the views of Australia-based hearing healthcare clinicians regarding group audiological rehabilitation practices.

DESIGN: A national cross-sectional self-report survey. Data were analysed using descriptive statistics and content analysis.

STUDY SAMPLE: Sixty-two Australia-based hearing healthcare clinicians, with experience working in an adult rehabilitation setting.

RESULTS: Clinicians appeared to positively view the provision of group audiological rehabilitation services, yet were limited in their ability to deliver these services due to organisational barriers. Although some organisational barriers were non-modifiable by the clinician (such as group AR services not prioritised within their workplace, a lack of support from colleagues/managers, lack of resources, and a lack of funding for the delivery of group AR services), others were within the clinicians’ ability to change (such as habit formation for recommending these services during clinical appointments). Participants expressed a desire for resources to assist them in delivering group AR, including downloadable lesson plans and information sheets for clients, clinician training videos and client educational videos. Clinicians called for increased diversity in program offerings, specifically relating to the emotional, relational and social impacts of hearing loss.

CONCLUSIONS: These results provide a framework for the development of interventional studies to increase the utilisation of group audiological rehabilitation services.

PMID:34120559 | DOI:10.1080/14992027.2021.1928304

Exp Biol Med (Maywood). 2021 Jun 12:15353702211024572. doi: 10.1177/15353702211024572. Online ahead of print.

ABSTRACT

Optical coherence tomography angiography (OCTA) is a functional extension of optical coherence tomography for non-invasive in vivo three-dimensional imaging of the microvasculature of biological tissues. Several algorithms have been developed to construct OCTA images from the measured optical coherence tomography signals. In this study, we compared the performance of three OCTA algorithms that are based on the variance of phase, amplitude, and the complex representations of the optical coherence tomography signals for rodent retinal imaging, namely the phase variance, improved speckle contrast, and optical microangiography. The performance of the different algorithms was evaluated by comparing the quality of the OCTA images regarding how well the vasculature network can be resolved. Quantities that are widely used in ophthalmic studies including blood vessel density, vessel diameter index, vessel perimeter index, vessel complexity index were also compared. Results showed that both the improved speckle contrast and optical microangiography algorithms are more robust than phase variance, and they can reveal similar vasculature features while there are statistical differences in the calculated quantities.

PMID:34120494 | DOI:10.1177/15353702211024572

J Prim Care Community Health. 2021 Jan-Dec;12:21501327211024390. doi: 10.1177/21501327211024390.

ABSTRACT

INTRODUCTION: In an effort to improve health outcomes and promote health equity, healthcare systems have increasingly begun to screen patients for unmet social needs and refer them to relevant social services and community-based organizations. This study aimed to identify factors associated with the successful connection (ie, services started) to social needs resources, as well as factors associated with an attempt to connect as a secondary, intermediate outcome.

METHODS: This retrospective cohort study included patients who had been screened, referred, and subsequently reached for follow-up navigation from March 2019 to December 2020, as part of a social needs intervention at a federally qualified health center (FQHC). Measures included demographic and social needs covariates collected during screening, as well as resource-related covariates that characterized the referred resources, including service domain (area of need addressed), service site (integration relative to the FQHC), and access modality (means of accessing services).

RESULTS: Of the 501 patients in the analytic sample, 32.7% had started services with 1 or more of their referred resources within 4 weeks of the initial referral, and 63.3% had at least attempted to contact 1 referred resource, whether or not they were able to start services. Receiving a referral to resources that patients could access via phone call or drop-in visit, as opposed to resources that required additional appointments or applications prior to accessing services, was associated with increased odds (aOR 1.95, 95% CI 1.05, 3.61) of connection success, after adjusting for age, sex, race, ethnicity, education, number of social needs, and resource-related characteristics. This study did not find statistically significant associations between connection attempt and any variable included in adjusted analyses.

CONCLUSION: These findings suggest that referral pathways may influence the success of patients’ connection to social needs resources, highlighting opportunities for more accessible solutions to addressing patients’ unmet social needs.

