Nevin Manimala

PLoS One. 2023 Feb 27;18(2):e0282282. doi: 10.1371/journal.pone.0282282. eCollection 2023.

ABSTRACT

INTRODUCTION: In the earlier phase of the pandemic situation, the Government of Bangladesh (GoB) badly suffered to adhere their people to preventive measures probably due to less knowledge and attitude toward Covid-19. To tackle the second wave of coronavirus, the GoB has again enforced an array of preventive measures, but still encountering the same problem after a year of the pandemic situation. As an attempt to find out the reasons behind this, our study aimed to assess the present knowledge and fear level regarding Covid-19, and attitude and practice of students toward Covid-19 preventive measures (CPM).

METHODS: A cross-sectional study was designed and conducted from 15th to 25th April 2021. A total of 382 participants met all the inclusion criteria and were considered for performing all the statistical analyses (Descriptive statistics, Mann-Whitney U test, Kruskal-Wallis H test, Multiple logistic regression, Spearman rank-order correlation).

RESULTS: All the participants were students aged 16 to 30 years. 84.8%, and 22.3% of participants had respectively more accurate knowledge, and moderate to high fear level regarding Covid-19. And, 66%, and 55% of participants had more positive attitude, and more frequent practice toward CPM, respectively. Knowledge, attitude, practice, and fear were interrelated directly or indirectly. It was found knowledgeable participants were more likely to have more positive attitude (AOR = 2.34, 95% CI = 1.23-4.47, P < 0.01) and very little fear (AOR = 2.17, 95% CI = 1.10-4.26, P < 0.05). More positive attitude was found as a good predictor of more frequent practice (AOR = 4.00, 95% CI = 2.44-6.56, P < 0.001), and very less fear had negative impact on both attitude (AOR = 0.44, 95% CI = 0.23-0.84, P < 0.01) and practice (AOR = 0.47, 95% CI = 0.26-0.84, P < 0.01).

CONCLUSIONS: The findings reflect that students had appreciable knowledge and very little fear, but disappointedly had average attitude and practice toward Covid-19 prevention. In addition, students lacked confidence that Bangladesh would win the battle against Covid-19. Thus, based on our study findings we recommend that policymakers should be more focused to scale up students’ confidence and attitude toward CPM by developing and implementing well-conceived plan of actions besides insisting them to practice CPM.

PMID:36848394 | DOI:10.1371/journal.pone.0282282

PLoS One. 2023 Feb 27;18(2):e0281670. doi: 10.1371/journal.pone.0281670. eCollection 2023.

ABSTRACT

The macro policy of the stock market is an important market information. The implementation goal of the macro policy of the stock market is mainly to improve the effectiveness of the stock market. However, whether this effectiveness has achieved the goal is worth verifying through empirical data. The exertion of this information utility is closely related to the effectiveness of the stock market. Use the run test method in statistics to collect and sort out the daily data of stock price index in recent 30 years, the linkage between 75 macro policy events and 35 trading days of market efficiencies before and after the macro event are tested since 1992 to 2022. The results show that 50.66% of the macro policies are positively linked to the effectiveness of the stock market, while 49.34% of the macro policies have reduced the effectiveness of the market operation. This shows that the effectiveness of China’s stock market is not high, and the nonlinear characteristics are obvious, so the policy formulation of the stock market needs further improvement.

PMID:36848368 | DOI:10.1371/journal.pone.0281670

PLoS One. 2023 Feb 27;18(2):e0282245. doi: 10.1371/journal.pone.0282245. eCollection 2023.

