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Nevin Manimala Statistics

Association between social network and functional disability in brazilian elderly

Rev Bras Enferm. 2021 Jun 18;74(3):e20200770. doi: 10.1590/0034-7167-2020-0770. eCollection 2021.

ABSTRACT

OBJECTIVE: to verify the association between social network and functional disability in elderly Brazilians.

METHODS: a cross-sectional study with secondary data of 11,177 elderly people, available on Brazilian Institute of Geography and Statistics’ website. Social network components were having trusted friends/relative, living with their spouse, practicing social activity, performing voluntary or paid work. The outcome was functional disability, measured by the difficulty in performing instrumental and basic activities of daily living. Logistic regression models were used.

RESULTS: disability prevalence for instrumental activities was 28.0% (95%CI: 26.7-29.4), and for basic activities, 15.5% (95%CI: 14.4-16.6). Not having components social network components was associated with greater chances of functional disability, especially among women.

CONCLUSION: there was an association between not having social network components with functional disability. There are differences in this association according to sex. Strengthening actions that expand social network can reduce the chance of this outcome in elderly people.

PMID:34161502 | DOI:10.1590/0034-7167-2020-0770

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Nevin Manimala Statistics

Spatial-temporal analysis of leprosy in a priority Brazilian northeast municipality for disease control

Rev Bras Enferm. 2021 Jun 18;74(3):e20201101. doi: 10.1590/0034-7167-2020-1101. eCollection 2021.

ABSTRACT

OBJECTIVES: to analyze the spatial-temporal distribution of leprosy in a priority municipality for leprosy control.

METHODS: ecological study, conducted in a city in the Northeast of Brazil, whose analysis units were census sectors. The study used compulsory notification data for cases registered between 2008 and 2017. TerraView software and the Batch Geocode tool was used for geocoding. The detection of spatial-temporal agglomerations of high relative risks was done by scanning statistics.

RESULTS: the spatial-temporal distribution of cases was heterogeneous, creating four agglomerations of high relative risks in the urban area of the municipality between the years 2008 and 2012; and annual prevalence rates classified from high to hyperendemic.

CONCLUSIONS: areas of higher risk and concentration of the disease in space-time were linked to the characteristics of high population density and social vulnerability of these spaces, raising the prioritization of health professionals’ actions, systems, and services for control, and monitoring the disease.

PMID:34161506 | DOI:10.1590/0034-7167-2020-1101

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Nevin Manimala Statistics

Epidemiological, neurofunctional profile and prevalence of factors associated with the occurrence of physical disabilities due to leprosy in a reference center in Northeast Brasil: a sectional study

Rev Assoc Med Bras (1992). 2021 Jan;67(1):19-25. doi: 10.1590/1806-9282.67.01.20200139.

ABSTRACT

OBJECTIVE: To describe the epidemiological and neurofunctional profile, as well as the prevalence of factors associated with the occurrence of physical disabilities due to leprosy in a reference center in Northeast Brasil.

METHODS: A cross-sectional study including 50 leprosy patients diagnosed in Juazeiro-Bahia. Variables analyzed: sex, age, history of leprosy in the family, time to diagnosis, clinical form, operational classification, degree of disability, eyes-hand-foot score, peripheral nerve function, muscle strength and sensitivity. Descriptive statistics and inferential statistics (χ² test or Fisher’s exact, Poisson regression with robust estimation and prevalence reason were used. Significance of 5%).

RESULTS: An equal distribution was found between men and women of economically active age and low education; multibacillary forms in men (64%) and paucibacillary forms in women (60%). 78% of individuals had some degree of disability and 64% had a compromised ulnar nerve. Plantar sensitivity was decreased in 66% of patients. The predictors of disability were: age ≥45 years (PR 1.44; p=0.005), no education (PR 1.21; p=0.013) and OMP score ≥6 (PR 1.29; p<0.001).

CONCLUSION: The findings show the importance of monitoring neural functions and developing measures that allow early diagnosis, the opportune method and the prevention of disabilities, especially in the male population.

