Category: Nevin Manimala

WMJ. 2021 Apr;120(1):45-50.

ABSTRACT

OBJECTIVE: The American College of Obstetrics and Gynecology (ACOG) has recommended every hospital disclose their level of maternal care (LOMC) to categorize the capabilities of their birthing center and regionalize perinatal care. Of the 98 birthing centers in Wisconsin, 44% have self-disclosed their LOMC. In many states, disclosing LOMC is mandated but, despite evidence and professional association recommendations, Wisconsin relies on voluntary self-reporting. We surveyed all birthing centers in Wisconsin to better understand the barriers to disclosing their LOMC.

STUDY DESIGN: An anonymous survey was sent to all 98 birthing centers in Wisconsin. Survey recipients were hospital administrators, nursing supervisors, or physician directors of obstetric units. The survey sought information on perceived barriers to completing self-assessments and disclosing their hospital’s LOMC. Quantitative descriptive statistics were used for data analysis.

RESULTS: Of 98 birth centers in Wisconsin, 40 (40.8%) responded. Fifteen of the 40 responses were from birthing centers that have not yet disclosed their LOMC. Of these, 93% were unsure how to disclose, 73% found the paperwork confusing, and 80% did not have the time or staff to complete the paperwork. Respondents did not report lack of departmental support, concerns about losing business or reputation, or future physician recruitment as barriers. Of all respondents, 77.5% were aware of ACOG’s LOMC recommendations, but only 35% thought disclosing their LOMC would be beneficial to maternal care.

CONCLUSIONS: Birthing centers in Wisconsin need further guidance on how to complete a self-assessment of their LOMC. In order to increase self-disclosure of LOMC, statewide perinatal organizations will need to continue to emphasize the benefits of releasing this information. Organizations should also provide additional support to level 1 and 2 birthing centers and improve maternal and neonatal care overall.

PMID:33974765

J Infect Dis. 2021 May 11:jiab253. doi: 10.1093/infdis/jiab253. Online ahead of print.

ABSTRACT

BACKGROUND: Understanding the genetic interplay between human hosts and infectious pathogens is crucial for how we interpret virulence factors. Here, we tested for associations between HIV and host genetics, and interactive genetic effects on viral load (VL) in HIV+ ART-naive clinical trial participants.

METHODS: HIV genomes were sequenced and the encoded amino acid (AA) variants were associated with VL, human single nucleotide polymorphisms (SNPs) and imputed HLA alleles, using generalized linear models with Bonferroni correction.

RESULTS: Human (388,501 SNPs) and HIV (3,010 variants) genetic data was available for 2,122 persons. Four HIV variants were associated with VL (p-values<1.66×10 -5). Twelve HIV variants were associated with a range of 1-512 human SNPs (p-value<4.28×10 -11). We found 46 associations between HLA alleles and HIV variants (p-values<1.29×10 -7). We found HIV variants and immunotypes when analyzed separately, were associated with lower VL, whereas the opposite was true when analyzed in concert. Epitope binding prediction showed HLA alleles to be weaker binders of associated HIV AA variants relative to alternative variants on the same position.

CONCLUSIONS: Our results show the importance of immunotype specificity on viral antigenic determinants, and the identified genetic interplay puts emphasis that viral and human genetics should be studied in the context of each other.

PMID:33974707 | DOI:10.1093/infdis/jiab253

Catheter Cardiovasc Interv. 2021 May 1;97(6):1139-1140. doi: 10.1002/ccd.29726.

NO ABSTRACT

PMID:33974740 | DOI:10.1002/ccd.29726

WMJ. 2021 Apr;120(1):8-16.

ABSTRACT

PROBLEM CONSIDERED: Medical schools historically have utilized instructor-centered lectures to teach medical students the basic sciences. Several commercial electronic-based resources are now available to enhance lecture-based content. This study examines perceptions between students and faculty regarding the efficacy of lecture-based teaching and learning strategies used by students overall.

RESEARCH METHODS: The authors distributed surveys to medical students and basic science teaching faculty at the Medical College of Wisconsin. Survey items used categorical and 10-point scales and open-ended text response. Mean scores were compared with independent t tests and Cohen d effect sizes. Pearson (r) and Spearman rho (ρ) correlations were used for relational analysis. IBM SPSS 24.0 was used for statistical analysis, NVivo 11 was used for qualitative analysis.

RESULTS: Faculty’s perception of meeting students’ learning needs was rated significantly higher (mean [SD] = 7.3 [1.3]) than students (5.9 [2.0]) (Cohen d = 1.0/P < .001). There was a significant negative correlation between lectures meeting students’ learning needs and time students spent outside of lecture seeking supplemental learning resources (ρ = -0.4/P < .001). Students highlighted their use of personal learning strategies, desire for equitable access to resources, and preparation for national board examinations. Faculty emphasized their perceptions of learning resources, recognition of learning styles, time restrictions, and desire to utilize diverse teaching methods.

