Category: Statistics

PLoS One. 2023 Aug 15;18(8):e0289045. doi: 10.1371/journal.pone.0289045. eCollection 2023.

ABSTRACT

BACKGROUND: This paper aims to estimate the prevalence of antibiotic use for diarrhea among under-five children (u5c) in low- and middle-income countries (LMICs) using data from 112 Demographic Health Surveys (DHS) conducted between 2006 and 2018. The focus is on understanding the extent of antibiotic usage for managing diarrhea, a condition characterized by frequent loose or watery bowel movements that can lead to severe dehydration.

METHODS AND FINDINGS: A cross-sectional study design was employed in the DHS. The prevalence of antibiotic use for diarrhea among under-five children was estimated by analyzing DHS data from 2006 to 2018 and using the R statistical programming language. Out of a total of 12,69,944 children under five included in this study, 1,80,067 children had diarrhea and 19,502 children had bloody diarrhea. The overall prevalence of diarrhea estimated at ~14% (prevalence = 0.142; 95% CI = 0.141, 0.142). Among the children with diarrhea, 47,755 child received antibiotic treatment, resulting a prevalence of ~27% (prevalence = 0.27, 95% CI = 0.26, 0.27) globally. Central Asia had the highest prevalence of antibiotic use at ~55% (prevalence = (967/1748) = 0.55, 95% CI = 0.52, 0.59), followed by the Europe region with a prevalence of ~44% (prevalence = (5483/12502) = 0.44, 95% CI = 0.43, 0.45). In the South East and Central Asia region, DHS conducted between 2006 and 2018, showed the highest prevalence of antibiotic use in DHS 2007 (~44%), DHS 2012 (~49%), DHS 2016 (~40%) and DHS 2017 (~65%). The linear trend analysis showed an upward trend for using antibiotic of diarrhea in the South East and Central Asia region.

CONCLUSIONS: The Central Asia region had the highest proportion of antibiotic use, with an estimated prevalence of ~55% (95% CI = 0.52, 0.59). The Europe region followed closely with a prevalence of ~44% (95% CI = 0.43, 0.45). The South East Asia region had the lowest prevalence of antibiotic use estimated at ~23% (95% CI = 0.22, 0.24), with a gradual increasing trend.

PMID:37582081 | DOI:10.1371/journal.pone.0289045

PLoS One. 2023 Aug 15;18(8):e0289562. doi: 10.1371/journal.pone.0289562. eCollection 2023.

ABSTRACT

INTRODUCTION: Dermoscopy is a safe, rapid, and non-invasive tool that aids in the clinical examination of pigmented and non-pigmented lesions. The upward trend in the use of dermoscopy can be attributed to the availability of compact hand-held and sophisticated dermoscopes, that are small enough to be carried around in a pocket. The extent of dermoscopy is not only limited to the evaluation of cutaneous lesions but also involves its use in the assessment of mucosal lesions along with lesions of hair and nails.

METHODS: In a descriptive cross-sectional study, subjects (n = 100) with oral or genital mucosal lesions will be enrolled. Following a thorough clinical examination, a dermoscopy of the lesion will be performed with Dermlite DL4© Dermoscope, having a magnification of 10x. Images obtained would be stored and evaluated for observing specific morphologic patterns on dermoscopy which would be utilized to describe those patterns and arrive at a specific diagnosis. Descriptive statistics will include mean and standard deviation to summarise quantitative variation. Dermoscopic features of oral and genital mucosal lesions will be estimated in percentage.

PURPOSE OF STUDY: Mucosal lesions several times mimic each other morphologically. Performing a biopsy is not always feasible for oral and genital lesions because they may be difficult to reach and tend to bleed more profusely compared to the skin surface due to its rich vascular nature. Dermoscopy is a non-invasive tool that helps in the diagnosis that is used mostly for the evaluation of non-mucosal lesions. For the same reason, there is no or minimal information in the published literature with regard to dermoscopic patterns of mucosal lesions. The current study intends to describe dermoscopic patterns in oral and genital mucosal diseases so that this important information would assist the diagnosis in a non-invasive manner thereby reducing the need for invasive investigations like mucosal biopsy.

EXPECTED CLINICAL OUTCOMES: To summarize, this research is intended to add to the scarce literature on dermoscopic findings of oral and genital mucosal lesions. The study findings would establish the diagnosis and eliminate the need for unwarranted invasive biopsies of mucosal lesions and, if need be, help in the selection of the biopsy site.