ABSTRACT

Klebsiella pneumoniae is a major zoonotic pathogen that causes a variety of severe illnesses as well as mastitis. The distribution of mastitis-causing K. Pneumoniae and its virulence factors vary by country and geographical location. The present study aimed to find out the occurrence of Multidrug-resistant (MDR) K. Pneumoniae and their capsular resistance genes which were undocumented previously in cow farms of district Peshawar, Pakistan. A total of 700 milk samples from symptomatic mastitic cows were screened for MDR K. Pneumoniae. Furthermore, the characterization of capsular resistance genes was done by molecular techniques. Among these samples, K. pneumoniae was found 180/700 (25.7%), while MDR K. pneumoniae was found 80/180 (44.4%). The antibiogram analysis revealed high resistance to Vancomycin (95%) while highly sensitive to Ceftazidime (80%). The distribution of capsular genes shows the most common serotype K2 gene 39/80 (48.7%), followed by serotype K1 gene 34/80 (42.5%), serotype K5 17/80 (21.2%), and serotype K54 13/80 (16.2), respectively. Moreover, the co-occurrence of serotypes K1+K2 was found at 11.25%, KI+K5 was 05%, K1+K54 was 3.75%, and K2+K5 was 7.5%, respectively. A statistically significant association (p ≤ 0.05) was found between predicted and discovered K. pneumoniae values. In conclusion, the presence of MDR K. pneumoniae in combination with capsular genes may be a possible threat to dairy farm animals and humans in Peshawar, Pakistan. It may give us special attention to follow up on hygienic practices in livestock management.

PMID:36848367 | DOI:10.1371/journal.pone.0282245

PLoS One. 2023 Feb 27;18(2):e0279765. doi: 10.1371/journal.pone.0279765. eCollection 2023.

ABSTRACT

BACKGROUND: Chronic kidney disease (CKD) is an important risk factor for mortality from COVID-19. Remdesivir has been shown to shorten time to recovery in patients with severe COVID-19. However, exclusion of patients with severe kidney function impairment in clinical trials has led to concerns about kidney safety of remdesivir in patients with pre-existing kidney disease.

METHODS: Retrospective propensity score matched cohort study of hospitalized patients with COVID-19 admitted with estimated glomerular filtration rate (eGFR) between 15 – 60 mL/min/1.73m2. Remdesivir-treated patients were 1:1 matched to historical comparators admitted during the first wave of COVID-19 (between March-April 2020) prior to emergency use authorization of remdesivir using propensity scores accounting for factors predicting treatment assignment. Dependent outcomes included in-hospital peak creatinine, incidence of doubling of creatine, rate of kidney replacement therapy initiation and eGFR among surviving patients at day 90.

RESULTS: 175 remdesivir-treated patients were 1:1 matched to untreated historical comparators. Mean age was 74.1 (SD 12.8), 56.9% were male, 59% patients were white, and the majority (83.1%) had at least one co-morbidity. There were no statistically significant differences in peak creatinine during hospitalization (2.3mg/dL vs. 2.5 mg/dL, P = 0.34), incidence of doubling of creatinine (10.3% vs. 13.1%, P = 0.48), and rate of kidney replacement therapy initiation (4.6% vs. 6.3%, P = 0.49) in remdesivir-treated patients versus matched untreated historical comparators, respectively. Among surviving patients, there was no difference of the average eGFR at day 90 (54.7 ± 20.0 mL/min/1.73m2 for remdesivir-treated patients vs. 51.7 ± 19.5 mL/min/1.73m2 for untreated comparators, P = 0.41).

CONCLUSIONS: Remdesivir use in patients with impaired kidney function (eGFR between 15 – 60 mL/min/1.73m2) who present to the hospital with COVID-19 is not associated with increased risk of adverse kidney outcomes.

PMID:36848366 | DOI:10.1371/journal.pone.0279765

PLoS Med. 2023 Feb 27;20(2):e1004180. doi: 10.1371/journal.pmed.1004180. eCollection 2023 Feb.

ABSTRACT

BACKGROUND: Cash transfer programmes are increasingly used in humanitarian contexts to help address people’s needs across multiple sectors. However, their impact on the key objectives of reducing malnutrition and excess mortality remains unclear. mHealth interventions show great promise in many areas of public health, but evidence for their impact on reducing the risk factors for malnutrition is uncertain. We therefore implemented a trial to determine the impacts of 2 interventions in a protracted humanitarian context, a cash transfer conditionality and mHealth audio messages.

