Category: Nevin Manimala

PLoS One. 2021 Mar 31;16(3):e0249121. doi: 10.1371/journal.pone.0249121. eCollection 2021.

ABSTRACT

Pandemics have historically had a significant impact on economic inequality. However, official inequality statistics are only available at low frequency and with considerable delay, which challenges policymakers in their objective to mitigate inequality and fine-tune public policies. We show that using data from bank records it is possible to measure economic inequality at high frequency. The approach proposed in this paper allows measuring, timely and accurately, the impact on inequality of fast-unfolding crises, like the COVID-19 pandemic. Applying this approach to data from a representative sample of over three million residents of Spain we find that, absent government intervention, inequality would have increased by almost 30% in just one month. The granularity of the data allows analyzing with great detail the sources of the increases in inequality. In the Spanish case we find that it is primarily driven by job losses and wage cuts experienced by low-wage earners. Government support, in particular extended unemployment insurance and benefits for furloughed workers, were generally effective at mitigating the increase in inequality, though less so among young people and foreign-born workers. Therefore, our approach provides knowledge on the evolution of inequality at high frequency, the effectiveness of public policies in mitigating the increase of inequality and the subgroups of the population most affected by the changes in inequality. This information is fundamental to fine-tune public policies on the wake of a fast-moving pandemic like the COVID-19.

PMID:33788886 | DOI:10.1371/journal.pone.0249121

PLoS One. 2021 Mar 31;16(3):e0249329. doi: 10.1371/journal.pone.0249329. eCollection 2021.

ABSTRACT

Uranium, perhaps the most strategically important component of heavy minerals, finds particular significance in the nuclear industry. In prospecting trenches, the radioactivity of 238U and 232Th provides a good signature of the presence of heavy minerals. In the work herein, the activity concentrations of several key primordial radionuclides (238U, 232Th, and 40K) were measured in prospecting trenches (each of the latter being of approximately the same geometry and physical situation). All of these are located in the Seila area of the South Eastern desert of Egypt. A recently introduced industry standard, the portable hand-held RS-230 BGO gamma-ray spectrometer (1024 channels) was employed in the study. Based on the measured data, the trenches were classified as either non-regulated (U activity less than 1000 Bq kg-1) or regulated (with 238U activity more than 1000 Bq kg-1). Several radiological hazard parameters were calculated, statistical analysis also being performed to examine correlations between the origins of the radionuclides and their influence on the calculated values. While the radioactivity and hazard parameters exceed United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) guided limits, the mean annual effective doses of 0.49 and 1.4 mSv y-1 in non-regulated and regulated trenches respectively remain well below the International Commission on Radiological Protection (ICRP) recommended 20 mSv/y maximum occupational limit. This investigation reveals that the studied area contains high uranium content, suitable for extraction of U-minerals for use in the nuclear fuel cycle.

PMID:33788889 | DOI:10.1371/journal.pone.0249329

PLoS Negl Trop Dis. 2021 Mar 31;15(3):e0009193. doi: 10.1371/journal.pntd.0009193. Online ahead of print.