PMID:37582080 | DOI:10.1371/journal.pone.0289562

PLoS One. 2023 Aug 15;18(8):e0289511. doi: 10.1371/journal.pone.0289511. eCollection 2023.

ABSTRACT

BACKGROUND: Patient safety is a global concern. Safe and effective care can shorten hospital stays and prevent or minimize unintentional harm to patients. Therefore, it is necessary to continuously monitor and improve patient safety in all medical environments. This study is aimed at improving patient safety in gastroenterology departments.

METHODS: The study was carried out as action research. The participants were patients, nurses and doctors of the gastroenterology department of Ayatollah Taleghani Hospital in Tehran in 2021-2022. Data were collected using questionnaires (medication adherence tool, patient education effectiveness evaluation checklist, and medication evidence-based checklist), individual interviews and focus groups. The quantitative data analysis was done using SPSS (v.20) and qualitative data analysis was done through content analysis method using MAXQDA analytic pro 2022 software.

RESULTS: The majority of errors were related to medication and the patient’s fault due to their lack of education and prevention strategy were active supervision, modification of clinical processes, improvement of patient education, and promotion of error reporting culture. The findings of the research showed that the presence of an active supervisor led to the identification and prevention of more errors (P<0.01). Regarding the improvement of clinical processes, elimination of reworks can increase satisfaction in nurses (P<0.01). In terms of patient education, the difference was not statistically significant (P>0.01); however, the mean medication adherence score was significantly different (P<0.01).

CONCLUSION: The improvement strategies of patient safety in Gastroenterology department included the modification of ward monitoring processes, improving/modification clinical processes, improvement of patient education, and development of error reporting culture. Identifying inappropriate processes and adjusting them based on the opinion of the stakeholders, proper patient education regarding self-care, careful monitoring using appropriate checklists, and presence of a supervisor in the departments can be effective in reducing the incidence rate. A comprehensive error reporting program provides an opportunity for employees to report errors.

PMID:37582075 | DOI:10.1371/journal.pone.0289511

PLoS One. 2023 Aug 15;18(8):e0289735. doi: 10.1371/journal.pone.0289735. eCollection 2023.

ABSTRACT

BACKGROUND: Researchers find it difficult to distinguish between depression with ASD (Depress-wASD) and without ASD (Depression) in adult patients. We aimed to clarify the differences in brain connectivity between patients with depression with ASD and without ASD.

METHODS: From April 2017 to February 2019, 22 patients with suspected depression were admitted to the hospital for diagnosis or follow-up and met the inclusion criteria. The diagnosis was determined according to the Diagnostic and Statistical Manual of Mental Disorders-5 by skilled psychiatrists. The Hamilton Depression Rating Scale (HAM-D), Young Mania Raging Scale (YMRS), Mini-International Neuropsychiatric Interview, Parent-interview ASD Rating Scale-Text Revision (PARS-TR), and Autism-Spectrum Quotient-Japanese version (AQ-J) were used to assess the patients’ background and help with diagnosis. Resting-state functional magnetic resonance imaging (rs-fMRI) was performed using the 3-T-MRI system. rs-fMRI was processed using the CONN functional connectivity toolbox. Voxel-based morphometry was performed using structural images.

RESULTS: No significant difference was observed between the Depress-wASD and Depression groups using the HAM-D, YMRS, AQ-J, Intelligence Quotient (IQ), and verbal IQ results. rs-fMRI for the Depress-wASD group indicated a positive connection between the salience network (SN) and right supramarginal gyrus (SMG) and a negative connection between the SN and hippocampus and para-hippocampus than that for the Depression group. No significant structural differences were observed between the groups.

CONCLUSIONS: We identified differences in the SN involving the SMG and hippocampal regions between the Depress-wASD and Depression groups.

PMID:37582068 | DOI:10.1371/journal.pone.0289735

RMD Open. 2022 Sep;8(2):e002529. doi: 10.1136/rmdopen-2022-002529.

ABSTRACT

BACKGROUND: Although genome-wide association studies (GWASs) have identified more than 100 loci associated with rheumatoid arthritis (RA) susceptibility, the causal genes and biological mechanisms remain largely unknown.