METHODS AND FINDINGS: A 2 × 2 factorial cluster-randomised trial was implemented in camps for internally displaced people (IDP) near Mogadishu, Somalia, starting in January 2019. The main study outcomes were assessed at midline and endline and included coverage of measles vaccination and the pentavalent immunisation series, timely vaccination, caregiver’s health knowledge, and child diet diversity. Twenty-three clusters (camps) were randomised to receive or not receive conditional cash transfers (CCTs) and an mHealth intervention, and 1,430 households were followed up over 9 months. All camps received cash transfers made at emergency humanitarian level (US$70/household/month) for 3 months followed by a further 6 months at a safety net level (US$35). To be eligible to receive cash, households in camps receiving CCT were required to take their children <5 years age to attend a single health screening at a local clinic and were issued with a home-based child health record card. Participants in camps receiving the mHealth intervention were asked (but not required) to listen to a series of audio messages about health and nutrition that were broadcast to their mobile phone twice a week for 9 months. Participants and investigators were not blinded. Adherence to both interventions was monitored monthly and found to be high (>85%). We conducted intention-to-treat analysis. During the humanitarian intervention phase, the CCT improved coverage of measles vaccination (MCV1) from 39.2% to 77.5% (aOR 11.7, 95% CI [5.2, 26.1]; p < 0.001) and completion of the pentavalent series from 44.2% to 77.5% (aOR 8.9, 95% CI [2.6, 29.8]; p = < 0.001). By the end of the safety net phase, coverage remained elevated from baseline at 82.2% and 86.8%, respectively (aOR 28.2, 95% CI [13.9, 57.0]; p < 0.001 and aOR 33.8, 95% CI [11.0, 103.4]; p < 0.001). However, adherence to timely vaccination did not improve. There was no change in the incidence of mortality, acute malnutrition, diarrhoea, or measles infection over the 9 months of follow-up. Although there was no evidence that mHealth increased Mother’s knowledge score (aOR 1.32, 95% CI [0.25, 7.11]; p = 0.746) household dietary diversity increased from a mean of 7.0 to 9.4 (aOR 3.75, 95% CI [2.04, 6.88]; p < 0.001). However, this was not reflected by a significant increase in child diet diversity score, which changed from 3.19 to 3.63 (aOR 2.1, 95% CI [1.0, 4.6]; p = 0.05). The intervention did not improve measles vaccination, pentavalent series completion, or timely vaccination, and there was no change in the incidence of acute malnutrition, diarrhoea, measles infection, exclusive breastfeeding, or child mortality. No significant interactions between the interventions were found. Study limitations included the limited time available to develop and test the mHealth audio messages and the necessity to conduct multiple statistical tests due to the complexity of the study design.

CONCLUSIONS: A carefully designed conditionality can help achieve important public health benefits in humanitarian cash transfer programmes by substantially increasing the uptake of child vaccination services and, potentially, other life-saving interventions. While mHealth audio messages increased household diet diversity, they failed to achieve any reductions in child morbidity, malnutrition, or mortality.

TRIAL REGISTRATION: ISRCTN ISRCTN24757827. Registered November 5, 2018.

PMID:36848361 | DOI:10.1371/journal.pmed.1004180

PLOS Digit Health. 2023 Feb 27;2(2):e0000201. doi: 10.1371/journal.pdig.0000201. eCollection 2023 Feb.

ABSTRACT

To conduct a systematic review to evaluate the effects of physiotherapy exercises delivered via telemedicine on lung function and quality-of-life in people with Cystic Fibrosis (CF). The databases AMED, CINAHL and MEDLINE were searched from December 2001 until December 2021. Reference lists of included studies were hand-searched. The PRISMA 2020 statement was used to report the review. Studies of any design reported in the English language, included participants with CF, and within outpatient settings were included. Meta-analysis was not deemed appropriate due to the diversity of interventions and heterogeneity of the included studies. Following screening, eight studies with 180 total participants met the inclusion criteria. Sample sizes ranged from 9 to 41 participants. Research designs included five single cohort intervention studies, two randomised control trials and one feasibility study. Telemedicine-based interventions included Tai-Chi, aerobic, and resistance exercise delivered over a study period of six to twelve weeks. All included studies which measured percentage predicted forced expiratory volume in one second found no significant difference. Five studies measuring the Cystic Fibrosis Questionnaire-Revised (CFQ-R) respiratory domain found improvements, however, did not meet statistical significance. For the CFQ-R physical domain, measured by five studies, two studies found an improvement, although not statistically significant. No adverse events were reported across all studies. The included studies indicate that telemedicine-based exercise over 6-12 weeks does not significantly change lung function or quality-of-life in people with CF. Whilst the role of telemedicine in the care of pwCF is acceptable and promising; further research with standardised outcome measures, larger sample sizes and longer follow-up are required before clinical practice recommendations can be developed.