PMID:34120507 | DOI:10.1177/21501327211024390

J Wound Care. 2021 Jun 1;30(Sup6):S23-S32. doi: 10.12968/jowc.2021.30.Sup6.S23.

ABSTRACT

OBJECTIVE: To compare consultations carried out via video with those performed in person for patients with painful, hard-to-heal ulcers, with a focus on ulcer pain and pain treatment. A further aim was to investigate predictors for pain and pain treatment.

METHOD: This was a register-based, quasi-experimental study based on data from the Swedish Registry of Ulcer Treatment (RUT). A total of 100 patients with hard-to-heal ulcers diagnosed via video consultation were compared with 1888 patients diagnosed in person with regard to pain assessment, intensity and treatment. Ulcer pain intensity was assessed by the visual analogue scale (VAS). Normally distributed variables (age, VAS) were compared between consultation groups using Student’s t-test. Non-normally distributed variables (ulcer size, ulcer duration) were compared using the Mann-Whitney U-test, except for healing time, which was analysed with a log-rank test. Categorical variables (gender, ulcer aetiology and prescribed analgesics) were compared using Pearson’s chi-square test (χ²). A p value of less than 0.05 was considered to indicate statistical significance. Predictors for pain and pain treatment were analysed in multiple regression analyses.

RESULTS: The results showed a high presence of pain; 71% of patients with pain reported severe ulcer pain. There was no significant difference in ability to assess pain by VAS in the group diagnosed via video consultation (90%) compared with the group diagnosed in person (86%) (χ², p=0.233). A significantly higher amount of prescribed analgesics was found for patients diagnosed via video (84%) compared with patients diagnosed by in-person assessment (68%) (χ², p=0.044). Predictors for high-intensity pain were female gender or ulcers due to inflammatory vessel disease, while the predictors for receiving analgesics were older age, longer healing time and being diagnosed via video consultation.

CONCLUSION: To identify, assess and treat ulcer pain is equally possible via video as by in-person consultation. The results of this study confirm that patients with hard-to-heal ulcers suffer from high-intensity ulcer pain, with a discrepancy between pain and pain relief. Further well-designed randomised controlled studies are necessary to understand how best to deploy telemedicine in ulcer pain treatment.

PMID:34120467 | DOI:10.12968/jowc.2021.30.Sup6.S23

Ann Clin Biochem. 2021 Jun 12:45632211026961. doi: 10.1177/00045632211026961. Online ahead of print.

ABSTRACT

OBJECTIVE: Carbohydrate antigen 72-4 (CA72-4) is widely used in the diagnosis and monitoring of many cancers. However, there are few studies on the differences of CA72-4 levels in terms of age and gender.

METHODS: 10957 healthy subjects were divided into two groups according to gender and three age groups. The serum CA72-4 were detected. Statistical analysis was performed by SPSS.

RESULTS: The CA72-4 level in female group was significantly higher than that in male group. The level of CA72-4 gradually decreased with age. Compared with the age >60 group, the CA72-4 levels were increased in the age 46-60 group and 16-45 group (P >0.05, respectively). To better observe the age difference, the age 16-45 and 46â60 group were combined into the age 16-60 group. In comparison to the age >60 group, the CA72-4 level of age 16-60 group was significantly increased (P =0.000). In the age >60 group, there was no difference between genders. Nevertheless, the difference between the sexes in the age 16-60 group was significant (P =0.023).

CONCLUSIONS: The reference interval of CA72-4 for local healthy population was established. CA72-4 levels gradually decreased with the increase of age, and CA72-4 level in females aged 16-60 years (0-18.0 U/mL) was higher than in males (0-14.5 U/mL), however there was no gender difference in the age group above 60 years old (0-14.5 U/mL). Moreover, male CA72-4 was no significant difference among all age groups, while the potential mechanism of female changes with age needed further study.

PMID:34120477 | DOI:10.1177/00045632211026961