Nevin Manimala

J Clin Lab Anal. 2021 Dec 3:e24164. doi: 10.1002/jcla.24164. Online ahead of print.

ABSTRACT

AIMS: The study aimed to investigate the value of autoantibodies in predicting the risk of ketoacidosis or microalbuminuria in children with type 1 diabetes mellitus.

METHODS: Clinical data and laboratory indicators of 80 patients with type 1 diabetes admitted to the Department of Endocrinology in Tianjin Children’s Hospital, from June 2017 to March 2019, were retrospectively analyzed. The patients were divided into two groups: diabetes without ketoacidosis group (n = 20) and diabetes with ketoacidosis group (n = 60). The differences in general data, laboratory test indexes, and autoantibodies between the two groups were analyzed. Finally, ROC curves and multivariate logistic regression analysis were used to explore the value of autoantibodies in patients with ketoacidosis or microalbuminuria.

RESULTS: A total of 80 children with type 1 diabetes were assessed, including 35 boys and 45 girls, ranging in age from 10 months to 15 years. The concentration of GADA, IA2A, and ZnT8A was not statistically different between the two groups, but the positive rate of ZnT8A was statistically significant (p = 0.038) and had a diagnostic value for the occurrence of ketoacidosis (p = 0.025). ZnT8A-positive patients had a higher titer of IA2A and a more frequent prevalence of GADA and IA2A than ZnT8A-negative patients (p < 0.01). In multivariate logistic regression analyses, the presence of positive ZnT8A was associated with a higher risk of microalbuminuria independent of age, sex, and BMI (OR = 4.184 [95% CI 1.034~16.934], p = 0.045).

CONCLUSIONS: The positive ZnT8A had diagnostic value for ketoacidosis in children with type 1 diabetes and had the highest specificity among the three kinds of autoantibodies. Moreover, ZnT8A positivity was related to a higher titer of IA2A and more frequent occurrence of multiple diabetes-related autoantibodies. Besides, the presence of positive ZnT8A was an independent risk factor of microalbuminuria in children with type 1 diabetes. Therefore, we can infer that positive ZnT8A may be related to ketoacidosis and microalbuminuria, accelerating the progression of T1DM.

PMID:34861060 | DOI:10.1002/jcla.24164

PLoS One. 2021 Dec 3;16(12):e0261055. doi: 10.1371/journal.pone.0261055. eCollection 2021.

ABSTRACT

The knowledge, awareness, and practices (KAP) about COVID-19 among the marine fishers who are engaged in the high-risk occupations and depend on the vulnerable sources of income in the Maharashtra state of India, were investigated to understand the behavioral changes and vulnerability among the respondents because of COVID-19. Data were collected through an online survey from 1st July to 30th July 2020 during the first peak of COVID-19 in the study area by using the questionnaire. Authors based on the latest recommendations by the World Health Organization (WHO) developed the questionnaire and covered the KAP aspects under study. The questionnaire was administered through Google form link and the link was disseminated through social media such as Facebook and What’s App. The completed responses (n = 533) received from the eligible sample, excluding those outsides of the fisher community and duplicate entries were considered for analysis. Appropriate statistical tools were used to analyze the data. Among the respondents, 447 men (83.86%) and 86 women (16.14%), with a mean age of 45.4 years (M = 45.4, SD = 1.18). The results revealed that 70.92% of respondents perceived a low risk of infection because of COVID-19 with M = 1.77 and SD = 0.583, but authors found the perceived severity score high (M = 3.95, SD = 1.21) among the 60.97% of respondents. Around 95% of respondents were aware of the COVID-19, while almost all respondents knew the medium of infection and symptoms of COVID-19. The behavior of respondents towards COVID-19 infection was positive and was following sufficient precautionary measures suggested by WHO to protect themselves from COVID-19 infection. The results of multiple regression analysis revealed that the demographic features of respondents like age, education were significantly contributing to the KAP of the fisher community. The results confirmed the importance of KAP which is reflected in the behavioral responses of the fishers while tackling the COVID-19 pandemic situation. The results regarding the risk perception, severity, KAP about COVID-19 provide a collective understanding of the emerging infectious disease among the marine fishers of Maharashtra state of India.

