Category: Nevin Manimala

PLoS One. 2021 Oct 29;16(10):e0258304. doi: 10.1371/journal.pone.0258304. eCollection 2021.

ABSTRACT

The annual assessment of Family Planning (FP) indicators, such as the modern contraceptive prevalence rate (mCPR), is a key component of monitoring and evaluating goals of global FP programs and initiatives. To that end, the Family Planning Estimation Model (FPEM) was developed with the aim of producing survey-informed estimates and projections of mCPR and other key FP indictors over time. With large-scale surveys being carried out on average every 3-5 years, data gaps since the most recent survey often exceed one year. As a result, survey-based estimates for the current year from FPEM are often based on projections that carry a larger uncertainty than data informed estimates. In order to bridge recent data gaps we consider the use of a measure, termed Estimated Modern Use (EMU), which has been derived from routinely collected family planning service statistics. However, EMU data come with known limitations, namely measurement errors which result in biases and additional variation with respect to survey-based estimates of mCPR. Here we present a data model for the incorporation of EMU data into FPEM, which accounts for these limitations. Based on known biases, we assume that only changes in EMU can inform FPEM estimates, while also taking inherent variation into account. The addition of this EMU data model to FPEM allows us to provide a secondary data source for informing and reducing uncertainty in current estimates of mCPR. We present model validations using a survey-only model as a baseline comparison and we illustrate the impact of including the EMU data model in FPEM. Results show that the inclusion of EMU data can change point-estimates of mCPR by up to 6.7 percentage points compared to using surveys only. Observed reductions in uncertainty were modest, with the width of uncertainty intervals being reduced by up to 2.7 percentage points.

PMID:34714856 | DOI:10.1371/journal.pone.0258304

PLoS One. 2021 Oct 29;16(10):e0259156. doi: 10.1371/journal.pone.0259156. eCollection 2021.

ABSTRACT

Maps of bottom type are essential to the management of marine resources and biodiversity because of their foundational role in characterizing species’ habitats. They are also urgently needed as countries work to define marine protected areas. Current approaches are time consuming, focus largely on grain size, and tend to overlook shallow waters. Our random forest classification of almost 200,000 observations of bottom type is a timely alternative, providing maps of coastal substrate at a combination of resolution and extents not previously achieved. We correlated the observations with depth, depth-derivatives, and estimates of energy to predict marine substrate at 100 m resolution for Canada’s Pacific shelf, a study area of over 135,000 km2. We built five regional models with the same data at 20 m resolution. In addition to standard tests of model fit, we used three independent data sets to test model predictions. We also tested for regional, depth, and resolution effects. We guided our analysis by asking: 1) does weighting for prevalence improve model predictions? 2) does model resolution influence model performance? And 3) is model performance influenced by depth? All our models fit the build data well with true skill statistic (TSS) scores ranging from 0.56 to 0.64. Weighting models with class prevalence improved fit and the correspondence with known spatial features. Class-based metrics showed differences across both resolutions and spatial regions, indicating non-stationarity across these spatial categories. Predictive power was lower (TSS from 0.10 to 0.36) based on independent data evaluation. Model performance was also a function of depth and resolution, illustrating the challenge of accurately representing heterogeneity. Our work shows the value of regional analyses to assessing model stationarity and how independent data evaluation and the use of error metrics can improve understanding of model performance and sampling bias.

PMID:34714844 | DOI:10.1371/journal.pone.0259156

PLoS One. 2021 Oct 29;16(10):e0259126. doi: 10.1371/journal.pone.0259126. eCollection 2021.

ABSTRACT

INTRODUCTION: Take-Home Naloxone programs have been introduced across North America in response to rising opioid overdose deaths. There is currently limited real-world data on bystander naloxone administration, overdose outcomes, and evidence related to adverse events following bystander naloxone administration.

METHODS: The research team used descriptive statistics from Take-Home Naloxone administration forms. We explored reported demographic variables and adverse events among people who received by-stander administered naloxone in a suspected opioid overdose event between August 31, 2012 and December 31, 2018 in British Columbia. We examined and contextualized differences across years given policy, program and drug toxicity changes. We used multivariate logistic regression to examine whether an association exists between number of ampoules of naloxone administered and the odds that the recipient will experience withdrawal symptoms.

