Nevin Manimala

PLoS One. 2025 May 2;20(5):e0322015. doi: 10.1371/journal.pone.0322015. eCollection 2025.

ABSTRACT

INTRODUCTION: Patients often spend significant time waiting for care, which influences patient satisfaction, perceived quality, access to care, and utilization of various health care services. Waiting time and resulting implications remain understudied in low- and middle-income countries like Kenya. This study aimed to describe the impact on the perception of waiting times on patient satisfaction and care at a tertiary healthcare institution in Kenya.

METHOD: We conducted a prospective cross-sectional study between the first of April 2023 and the thirty-first of August 2023 at the Emergency Room (ER) at Aga Khan University Hospital, Nairobi. Data was collected through a structured questionnaire examining demographics and patient wait times. Descriptive statistics were summarized using frequencies and percentages, and univariate analyses using Fisher’s exact test were conducted for group comparisons.

RESULTS: A total of 941 patients participated in the study, with 52.0% being females and 53.6% in the 20-40-year age group. More than half of the patients were married (52.4%), had a university education (75.9%), and were employed (70.6%). Of the patients who took the survey, 51.1% reported waiting for 31-60 minutes, while 25.4% reported waiting for more than 60 minutes. Most patients presented to the ER on Monday, most frequently between 0800 and 1200 hrs. Most patients (70.8%) were likely to return for care and 71.7% were likely to recommend care at the ER to relatives and friends.

CONCLUSION: Specific days and times of visits to the ER were associated with prolonged waiting times. To reduce waiting times and improve access to healthcare services, facilities should consider increasing the number of healthcare providers during these peak hours to ensure timely and quality consultations. Identifying bottlenecks and gridlocks within healthcare facilities is crucial to developing an efficient blueprint that aims to improve waiting times, leading to improved patient satisfaction and care.

PMID:40315218 | DOI:10.1371/journal.pone.0322015

PLoS One. 2025 May 2;20(5):e0322515. doi: 10.1371/journal.pone.0322515. eCollection 2025.

ABSTRACT

BACKGROUND: Identifying underlying subgroups might be a way to examine the development of co-occurrent substance use and delinquency. The aim of this study was to identify latent classes of substance misuse and delinquency in adolescence and which general risk factors are associated with these classes.

METHODS: Data of two waves from a national representative Swedish birth cohort was used that consisted of 4,013 randomly selected adolescents (Male = 1,798, Female = 2,201, Missing = 14) Latent class analysis was used to identify classes of substance misuse and delinquency at age 17/18 and. logistic regression analysis was used to assess risk factors at age 15/16.

RESULTS: Identified classes were: “Low/abstainers” (74.80%, n = 2858, Male = 1191 Female = 1656, Missing = 11) which acted as reference, “Alcohol only” (22.21%, n = 849, Male = 420, Female = 426, Missing = 3), “Polydrug use and crime” (2.15%, n = 82, Male = 52, Female = 30) and “High crime” (0.84%, n = 32, Male = 30, Females = 2). Factors associated with belonging to any classes engaging in substance use and delinquency were lower parental support, supervision, peer problems, and higher conduct problems, sensation-seeking behavior, distrust in society, and truancy.

CONCLUSIONS: Most people did not engage in substance use or delinquency. When accounting for less frequent behaviors such as normative adolescent drinking and one-time events of crime and drug use, about 3% of the population engaged in co-occurring substance use and delinquency. Several different factors from several domains where related to belonging to a class that used substances and/or engaged in delinquency. There were indications that the most extensive users and offender displayed a wide variety of severe level risk factors, which could have implications for targeted interventions. Though, statistical power was a problem and future research should use larger samples or alternative methods.

PMID:40315216 | DOI:10.1371/journal.pone.0322515

PLoS One. 2025 May 2;20(5):e0320568. doi: 10.1371/journal.pone.0320568. eCollection 2025.