ABSTRACT

Single brain enhancing lesions (SEL) are the most common presentation of neurocysticercosis (NCC) observed on neuroimaging in people presenting with epileptic seizures not only on the Indian sub-continent and in travelers returning from cysticercosis-endemic regions, but also globally. The aim of this study, which consisted of a systematic review (CRD42019087665), a meta-analysis and an expert group consultation, was to reach consensus on the best anti-seizure medication and anti-inflammatory treatment for individuals with SEL NCC. Standard literature review methods were used, including the Cochrane risk of bias random effects model, meta-analyses were performed and the quality of the body of evidence was rated using GRADE tables. The expert committee included 12 gender and geographically balanced members and recommendations were reached by applying the GRADE framework for guideline development. The 1-1.5-year cumulative incidence of seizure recurrence, cyst resolution or calcification following anti-seizure medication (ASM) withdrawal was not statistically different between ASM of 6, 12 or 24 months. In contrast, in persons whose cyst calcified post treatment, longer ASM decreased seizure recurrence. The cumulative incidence ratio (CIR) 1-1.5 years after stopping ASM was 1.79 95% CI: (1.00, 3.20) for patients given 6 versus 24 months treatment. Duration of treatment had no effect on seizure recurrence in patients whose cyst did not calcify. Anti-inflammatory treatment with corticosteroids in patients treated with ASM compared to patients treated with ASM only showed a statistically significant beneficial effect on seizure reduction (CIR 0.44, 95% CI 0.23, 0.85) and cyst resolution (CIR 1.37, 95%CI: 1.07, 1.75). Our results indicate that ASM in patients with SEL NCC whose cysts resolved can be withdrawn, while patients whose cysts calcified seem to benefit from prolonged anti-seizure medication. Additional corticosteroid treatment was found to have a beneficial effect both on seizure reduction and cyst resolution.

PMID:33788843 | DOI:10.1371/journal.pntd.0009193

PLoS One. 2021 Mar 31;16(3):e0248312. doi: 10.1371/journal.pone.0248312. eCollection 2021.

ABSTRACT

As is already known, statistical models are very important for modeling data in applied fields, particularly in engineering, medicine, and many other disciplines. In this paper, we propose a new family to introduce new distributions suitable for modeling reliability engineering data. We called our proposed family a new generalized-X family of distributions. For the practical illustration, we introduced a new special sub-model, called the new generalized-Weibull distribution, to describe the new family’s significance. For the proposed family, we introduced some mathematical reliability properties. The maximum likelihood estimators for the parameters of the new generalized-X distributions are derived. For assessing the performance of these estimators, a comprehensive Monte Carlo simulation study is carried out. To assess the efficiency of the proposed model, the new generalized-Weibull model is applied to the coating machine failure time data. Finally, Bayesian analysis and performance of Gibbs sampling for the coating machine failure time data are also carried out. Furthermore, the measures such as Gelman-Rubin, Geweke and Raftery-Lewis are used to track algorithm convergence.

PMID:33788850 | DOI:10.1371/journal.pone.0248312

PLoS Negl Trop Dis. 2021 Mar 31;15(3):e0009256. doi: 10.1371/journal.pntd.0009256. Online ahead of print.

ABSTRACT

Residents of urban slums suffer from a high burden of zoonotic diseases due to individual, socioeconomic, and environmental factors. We conducted a cross-sectional sero-survey in four urban slums in Salvador, Brazil, to characterize how poverty and sanitation contribute to the transmission of rat-borne leptospirosis. Sero-prevalence in the 1,318 participants ranged between 10.0 and 13.3%. We found that contact with environmental sources of contamination, rather than presence of rat reservoirs, is what leads to higher risk for residents living in areas with inadequate sanitation. Further, poorer residents may be exposed away from the household, and ongoing governmental interventions were not associated with lower transmission risk. Residents at higher risk were aware of their vulnerability, and their efforts improved the physical environment near their household, but did not reduce their infection chances. This study highlights the importance of understanding the socioeconomic and environmental determinants of risk, which ought to guide intervention efforts.

PMID:33788864 | DOI:10.1371/journal.pntd.0009256

PLoS One. 2021 Mar 31;16(3):e0248518. doi: 10.1371/journal.pone.0248518. eCollection 2021.

ABSTRACT

BACKGROUND: Protecting people from financial hardship and impoverishment due to health care costs is one of the fundamental purposes of the Mongolian health system. However, the inefficient, oversized hospital sector is considered one of the main shortcomings of the system. The aim of this study is to contribute to policy discussions by estimating the extent of catastrophic health expenditure and impoverishment due to inpatient care at secondary-level and tertiary-level public hospitals and private hospitals.