CONCLUSIONS: Student and faculty perceptions regarding student learning needs were significantly different. Students use lectures extensively, but additionally add to the financial burden of medical school by personally funding supplemental resources. This study helps bridge the gap between medical students and faculty regarding what educational tools are best suited to support a student population with increasingly diverse learning needs.

PMID:33974759

PLoS One. 2021 May 11;16(5):e0251075. doi: 10.1371/journal.pone.0251075. eCollection 2021.

ABSTRACT

Chlamydia trachomatis, the leading cause of bacterial sexually transmitted diseases in developed countries, with around 127 million new cases per year, is mainly responsible for urethritis and cervicitis in women, and urethritis and epididymitis in men. Most C. trachomatis infections remain asymptomatic (>50%) and, hence, untreated, leading to severe reproductive complications in both women and men, like infertility. Therefore, the detection of C. trachomatis as well as the antimicrobial susceptibility testing becomes a priority, and, along the years, several methods have been recommended, like cell culture and direct immunofluorescence (DFA) on cell cultures. Herein, we described the application of In-Cell Western assay (ICW) via Odyssey CLx as a fast, more accessible, and high-throughput platform for the quantification of C. trachomatis and the screening of anti-chlamydial drugs. As a first step, we set up a standard curve by infecting cell monolayers with 2-fold serial dilutions of C. trachomatis Elementary Body (EB) suspension. Then, different unknown C. trachomatis EB suspensions were quantified and the chlamydial susceptibility testing to erythromycin was performed, using the DFA as comparison. Our results showed a very high concordance between these two assays, as evidenced by the enumeration of chlamydial IFUs as well as the determination of erythromycin Minimum Inhibitory Concentration (MIC). In conclusion, the ICW assay may be a promising candidate as an accurate and accessible methodology for C. trachomatis antimicrobial susceptibility testing.

PMID:33974662 | DOI:10.1371/journal.pone.0251075

PLoS One. 2021 May 11;16(5):e0251436. doi: 10.1371/journal.pone.0251436. eCollection 2021.

ABSTRACT

BACKGROUND: In recent years, the price of pork in China continues to fluctuate at a high level. The forecast of pork price becomes more important. Single prediction models are often used for this work, but they are not accurate enough. This paper proposes a new method based on Census X12-GM(1,1) combination model.

METHODS: Monthly pork price data from January 2014 to December 2020 were obtained from the State Statistics Bureau(Mainland China). Census X12 model was adopted to get the long-term trend factor, business cycle change factor and seasonal factor of pork price data before September 2020. GM (1,1) model was used to fit and predict the long-term trend factor and business cycle change factor. The fitting and forecasting values of GM(1,1) were multiplied by the seasonal factor and empirical seasonal factor individually to obtain the fitting and forecasting values of the original monthly pork price series.

RESULTS: The expression of GM(1,1) model for fitting and forecasting long-term trend factor and and business cycle change factor was X(1)(k) = -1704.80e-0.022(k-1) + 1742.36. Empirical seasonal factor of predicted values was 1.002 Using Census X12-GM(1,1) method, the final forecast values of pork price from July 2020 to December 2020 were 34.75, 33.98, 33.23, 32.50, 31.78 and 31.08 respectively. Compared with ARIMA, GM(1,1) and Holt-Winters models, Root mean square error (RMSE), mean absolute percentage error (MAPE) and mean absolute error (MAE) of Census X12-GM(1,1) method was the lowest on forecasting part.

CONCLUSIONS: Compared with other single model, Census X12-GM(1,1) method has better prediction accuracy for monthly pork price series. The monthly pork price predicted by Census X12-GM(1,1) method can be used as an important reference for stakeholders.

PMID:33974663 | DOI:10.1371/journal.pone.0251436

Eur Heart J Acute Cardiovasc Care. 2021 May 11;10(3):329-334. doi: 10.1177/2048872619848661.

ABSTRACT

BACKGROUND: Infectious endocarditis is often complicated by conduction abnormalities at the time of presentation. Cardiac surgery is the treatment of choice for many infectious endocarditis patients, but carries an additional risk of persistent postoperative conduction abnormality. We sought to define the incidence and clinical predictors of significant postoperative conduction abnormalities necessitating permanent pacemaker implantation after cardiac surgery for infectious endocarditis.

METHODS: All consecutive patients with infectious endocarditis who were surgically treated at Cleveland Clinic from 2007 to 2013 were identified using the Cleveland Clinic Infective Endocarditis Registry and the Cardiovascular Information Registry. Patients with a pre-existing cardiac implantable electronic device were excluded. The primary outcome was the need for permanent pacemaker placement postoperatively for atrioventricular block. Regression analysis was performed to identify risk factors for permanent pacemaker requirement.

RESULTS: Among 444 infectious endocarditis patients who underwent cardiac surgery for infectious endocarditis, 57 (13%) required postoperative permanent pacemaker for atrioventricular block. Multivariable analysis identified that prolongation in preoperative PR and QRS intervals, Staphylococcus aureus as the infectious endocarditis organism, the presence of intracardiac abscess, tricuspid valve involvement, and prior valvular surgery independently predicted postoperative permanent pacemaker placement. The developed model exhibited excellent predictive ability (c-statistic 0.88) and calibration.

