PLoS One. 2021 Apr 7;16(4):e0250030. doi: 10.1371/journal.pone.0250030. eCollection 2021.
ABSTRACT
[This corrects the article DOI: 10.1371/journal.pone.0237507.].
PMID:33826666 | DOI:10.1371/journal.pone.0250030
Category: Statistics
Category Added in a WPeMatico Campaign
PLoS One. 2021 Apr 7;16(4):e0249793. doi: 10.1371/journal.pone.0249793. eCollection 2021.
ABSTRACT
INTRODUCTION: Returning to health facility for postnatal care (PNC) use after giving birth at health facility could reflect the health seeking behavior of mothers. However, such studies are rare though they are critically important to develop vigorous strategies to improve PNC service utilization. Therefore, this study aimed to determine the magnitude and factors associated with returning to health facilities for PNC among mothers who delivered in Ethiopian health facilities after they were discharged.
METHODS: This cross-sectional study used 2016 Ethiopian Demographic and Health Survey data. A total of 2405mothers who gave birth in a health facility were included in this study. Multilevel mixed-effect logistic regression model was fitted to estimate both independent (fixed) effects of the explanatory variables and community-level (random) effects on return for PNC utilization. Variable with p-value of ≤ 0.25 from unadjusted multilevel logistic regression were selected to develop three models and p-value of ≤0.05 was used to declare significance of the explanatory variables on the outcome variable in the final (adjusted) model. Analysis was done using IBM SPSS statistics version 21.
RESULT: In this analysis, from the total 2405 participants, 14.3% ((95%CI: 12.1-16.8), (n = 344)) of them returned to health facilities for PNC use after they gave birth at a health facility. From the multilevel logistic regression analysis, being employed (AOR = 1.51, 95%CI: 1.04-2.19), receiving eight and above antenatal care visits (AOR = 2.90, 95%CI: 1.05-8.00), caesarean section delivery (AOR = 2.53, 95%CI: 1.40-4.58) and rural residence (AOR = 0.56, 95%CI: 0.36-0.88) were found significantly associated with return to health facilities for PNC use among women who gave birth at health facility.
CONCLUSION: Facility-based PNC utilization among mothers who delivered at health facilities is low in Ethiopia. Both individual and community level variables were determined women to return to health facilities for PNC use. Thus, adopting context-specific strategies/policies could improve PNC utilization and should be paid a due focus.
PMID:33826670 | DOI:10.1371/journal.pone.0249793
Am J Clin Nutr. 2021 Apr 7:nqab033. doi: 10.1093/ajcn/nqab033. Online ahead of print.
ABSTRACT
BACKGROUND: Evidence points to diverse risk factors associated with small- (SGA) and large-for-gestational-age (LGA) births. A more comprehensive understanding of these factors is imperative, especially in vulnerable populations.
OBJECTIVES: To estimate the occurrence of and sociodemographic factors associated with SGA and LGA births in poor and extremely poor populations of Brazil.
METHODS: The study population consisted of women of reproductive age (14-49 y), whose last child was born between 2012 and 2015. INTERGROWTH 21st consortium criteria were used to classify weight for gestational age according to sex. Multinomial logistic regression modeling was performed to investigate associations of interest.
RESULTS: Of 5,521,517 live births analyzed, SGA and LGA corresponded to 7.8% and 17.1%, respectively. Multivariate analysis revealed greater odds of SGA in children born to women who self-reported as black (OR: 1.21; 95% CI: 1.19, 1.22), mixed-race (parda) (OR: 1.08; 95% CI: 1.07, 1.09), or indigenous (OR: 1.11; 95% CI: 1.06, 1.15), were unmarried (OR: 1.08; 95% CI: 1.07, 1.08), illiterate (OR: 1.47; 95% CI: 1.42, 1.52), did not receive prenatal care (OR: 1.57; 95% CI: 1.53, 1.60), or were aged 14-20 y (OR: 1.21; 95% CI: 1.20, 1.22) or 35-49 y (OR: 1.12; 95% CI: 1.10, 1.13). Considering LGA children, higher odds were found in infants born to women living in households with ≥3 inadequate housing conditions (OR: 1.11; 95% CI: 1.10, 1.12), in indigenous women (OR: 1.22; 95% CI: 1.19, 1.25), those who had 1-3 y of schooling (OR: 1.18; 95% CI: 1.17, 1.19), 1-3 prenatal visits (OR: 1.16; CI 95%: 1.14, 1.17), or were older (OR: 1.26; 95% CI: 1.25, 1.27).