ABSTRACT

Human capital management (HCM) helps manage and develop human capital (HC) in businesses through investments that increase the value of HC and contribute to improving the financial situation of companies. Industry 4.0 (4IR) presents new challenges especially for small and medium-sized enterprises (SMEs). The article aim is to find out how important SMEs perceive investments in HC, whether they evaluate the effectiveness of investments in HC and which of the selected HCM activities related to digitization they consider essential. It was used basic scientific methods, Cronbach’s alpha, descriptive statistics, and the chi-square test. It was found that in 2020 up to 49.56% and in 2021 up to 63.94% of respondents consider the funds spent on employees as investments in HC. In connection with digitization, it is striking that up to 76.98% of SMEs in 2020 and 68.34% of respondents in 2021 did not use a personnel information system (HRIS) and an even greater number of companies did not even prepare reports for the HC area. The originality of the article lies in the processing of a two-year questionnaire survey and in the intersection of HCM and Industry 4.0. This is a very current topic, which is also emphasized by the European Union. Future research could focus on employee training models (HC development), or on the culture of innovation and adaptability in companies that digitalize.

PMID:40315210 | DOI:10.1371/journal.pone.0320568

PLoS One. 2025 May 2;20(5):e0322748. doi: 10.1371/journal.pone.0322748. eCollection 2025.

ABSTRACT

BACKGROUND: Thyroid hormones substantially influence the metabolism and production of blood cells; as a result, blood disorders are frequently seen among patients with thyroid hormone disorders. Therefore, this study aimed to assess hematological abnormalities and associated factors among patients with thyroid hormone dysfunction.

METHODS: A hospital-based cross-sectional study was conducted from March 12/03/2022 to May 26/05/2022 among consecutive selected 308 study participants at the University Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. A structured questionnaire and data extraction sheet were used to collect socio-demographic and Clinical data, respectively. For complete blood cell count analysis venous blood was collected and analyzed by Beckman-coulter DXH-800 hematology analyzer. Data was entered by Epi data version 3.1 and analyzed by Stata version 14. Binary and multivariable logistic regressions were done to identify associated factors of hematological abnormality. A P-value less than 0.05 was considered statistically significant.

RESULTS: The overall magnitude of anemia, leukopenia, thrombocytopenia, thrombocytosis, leukocytosis, and polycythemia was 26.3%, 5.5%, 2.6%, 2.3%, 2.3%, and 1.3%, respectively. Hypothyroidism (AOR = 2, 95% CI:1.0-3.6), alcohol consumption (AOR = 4, 95% CI: 1.7-9.2), meat consumption (AOR = 4, 95% CI: 1.6-10.4), vegetable consumption (AOR = 2.5, 95% CI:1.1-5.5) and febrile illness (AOR = 2.6, 95% CI:1.3-5.4) were found to be associated with anemia.

CONCLUSION: Anemia was a moderate public health problem among thyroid dysfunction patients, mainly normocytic normochromic anemia was the most common type of anemia, leukopenia was second major hematological abnormality. Hypothyroidism, alcohol consumption, meat consumption, vegetable consumption, and febrile illness were associated with anemia. Thus, all patients with thyroid dysfunction should have regular anemia screenings, particularly those with important risk factors. This could aid in the early identification and efficient treatment of anemia, improving the patients’ quality of life.

PMID:40315206 | DOI:10.1371/journal.pone.0322748

Bioinformatics. 2025 May 2:btaf264. doi: 10.1093/bioinformatics/btaf264. Online ahead of print.

ABSTRACT

MOTIVATION: Genome-Wide Association Studies (GWAS) are widely used to investigate the role of genetics in disease traits, but the resulting file sizes from these studies are large, posing barriers to efficient storage, sharing, and querying. This issue is especially important for biobanks like the UK Biobank that publish GWAS for thousands of traits, increasing the volume of data that must be effectively managed. Current compression and query methods reduce file sizes and allow for quick genomic position-based queries but do not provide utility for quickly finding loci based on their summary statistics. For example, finding all SNVs in a particular p-value range would require decompressing and scanning the whole file. We propose a new tool, STABIX, which introduces summary-statistic-based queries and improves upon the standard bgzip compression and Tabix query tool in both compression ratio and decompression speed.

RESULTS: When applied to ten GWAS files from PanUKBB, STABIX created smaller compressed data and indices than Tabix for all files, where bgzip and tbi files were an average of 1.2 times the size of STABIX compressed files and indexes. In the same ten files, STABIX per gene decompression was, on average 7x faster than Tabix per gene decompression, and achieved faster per gene decompression times for over 99% of nearly 20,000 genes.

AVAILABILITY: Software freely available for download at GitHub: https://github.com/kristen-schneider/stabix/.

SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

PMID:40315153 | DOI:10.1093/bioinformatics/btaf264

Clin Exp Rheumatol. 2025 May 1. doi: 10.55563/clinexprheumatol/8x1nhn. Online ahead of print.

ABSTRACT

OBJECTIVES: To explore the value of the vascular index (VI) based on superb microvascular imaging (SMI) technique in assessing rheumatoid arthritis (RA) disease activity.

METHODS: The study involved 119 RA patients who underwent SMI examinations of 28 joints. Observers obtained the VI values by manually drawing the area of interest and calculating the sum of the VI values for each patient to obtain the VIsum, and then dividing the VIsum by the number of signal-positive joints to obtain the VIstand. Data of patients’ 28-joint Disease Activity Score (DAS28) and laboratory tests were also collected. The relationship between VI parameters and clinical indexes as well as the differences of VI parameters among groups with different disease activity were investigated. Moreover, the cut-off values of VI parameters to identify RA patients with DAS28 <2.6/DAS28 ≤3.2 were calculated using the receiver operating characteristic (ROC) curves.

RESULTS: VIsum, VIstand correlated with clinical and laboratory indicators, especially with DAS28 (r=0.740, 0.659, respectively, p<0.05). The differences of VIsum and VIstand among the 4 groups of patients were statistically significant (p<0.05). VIsum had higher diagnostic efficacy than VIstand for identifying patients in remission or in low and below activity. With a VIsum cut-off value of 35.5/47.8, the area under the ROC curve for identifying DAS28 <2.6/DAS28 ≤3.2 was 0.872/0.846.

CONCLUSIONS: As a quantitative indicator to assess synovitis activity of RA patients, SMI-based VI was helpful in assessing RA disease activity.

PMID:40314989 | DOI:10.55563/clinexprheumatol/8x1nhn

Proc Natl Acad Sci U S A. 2025 May 6;122(18):e2501394122. doi: 10.1073/pnas.2501394122. Epub 2025 May 2.

ABSTRACT

Many organisms employ reversible dormancy, or seedbank, in response to environmental fluctuations. This life-history strategy alters fundamental ecoevolutionary forces, leading to distinct patterns of genetic diversity. Two models of dormancy have been proposed based on the average duration of dormancy relative to coalescent timescales: weak seedbank, induced by scheduled seasonality (e.g., plants, invertebrates), and strong seedbank, where individuals stochastically switch between active and dormant states (e.g., bacteria, fungi). The weak seedbank coalescent is statistically equivalent to the Kingman coalescent with a scaled mutation rate, allowing the use of existing inference methods. In contrast, the strong seedbank coalescent differs fundamentally, as only active lineages can coalesce, while dormant lineages cannot. Additionally, dormant individuals typically mutate at a slower rate than active ones. Consequently, despite the significant role of dormancy in the ecoevolutionary dynamics of many organisms, no methods currently exist for inferring population dynamics involving dormancy and associated parameters. We present a Bayesian framework for jointly inferring a latent genealogy, seedbank parameters, and evolutionary parameters from molecular sequence data under the strong seedbank coalescent. We derive the exact probability density of genealogies sampled under the strong seedbank coalescent, characterize the corresponding likelihood function, and present efficient computational algorithms for its evaluation based on our theoretical framework. We develop a tailored Markov chain Monte Carlo sampler and implement our inference framework as a package SeedbankTree within BEAST2. Our work provides both a theoretical foundation and practical inference framework for studying the population genetic and genealogical impacts of dormancy.

PMID:40314983 | DOI:10.1073/pnas.2501394122

Proc Natl Acad Sci U S A. 2025 May 6;122(18):e2414578122. doi: 10.1073/pnas.2414578122. Epub 2025 May 2.

ABSTRACT

Through a field study (N = 1,519) that uses a technology to record real-time data on waste sorting, we find that offering the opportunity to sign a pledge increases the effectiveness of an environmental campaign. With a timespan of over four years, the pledge increased waste sorting participation by 4.55 to 5.10 percentage points (SD = 0.1997). The effect is greater immediately after the campaign (around 9 to 10 pp during the first 15 wk), but it remains sizable and statistically significant 150 to 210 wk after signing (3.11 to 4.45 pp).

