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Nevin Manimala Statistics

Covid-19 vaccines in Italian public opinion: Identifying key issues using Twitter and Natural Language Processing

PLoS One. 2022 Nov 17;17(11):e0277394. doi: 10.1371/journal.pone.0277394. eCollection 2022.

ABSTRACT

The COVID-19 pandemic has changed society and people’s lives. The vaccination campaign started December 27th 2020 in Italy, together with most countries in the European Union. Social media platforms can offer relevant information about how citizens have experienced and perceived the availability of vaccines and the start of the vaccination campaign. This study aims to use machine learning methods to extract sentiments and topics relating to COVID-19 vaccination from Twitter. Between February and May 2021, we collected over 71,000 tweets containing vaccines-related keywords from Italian Twitter users. To get the dominant sentiment throughout the Italian population, spatial and temporal sentiment analysis was performed using VADER, highlighting sentiment fluctuations strongly influenced by news of vaccines’ side effects. Additionally, we investigated the opinions of Italians with respect to different vaccine brands. As a result, ‘Oxford-AstraZeneca’ vaccine was the least appreciated among people. The application of the Dynamic Latent Dirichlet Allocation (DLDA) model revealed three fundamental topics, which remained stable over time: vaccination plan info, usefulness of vaccinating and concerns about vaccines (risks, side effects and safety). To the best of our current knowledge, this one the first study on Twitter to identify opinions about COVID-19 vaccination in Italy and their progression over the first months of the vaccination campaign. Our results can help policymakers and research communities track public attitudes towards COVID-19 vaccines and help them make decisions to promote the vaccination campaign.

PMID:36395254 | DOI:10.1371/journal.pone.0277394

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Factors associated with infants’ sunlight exposure among mothers attending the EPI unit of Wolkite University Specialized Hospital

PLoS One. 2022 Nov 17;17(11):e0277349. doi: 10.1371/journal.pone.0277349. eCollection 2022.

ABSTRACT

BACKGROUND: Infant sunlight exposure in their early infancy is essential for the cutaneous synthesis of vitamin D. Vitamin D deficiency is highly prevalent due to inadequate exposure to sunlight. In Ethiopia, one in thirteen children had rickets, which could be prevented by sunlight exposure or supplementation. This study aimed to identify the practice of infants’ sunlight exposure and associated factors among mothers attending the Expanded program immunization unit of Wolkite University Specialized Hospital.

METHOD: This study employed an institutional-based cross-sectional study design to collect data. Data were collected from 220 mothers using an interviewer-administered questionnaire. The study employed a systematic random sampling technique to reach the study participants. The collected data were entered into a computer using the software Epidata 3.1 version and exported to SPSS version 23 for statistical analysis. Descriptive and inferential analysis was conducted. Logistic regression analysis was done, and a statistical association was declared at a p-value < 5% and a 95% confidence interval(CI). Then the results were presented using a frequency table, figures, and description.

RESULT: A total of 220 infant-coupled mothers who visited the Expanded program immunization unit were included in the study. According to the current study, 67.3% of mothers had good practice with infants’ sunlight exposure. Mothers’ practice of infant sunlight exposure was affected by age of mothers 30-34 years, [AOR = 3.10, 95%CI (1.13, 8.51)], and age ≥35 years, [AOR = 4.49, 95%CI (1.20, 16.86)], and living in urban, [AOR = 1.94, 95%CI (1.053, 3.57)].

CONCLUSION: The current study showed that two-thirds (67.3%) of mothers had good practice of sunlight exposure to their infants. Factors that affect mothers’ practice of infants’ sunlight exposure are age and place of residence. Health professionals should provide health education for mothers on the benefits of infants’ sunlight exposure.

PMID:36395250 | DOI:10.1371/journal.pone.0277349

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Addressing obstetricians’ awareness of compassion, communication, and self-care when caring for families experiencing stillbirth: Evaluation of a novel educational workshop using applied drama techniques

PLoS One. 2022 Nov 17;17(11):e0277496. doi: 10.1371/journal.pone.0277496. eCollection 2022.