PMID:34860859 | DOI:10.1371/journal.pone.0261055

PLoS One. 2021 Dec 3;16(12):e0261091. doi: 10.1371/journal.pone.0261091. eCollection 2021.

ABSTRACT

More voices are calling for a quicker transition towards clean energy. The exploration and exploitation of clean energy such as wind energy and solar energy are effective means to optimise energy structure and improve energy efficiency. To provide in-depth understanding of clean energy transition, this paper utilises a combination of multiple bibliometric mapping techniques, including HistCite, CiteSpace and R Bibliometrix, to conduct a systematic review on 2,191 clean energy related articles obtained from Web of Science (WoS). We identify five current main research streams in the clean energy field, including Energy Transition, Clean Energy and Carbon Emission Policy, Impact of Oil Price on Alternative Energy Stocks, Clean Energy and Economics, and Venture Capital Investments in Clean Energy. Clearly, the effectiveness of policy-driven and market-driven energy transition is an important ongoing debate. Emerging research topics are also discussed and classified into six areas: Clean Energy Conversion Technology and Biomass Energy Utilisation, Optimisation of Energy Generation Technology, Policy-Making in Clean Energy Transition, Impact of Clean Energy Use and Economic Development on Carbon Emissions, Household Use of Clean Energy, and Clean Energy Stock Markets. Accordingly, more and more research attention has been paid to how to improve energy efficiency through advanced clean energy technology, and how to make targeted policies for clean energy transition and energy market development. This article moves beyond the traditional literature review methods and delineates a systematic research agenda for clean energy research, providing research directions for achieving low-carbon development through the clean energy transition.

PMID:34860855 | DOI:10.1371/journal.pone.0261091

PLoS One. 2021 Dec 3;16(12):e0260992. doi: 10.1371/journal.pone.0260992. eCollection 2021.

ABSTRACT

The use of automated systems within the medication use process has significantly reduce the occurrence of medication errors and the associated clinical and financial burden. However, automated systems lull into a false sense of security and increase the risk of medication errors that are often associated with socio-technical interactions, automation bias, workarounds and overrides. The objective of the systematic review is to determine the prevalence, types and severity of medication errors that are associated the use of automated systems in ambulatory and institutionalized care settings. The search strategy will be guided by PRISMA framework. Selected databases and relevant gray literature were searched and screening was done independently by two researchers between 01 April and 29 June 2021. These covered all relevant articles published from the inception of the use of automation in the medication use process (2000) until 2020. De-duplication and screening of all studies were done independently by two researchers with a clear inclusion / exclusion criteria. Data extraction and synthesis are currently on going (started on 06 July 2021) and being conducted independently but the validity and completeness of the processes will be confirmed by the third researcher. The Cochrane Risk of Bias tool and the Hoy et al’s quality assessment checklist will be used for the assessment of methodological bias while the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system will be used for the quality of evidence assessment. Detailed qualitative synthesis of key findings will be done with thematic and descriptive analyses. If the number and types of included studies permit, fixed or random effect model meta-analysis will be conducted based on the degree of homogeneity in the sampling frame used in the included studies. Heterogeneity will be assessed with I2 statistics and I2 > 50% will be considered a high statistical heterogeneity. The systematic review may provide new perspective especially from developing settings about the prevalence, types and severity of medication errors associated with the use of automated systems at all the stages of medication use process, and in all categories of patients. This may add to global knowledge in the research area. Systematic review registration: The systematic review was registered and published by PROSPERO (CRD42020212900).

PMID:34860852 | DOI:10.1371/journal.pone.0260992

PLoS One. 2021 Dec 3;16(12):e0260769. doi: 10.1371/journal.pone.0260769. eCollection 2021.

ABSTRACT

OBJECTIVE: The Spanish health system is made up of seventeen regional health systems. Through the official reporting systems, some inconsistencies and differences in case fatality rates between Autonomous Communities (CC.AA.) have been observed. Therefore the objective of this paper is to compare COVID-19 case fatality rates across the Spanish CC.AA.

MATERIAL AND METHODS: Observational descriptive study. The COVID-19 case fatality rate (CFR) was estimated according to the official records (CFR-PCR+), the daily mortality monitory system (MoMo) record (CFR-Mo), and the seroprevalence study ENE-COVID-19 (Estudio Nacional de sero Epidemiologia Covid-19) according to sex, age group and CC.AA. between March and June 2020. The main objective is to detect whether there are any differences in CFR between Spanish Regions using two different register systems, i. e., the official register of the Ministry of Health and the MoMo.

