Category: Nevin Manimala

PLoS Negl Trop Dis. 2023 Dec 27;17(12):e0011863. doi: 10.1371/journal.pntd.0011863. Online ahead of print.

ABSTRACT

BACKGROUND: The first chikungunya virus (CHIKV) outbreaks during the modern scientific era were identified in the Americas in 2013, reaching high attack rates in Caribbean countries. However, few cohort studies have been performed to characterize the initial dynamics of CHIKV transmission in the New World.

METHODOLOGY/PRINCIPAL FINDINGS: To describe the dynamics of CHIKV transmission shortly after its introduction in Brazil, we performed semi-annual serosurveys in a long-term community-based cohort of 652 participants aged ≥5 years in Salvador, Brazil, between Feb-Apr/2014 and Nov/2016-Feb/2017. CHIKV infections were detected using an IgG ELISA. Cumulative seroprevalence and seroincidence were estimated and spatial aggregation of cases was investigated. The first CHIKV infections were identified between Feb-Apr/2015 and Aug-Nov/2015 (incidence: 10.7%) and continued to be detected at low incidence in subsequent surveys (1.7% from Aug-Nov/2015 to Mar-May/2016 and 1.2% from Mar-May/2016 to Nov/206-Feb/2017). The cumulative seroprevalence in the last survey reached 13.3%. It was higher among those aged 30-44 and 45-59 years (16.1% and 15.6%, respectively), compared to younger (12.4% and 11.7% in <15 and 15-29 years, respectively) or older (10.3% in ≥60 years) age groups, but the differences were not statistically significant. The cumulative seroprevalence was similar between men (14.7%) and women (12.5%). Yet, among those aged 15-29 years, men were more often infected than women (18.1% vs. 7.4%, respectively, P = 0.01), while for those aged 30-44, a non-significant opposite trend was observed (9.3% vs. 19.0%, respectively, P = 0.12). Three spatial clusters of cases were detected in the study site and an increased likelihood of CHIKV infection was detected among participants who resided with someone with CHIKV IgG antibodies.

CONCLUSIONS/SIGNIFICANCE: Unlike observations in other settings, the initial spread of CHIKV in this large urban center was limited and focal in certain areas, leaving a high proportion of the population susceptible to further outbreaks. Additional investigations are needed to elucidate the factors driving CHIKV spread dynamics, including understanding differences with respect to dengue and Zika viruses, in order to guide prevention and control strategies for coping with future outbreaks.

PMID:38150470 | DOI:10.1371/journal.pntd.0011863

PLoS One. 2023 Dec 27;18(12):e0291035. doi: 10.1371/journal.pone.0291035. eCollection 2023.

ABSTRACT

OBJECTIVE: To use a previously validated veterinary clinical examination sheet, Liverpool Osteoarthritis in Dogs (LOAD) questionnaire, combined with kinetic and kinematic gait analysis in dogs with/without mobility problems to demonstrate the capacity of a novel clinical metrology instrument (“GenPup-M”) to detect canine mobility impairments.

DESIGN: Quantitative study.

ANIMALS: 62 dogs (31 with mobility impairments and 31 without mobility impairments).

PROCEDURE: The dogs’ clinical history was obtained from owners and all dogs underwent a validated orthopaedic clinical examination. Mobility impairments were diagnosed in the mobility impaired group based on clinical history and orthopaedic examination. Owners were asked to complete GenPup-M along with a previously validated mobility questionnaire (Liverpool Osteoarthritis in Dogs (LOAD)) to identify construct validity. As a test of criterion validity, the correlation between instrument scores and the overall clinical examination scores, along with force-platform obtained peak vertical forces (PVF) were calculated. GenPup-M underwent internal consistency and factor analysis. Spatiotemporal parameters were calculated for dogs with/without mobility impairments to define the gait differences between these two groups.