ABSTRACT

INTRODUCTION: Obstetricians describe feeling shocked and isolated following stillbirth. Few receive adequate training in how to care for bereaved parents or themselves. We developed a novel workshop for trainee obstetricians using applied drama techniques-in collaboration with the National Theatre of Ireland, the national training body for obstetricians and gynaecologists, and patient support groups-to teach obstetricians skills in communication and self-care around the time of stillbirth.

MATERIALS AND METHODS: Five workshops, delivered January-May 2018, are the focus of this evaluation. Senior trainees in Obstetrics attended and completed a post-workshop evaluation questionnaire. Five-point Likert scales were used to assess participants’ communication and support skills pre- and post- the workshop, and their views on pre-specified attributes needed when caring for families experiencing stillbirth and aspects of the workshop. Quantitative and qualitative data were analysed using descriptive statistics and content analysis, respectively.

RESULTS: 39/59 (66%) workshop participants completed the questionnaires. Most had received no prior training in caring for families experiencing antenatal (31/39, 80%) or intrapartum (34/39, 87%) stillbirth. Following the workshop there was a significant improvement in trainee’s level of confidence in breaking bad news, communicating clearly with the family when breaking bad news, recognising the emotional needs of the family, recognising their own emotional responses, and supporting their colleagues. Trainees were positive about the workshop content and delivery; 90% stated they would recommend it to a colleague.

DISCUSSION: Adequate, appropriate, and stimulating education and training in stillbirth care and self-care is clearly needed to improve patient care. Our findings demonstrate that this novel educational workshop using applied drama techniques-developed in collaboration with diverse stakeholders and underpinned by the views of parents and obstetricians who had experience of stillbirth-is an acceptable and appropriate way of training obstetricians in how to care for bereaved parents and/or to engage in self-care.

PMID:36395201 | DOI:10.1371/journal.pone.0277496

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Low transmission of SARS-CoV-2 derived from children in family clusters: An observational study of family households in the Barcelona Metropolitan Area, Spain

PLoS One. 2022 Nov 17;17(11):e0277754. doi: 10.1371/journal.pone.0277754. eCollection 2022.

ABSTRACT

BACKGROUND: Family clusters offer a good opportunity to study viral transmission in a stable setting. We aimed to analyze the specific role of children in transmission of SARS-CoV-2 within households.

METHODS: A prospective, longitudinal, observational study, including children with documented acute SARS-CoV-2 infection attending 22 summer-schools in Barcelona, Spain, was performed. Moreover, other patients and families coming from other school-like environments that voluntarily accessed the study were also studied. A longitudinal follow-up (5 weeks) of the family clusters was conducted to determine whether the children considered to be primary cases were able to transmit the virus to other family members. The household reproduction number (Re*) and the secondary attack rate (SAR) were calculated.

RESULTS: 1905 children from the summer schools were screened for SARS-CoV-2 infection and 22 (1.15%) tested positive. Moreover, 32 additional children accessed the study voluntarily. Of these, 37 children and their 26 households were studied completely. In half of the cases (13/26), the primary case was considered to be a child and secondary transmission to other members of the household was observed in 3/13, with a SAR of 14.2% and a Re* of 0.46. Conversely, the SAR of adult primary cases was 72.2% including the kids that gave rise to the contact tracing study, and 61.5% without them, and the estimated Re* was 2.6. In 4/13 of the paediatric primary cases (30.0%), nasopharyngeal PCR was persistently positive > 1 week after diagnosis, and 3/4 of these children infected another family member (p<0.01).

CONCLUSIONS: Children may not be the main drivers of the infection in household transmission clusters in the study population. A prolonged positive PCR could be associated with higher transmissibility.

PMID:36395194 | DOI:10.1371/journal.pone.0277754

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Comparison of sampling methods for small oxbow wetland fish communities

PLoS One. 2022 Nov 17;17(11):e0277698. doi: 10.1371/journal.pone.0277698. eCollection 2022.