PMID:36848358 | DOI:10.1371/journal.pdig.0000201

PLoS One. 2023 Feb 27;18(2):e0282268. doi: 10.1371/journal.pone.0282268. eCollection 2023.

ABSTRACT

Scalp Electroencephalography (EEG) is one of the most popular noninvasive modalities for studying real-time neural phenomena. While traditional EEG studies have focused on identifying group-level statistical effects, the rise of machine learning has prompted a shift in computational neuroscience towards spatio-temporal predictive analyses. We introduce a novel open-source viewer, the EEG Prediction Visualizer (EPViz), to aid researchers in developing, validating, and reporting their predictive modeling outputs. EPViz is a lightweight and standalone software package developed in Python. Beyond viewing and manipulating the EEG data, EPViz allows researchers to load a PyTorch deep learning model, apply it to EEG features, and overlay the output channel-wise or subject-level temporal predictions on top of the original time series. These results can be saved as high-resolution images for use in manuscripts and presentations. EPViz also provides valuable tools for clinician-scientists, including spectrum visualization, computation of basic data statistics, and annotation editing. Finally, we have included a built-in EDF anonymization module to facilitate sharing of clinical data. Taken together, EPViz fills a much needed gap in EEG visualization. Our user-friendly interface and rich collection of features may also help to promote collaboration between engineers and clinicians.

PMID:36848345 | DOI:10.1371/journal.pone.0282268

Am J Speech Lang Pathol. 2023 Feb 27:1-14. doi: 10.1044/2022_AJSLP-22-00119. Online ahead of print.

ABSTRACT

PURPOSE: Although there are several reports of attention deficits in aphasia, studies are typically limited to a single component within this complex domain. Furthermore, interpretation of results is affected by small sample size, intraindividual variability, task complexity, or nonparametric statistical models of performance comparison. The purpose of this study is to explore multiple subcomponents of attention in persons with aphasia (PWA) and compare findings and implications from various statistical methods-nonparametric, mixed analysis of variance (ANOVA), and linear mixed-effects model (LMEM)-when applied to a small sample size.

METHOD: Eleven PWA and nine age- and education-matched healthy controls (HCs) completed the computer-based Attention Network Test (ANT). ANT examines the effects of four types of warning cues (no, double, central, spatial) and two flanker conditions (congruent, incongruent) to provide an efficient way to assess the three subcomponents of attention (alerting, orienting, and executive control). Individual response time and accuracy data from each participant are considered for data analysis.

RESULTS: Nonparametric analyses showed no significant differences between the groups on the three subcomponents of attention. Both mixed ANOVA and LMEM showed statistical significance on alerting effect in HCs, orienting effect in PWA, and executive control effect in both PWA and HCs. However, LMEM analyses additionally highlighted significant differences between the groups (PWA vs. HCs) for executive control effect, which were not evident on either ANOVA or nonparametric tests.

CONCLUSIONS: By considering the random effect of participant ID, LMEM was able to show deficits in alerting and executive control ability in PWA when compared to HCs. LMEM accounts for the intraindividual variability based on individual response time performances instead of relying on measures of central tendencies.

PMID:36848333 | DOI:10.1044/2022_AJSLP-22-00119

J Anim Sci. 2023 Feb 27:skad065. doi: 10.1093/jas/skad065. Online ahead of print.