RESULTS: Overall, the CFR-Mo was higher than the CFR-PCR+, 1.59% vs 0.98%. The differences in case fatality rate between both methods were significantly higher in Castilla La Mancha, Castilla y León, Cataluña, and Madrid. The difference between both methods was higher in persons over 74 years of age (CFR-PCR+ 7.5% vs 13.0% for the CFR-Mo) but without statistical significance. There was no correlation of the estimated prevalence of infection with CFR-PCR+, but there was with CFR-Mo (R2 = 0.33). Andalucía presented a SCFR below 1 with both methods, and Asturias had a SCFR higher than 1. Cataluña and Castilla La Mancha presented a SCFR greater than 1 in any scenario of SARS-CoV-2 infection calculated with SCFR-Mo.

CONCLUSIONS: The PCR+ case fatality rate underestimates the case fatality rate of the SARS-CoV- 2 virus pandemic. It is therefore preferable to consider the MoMo case fatality rate. Significant differences have been observed in the information and registration systems and in the severity of the pandemic between the Spanish CC.AA. Although the infection prevalence correlates with case fatality rate, other factors such as age, comorbidities, and the policies adopted to address the pandemic can explain the differences observed between CC.AA.

PMID:34860848 | DOI:10.1371/journal.pone.0260769

PLoS One. 2021 Dec 3;16(12):e0260847. doi: 10.1371/journal.pone.0260847. eCollection 2021.

ABSTRACT

An extensive simulation program is used in this study to discover the best ANN model for predicting the compressive strength of concrete containing Ground Granulated Blast Furnace Slag (GGBFS). To accomplish this purpose, an experimental database of 595 samples is compiled from the literature and utilized to find the best ANN architecture. The cement content, water content, coarse aggregate content, fine aggregate content, GGBFS content, carboxylic type hyper plasticizing content, superplasticizer content, and testing age are the eight inputs in this database. As a result, the optimal selection of the ANN design is carried out and evaluated using conventional statistical metrics. The results demonstrate that utilizing the best architecture [8-14-4-1] among the 240 investigated architectures, and the best ANN model, is a very efficient predictor of the compressive strength of concrete using GGBFS, with a maximum R2 value of 0.968 on the training part and 0.965 on the testing part. Furthermore, a sensitivity analysis is performed over 500 Monte Carlo simulations using the best ANN model to determine the reliability of ANN model in predicting the compressive strength of concrete. The findings of this research may make it easier and more efficient to apply the ANN model to many civil engineering challenges.

PMID:34860842 | DOI:10.1371/journal.pone.0260847

PLoS One. 2021 Dec 3;16(12):e0260976. doi: 10.1371/journal.pone.0260976. eCollection 2021.

ABSTRACT

The Banana Bunchy Top Disease (BBTD), caused by the Banana Bunchy Top Virus (BBTV) is the most important and devastating in many tropical countries. BBTD epidemiology has been little studied, mixed landscape smallholder systems. The relative risks associated with this disease vary between geographical areas and landscapes. This work analyzed the management and vegetation conditions in smallholder gardens to assess the factors linked to landscape-level BBTV transmission and management. Mapping was done in this study area which is in a BBTD-endemic region, involving farmers actively managing the disease, but with household-level decision making. A spatial scanning statistic was used to detect and identify spatial groups at the 5% significance threshold, and a Poisson regression model was used to explore propagation vectors and the effect of surrounding vegetation and crop diversity. Spatial groups with high relative risk were identified in three communities, Dangbo, Houéyogbé, and Adjarra. Significant associations emerged between the BBTD prevalence and some crop diversity, seed systems, and BBTD management linked factors. The identified factors form important candidate management options for the detailed assessment of landscape-scale BBTD management in smallholder communities.

PMID:34860836 | DOI:10.1371/journal.pone.0260976

MCN Am J Matern Child Nurs. 2022 Jan-Feb 01;47(1):47-51. doi: 10.1097/NMC.0000000000000775.