CONCLUSIONS: In poorer Brazilian populations, socioeconomic, racial, and maternal characteristics are consistently associated with the occurrence of SGA births, but remain less clearly linked to the occurrence of LGA births.
PMID:33826704 | DOI:10.1093/ajcn/nqab033
PLoS One. 2021 Apr 7;16(4):e0245113. doi: 10.1371/journal.pone.0245113. eCollection 2021.
ABSTRACT
Previous research investigating language in attention-deficit hyperactivity disorder (ADHD) has demonstrated several deficits in many aspects. However, no previous study employed quantitative methodology providing objective measures that could be compared among different studies with diverse samples. To fill this gap, we used network analysis to investigate how ADHD symptomatology impacts narrative discourse, a complex linguistic task considered to be an ecological measure of language. Fifty-eight adults (34 females and 24 males) with a mean age of 26 years old and a mean of 17 years of educational level were administered the Adult Self-Rating Scale for ADHD symptomatology. They also completed the State-Trait Anxiety Inventory, the Beck Depression Inventory and the Urgency, Premeditation, Perseverance, Sensation Seeking Behavior Scale. Intelligence quotient was calculated. Individuals were asked to tell a story based on a wordless picture book. Speech was recorded and transcribed as an input to SpeechGraphs software. Parameters were total number of words (TNW), number of loops of one node (L1), repeated edges (RE), largest strongly connected component (LSC) and average shortest path (ASP). Verbosity was controlled. Statistical analysis was corrected for multiples comparisons and partial correlations were performed for confounding variables. After controlling for anxiety, depression, IQ, and impulsiveness ADHD symptomatology was positively correlated with L1 and negatively correlated with LSC. TNW was positively correlated with ADHD symptoms. In a subdomain analysis, both inattention and hyperactivity-impulsivity were negatively correlated with LSC. Only hyperactivity-impulsivity positively correlated with TNW and L1. Results indicated a correlation between ADHD symptoms and lower connectedness in narrative discourse (as indicated by higher L1 and lower LSC), as well as higher total number of words (TNW). Our results suggest that the higher the number of ADHD symptoms, the less connectivity among words, and a higher number of words in narrative discourse.
PMID:33826632 | DOI:10.1371/journal.pone.0245113
PLoS One. 2021 Apr 7;16(4):e0249775. doi: 10.1371/journal.pone.0249775. eCollection 2021.
ABSTRACT
BACKGROUND: The purpose of the present study was to evaluate the relationship between chronic endometritis and the epithelial-mesenchymal transition in the endometrium of infertile patients in the implantation phase.
METHODS: Endometrial biopsy specimens from 66 infertility patients were analyzed. The presence of chronic endometritis was investigated by immunostaining for CD138. Immunohistochemical staining for E-cadherin, N-cadherin, Slug, and Snail was performed, and the expression profiles were statistically analyzed according to the presence of chronic endometritis. When the loss of E-cadherin expression and/or the positive expression of N-cadherin was detected, the specimen was considered epithelial-mesenchymal transition-positive. Epithelial-mesenchymal transition-positive cases were also statistically analyzed according to the presence of chronic endometritis. The characteristics of the patients in the epithelial-mesenchymal transition-positive and epithelial-mesenchymal transition-negative groups were compared. The association between variables, including age, body mass index, gravidity, parity, and each causative factor of infertility and epithelial-mesenchymal transition positivity was analyzed.
RESULTS: The rates of the loss of E-cadherin expression, the gain of N-cadherin and epithelial-mesenchymal transition positivity were significantly higher in chronic endometritis patients. The expression of Slug, cytoplasmic Snail, and nuclear Snail was also detected at significantly higher rates in chronic endometritis patients. Chronic endometritis were related to the epithelial-mesenchymal transition.