RESULTS: A large majority (98.1%) of individuals who were administered naloxone survived their overdose and 69.2% had no or only mild withdrawal symptoms. Receiving three (Adjusted Odds Ratio (AOR) 1.64 (95% Confidence Interval (CI): 1.08-2.48)) or four or more (AOR 2.19 (95% CI: 1.32-3.62)) ampoules of naloxone was significantly associated with odds of moderate or severe withdrawal compared to receiving one ampoule of naloxone.

CONCLUSIONS: This study provides evidence from thousands of bystander reversed opioid overdoses using Take-Home Naloxone kits in British Columbia, and suggests bystander-administered naloxone is safe and effective for opioid overdose reversal. Data suggests an emphasis on titration during bystander naloxone training in situations where the person experiencing overdose can be adequately ventilated may help avoid severe withdrawal symptoms. We identified a decreasing trend in the likelihood of moderate or severe withdrawal over the study period.

PMID:34714854 | DOI:10.1371/journal.pone.0259126

PLoS One. 2021 Oct 29;16(10):e0258206. doi: 10.1371/journal.pone.0258206. eCollection 2021.

ABSTRACT

The Carpathian Basin represents the cradle of human agricultural development during the Neolithic period, when large parts were transformed into ‘cultural landscapes’ by first farmers from the Balkans. It is assumed that an Early Neolithic subsistence economy established along the hydrologic systems and on Chernozem soil patches, which developed from loess deposits. However, recent results from soil chemistry and geoarchaeological analyses raised the hypothesis that extensive Chernozem coverage developed from increased land-use activity and that Early Neolithic ‘cultural’ groups were not restricted to loess-covered surfaces but rather preferred hydromorphic soils that formed in the floodplains. This article performs multivariable statistics from large datasets of Neolithic sites in Hungary and allows tracing Early to Late Neolithic site preferences from digital environmental data. Quantitative analyses reveal a strong preference for hydromorphic soils, a significant avoidance of loess-covered areas, and no preference for Chernozem soils throughout the Early Neolithic followed by a strong transformation of site preferences during the Late Neolithic period. These results align with socio-cultural developments, large-scale mobility patterns, and land-use and surface transformation, which shaped the Carpathian Basin and paved the way for the agricultural revolution across Europe.

PMID:34714837 | DOI:10.1371/journal.pone.0258206

PLoS One. 2021 Oct 29;16(10):e0259106. doi: 10.1371/journal.pone.0259106. eCollection 2021.

ABSTRACT

BACKGROUND: Drug coated balloons (DCB) with paclitaxel (Ptx) dose of 2-3.5 μg/mm2 balloon surface inhibit restenosis with different effectiveness and duration of success. A clinical dose finding study is not known for any of the currently marketed products. The aim of the present preclinical trial was to investigate a novel DCB coated with 6 μg Ptx/mm2 in a porcine model.

METHODS AND RESULTS: The current study investigated a DCB with a novel, modified iopromide based matrix with 6 μg Ptx/mm2. Drug transfer to the vessel wall of peripheral arteries was compared with a dose of 3 μg Ptx/mm2 and two fully overlapping DCB with 3 μg Ptx/mm2, each. Ptx concentration in the vessel wall after drug transfer was about twice as high for balloons with 6 μg/mm2 (1957±1472 μg/g) and two overlapping DCB with 3 μg Ptx/mm2, each (1287±619 μg/g) compared to a single balloon with 3 μg Ptx/mm2, (787±738 μg/g), with statistical significant differences for 1×6 μg/mm2 vs. 1×3 μg/mm2 (p = 0.017) but not for 2×3 μg/mm2 vs. 1×3 μg/mm2 (p = 0.184) and 1×6 μg/mm2 vs. 2×3 μg/mm2 (p = 0.178). The proportion of residual Ptx on balloon after treatment was similar for all groups between 6±1% and 10±3% of dose on balloon.

CONCLUSION: The dose of 6 μg Ptx/mm2 was successfully as well as reproducibly coated on conventional balloon catheters. Increased Ptx on balloons resulted in increased drug concentration in the vessel wall. A single balloon with 6 μg Ptx/mm2 seems to provide double dose compared to 3 μg Ptx/mm2, facilitates the procedure, and may reduce medico-economic cost compared to the use of two standard DCB.

PMID:34714843 | DOI:10.1371/journal.pone.0259106

PLoS One. 2021 Oct 29;16(10):e0258224. doi: 10.1371/journal.pone.0258224. eCollection 2021.