ABSTRACT

Spray dried plasma (SDP) is commonly used in phase 1 diets for weanling pigs, but it is unknown if SDP affects energy or nutrient digestibility of the subsequent diet. Therefore, two experiments were conducted to test the null-hypothesis that inclusion of SDP in a phase 1 diet fed to weanling pigs will not affect energy or nutrient digestibility of a phase 2 diet without SDP. In Exp. 1, 16 newly weaned barrows with an initial body weight (BW) of 4.47 ± 0.35 kg were randomly allotted to a phase 1 diet without SDP or a diet including 6% SDP for 14 d. Both diets were fed on an ad libitum basis. All pigs (BW: 6.92 ± 0.42 kg) had a T-cannula surgically inserted in the distal ileum, moved to individual pens, and fed the common phase 2 diet for 10 d with ileal digesta collection on d 9 and 10. In Exp. 2, 24 newly weaned barrows (initial BW: 6.60 ± 0.22 kg) were randomly allotted to phase 1 diets without SDP or a diet containing 6% SDP for 20 d. Both diets were provided on an ad libitum basis. All pigs (BW: 9.37 ± 1.40 kg) were then moved to individual metabolism crates and fed the common phase 2 diet for 14 d with the initial 5 d being the adaptation period to the diet followed by 7 d of fecal and urine collection according to the marker-to-marker procedure. The apparent ileal digestibility (AID) of starch, crude protein (CP), amino acids (AA), and acid hydrolyzed ether extract (AEE), was determined in Exp. 1, and the apparent total tract digestibility (ATTD) of gross energy (GE), insoluble-, soluble-, and total-dietary fiber, Ca, and P, and the retention and biological value of N were determined in Exp. 2. The statistical model included diet as fixed effect and block and pig within block as random effects. Results of Exp. 1 indicated that the AID of starch, CP, AEE, and AA in phase 2 were not affected by phase 1 treatment. Results of Exp. 2 indicated that the ATTD of GE, insoluble-, soluble-, and total-dietary fiber, Ca, and P and N retention and biological value in phase 2 were also not affected by phase 1 treatment. In conclusion, feeding weanling pigs a diet with 6% SDP in phase 1 did not affect the AID or ATTD of energy and nutrients in a phase 2 diet without SDP.

PMID:36848328 | DOI:10.1093/jas/skad065

Horm Mol Biol Clin Investig. 2023 Feb 27. doi: 10.1515/hmbci-2022-0042. Online ahead of print.

ABSTRACT

Major Depressive Disorder (MDD) is a mood disorder classified as a persistent depressive mood and loss of interest lasting for more than two weeks and accompanied by a list of symptoms outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) diagnostic criteria. MDD affects approximately 264 million people worldwide and is the most prevailing form of neuropsychiatric disorder. Owing to the probable hypothesized pathophysiology of MDD being an outcome of abnormalities in the amino acid neurotransmitter system, including glutamate (the primary excitatory neurotransmitter) and γ-aminobutyric acid (GABA), SAGE-217 (Zuranolone) is being evaluated as a possible therapeutic treatment for MDD. Zuranolone is a synthetic, neuroactive steroid (NAS) and positive allosteric modulator (PMA) of GABAA receptors, regulating both synaptic and extra-synaptic release of GABA. It is administered as a once-daily oral dose for 2 weeks due to its low-moderate clearance. A change in total HAM-D score from baseline was the primary end-point of all the trials. A phase II trial conducted to evaluate the efficacy and safety of Zuranolone (30 mg, once-daily dose), described a significant reduction in total HAM-D score at day 14 and reported the drug to be well tolerated with headache, dizziness, nausea, and somnolence as the most common adverse events (AE). Additional phase III trials were also conducted to evaluate similar outcomes, the interim topline results of which have been released. Consequently, this article attempts to briefly analyze the pharmacology of Zuranolone, review the available clinical data and outcomes regarding its use, and evaluate its place as a prospective novel therapy in the effective management of MDD.

PMID:36848317 | DOI:10.1515/hmbci-2022-0042