METHODS: A cross-tissue transcriptome-wide association study (TWAS) using the unified test for molecular signaturestool was performed to integrate GWAS summary statistics from 58 284 individuals (14 361 RA cases and 43 923 controls) with gene-expression matrix in the Genotype-Tissue Expression project. Subsequently, a single tissue by using FUSION software was conducted to validate the significant associations. We also compared the TWAS with different gene-based methodologies, including Summary Data Based Mendelian Randomization (SMR) and Multimarker Analysis of Genomic Annotation (MAGMA). Further in silico analyses (conditional and joint analysis, differential expression analysis and gene-set enrichment analysis) were used to deepen our understanding of genetic architecture and comorbidity aetiology of RA.

RESULTS: We identified a total of 47 significant candidate genes for RA in both cross-tissue and single-tissue test after multiple testing correction, of which 40 TWAS-identified genes were verified by SMR or MAGMA. Among them, 13 genes were situated outside of previously reported significant loci by RA GWAS. Both TWAS-based and MAGMA-based enrichment analyses illustrated the shared genetic determinants among autoimmune thyroid disease, asthma, type I diabetes mellitus and RA.

CONCLUSION: Our study unveils 13 new candidate genes whose predicted expression is associated with risk of RA, providing new insights into the underlying genetic architecture of RA.

PMID:37582060 | DOI:10.1136/rmdopen-2022-002529

Opt Lett. 2023 Aug 15;48(16):4392-4395. doi: 10.1364/OL.498188.

ABSTRACT

The single-pixel imaging technique uses multiple patterns to modulate the entire scene and then reconstructs a two-dimensional (2-D) image from the single-pixel measurements. Inspired by the statistical redundancy of natural images that distinct regions of an image contain similar information, we report a highly compressed single-pixel imaging technique with a decreased sampling ratio. This technique superimposes an occluded mask onto modulation patterns, realizing that only the unmasked region of the scene is modulated and acquired. In this way, we can effectively decrease 75% modulation patterns experimentally. To reconstruct the entire image, we designed a highly sparse input and extrapolation network consisting of two modules: the first module reconstructs the unmasked region from one-dimensional (1-D) measurements, and the second module recovers the entire scene image by extrapolation from the neighboring unmasked region. Simulation and experimental results validate that sampling 25% of the region is enough to reconstruct the whole scene. Our technique exhibits significant improvements in peak signal-to-noise ratio (PSNR) of 1.5 dB and structural similarity index measure (SSIM) of 0.2 when compared with conventional methods at the same sampling ratios. The proposed technique can be widely applied in various resource-limited platforms and occluded scene imaging.

PMID:37582040 | DOI:10.1364/OL.498188

Opt Lett. 2023 Aug 15;48(16):4245-4248. doi: 10.1364/OL.495624.

ABSTRACT

We present an unsupervised learning denoising method, RepE (representation and enhancement), designed for nonlinear optical microscopy images, such as second harmonic generation (SHG) and two-photon fluorescence (TPEF). Addressing the challenge of effectively denoising images with various noise types, RepE employs an encoder network to learn noise-free representations and a reconstruction network to generate denoised images. It offers several key advantages, including its ability to (i) operate without restrictive statistic assumptions, (ii) eliminate the need for clean-noisy pairs, and (iii) requires only a few training images. Comparative evaluations on real-world SHG and TPEF images from esophageal cancer tissue slides (ESCC) demonstrate that our method outperforms existing techniques in image quality metrics. The proposed method provides a practical, robust solution for denoising nonlinear optical microscopy images, and it has the potential to be extended to other nonlinear optical microscopy modalities.

PMID:37582003 | DOI:10.1364/OL.495624

Opt Lett. 2023 Aug 15;48(16):4237-4240. doi: 10.1364/OL.491689.

ABSTRACT

Semiconductor lasers subjected to strong current modulation produce gain-switched optical pulse trains. These lasers can also produce pulse trains at sub-harmonic repetition rates relative to the driving current modulation. We experimentally observe, and numerically model, that these pulse trains can be interrupted by single-cycle extreme pulses whose characteristics and statistics are similar to rogue waves. Modeling indicates that drops in the circulating optical power in the optical cavity precede the appearance of extreme pulses. At the single photon level, the stochastic source terms in the optical field equation dominate the circulating optical power.

PMID:37582001 | DOI:10.1364/OL.491689

IEEE Trans Neural Netw Learn Syst. 2023 Aug 15;PP. doi: 10.1109/TNNLS.2023.3301711. Online ahead of print.