ABSTRACT

Throughout the world, wetlands have experienced degradation and declines in areal coverage. Fortunately, recognition of the value of wetlands has generated interest in preserving and restoring them. Post-restoration monitoring is necessary to analyze success or failure, thereby informing subsequent management decisions. Restoration of oxbow wetlands has become the focus of targeted restoration efforts to promote recovery of biodiversity and sensitive species, and to enhance ecosystem services. The fish communities of oxbows have been the subject of many monitoring studies. However, a recommended sampling methodology for monitoring the fish communities of oxbows has not been described, thereby limiting our capacity to effectively monitor these ecosystems. We compared four sampling methodologies (backpack electrofishing, fyke netting, minnow trapping, and seining) for fish community data collection with a primary objective of determining an effective method for sampling fish communities in small oxbow wetlands. Seining and fyke netting were determined to be effective methods for sampling oxbow fish communities. Backpack electrofishing and minnow trapping produced low taxonomic richness values and sampled a smaller proportion of species present than seining and fyke netting. Although seining and fyke netting produced similar taxonomic diversity and abundance values, these two gears differ in their ease of implementation and potential habitat disturbance generated by sampling. Therefore, consideration must be given to how species present (especially sensitive species) within the wetland could be impacted by sampling disturbance when choosing between seining and fyke netting.

PMID:36395176 | DOI:10.1371/journal.pone.0277698

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Contraceptive utilization and associated factors among youths in Hossana town administrative, Hadiya zone, Southern Ethiopia

PLoS One. 2022 Nov 17;17(11):e0275124. doi: 10.1371/journal.pone.0275124. eCollection 2022.

ABSTRACT

BACKGROUND: In low-income countries out of, 60.7 million unintended pregnancies, 19% of them are subjected to abortion of which 11% of were unsafe. Surprisingly, about 2.5 million occur in women under the age of 20 years. Aim of this study is to measure the level of contraceptive utilization and associated factors among youths in Hosanna town administration.

METHOD: Institutional based cross-sectional study was conducted in Hossana town administration, Hadiya zone, Southern Ethiopia. A multistage sampling procedure was employed by clustering health facilities into reproductive health clubs and health facilities to select 781 study participants. Data was collected by using structured pre-tested, self-administered questionnaires. All coded and cleaned data were entered into EPI-info version 3.5.1 and it was exported to SPSS version 16.0 for recoding and further analysis.

RESULT: Among youths who had been sexually active within the last 12 months, 67.6% had used contraceptives prior to the survey. Multivariate analysis was found statistically significant association between contraceptive utilization and education status of mothers who attained university AOR = 4.57 [95% CI (1.29, 16.19)], utilization of sexual and reproductive health services within last 12 months AOR = 2.26 [(95% CI: 1.33, 3.86)], age initiation of first sex between 15-19 year OR = 2.63 [(95% CI 1.48,4.64)], discussion with sexual partner AOR = 1.99 [(95% CI: 1.27, 3.13)], good knowledge on contraceptive advantage AOR = [1.89 (95%CI: 1.07, 3.32)]. Whereas educational status: being secondary level decrease utilization of contraceptives by 51% AOR = 0.49 [95% CI (0.27, 0.94)].

CONCLUSION & RECOMMENDATION: The findings of our study imply that level of contraceptive utilization is higher than as compared to the previous studies. Discussion with a sexual partner as well as with a spouse, having awareness on contraceptive advantages, early age initiation of sexual intercourse, maternal educational status and getting sexual and reproductive health services recently were identified as predictors of contraceptive utilization.

PMID:36395174 | DOI:10.1371/journal.pone.0275124

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Completion of an Enhanced Recovery Program in a Pediatric Ambulatory Surgery Center: A Quality Improvement Initiative

Anesth Analg. 2022 Dec 1;135(6):1271-1281. doi: 10.1213/ANE.0000000000006256. Epub 2022 Nov 16.

ABSTRACT

BACKGROUND: Enhanced Recovery After Surgery (ERAS) was first established in 2001 focusing on recovery from complex surgical procedures in adults and recently expanded to ambulatory surgery. The evidence for ERAS in children is limited. In 2018, recognized experts began developing needed pediatric evidence. Center-wide efforts involving all ambulatory surgical patients and procedures have not previously been described.