PMID:40314980 | DOI:10.1073/pnas.2414578122

Proc Natl Acad Sci U S A. 2025 May 13;122(19):e2423266122. doi: 10.1073/pnas.2423266122. Epub 2025 May 2.

ABSTRACT

This paper examines the relationship between democratization and the development of AI and information and communication technology (ICT). Our empirical evidence shows that in the past 10 y, the advancement of AI/ICT has hindered the development of democracy in many countries around the world. Given that both the state rulers and civil society groups can use AI/ICT, the key that determines which side would benefit more from the advancement of these technologies hinges upon “technology complementarity.” In general, AI/ICT would be more complementary to the government rulers because they are more likely than civil society groups to access various administrative big data. Empirically, we propose three hypotheses and use statistical tests to verify our argument. Theoretically, we prove a proposition, showing that when the above-mentioned complementarity assumption is true, the AI/ICT advancements would enable rulers in authoritarian and fragile democratic countries to achieve better control over civil society forces, which leads to the erosion of democracy. Our analysis explains the recent ominous development in some fragile-democracy countries.

PMID:40314966 | DOI:10.1073/pnas.2423266122

JAMA Netw Open. 2025 May 1;8(5):e258342. doi: 10.1001/jamanetworkopen.2025.8342.

ABSTRACT

IMPORTANCE: Approximately 30% of US patients develop acute kidney injury (AKI) after cardiac surgery, which is associated with increased morbidity, mortality, and health care costs. The variation in potentially modifiable hospital- and clinician-level operating room practices and their implications for AKI have not been rigorously evaluated.

OBJECTIVE: To quantify variation in clinician- and hospital-level hemodynamic and resuscitative practices during cardiac surgery and identify their associations with AKI.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study analyzed integrated hospital, clinician, and patient data extracted from the Multicenter Perioperative Outcomes Group dataset and the Society of Thoracic Surgeons Adult Cardiac Surgical Database. Participants were adult patients (aged ≥18 years) who underwent cardiac surgical procedures between January 1, 2014, and February 1, 2022, at 8 geographically diverse US hospitals. Patients were followed up through March 2, 2022. Statistical analyses were performed from October 2024 to February 2025.

EXPOSURES: Hospital- and clinician-level variations in operating room hemodynamic practices (inotrope infusion >60 minutes and vasopressor infusion >60 minutes) and resuscitative practices (homologous red blood cell [RBC] transfusion and total fluid volume administration).

MAIN OUTCOMES AND MEASURES: The primary outcome was consensus guideline-defined AKI (any stage) within 7 days after cardiac surgery. Hospital- and clinician-level variations were quantified using intraclass correlation coefficients (ICCs). Associations of hospital- and clinician-level practices with AKI were analyzed using multilevel mixed-effects models, adjusting for patient-level characteristics.

RESULTS: Among 23 389 patients (mean [SD] age, 63 [13] years; 16 122 males [68.9%]), 4779 (20.4%) developed AKI after cardiac surgery. AKI rates varied across hospitals (median [IQR], 21.7% [15.5%-27.2%]) and clinicians (18.1% [10.1%-23.7%]). Significant clinician- and hospital-level variation existed for inotrope infusion (ICC, 6.2% [95% CI, 4.2%-8.0%] vs 17.9% [95% CI, 3.3%-31.9%]), vasopressor infusion (ICC, 11.7% [95% CI, 8.3%-14.9%] vs 44.5% [95% CI, 11.7%-63.5%]), RBC transfusion (ICC, 1.7% [95% CI, 0.9%-2.6%] vs 4.5% [95% CI, 1.2%-9.4%]), and fluid volume administration (ICC, 2.1% [95% CI, 1.3%-2.7%] vs 23.8% [95% CI, 2.7%-39.9%]). In multilevel risk-adjusted models, the AKI rate was higher for patients at hospitals with higher inotrope infusion rates (adjusted odds ratio [AOR], 1.98; 95% CI, 1.18-3.33; P = .01) and lower among clinicians with higher RBC transfusion rates (AOR, 0.89; 95% CI, 0.79-0.99; P = .03). Other practice variations were not associated with AKI.

CONCLUSIONS AND RELEVANCE: This cohort study of adult patients found that hospital- and clinician-level variation in operating room practices was associated with AKI after cardiac surgery, suggesting possible targets for intervention.

PMID:40314957 | DOI:10.1001/jamanetworkopen.2025.8342