RESULTS: Principal Component Analysis identified GenPup-M had two components with Eigenvalues >1 (“stiffness/ease of movement” and “willingness to be active/exercise”). Cronbach’s α was used to test internal consistency of GenPup-M and was found to be “good” (0.87). There was a strong, positive correlation between GenPup-M and LOAD responses (r2 = 0.69, p<0.001) highlighting construct validity. Criterion validity was also shown when comparing GenPup-M to clinical examination scores (r2 = 0.74, p<0.001) and PVF (r2 = 0.43, p<0.001). Quantitative canine gait analysis showed that there were statistically significant differences between peak vertical forces (PVF) of mobility impaired and non-mobility impaired dogs (p<0.05). Analyses of PVF showed that non-mobility impaired dogs more evenly distributed their weight across all thoracic and pelvic limbs when compared to mobility impaired dogs. There were also consistent findings that mobility impaired dogs moved slower than non-mobility impaired dogs.

CONCLUSION AND CLINICAL RELEVANCE: GenPup-M is a clinical metrology instrument (CMI) that can be completed by dog owners to detect all mobility impairments, including those that are early in onset, indicating the versatility of GenPup-M to assess dogs with and without mobility impairments. Results of the study found that GenPup-M positively correlated with all three objective measures of canine mobility and consequently showed criterion and construct validity. Owner-reported CMIs such as GenPup-M allow non-invasive scoring systems which veterinary surgeons and owners can use to allow communication and longitudinal assessment of a dog’s mobility. It is anticipated that GenPup-M will be used by owners at yearly vaccinations/health checks, allowing identification of any subtle mobility changes, and enabling early intervention.

PMID:38150469 | DOI:10.1371/journal.pone.0291035

PLOS Glob Public Health. 2023 Dec 27;3(12):e0002063. doi: 10.1371/journal.pgph.0002063. eCollection 2023.

ABSTRACT

There has been raging discussion and debate around the quality of COVID death data in South Asia. According to WHO, of the 5.5 million reported COVID-19 deaths from 2020-2021, 0.57 million (10%) were contributed by five low and middle income countries (LMIC) countries in the Global South: India, Pakistan, Bangladesh, Sri Lanka and Nepal. However, a number of excess death estimates show that the actual death toll from COVID-19 is significantly higher than the reported number of deaths. For example, the IHME and WHO both project around 14.9 million total deaths, of which 4.5-5.5 million were attributed to these five countries in 2020-2021. We focus our gaze on the COVID-19 performance of these five countries where 23.5% of the world population lives in 2020 and 2021, via a counterfactual lens and ask, to what extent the mortality of one LMIC would have been affected if it adopted the pandemic policies of another, similar country? We use a Bayesian semi-mechanistic model developed by Mishra et al. (2021) to compare both the reported and estimated total death tolls by permuting the time-varying reproduction number (Rt) across these countries over a similar time period. Our analysis shows that, in the first half of 2021, mortality in India in terms of reported deaths could have been reduced to 96 and 102 deaths per million compared to actual 170 reported deaths per million had it adopted the policies of Nepal and Pakistan respectively. In terms of total deaths, India could have averted 481 and 466 deaths per million had it adopted the policies of Bangladesh and Pakistan. On the other hand, India had a lower number of reported COVID-19 deaths per million (48 deaths per million) and a lower estimated total deaths per million (80 deaths per million) in the second half of 2021, and LMICs other than Pakistan would have lower reported mortality had they followed India’s strategy. The gap between the reported and estimated total deaths highlights the varying level and extent of under-reporting of deaths across the subcontinent, and that model estimates are contingent on accuracy of the death data. Our analysis shows the importance of timely public health intervention and vaccines for lowering mortality and the need for better coverage infrastructure for the death registration system in LMICs.

PMID:38150465 | DOI:10.1371/journal.pgph.0002063

PLoS One. 2023 Dec 27;18(12):e0286441. doi: 10.1371/journal.pone.0286441. eCollection 2023.