PMID:34161488 | DOI:10.1590/1806-9282.67.01.20200139

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Nevin Manimala Statistics

Predictors of moral harassment in nursing work in critical care units

Rev Bras Enferm. 2021 Jun 18;74(3):e20200442. doi: 10.1590/0034-7167-2020-0442. eCollection 2021.

ABSTRACT

OBJECTIVES: to analyze the predictors of moral harassment in nursing work in critical care units.

METHODS: a cross-sectional study conducted in a public hospital in Fortaleza, Ceará, with 167 nursing professionals in 2016. Sociodemographic/occupational questionnaire and Negative Acts Questionnaire Revised were applied. The analysis included descriptive statistics, measures of central tendency and dispersion, as well as Mann-Whitney, Kruskal-Wallis and Conover Inman U-tests for multiple comparisons.

RESULTS: there was a 33% prevalence of self-perception of moral harassment, highlighting personal/professional disqualification and work-related harassment. The predictors of moral harassment included age, time working in the job and time in the unit, employment relationship and sector.

CONCLUSIONS: young professionals (< 30 years), cooperative, crowded in intensive care or emergency units, with less time working in the job (< 5 years) or greater time in the unit (above 10 years) are the biggest victims of moral harassment in the work of nursing in critical environments.

PMID:34161497 | DOI:10.1590/0034-7167-2020-0442

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Nevin Manimala Statistics

Postoperative transient elevation of serum cancer antigen 125 in non-small cell lung cancer patients

Rev Assoc Med Bras (1992). 2021 Jan;67(1):39-44. doi: 10.1590/1806-9282.67.01.20200102.

ABSTRACT

OBJECTIVE: The aim of this retrospective study was to investigate the correlation of transiently elevated postoperative serum cancer antigen 125 levels and prognosis in patients with non-small cell lung cancer.

METHODS: A total of 181 non-small cell lung cancer patients with normal levels of preoperative serum cancer antigen 125 were statistically summarized in this study.

RESULTS: Out of the analyzed patients, 22 (12.2%) showed elevation of serum cancer antigen 125 within one month after surgery. Serum cancer antigen 125 level decreased to normal at three months postoperation. Serum cancer antigen 125 was positively correlated with pro-brain natriuretic peptide in non-small cell lung cancer postoperative patients (p=0.00035). Univariate analysis did not find significant difference in disease progression survival between those who experienced cancer antigen 125 elevation in the early postoperation and those who did not (p=0.646).

CONCLUSIONS: In conclusion, transient elevation of cancer antigen 125 is associated to pro-brain natriuretic peptide increase after pulmonary surgery in non-small cell lung cancer patients.

PMID:34161480 | DOI:10.1590/1806-9282.67.01.20200102

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Nevin Manimala Statistics

Comparison of two pandemics: H1N1 and SARS-CoV-2

Rev Assoc Med Bras (1992). 2021 Jan;67(1):115-119. doi: 10.1590/1806-9282.67.01.20200584.

ABSTRACT

OBJECTIVE: We aimed to compare the clinical, epidemiological, and prognostic features of the H1N1 pandemic in 2009 and the severe acute respiratory syndrome coronavirus 2 pandemic in 2020.

METHODS: This retrospective study involved subjects from seven centers that were admitted and found to be positive for H1N1 or COVID-19 real-time polymerase chain reaction test.

RESULTS: A total of 143 patients with H1N1 and 309 patients with COVID-19 were involved in the study. H1N1 patients were younger than COVID-19 ones. While 58.7% of H1N1 patients were female, 57.9% of COVID-19 patients were male. Complaints of fever, cough, sputum, sore throat, myalgia, weakness, headache, and shortness of breath in H1N1 patients were statistically higher than in COVID-19 ones. The duration of symptoms until H1N1 patients were admitted to the hospital was shorter than that for COVID-19 patients. Leukopenia was more common in COVID-19 patients. C-reactive protein levels were higher in COVID-19 patients, while lactate dehydrogenase levels were higher in H1N1 ones. The mortality rate was also higher in H1N1 cases.