CONCLUSION: Infectious endocarditis cardiac surgery patients often require a postoperative permanent pacemaker. Preoperative conduction abnormality, S. aureus infection, abscess, tricuspid valve involvement, and prior valvular surgery are strong predictors of postoperative permanent pacemaker placement.

PMID:33974691 | DOI:10.1177/2048872619848661

Int Health. 2021 May 11:ihab024. doi: 10.1093/inthealth/ihab024. Online ahead of print.

ABSTRACT

The emotional impact of the coronavirus disease 2019 (COVID-19) pandemic on populations at large is emerging in the literature. However, the emotional response of persons with diabetes to the pandemic is only now beginning to emerge. Therefore this study aimed to identify factors contributing to emotional reactions towards this pandemic among persons with diabetes. A total of 205 persons with diabetes participated in this cross-sectional online survey between 14 May and 22 June 2020. Participants completed measures of emotional reactions towards COVID-19, perceived diabetes status, perceived susceptibility, knowledge about COVID-19, sense of mastery and sociodemographic questionnaires. Statistical analyses included Pearson correlations and regression analysis. According to the results, the mean score of negative emotional reactions towards COVID-19 was 3.45 (standard deviation 1.11, range 1-5), meaning that the score was relatively high. Higher levels of negative emotional reactions towards COVID-19 were associated with higher perceived susceptibility, greater knowledge about COVID-19 and a lower sense of mastery. The study’s findings emphasize the need to communicate ongoing knowledge regarding COVID-19 and diabetes as well as to provide persons with diabetes with the necessary emotional support related to coping with diabetes and COVID-19.

PMID:33974703 | DOI:10.1093/inthealth/ihab024

PLoS One. 2021 May 11;16(5):e0251364. doi: 10.1371/journal.pone.0251364. eCollection 2021.

ABSTRACT

BACKGROUND: In resource-limited countries like Ethiopia, where malnutrition is a common problem, incarcerated people’s sentences might be changed into a death sentence if the problems of undernutrition are not well understood and managed properly. There is limited evidence on nutritional status and associated factors among incarcerated people in low- income countries like Ethiopia, including the study area.

OBJECTIVE: To assess the magnitude of undernutrition and associated factors among incarcerated people in Mizan prison institute, southwest Ethiopia.

METHODS: An institution based cross-sectional study was conducted among 340 incarcerated people in Mizan prison institute from April 1 to 27, 2020, using a stratified sampling technique. An interviewer-administered structured questionnaire was used to collect data. The outcome variable (undernutrition) was assessed by measuring body mass index (BMI). Binary logistic regression was used to identify factors associated with undernutrition. Adjusted odds ratio (AOR) and 95% confidence intervals (CI) were used to measure the strength of association and a p-value less than 0.05 was used to declare the level of statistical significance.

RESULTS: The magnitude of undernutrition was 18.6% (95%CI: 14.4%, 22.8%). Being in the age category of 18-29 years (AOR = 2.60; 95%CI: 1.22,5.52), history of previous incarceration (AOR = 2.31;95%CI: 1.23,4.34), duration of imprisonment (AOR = 1.19; 95%CI: 1.05,1.34), having depression (AOR = 2.1; 95% CI: 1.10,3.97) and sleeping in group (AOR = 2.17; 95% CI: 1.18,4.01) were factors significantly associated with an increased odds of undernutrition. However, the presence of family support significantly decreased (AOR = 0.29; 95%CI: 0.12, 0.69) the odds of undernutrition.

CONCLUSION: The magnitude of undernutrition in the prison was found to be comparable to that of the general population in Ethiopia. The efforts on the ground to tackle undernutrition in the general population shall be extended to incarcerated people, especially by focusing on vulnerable groups such as those who had longer durations of incarceration, history of previous imprisonment, depression and no support.

PMID:33974638 | DOI:10.1371/journal.pone.0251364

PLoS One. 2021 May 11;16(5):e0250790. doi: 10.1371/journal.pone.0250790. eCollection 2021.

ABSTRACT

In recent years, the trigonometric families of continuous distributions have found a place of choice in the theory and practice of statistics, with the Sin-G family as leader. In this paper, we provide some contributions to the subject by introducing a flexible extension of the Sin-G family, called the transformed Sin-G family. It is constructed from a new polynomial-trigonometric function presenting a desirable “versatile concave/convex” property, among others. The modelling possibilities of the former Sin-G family are thus multiplied. This potential is also highlighted by a complete theoretical work, showing stochastic ordering results, studying the analytical properties of the main functions, deriving several kinds of moments, and discussing the reliability parameter as well. Then, the applied side of the proposed family is investigated, with numerical results and applications on the related models. In particular, the estimation of the unknown model parameters is performed through the use of the maximum likelihood method. Then, two real life data sets are analyzed by a new extended Weibull model derived to the considered trigonometric mechanism. We show that it performs the best among seven comparable models, illustrating the importance of the findings.

PMID:33974643 | DOI:10.1371/journal.pone.0250790