ABSTRACT

BACKGROUND: Burnout is a syndrome of emotional exhaustion, low personal accomplishment and depersonalization experienced by a health professional and it is more common in nurses due to high workload and job stress that is mostly caused by working proximity to patients and taking care of them. Burnout compromises the provision of quality health care. Despite this, there is no information in Ethiopia on burnout among nurses in study area.

OBJECTIVES: To determine the magnitude of burnout and associated factors among nurses working in public hospitals of Harari regional state and Dire Dawa administration, eastern Ethiopia, February 1-29, 2020.

METHODS: Institutional based quantitative cross-sectional study was employed from February 1-29 among 412 randomly selected nurses who have been working in hospitals for the last 6 months. Simple random sampling method was employed and data was collected by self-administered, standardized, reliable and valid, questionnaire (Maslachs Burnout Inventory- Human Services Survey). Data was entered into EpiData Version 3.1 and exported to statistical package for social science version 20 for analysis. All covariate with P-value less than 0.25 in bivariable analysis were candidate for multivariable analysis. Level of statistical significance was declared at p-value < 0.05.

RESULTS: Among 412 nurses taking part in this study, 183(44.4%) of nurses with 95% CI, had experienced burnout. Married marital status [AOR:2.3,95%CI:(1.2-4.3)], poor current health status [AOR:4.8, 95% CI:(1.1-21.4)] and fair current health status [AOR:12, 95% CI:(4.5-32)], working greater than eight hour per-day[AOR:0.52, 95%CI:(0.29-0.92)], intention to leave a job [AOR:0.48,95%CI:(0.2-0.88), being working in emergency room [AOR:0.3,95%CI:(0.1-0.98)] and using a different medication related to work related health problems were factors associated with nurses’ burnout.

CONCLUSION: The nurses’ burnout in this study is high and it is attributed by marriage, perceiving health status as poor and fair, whereas, having the intention to leave job, being working in emergency room and using a medication in relation to work related health problems reduced risk of developing burnout. So, the concerned bodies should provide trainings which focus on stress copying mechanisms and assertiveness program.

PMID:34714836 | DOI:10.1371/journal.pone.0258224

Zh Vopr Neirokhir Im N N Burdenko. 2021;85(5):23-29. doi: 10.17116/neiro20218505123.

ABSTRACT

BACKGROUND: Non-invasive EEG reveals epileptogenic zone in 70% of patients. In other cases, invasive EEG monitoring is indicated. Various implantation strategies and techniques of intracranial EEG (icEEG) potentially provide different outcomes. Choosing the optimal icEEG technique may be challenging.

OBJECTIVE: To analyze the results of icEEG in adults with temporal lobe epilepsy and to determine the algorithm for selection of optimal invasive EEG technique.

MATERIAL AND METHODS: The study included 82 patients with temporal lobe epilepsy who underwent invasive EEG. Effectiveness of invasive EEG was determined by detection of epileptogenic zone and post-resection outcomes. Postoperative results were analyzed throughout more than 6-month follow-up period using the Engel grading system. Statistical analysis was conducted using the Fisher’s exact test.

RESULTS: Epileptogenic zone was revealed in 72 (88%) cases. Invasive EEG was supplemented by another modality in 3 (4%) patients. Mean follow-up period after resection was 17 months in 45 patients. Favorable outcomes were achieved in 31 (69%) cases. Statistical analysis showed that identification of epileptogenic zone depends existing of lesion and symptoms of seizures. Selection algorithm for optimal technique of invasive EEG was determined considering own results and literature data.

CONCLUSION: Invasive EEG results and post-resection outcomes demonstrated favorable efficacy of original algorithm. The last one may be used in decision-making on optimal technique of invasive EEG in adults with temporal lobe epilepsy.

PMID:34714000 | DOI:10.17116/neiro20218505123

J Periodontal Implant Sci. 2021 Oct;51(5):342-351. doi: 10.5051/jpis.2100920046.

ABSTRACT

PURPOSE: The aim of this study was to compare the inflammatory and lipid profile of patients with and without peri-implantitis.

METHODS: A cross-sectional biochemical study was carried out in which blood samples were collected from 16 patients with peri-implantitis and from 31 subjects with healthy implants. Clinical peri-implant parameters were obtained from all subjects. Levels of tumor necrosis factor-alpha and interleukin-10 (IL-10) were measured in serum. Lipid fractions, glucose and creatinine levels, and complete blood count were also assessed.