CONCLUSION: The epithelial-mesenchymal transition was frequently detected in the endometrium in infertile patients with chronic endometritis. Since the epithelial-mesenchymal transition is associated with chronic endometritis, the epithelial-mesenchymal transition appears to be involved in the alteration of mechanisms of implantation.
PMID:33826645 | DOI:10.1371/journal.pone.0249775
PLoS One. 2021 Apr 7;16(4):e0249727. doi: 10.1371/journal.pone.0249727. eCollection 2021.
ABSTRACT
Special Care Dentistry (SCD) or Special Needs Dentistry is a branch of dentistry concerned with the oral health of people with a variety of medical conditions or limitations that require more than routine delivery of care. There were reports on oral status of special care patients and special interest group for SCD dentists in Indonesia has existed. However, there was not perception report on SCD amongst dentists in Jakarta. This paper will describe the perception of dentists in Jakarta towards SCD. A cross-sectional questionnaire, translated and cross adapted to Indonesian, was distributed online through Whatsapp to dentists registered in Jakarta late 2019. Quantitative data was analyzed using statistical software for proportion and correlation using Chi-Square test. The questionnaire explored dentists’ perception towards SCD. A total of 250 dentists participated in this study, of them 173 general practitioners and 77 specialist dentists. Most respondents reported that they did not have SCD component during undergraduate dental school and did not provide treatment to patients with special needs in their clinical practice. Most respondents have poor perception of SCD, however, most of the respondents showed motivation and interest towards SCD training. Dentists in Jakarta involved in this study had poor perception of SCD. More efforts should be performed to improve SCD education and awareness.
PMID:33826661 | DOI:10.1371/journal.pone.0249727
J Pediatr Orthop. 2021 Apr 8. doi: 10.1097/BPO.0000000000001820. Online ahead of print.
ABSTRACT
BACKGROUND: Previous studies have demonstrated that the use of tranexamic acid (TXA) reduces blood loss and transfusion requirements in children undergoing scoliosis surgery. Although TXA is safe and effective, significant adverse events have been reported. Using the lowest effective dose of TXA is advisable. We evaluated a new low dosing regimen for TXA based on an improved pharmacokinetic model and therapeutic plasma concentration. The purpose of this study is to evaluate the effectiveness of this new low dosing regimen in reducing blood loss and transfusion requirements in patients with adolescent idiopathic scoliosis undergoing posterior spinal fusion when compared with a control group who did not receive TXA.
METHODS: We retrospectively reviewed 90 consecutive patients with idiopathic scoliosis undergoing posterior spinal fusion at our institution from 2017 to 2020. Forty patients received TXA at the new dosing regimen (10 mg/kg load, 5 mg/kg/h infusion) and 50 patients were in the non-TXA control group. The same 2 orthopaedic surgeons, working as a team, performed all surgical procedures. We assessed the use of TXA as an independent risk factor for estimated blood loss and transfusion requirement after adjusting for age, surgical duration, body mass index, major coronal curve, and sex.
RESULTS: A comparison of the intraoperative cumulative blood loss in the 2 groups showed a significantly lower blood loss in the TXA group. (583.5±272.0 vs. 479.5±288.7 mL, P=0.03) This difference persisted when blood loss was calculated as percent of total blood volume and per vertebral level. Transfusion requirements were lower in the TXA group (4/50 patients vs. 0/40 patients, P=0.13). No patient in the TXA group required a blood transfusion during their hospitalization.
CONCLUSION: This study is the first to provide evidence that a new low dosing regimen of TXA can significantly reduce blood loss and transfusion requirements for idiopathic scoliosis patients and supports the need for a prospective, randomized clinical trial to confirm these findings.
LEVEL OF EVIDENCE: Level III-retrospective cohort study.
PMID:33826563 | DOI:10.1097/BPO.0000000000001820
Crit Care Med. 2021 Apr 8. doi: 10.1097/CCM.0000000000005044. Online ahead of print.
ABSTRACT
OBJECTIVES: To determine if a restrictive visitor policy inadvertently lengthened the decision-making process for dying inpatients without coronavirus disease 2019.
DESIGN: Regression discontinuity and time-to-event analysis.
SETTING: Two large academic hospitals in a unified health system.
PATIENTS OR SUBJECTS: Adult decedents who received greater than or equal to 1 day of ICU care during their terminal admission over a 12-month period.