ABSTRACT

Hepatitis B virus (HBV) infection has gradually been considered to associate with cancer development and progression. This study aimed to explore the associations of serological indicators of HBV infection with mortality risk among cancer survivors and further validated using a gastric cancer (GC) cohort from China, where HBV infection is endemic. National Center for Health Statistics’ National Health and Nutrition Examination Survey (NHANES) data were used in this study. Individuals with positive results of hepatitis B core antigen (anti-HBc) were considered to have current or past HBV infection. Serological indicators were positive only for hepatitis B surface antibodies (anti-HBs), indicating vaccine-induced immunity, whereas negativity for all serologic indicators was considered to indicate the absence of HBV infection and immunity to HBV. The GC cohort included patients from the First Hospital of Jilin University, China. The median follow-up time of the NHANES was 10 years; during the follow-up, 1505 deaths occurred. The results revealed that anti-HBs-positive cancer survivors had a 39% reduced risk of mortality (hazard ratio [HR] 0.61, 95% confidence interval [CI] 0.44-0.85). Men and individuals aged <65 years old with past exposure to HBV had higher mortality risk (HR 1.52, 95% CI 1.09-2.13; HR 2.07, 95% CI 1.13-3.83). In this GC cohort, individuals who were only anti-HBs-positive showed a reduced risk of mortality (HR 0.77, 95% CI 0.62-0.95). Thus, anti-HBs positivity was a significant factor of decreased mortality among cancer survivors. More rigorous surveillance is necessary for cancer survivors with anti-HBc positivity, particularly men, and younger individuals.

PMID:38150459 | DOI:10.1371/journal.pone.0286441

PLoS One. 2023 Dec 27;18(12):e0293751. doi: 10.1371/journal.pone.0293751. eCollection 2023.

ABSTRACT

Changes in soil temperature (ST) play an important role in the main mechanisms within the soil, including biological and chemical activities. For instance, they affect the microbial community composition, the speed at which soil organic matter breaks down and becomes minerals. Moreover, the growth and physiological activity of plants are directly influenced by the ST. Additionally, ST indirectly affects plant growth by influencing the accessibility of nutrients in the soil. Therefore, designing an efficient tool for ST estimating at different depths is useful for soil studies by considering meteorological parameters as input parameters, maximal air temperature, minimal air temperature, maximal air relative humidity, minimal air relative humidity, precipitation, and wind speed. This investigation employed various statistical metrics to evaluate the efficacy of the implemented models. These metrics encompassed the correlation coefficient (r), root mean square error (RMSE), Nash-Sutcliffe (NS) efficiency, and mean absolute error (MAE). Hence, this study presented several artificial intelligence-based models, MLPANN, SVR, RFR, and GPR for building robust predictive tools for daily scale ST estimation at 05, 10, 20, 30, 50, and 100cm soil depths. The suggested models are evaluated at two meteorological stations (i.e., Sulaimani and Dukan) located in Kurdistan region, Iraq. Based on assessment of outcomes of this study, the suggested models exhibited exceptional predictive capabilities and comparison of the results showed that among the proposed frameworks, GPR yielded the best results for 05, 10, 20, and 100cm soil depths, with RMSE values of 1.814°C, 1.652°C, 1.773°C, and 2.891°C, respectively. Also, for 50cm soil depth, MLPANN performed the best with an RMSE of 2.289°C at Sulaimani station using the RMSE during the validation phase. Furthermore, GPR produced the most superior outcomes for 10cm, 30cm, and 50cm soil depths, with RMSE values of 1.753°C, 2.270°C, and 2.631°C, respectively. In addition, for 05cm soil depth, SVR achieved the highest level of performance with an RMSE of 1.950°C at Dukan station. The results obtained in this research confirmed that the suggested models have the potential to be effectively used as daily predictive tools at different stations and various depths.

PMID:38150451 | DOI:10.1371/journal.pone.0293751

PLoS One. 2023 Dec 27;18(12):e0296243. doi: 10.1371/journal.pone.0296243. eCollection 2023.

ABSTRACT

AIM AND OBJECTIVES: The aim of this study was to conduct a systematic review analysis to identify and evaluate the available literature on implementation science outcomes research in relation to End Stage Renal Disease (ESRD) in Pakistan.