METHODS: Data were derived from a nationally representative survey, the Household Socio-Economic Survey 2012, conducted by the National Statistical Office of Mongolia. A total of 12,685 households were involved in the study. “Catastrophic health expenditure” is defined as out-of-pocket payments for inpatient care that exceed a threshold of 40% of households’ non-discretionary expenditure. The “impoverishment” effect of out-of-pocket payments for inpatient care was estimated as the difference between the poverty level before health care payments and the poverty level after these payments.

RESULTS: At the threshold of 40% of capacity to pay, 0.31%, 0.07%, and 0.02% of Mongolian households suffered financially as a result of their member(s) staying in tertiary-level and secondary-level public hospitals and private hospitals respectively. About 0.13% of the total Mongolian population was impoverished owing to out-of-pocket payments for inpatient care at tertiary-level hospitals. Out-of-pocket payments for inpatient care at secondary-level hospitals and private hospitals were responsible for 0.10% and 0.09% respectively of the total population being pushed into poverty.

CONCLUSIONS: Although most inpatient care at public hospitals is covered by the social health insurance benefit package, patients who utilized inpatient care at tertiary-level public hospitals were more likely to push their households into financial hardship and poverty than the inpatients at private hospitals. Improving the hospital sector’s efficiency and financial protection for inpatients would be a crucial means of attaining universal health coverage in Mongolia.

PMID:33788865 | DOI:10.1371/journal.pone.0248518

PLoS One. 2021 Mar 31;16(3):e0249310. doi: 10.1371/journal.pone.0249310. eCollection 2021.

ABSTRACT

Since the World Health Organization (WHO) announced that the coronavirus disease (COVID-19) is a worldwide pandemic, many countries’ authorities, including the Iraqi authorities, started responding and taking action to control the spread of the pandemic. The public’s knowledge and practices play an important role in curbing the spreading of the virus by following the health guidelines. This study aimed to assess the socio-demographic correlate of knowledge and practices of Iraqi living in Mosul-Iraq towards COVID-19 during its rapid rise. A cross-sectional online survey of 909 participants was conducted among a sample of the Mosul-Iraq population between 20th June to 1st July 2020. The survey included three parts: 1) socio-demographic characteristics, 2) participants’ knowledge, 3) participants’ practices. T-test, ANOVA, chi-square, and binary logistic regression were used. A p-value less than 0.05 (p < 0.05) was considered statistically significant. The results showed a knowledge and practice mean score of (12.91±1.67) and (21.56± 2.92) with cumulative knowledge and practice of 86% and 76% respectively towards COVID-19. Socio-demographic characteristics such as age, marital status, gender, level of education and employment were statistically related with a higher mean score of knowledge and practice towards the virus as P<0.05. We concluded that the majority of the respondents demonstrate a high level of knowledge and practices towards COVID-19 except for respondents with socio-demographic characteristics such as those who were younger, male respondents, those with lower education and those unemployed as such campaigns that will increase the knowledge and encourage adequate preventive practice towards COVID-19 should be targeted towards this group.

PMID:33788835 | DOI:10.1371/journal.pone.0249310

Wound Manag Prev. 2021 Mar;67(3):30-35.

ABSTRACT

BACKGROUND: Medical device-related pressure ulcers/injuries (MDRPU/Is) are a serious concern in health care.

PURPOSE: To develop and assess the psychometric testing of a questionnaire to measure nursing students’ attitudes about the care and prevention of MDRPU/Is.

METHODS: Based on a review of the literature, a 26-item questionnaire was developed; face validity was assessed by ten (10) nursing students. The modified Lawshe’s model was used, and both the content validity index (CVI) and content validity ratio were calculated. Items with a CVI more than 0.63 were retained. The minimum optimal CVI for the new instrument was 79%. Qualitative assessments were performed by 10 experienced faculty members. One-hundred-and-eighty seven (187) nursing students participated in the construct validity testing of the 11-item questionnaire. The Kaiser-Meyer-Olkin test of sampling adequacy and Bartlett’s test of sphericity were performed. Following analysis of the main components and the varimax rotation, the factor analysis was determined. Internal consistency (Cronbach’s alpha) and test-retest were determined using Pearson’s correlation and intraclass correlation coefficient to evaluate reliability.