INTERVENTIONS: Implementation of a visit restriction policy.
MEASUREMENTS AND MAIN RESULTS: We identified 940 adult decedents without coronavirus disease 2019 during the study period. For these patients, ICU length of stay was 0.8 days longer following policy implementation, although this effect was not statistically significant (95% CI, -2.3 to 3.8; p = 0.63). After excluding patients admitted before the policy but who died after implementation, we observed that ICU length of stay was 2.9 days longer post-policy (95% CI, 0.27-5.6; p = 0.03). A time-to-event analysis revealed that admission after policy implementation was associated with a significantly longer time to first do not resuscitate/do not intubate/comfort care order (adjusted hazard ratio, 2.2; 95% CI, 1.6-3.1; p < 0.0001).
CONCLUSIONS: Policies restricting family presence may lead to longer ICU stays and delay decisions to limit treatment prior to death. Further policy evaluation and programs enabling access to family-centered care and palliative care during the ongoing coronavirus disease 2019 pandemic are imperative.
PMID:33826588 | DOI:10.1097/CCM.0000000000005044
PLoS One. 2021 Apr 7;16(4):e0248583. doi: 10.1371/journal.pone.0248583. eCollection 2021.
ABSTRACT
Adequate diversity and abundance of native seed for large-scale grassland restorations often require commercially produced seed from distant sources. However, as sourcing distance increases, the likelihood of inadvertent introduction of multiple novel, non-native weed species as seed contaminants also increases. We created a model to determine an “optimal maximum distance” that would maximize availability of native prairie seed from commercial sources while minimizing the risk of novel invasive weeds via contamination. The model focused on the central portion of the Level II temperate prairie ecoregion in the Midwest US. The median optimal maximum distance from which to source seed was 272 km (169 miles). In addition, we weighted the model to address potential concerns from restoration practitioners: 1. sourcing seed via a facilitated migration strategy (i.e., direct movement of species from areas south of a given restoration site to assist species’ range expansion) to account for warming due to climate change; and 2. emphasizing non-native, exotic species with a federal mandate to control. Weighting the model for climate change increased the median optimal maximum distance to 398 km (247 miles), but this was not statistically different from the distance calculated without taking sourcing for climate adaptation into account. Weighting the model for federally mandated exotic species increased the median optimal maximum distance only slightly to 293 km (182 miles), so practitioners may not need to adjust their sourcing strategy, compared to the original model. This decision framework highlights some potential inadvertent consequences from species translocations and provides insight on how to balance needs for prairie seed against those risks.
PMID:33826620 | DOI:10.1371/journal.pone.0248583
Environ Technol. 2021 Apr 7:1-18. doi: 10.1080/09593330.2021.1914177. Online ahead of print.
ABSTRACT
Current study addresses a problem of elevated aluminum concentrations deteriorating Khibiny Alkaline Massif groundwater quality. The application of chemometric methods to the field dataset 1999-2018 allows to quantitatively describe the groundwater quality, reveal variability patterns and potential sources of elevated aluminum level in the groundwater. The field dataset contains almost 40% more observations of 12 physicochemical groundwater quality parameters than the dataset analyzed in our previous studies on Khibiny groundwater quality assessment reported in the literature. The results revealed statistically significant (α-level=0.05) associations between Al and pH, Cl–, NO3–, SO42- according to the calculated matrix using distance correlation method. The mathematical models developed with the application of multiple regression and factor/principal component analysis elucidate up to 55.5% Al concentration variability and up to 68.3% of total dataset variance. Calculated for the 19-year period the water quality index values, which changed in early 2000s from fair to a marginal category, still belongs to this category reflecting unsatisfactory water quality conditions. Comparing the current study results to the conclusions drawn in our previous publications it is assumed that the main factors determining substandard groundwater quality have remained the same since last groundwater quality assessment reported in the literature. The examined combination of chemometric methods allows to gain insight into the main features of variability patterns of water quality characteristics and the potential sources of groundwater contamination. This approach forms a reliable foundation for enhancing groundwater quality monitoring and control in the Arctic region of interest and other locations experiencing similar problems.
PMID:33826472 | DOI:10.1080/09593330.2021.1914177