METHODS: A systematic database search of PubMed, Web of Science, EMBASE, Cochrane Library, CINAHL, and Ovid was conducted through October 22nd, 2022, without any restrictions on publication dates. A screening and data extraction tool, Covidence, was used to evaluate the literature against our inclusion and exclusion criteria. Furthermore, a Mixed Methods Appraisal Tool (MMAT) was used to evaluate the selected studies.

RESULTS: We identified four studies that presented findings of implementation outcomes research which were related to appropriateness, feasibility, and acceptability. Appropriateness was examined using knowledge scores (p = 0.022) and medication adherence scores (p < 0.05) that showed statistical significance between the control and intervention groups. Acceptability was assessed through a cross sectional quantitative descriptive study that evaluated the reasons for refusal and acceptance of treatment in a cohort of patients suffering from ESRD. Feasibility was examined in one cross sectional, and one mixed methods study that aimed to evaluate and understand the impact of initiating dialysis treatment and the feasibility of maintaining it in low-income families that care for children or adults with ESRD.

CONCLUSION: The preliminary results of this review indicate a gap in the availability of implementation research studies about ESRD in Pakistan. The burden of ESRD, and the implementation methods by which it is treated is notable in Pakistan and requires evidence-based measures to be implemented to support the critical healthcare delivery platforms that provide treatment.

PMID:38150440 | DOI:10.1371/journal.pone.0296243

PLOS Glob Public Health. 2023 Dec 27;3(12):e0001755. doi: 10.1371/journal.pgph.0001755. eCollection 2023.

ABSTRACT

Asylum seekers and refugees (ASR) in Germany are dispersed quasi-randomly to state-provided, collective accommodation centres. We aimed to analyse contextual effects of post-migration housing environment on their mental health. We drew a balanced random sample of 54 from 1 938 accommodation centres with 70 634 ASR in Germany’s 3rd largest federal state. Individual-level data on depression and anxiety as well as sociodemographic- and asylum-related covariates, were collected and linked to contextual geo-referenced data on housing environment (‘Small-area Housing Environment Deterioration’ index, number of residents, remoteness, urbanity, and German Index of Multiple Deprivation). We fitted two-level random-intercept models to exploratively estimate adjusted contextual effects. Of 411 surveyed participants, 45.53% and 44.83%, respectively, reported symptoms of depression or anxiety. 52.8% lived in centres with highest deterioration, 46.2% in centres with > = 50 residents, 76.9% in urban, and 56% in deprived districts. 7.4% of centres were remote. We found statistically significant clustering in reporting anxiety on the level of accommodation centres. The model resulted in an intraclass correlation of 0.16 which translated into a median odds ratio of 2.10 for the accommodation-level effects. No significant clustering was found for symptoms of depression. The highest degree of deterioration, large accommodation size, remoteness, and district urbanity showed higher, but statistically not significant, odds for reporting anxiety or depression. District deprivation demonstrated higher odds for anxiety and lower odds for depression yet remained statistically insignificant for both. Evidence for contextual effects of housing environment on mental health of ASR could not be established but residual confounding by length of stay in the accommodation centre cannot be ruled out. Confirmatory analyses with prior power calculations are needed to complement these exploratory estimates.

PMID:38150435 | DOI:10.1371/journal.pgph.0001755

Mil Med. 2023 Dec 27:usad474. doi: 10.1093/milmed/usad474. Online ahead of print.

ABSTRACT

INTRODUCTION: The Airborne Hazards and Open Burn Pit Registry (AHOBPR) allows service members to self-report exposure to burn pits during military deployments and functional status (a composite metric of physical fitness status). This study investigated whether general exposure to burn pits, specific performance of burn pit duties, or the cumulative number of days deployed in Southwest Asia was associated with a change in functional status.

MATERIALS AND METHODS: A retrospective cross-sectional analysis of 234,061 participants in the AHOBPR who completed questionnaires before August 2021 was conducted. Exposure was presumed if an individual reported any burn pits exposure during deployment or if an individual reported having to work at a burn pit as part of their duties and was quantified by the cumulative-reported exposure days. The outcome was the reported composite functional score. Statistical analysis used linear regression, which was adjusted for significant variables. A possible dose-response effect from cumulative deployment and burn pits exposure days was evaluated. Statistical significance was determined at P < 0.05.