RESULTS: After controlling for a history of periodontitis, statistically significant differences between peri-implantitis patients and controls were found for total cholesterol (estimated adjusted mean difference, 76.4 mg/dL; 95% confidence interval [CI], 39.6, 113.2 mg/dL; P<0.001), low-density lipoprotein (LDL) cholesterol (estimated adjusted mean difference, 57.7 mg/dL; 95% CI, 23.8, 91.6 mg/dL; P<0.001), white blood cells (WBC) (estimated adjusted mean difference, 2.8×10³/μL; 95% CI, 1.6, 4.0×10³/μL; P<0.001) and IL-10 (estimated adjusted mean difference, -10.4 pg/mL; 95% CI, -15.8, -5.0 pg/mL; P<0.001). The peri-implant probing pocket depth (PPD) was modestly positively correlated with total cholesterol (r=0.512; P<0.001), LDL cholesterol (r=0.463; P=0.001), and WBC (r=0.519; P<0.001). A moderate negative correlation was observed between IL-10 and PPD (r=0.609; P<0.001).

CONCLUSIONS: Otherwise healthy individuals with peri-implantitis showed increased low-grade systemic inflammation and dyslipidemia.

PMID:34713995 | DOI:10.5051/jpis.2100920046

J Periodontal Implant Sci. 2021 Oct;51(5):352-363. doi: 10.5051/jpis.2007520376.

ABSTRACT

PURPOSE: Some systemic conditions, especially diabetes mellitus (DM), adversely affect dental implant success. This study aimed to investigate the effects of ibuprofen-loaded TiO₂ nanotube (ILTN) dental implants in alloxan-induced diabetic rabbits.

METHODS: Twenty-six New Zealand white rabbits were treated with alloxan monohydrate to induce DM. At 2 weeks following DM induction, 3 types of implants (sandblasted, large-grit, and acid-etched [SLA], ILTN, and machined) were placed into the proximal tibia in the 10 rabbits that survived following DM induction. Each type of implant was fitted randomly in 1 of the holes (round-robin method). The animals were administered alizarin (at 3 weeks) and calcein (at 6 weeks) as fluorescent bone markers, and were sacrificed at 8 weeks for radiographic and histomorphometric analyses.

RESULTS: TiO₂ nanotube arrays of ~70 nm in diameter and ~17 μm in thickness were obtained, and ibuprofen was loaded into the TiO₂ nanotube arrays. A total of 26 rabbits were treated with alloxan monohydrate and only 10 rabbits survived. The 10 surviving rabbits showed a blood glucose level of 300 mg/dL or higher, and the implants were placed in these diabetic rabbits. The implant stability quotient (ISQ) and bone-to-implant contact (BIC) values were significantly higher in the ILTN group (ISQ: 61.8, BIC: 41.3%) and SLA group (ISQ: 62.6, BIC: 46.3%) than in the machined group (ISQ: 53.4, BIC: 20.2%), but the difference in the BIC percentage between the SLA and ILTN groups was not statistically significant (P=0.628). However, the bone area percentage was significantly higher in the ILTN group (78.0%) than in the SLA group (52.1%; P=0.000).

CONCLUSIONS: The ILTN dental implants showed better stability (ISQ) and BIC than the machined implants; however, these values were similar to the commercially used SLA implants in the 2-week diabetic rabbit model.

PMID:34713996 | DOI:10.5051/jpis.2007520376

Clin Exp Dent Res. 2021 Oct 29. doi: 10.1002/cre2.509. Online ahead of print.

ABSTRACT

OBJECTIVES: The aim was to analyze clinical parameters of peri-implantitis in human subjects exposed and non-exposed to use of systemic statins.

MATERIAL AND METHODS: This retrospective cohort pilot study compared patient records of 60 exposed individuals to 196 non-exposed individuals as of 2011 throughout 2017. Source of records were specialist and general dentistry clinics in Public Dental Service, Stockholm County, Sweden. Extent/severity of peri-implantitis and peri-implant bone loss were registered as well as intake of systemic statins. Background variables considered were bleeding on probing, bone-loss, age, gender, earlier periodontitis, prosthetic quality, and smoking. Stepwise linear and logistic regression analysis at the individual level was adopted in order to study the influence of statin use on the severity of peri-implantitis and the incidence of peri-implant bone loss. Results were considered statistically significant at p < 0.05.

RESULTS: Peri-implant bone loss was significantly correlated to use of statin after compensation for age and sex.

CONCLUSIONS: The results render an actual effect of statins on peri-implant bone loss plausible. Further research is warranted.

PMID:34713988 | DOI:10.1002/cre2.509