METHODS: A comprehensive assessment and gap analysis of ERAS elements in our ambulatory center identified 11 of 19 existing elements. The leadership committed to implementing an Enhanced Recovery Program (ERP) to improve existing elements and close as many remaining gaps as possible. A quality improvement (QI) team was launched to improve 5 existing ERP elements and to introduce 6 new elements (target 17/19 ERP elements). The project plan was broken into 1 preparation phase to collect baseline data and 3 implementation phases to enhance existing and implement new elements. Statistical process control methodology was used. Team countermeasures were based on available evidence. A consensus process was used to resolve disagreement. Monthly meetings were held to share real-time data, gather new feedback, and modify countermeasure plans as needed. The primary outcome measure selected was mean postanesthesia care unit (PACU) length of stay (LOS). Secondary outcomes measures were mean maximum pain score in PACU and patient/family satisfaction scores.

RESULTS: The team had expanded the pool of active ERP elements from 11 to 16 of 19. The mean PACU LOS demonstrated significant reduction (early in phase 1 and again in phase 3). No change was seen for the mean maximum pain score in PACU or surgical complication rates. Patient/family satisfaction scores were high and sustained throughout the period of study (91.1% ± 5.7%). Patient/family and provider engagement/compliance were high.

CONCLUSIONS: This QI project demonstrated the feasibility of pediatric ERP in an ambulatory surgical setting. Furthermore, a center-wide approach was shown to be possible. Additional studies are needed to determine the relevance of this project to other institutions.

PMID:36384014 | DOI:10.1213/ANE.0000000000006256

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School District Prevention Policies and Risk of COVID-19 Among In-Person K-12 Educators, Wisconsin, 2021

Am J Public Health. 2022 Dec;112(12):1791-1799. doi: 10.2105/AJPH.2022.307095.

ABSTRACT

Objectives. To assess the rate of COVID-19 among in-person K-12 educators and the rate’s association with various COVID-19 prevention policies in school districts. Methods. We linked actively working, in-person K-12 educators in Wisconsin to COVID-19 cases with onset from September 2 to November 24, 2021. A mixed-effects Cox proportional hazards model, adjusted for pertinent person- and community-level confounders, compared the hazard rate of COVID-19 among educators working in districts with and without specific COVID-19 prevention policies. Results. In-person educators working in school districts that required masking for students and staff experienced 19% lower hazards of COVID-19 than did those in districts without any masking policy (hazard ratio = 0.81; 95% confidence interval = 0.72, 0.92). Reduced COVID-19 hazards were consistent and remained statistically significant when educators were stratified by elementary, middle, and high school environments. Conclusions. In Wisconsin’s K-12 school districts, during the fall 2021 academic semester, a policy that required both students and staff to mask was associated with significantly reduced risk of COVID-19 among in-person educators across all grade levels. (Am J Public Health. 2022;112(12):1791-1799. https://doi.org/10.2105/AJPH.2022.307095).

PMID:36383939 | DOI:10.2105/AJPH.2022.307095

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Chronic exposure to cigarette smoke transiently worsens the disease course in a mouse model of pulmonary paracoccidioidomycosis

Rev Inst Med Trop Sao Paulo. 2022 Nov 14;64:e71. doi: 10.1590/S1678-9946202264071. eCollection 2022.