RESULTS: The burn pit exposure groups were notably different in size (exposed: 230,079, non-exposed: 3982) and were significantly different for all compared variables. There was a negative association between cumulative exposure days and functional score with a significant test for trend. There was a marginal positive significant association between cumulative deployment days and functional score with a significant test for trend. Reporting exposure to burn pit duties was also significantly associated with a lower functional score.

CONCLUSION: This study suggests a dose-response relationship between cumulative burn pit exposure and decreased functional status. It also suggests a modest positive relationship between cumulative deployment days and reported function, which may represent a “healthy deployer” effect.

PMID:38150392 | DOI:10.1093/milmed/usad474

Shock. 2023 Dec 19. doi: 10.1097/SHK.0000000000002292. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate whether serial assessment of shock severity can improve prognostication in intensive care unit (ICU) patients.

MATERIALS AND METHODS: Retrospective cohort of 21,461 ICU patient admissions from 2014 to 2018. We assigned the Society for Cardiovascular Angiography and Interventions (SCAI) Shock Stage in each 4-hour block during the first 24 hours of ICU admission; shock was defined as SCAI Shock Stage C, D, or E. In-hospital mortality was evaluated using logistic regression.

RESULTS: The admission SCAI Shock Stage was: A, 39.0%; B, 27.0%; C, 28.9%; D, 2.6%; E, 2.5%. SCAI Shock Stage subsequently increased in 30.6%, and late-onset shock developed in 30.4%. In-hospital mortality was higher in patients who had shock on admission (11.9%) or late-onset shock (7.3%) versus no shock (4.3%). Persistence of shock predicted higher mortality (adjusted OR 1.09 [95% CI 1.06-1.13] for each ICU block with shock). The mean SCAI Shock Stage had higher discrimination for in-hospital mortality than the admission or maximum SCAI Shock Stage. Dynamic modeling of the SCAI Shock Classification improved discrimination for in-hospital mortality (C-statistic 0.64 to 0.71).

CONCLUSIONS: Serial application of the SCAI shock classification provides improved mortality risk stratification compared to a single assessment on admission, facilitating dynamic prognostication.

PMID:38150371 | DOI:10.1097/SHK.0000000000002292

Cancer. 2023 Dec 27. doi: 10.1002/cncr.35169. Online ahead of print.

ABSTRACT

BACKGROUND: This study examined repeat colorectal cancer screening rates at 12 and 24 months as part of a randomized intervention trial among Black persons living in the United States and factors associated with screening adherence.

METHODS: Participants completed a survey assessing demographics and Preventive Health Model (PHM) factors (e.g., self efficacy, susceptibility) and received either a culturally targeted photonovella plus free fecal immunochemical test (FIT) kits (intervention group) or a standard educational brochure plus free FIT kits (comparison group). FIT return was assessed at 6, 12, and 24 months. Descriptive statistics summarized patterns of repeat screening. Logistic regression models assessed FIT uptake overtime, and demographic and PHM factors associated with screening adherence.

RESULTS: Participants (N = 330) were U.S.-born (93%), non-Hispanic (97%), and male (52%). Initial FIT uptake within 6 months of enrollment was 86.6%, and subsequently dropped to 54.5% at 12 months and 36.6% at 24 months. Higher FIT return rates were observed for the brochure group at 24 months (51.5% vs 33.3% photonovella, p = .023). Multiple patterns of FIT kit return were observed: 37% completed FIT at all three time points (full adherence), 22% completed two of three (partial adherence), 29% completed one of three (partial adherence), and 12% did not return any FIT kits (complete nonadherence). Predictors of full adherence were higher levels of education and self-efficacy.

CONCLUSIONS: Full adherence to repeat screening was suboptimal. Most participants had partial adherence (one or two of three) to annual FIT screening. Future studies should focus on strategies to support repeat FIT screening.

PMID:38150285 | DOI:10.1002/cncr.35169