RESULTS: During the face validity phase of the initial 26 items, 7 items had impact scores less than 1.5. After calculating the CVI and content validity ratio for all items, 8 items did not achieve the desirable score. After performing exploratory factor analysis on the remaining 11 items, the Kaiser-Meyer-Olkin test value was 0.789, and Bartlett’s test of sphericity was 0.0001, which was statistically significant. Internal consistency of items (Cronbach’s alpha of 0.77) showed that all items had a high correlation. The reliability of test-retest was significant using an intraclass correlation coefficient of 0.75 and Pearson’s correlation coefficient of 0.86 at P < .005.

CONCLUSION: In this sample of nursing students, the Attitude Towards Medical-device Related Pressure Ulcers/Injuries Questionnaire was valid and reliable. Studies including licensed clinicians are needed to confirm these results.

PMID:33788773

Epidemiology. 2021 Mar 26. doi: 10.1097/EDE.0000000000001348. Online ahead of print.

ABSTRACT

BACKGROUND: Although many studies demonstrated reduced mortality risk with higher greenness, few studies examined the modifying effect of greenness on air pollution-health associations. We evaluated residential greenness as an effect modifier of the association between long-term exposure to fine particles (PM2.5) and mortality.

METHODS: We used data from all Medicare beneficiaries in North Carolina (NC) and Michigan (MI) (2001-2016). We estimated annual PM2.5 averages using ensemble prediction models. We estimated mortality risk per 1 µg/m3 increase using Cox proportional hazards modeling, controlling for demographics, Medicaid eligibility, and area-level covariates. We investigated health disparities by greenness using the Normalized Difference Vegetation Index (NDVI) with measures of urbanicity and socioeconomic status.

RESULTS: PM2.5 was positively associated with mortality risk. Hazard ratios (HRs) were 1.12 (95% confidence interval (CI) 1.12, 1.13) for NC and 1.01 (95% CI 1.00, 1.01 ) for MI. HRs were higher for rural than urban areas. Within each category of urbanicity, HRs were generally higher in less green areas. For combined disparities, HRs were higher in low greenness or low SES areas, regardless of the other factor. HRs were lowest in high-greenness and high-SES areas for both states.

CONCLUSIONS: In our study, those in low SES and high greenness areas had lower associations between PM2.5 and mortality than those in low SES and low greenness areas. Multiple aspects of disparity factors and their interactions may affect health disparities from air pollution exposures. Findings should be considered in light of uncertainties, such as our use of modeled PM2.5 data, and warrant further investigation.

PMID:33788795 | DOI:10.1097/EDE.0000000000001348

Anticancer Res. 2021 Mar;41(3):1203-1212. doi: 10.21873/anticanres.14877.

ABSTRACT

BACKGROUND/AIM: Hepatocellular carcinoma (HCC) remains one of the biggest medical issues. Pigment epithelial-derived factor (PEDF) is a glycoprotein that belongs to the superfamily of serine protease inhibitors. PEDF interacts with its two receptors, adipose triglyceride lipase (ATGL) and laminin receptor (LR).

MATERIALS AND METHODS: We conducted immunohistochemical staining for PEDF, LR and ATGL in 151 resected HCCs and their background liver tissues.

RESULTS: High expression of LR in HCC was associated with high histological grade and portal vein invasion, while high expression of PEDF in HCC was associated with absence of portal vein invasion. High LR expression in background liver was statistically associated with low serum albumin levels and was an independent prognostic factor of worse outcomes. No cases with more than 5% fatty degeneration in the background liver tissue showed high PEDF expression.

CONCLUSION: PEDF/LR/ATGL could be potential biomarkers in HCC and various chronic hepatic disorders.

PMID:33788711 | DOI:10.21873/anticanres.14877