ABSTRACT

Paracoccidioidomycosis (PCM) may present as an acute/subacute clinical form, characterized by a progressive disease arising from the airborne initial infection, or, most often, as an asymptomatic or subclinical infection that may manifest later during an individual’s life, the chronic form. Epidemiological studies show the existence of a strong association between smoking and the development of the chronic form. Current evidence demonstrates that cigarette smoke (CS) has immunosuppressive properties that could be implicated in the increasing susceptibility to the chronic form of PCM. To address this issue, we developed a murine model of a non-progressive pulmonary form of PCM that was exposed to CS at a magnitude that mimicked a moderate smoker. The chronic CS exposure started after 2 weeks and lasted up until 20 weeks post-infection, with the aim of mimicking human natural history, since it is estimated that individuals from endemic areas are infected early in life. The control group consisted of infected but not CS-exposed mice. We assessed the lung fungal burden (colony forming units [CFU]) and the area affected by the granulomatous inflammatory response, fungal dissemination to spleen and liver, and, by immunohistochemistry, the presence of CD4 and CD8 lymphocytes, CD68 and MAC-2 macrophages, and IFN-γ, IL-10 and TNF expressing cells within the granulomatous response. We detected a CS effect as early as 2 weeks after exposure (four weeks post-infection) when the lung CFU of exposed animals was significantly higher than in their non-exposed counterparts. At 12 weeks, the CS-exposed animals presented a more severe disease, as witnessed by the persistent higher lung fungal load (although it did not reach statistical significance [ p = 0.054]), greater dissemination to other organs, greater affected area of the lung, decreased IFN-γ/IL-10 ratio, and higher TNF expression within the granulomas, compared with CS-non-exposed mice. The number of CD4 and CD8 lymphocytes infiltrating the granulomas was similar between both mice groups, but there was a decrease in the number of MAC-2+ macrophages. No difference was noted in the CD68+ macrophage number. However, the follow-up in week 20 showed that the immunological effects of exposure to CS ceased, with both CS and NCS mice showing the same infectious features, i.e., a trend for resolution of the infection. In conclusion, we show that chronic CS-exposure alters the course of the disease in an experimental model of subclinical pulmonary PCM, confirming the epidemiological link between CS-exposure and the chronic form of PCM. However, we also show that this effect is transitory, being detected between 4- and 12-weeks post-infection but not thereafter. The possible immune mechanisms that mediate this effect and the reasons for its transitory effect are discussed.

PMID:36383893 | DOI:10.1590/S1678-9946202264071

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LAPAROSCOPIC INGUINAL HERNIA REPAIR: THE LONG-TERM ASSESSMENT OF CHRONIC PAIN AND QUALITY OF LIFE

Arq Bras Cir Dig. 2022 Nov 14;35:e1695. doi: 10.1590/0102-672020220002e1695. eCollection 2022.

ABSTRACT

BACKGROUND: Laparoscopic approaches to inguinal hernia repair include transabdominal extraperitoneal and transabdominal preperitoneal, both of which are widely performed and employ mesh. Indicators of success for these surgical procedures include incidence of complications, time to return to daily activities, incidence of postoperative chronic pain, and the long-term postoperative patient satisfaction.

OBJECTIVE: This study aimed to evaluate and compare long-term postoperative incidence of chronic pain and overall quality of life among patients undergoing transabdominal extraperitoneal or transabdominal preperitoneal inguinal hernia repair.

METHODS: This was a retrospective cross-sectional study. Medical records were analyzed, and the SF-36 questionnaire and Visual Analog Scale were applied to assess quality of life and chronic pain in patients undergoing laparoscopic inguinal hernia repair between January 2017 and February 2021.

RESULTS: A total of 167 patients status post laparoscopic inguinal hernia repair, who were 3 months postoperatively or longer, were included in the study. Among the early complications seen, seroma was most common in the transabdominal preperitoneal group (p=0.04). Subsequently, 40 of the initial 167 patients answered to the survey instrument (SF-36 and Visual Analog Scale). Mean patient-reported pain (Visual Analog Scale score) was statistically similar between groups, with 1.29 for transabdominal preperitoneal and 1.68 for transabdominal extraperitoneal (p=0.92). In the domains evaluated by the SF-36, there was no significant difference between the samples.

CONCLUSION: Both transabdominal extraperitoneal and transabdominal preperitoneal techniques for hernia repair have similar results in the late postoperative period regarding quality of life and prevalence of chronic pain. They are also comparable in terms of major early postoperative complications, except for seroma, with a higher incidence in patients undergoing transabdominal preperitoneal.

PMID:36383888 | DOI:10.1590/0102-672020220002e1695