CONCLUSIONS: The severe acute respiratory syndrome coronavirus 2 pandemic is a major public health problem that continues to affect the world with its high rate of contagion. In addition, no vaccines or a specific drug for the benefit of millions of people have been found yet. The H1N1 pandemic is an epidemic that affected the whole world about ten years ago and was prevented by the development of vaccines at a short period. Experience in the H1N1 pandemic may be the guide to prevent the COVID-19 pandemic from a worse end.

PMID:34161484 | DOI:10.1590/1806-9282.67.01.20200584

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Nevin Manimala Statistics

Effect of medication withdrawal on pain in Parkinson’s disease patients – an observational study based on a sample of patients without antiparkinsonian medications

Rev Assoc Med Bras (1992). 2021 Jan;67(1):125-130. doi: 10.1590/1806-9282.67.01.20200709.

ABSTRACT

OBJECTIVES: To assess the effect of withdrawal of the antiparkinsonian drug regimen administration on patients with PD and its relation to pain.

METHODS: The sample included 22 men and 12 women who were candidates for neurosurgery to control motor signs and symptoms treated with L-dopa as a drug, alone or in combination with others (Cholinergic Antagonists; Dopamine Agents). All of them were examined at two different moments, with and without medication, and analyzed for painful symptoms. The Hoehn and Yahr scale was used for functional staging of the disease. Pain intensity was assessed by using the numerical verbal scale.

RESULTS: The mean pain intensity among those on medication {2.17±0.39 (SE)} was significantly lower than in the abstinence group {4.2±0.59 (SE), p=0.006, Wilcoxon}, which corresponded to the increase in the total functional staging score from 93 to 111, respectively.

CONCLUSION: The interruption of the administration of specific medications in patients with Parkinson’s disease caused, or increased the intensity of, painful discomfort correlated with the intensity of functional impairment. This effect was also observed in women, but it was statistically relevant only for men. The results suggest that pain may be a “red flag” that points to the need for a therapeutic drug review when its presence or worsening is detected.

PMID:34161485 | DOI:10.1590/1806-9282.67.01.20200709

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Nevin Manimala Statistics

The contribution of TFPIα to the hemostatic response to injury in mice

J Thromb Haemost. 2021 Jun 23. doi: 10.1111/jth.15430. Online ahead of print.

ABSTRACT

BACKGROUND: TFPI is an essential regulator of coagulation, limiting thrombin generation and preventing thrombosis. In humans and mice, TFPIα is the sole isoform present in platelets.

OBJECTIVE: Here we asked whether TFPIα, because of its release from platelets at sites of injury, has a unique role in limiting the hemostatic response.

METHODS: TFPIα-mutant (TfpiΔα/Δα ) mice were generated by introducing a stop codon in the C-terminus. Platelet accumulation, platelet activation, and fibrin accumulation were measured following penetrating injuries in the jugular vein and cremaster muscle arterioles, and imaged by fluorescence and scanning electron microscopy. Time to bleeding cessation was recorded in the jugular vein studies.

RESULTS: TfpiΔα/Δα mice were viable and fertile. Plasma TFPI levels were normal in the TfpiΔα/Δα mice, no TFPI protein or activity was present in their platelets and thrombin-antithrombin (TAT) complex levels were indistinguishable from Tfpi+/+ littermates. There was a small, but statistically significant reduction in the time to bleeding cessation following jugular vein puncture injury in the TfpiΔα/Δα mice, but no measurable changes in platelet or fibrin accumulation or in hemostatic plug architecture following injury of the micro- or macrovasculature.

CONCLUSION: Loss of TFPIα expression does not produce a global prothrombotic state in mice. Platelet TFPIα is expected to be released or displayed in a focal manner at the site of injury, potentially accumulating to high concentrations in the narrow gaps between platelets. If so, the data from the vascular injury models studied here indicate this is not essential for a normal hemostatic response in mice.

PMID:34160126 | DOI:10.1111/jth.15430

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Nevin Manimala Statistics

Time series transcriptomics reveals a BBX32-directed control of acclimation to high light in mature Arabidopsis leaves

Plant J. 2021 Jun 23. doi: 10.1111/tpj.15384. Online ahead of print.