ABSTRACT

It is attractive to extract plausible 3-D information from a single 2-D image, and self-supervised learning has shown impressive potential in this field. However, when only monocular videos are available as training data, moving objects at similar speeds to the camera can disturb the reprojection process during training. Existing methods filter out some moving pixels by comparing pixelwise photometric error, but the illumination inconsistency between frames leads to incomplete filtering. In addition, existing methods calculate photometric error within local windows, which leads to the fact that even if an anomalous pixel is masked out, it can still implicitly disturb the reprojection process, as long as it is in the local neighborhood of a nonanomalous pixel. Moreover, the ill-posed nature of monocular depth estimation makes the same scene correspond to multiple plausible depth maps, which damages the robustness of the model. In order to alleviate the above problems, we propose: 1) a self-reprojection mask to further filter out moving objects while avoiding illumination inconsistency; 2) a self-statistical mask method to prevent the filtered anomalous pixels from implicitly disturbing the reprojection; and 3) a self-distillation augmentation consistency loss to reduce the impact of ill-posed nature of monocular depth estimation. Our method shows superior performance on the KITTI dataset, especially when evaluating only the depth of potential moving objects.

PMID:37581977 | DOI:10.1109/TNNLS.2023.3301711

JMIR Res Protoc. 2023 Aug 15;12:e48014. doi: 10.2196/48014.

ABSTRACT

BACKGROUND: Fungal-bacterial cocolonization and coinfections pose an emerging challenge among patients suspected of having pulmonary tuberculosis (PTB); however, the underlying pathogenic mechanisms and microbiome interactions are poorly understood. Understanding how environmental microbes, such as fungi and bacteria, coevolve and develop traits to evade host immune responses and resist treatment is critical to controlling opportunistic pulmonary fungal coinfections. In this project, we propose to study the coexistence of fungal and bacterial microbial communities during chronic pulmonary diseases, with a keen interest in underpinning fungal etiological evolution and the predominating interactions that may exist between fungi and bacteria.

OBJECTIVE: This is a protocol for a study aimed at investigating the metabolic and molecular ecological evolution of opportunistic pulmonary fungal coinfections through determining and characterizing the burden, etiological profiles, microbial communities, and interactions established between fungi and bacteria as implicated among patients with presumptive PTB.

METHODS: This will be a laboratory-based cross-sectional study, with a sample size of 406 participants. From each participant, 2 sputa samples (one on-spot and one early morning) will be collected. These samples will then be analyzed for both fungal and bacterial etiology using conventional metabolic and molecular (intergenic transcribed spacer and 16S ribosomal DNA-based polymerase chain reaction) approaches. We will also attempt to design a genome-scale metabolic model for pulmonary microbial communities to analyze the composition of the entire microbiome (ie, fungi and bacteria) and investigate host-microbial interactions under different patient conditions. This analysis will be based on the interplays of genes (identified by metagenomics) and inferred from amplicon data and metabolites (identified by metabolomics) by analyzing the full data set and using specific computational tools. We will also collect baseline data, including demographic and clinical history, using a patient-reported questionnaire. Altogether, this approach will contribute to a diagnostic-based observational study. The primary outcome will be the overall fungal and bacterial diagnostic profile of the study participants. Other diagnostic factors associated with the etiological profile, such as incidence and prevalence, will also be analyzed using univariate and multivariate schemes. Odds ratios with 95% CIs will be presented with a statistical significance set at P<.05.

RESULTS: The study has been approved by the Mbarara University Research Ethic Committee (MUREC1/7-07/09/20) and the Uganda National Council of Science and Technology (HS1233ES). Following careful scrutiny, the protocol was designed to enable patient enrollment, which began in March 2022 at Mbarara University Teaching Hospital. Data collection is ongoing and is expected to be completed by August 2023, and manuscripts will be submitted for publication thereafter.

CONCLUSIONS: Through this protocol, we will explore the metabolic and molecular ecological evolution of opportunistic pulmonary fungal coinfections among patients with presumptive PTB. Establishing key fungal-bacterial cross-kingdom synergistic relationships is crucial for instituting fungal bacterial coinfecting etiology.

TRIAL REGISTRATION: ISRCTN Registry ISRCTN33572982; https://tinyurl.com/caa2nw69.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/48014.

PMID:37581914 | DOI:10.2196/48014