ABSTRACT

PURPOSE: Elevated blood pressure is frequently associated with adverse health issues among women during and after childbirth in the United States. The purpose of this study was to describe incidence of and determine predictors of prehypertension and hypertension among women of childbearing age in the United States.

STUDY DESIGN AND METHODS: Using secondary data analysis, existing data from the National Health and Nutrition Examination Survey (NHANES; 2013-2018) were used to address study aims. Inclusion criteria were women in the age range commonly considered to be of childbearing age, 15 to 44 years of age. Simple random sampling was to select subjects from the 2,932 women in the NHANES dataset who met inclusion criteria. We calculated a sample size as adequate for the statistical group comparison to be significant with a power of 95% to detect a difference among groups. An ordinal logistic regression model was created to discriminate predictors of normotensive blood pressure, prehypertension, and hypertension.

RESULTS: The sample (n = 393) included 300 women with normal blood pressure, 46 women with prehypertension, and 47 with hypertension. Older women (within childbearing age range), women with high body mass index, and African American women are highly likely to have prehypertension and hypertension.

CLINICAL IMPLICATIONS: Contrary to previous research, poverty income ratio was not associated with prehypertension and hypertension. Future research should test interventions that include promoting heathy lifestyles and address elevated body mass index. Interventions should be tailored to be culturally appropriate for African American women and older women within this age range.

PMID:34860787 | DOI:10.1097/NMC.0000000000000775

J Am Assoc Nurse Pract. 2021 Feb 3;33(12):1300-1306. doi: 10.1097/JXX.0000000000000554.

ABSTRACT

BACKGROUND: Inconsistency and a lack of clarity exist regarding the advanced practice registered nurse peer review process in hospitals throughout the country.

LOCAL PROBLEM: The current APRN peer review process in place for over a decade at an academic medical center has never been evaluated, and neither fulfills ongoing professional practice evaluation requirements nor meets the expectations of peer review.

METHODS: Pre-post intervention quality improvement project (Standards for Quality Improvement Reporting Excellence checklist).

INTERVENTIONS: Using current professional standards and guidelines that meet the requirements for ongoing professional practice evaluation and nursing peer review, a redesigned process and tool was created and piloted in three specialty groups of nurse practitioners (NPs) at the medical center. Satisfaction before and after the pilot survey was measured using a Likert-type scale, and results were compared and analyzed following the completion of the pilot survey.

RESULTS: The posttest measure revealed a statistically significant improvement in satisfaction with the redesigned professional evaluation tool compared with the prepilot peer review tool.

CONCLUSIONS: The redesign project demonstrated that using current professional standards and guidelines, a comprehensive process and tool for professional evaluation and peer review is achievable across NP specialties.

PMID:34860753 | DOI:10.1097/JXX.0000000000000554

J Am Assoc Nurse Pract. 2021 Feb 3;33(12):1198-1206. doi: 10.1097/JXX.0000000000000553.

ABSTRACT

BACKGROUND: Obesity is a complex health issue associated with the leading causes of preventable chronic diseases, such as heart disease and type 2 diabetes. As part of an interprofessional team, nurse practitioners can play an integral role in leading worksite interventions to enhance health behavior change. Although worksite nutrition interventions have existed for many years, effective weight management programs are needed in the workplace.

PURPOSE: The purpose of this study was to determine the effect of a novel nutrition education program implemented in the workplace on health behaviors (dietary habits and physical activity), motivators and barriers, emotional eating, confidence, and biometrics (body mass index and lipid levels).

METHODS: A total of 96 university employees participated in a one-group pre- and postintervention from 2017 to 2019. The intervention included eight weekly face-face education sessions. We assessed dietary habits, physical activity, motivators and barriers of a healthy lifestyle, emotional eating, confidence levels, body mass index, and lipid levels. Descriptive statistics, chi-square test, one-way analysis of variance, and Wilcoxon rank test were performed.

RESULTS: The consumption of fruits, vegetables, beans, grains, and physical activity increased significantly. Barriers, body mass index, and triglycerides significantly decreased. There was no significant difference in emotional eating and motivators after the intervention.

IMPLICATIONS FOR PRACTICE: Nurse practitioners are positioned to lead an interprofessional team to provide nutrition education to help mitigate risk factors for obesity in various settings, including the workplace.

PMID:34860752 | DOI:10.1097/JXX.0000000000000553