ABSTRACT

The photosynthetic capacity of mature leaves increases after several days’ exposure to constant or intermittent episodes of high light (HL) and is manifested primarily as changes in chloroplast physiology. How this chloroplast-level acclimation to HL is initiated and controlled is unknown. From expanded Arabidopsis leaves, we determined HL-dependent changes in transcript abundance of 3844 genes in a 0-6h time-series transcriptomics experiment. It was hypothesised that among such genes were those that contribute to the initiation of HL acclimation. By focussing on differentially expressed transcription (co-)factor (TF) genes and applying dynamic statistical modelling to the temporal transcriptomics data, a regulatory network of 47 predominantly photoreceptor-regulated (co)-TF genes was inferred. The most connected gene in this network was B-BOX DOMAIN CONTAINING PROTEIN32 (BBX32). Plants over-expressing BBX32 were strongly impaired in acclimation to HL and displayed perturbed expression of photosynthesis-associated genes under LL and after exposure to HL. These observations led to demonstrating that as well as regulation of chloroplast-level acclimation by BBX32, CRYPTOCHROME1, LONG HYPOCOTYL5, CONSTITUTIVELY PHOTOMORPHOGENIC1 and SUPPRESSOR OF PHYA-105 are also important. Additionally, the BBX32-centric gene regulatory network provides a view of the transcriptional control of acclimation in mature leaves distinct from other photoreceptor-regulated processes, such as seedling photomorphogenesis.

PMID:34160110 | DOI:10.1111/tpj.15384

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Nevin Manimala Statistics

Integrative Machine Learning Prediction of Prostate Biopsy Results From Negative Multiparametric MRI

J Magn Reson Imaging. 2021 Jun 23. doi: 10.1002/jmri.27793. Online ahead of print.

ABSTRACT

BACKGROUND: Multiparametric MRI (mpMRI) is commonly recommended as a triage test prior to any prostate biopsy. However, there exists limited consensus on which patients with a negative prostate mpMRI could avoid prostate biopsy.

PURPOSE: To identify which patient could safely avoid prostate biopsy when the prostate mpMRI is negative, via a radiomics-based machine learning approach.

STUDY TYPE: Retrospective.

SUBJECTS: Three hundred thirty patients with negative prostate 3T mpMRI between January 2016 and December 2018 were included.

FIELD STRENGTH/SEQUENCE: A 3.0 T/T2-weighted turbo spin echo (TSE) imaging (T2 WI) and diffusion-weighted imaging (DWI).

ASSESSMENT: The integrative machine learning (iML) model was trained to predict negative prostate biopsy results, utilizing both radiomics and clinical features. The final study cohort comprised 330 consecutive patients with negative mpMRI (PI-RADS < 3) who underwent systematic transrectal ultrasound-guided (TRUS) or MR-ultrasound fusion (MRUS) biopsy within 6 months. A secondary analysis of biopsy naïve subcohort (n = 227) was also conducted.

STATISTICAL TESTS: The Mann-Whitney U test and Chi-Squared test were utilized to evaluate the significance of difference of clinical features between prostate biopsy positive and negative groups. The model performance was validated using leave-one-out cross-validation (LOOCV) and measured by AUC, sensitivity, specificity, and negative predictive value (NPV).

RESULTS: Overall, 306/330 (NPV 92.7%) of the final study cohort patients had negative biopsies, and 207/227 (NPV 91.2%) of the biopsy naïve subcohort patients had negative biopsies. Our iML model achieved NPVs of 98.3% and 98.0% for the study cohort and subcohort, respectively, superior to prostate-specific antigen density (PSAD)-based risk assessment with NPVs of 94.9% and 93.9%, respectively.

DATA CONCLUSION: The proposed iML model achieved high performance in predicting negative prostate biopsy results for patients with negative mpMRI. With improved NPVs, the proposed model can be used to stratify patients who in whom we might obviate biopsies, thus reducing the number of unnecessary biopsies.

EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 2.

PMID:34160114 | DOI:10.1002/jmri.27793