Nevin Manimala

PLoS One. 2022 Sep 22;17(9):e0274104. doi: 10.1371/journal.pone.0274104. eCollection 2022.

ABSTRACT

OBJECTIVES: This study aimed to assess the clinical characteristics, treatment and outcomes of the multisystem inflammatory syndrome in children (MIS-C) following COVID-19 in five different geographical regions of Iran.

METHODS: In this multicenter observational study, patients <21 years were included between March 2020 and October 2021. By Disease Control and Prevention (CDC) checklist, demographic characteristics, comorbidities, clinical signs and symptoms, laboratory and radiology findings, and treatment were collected. Statistical analysis was using Chi-square and t-test in STATA14.

RESULTS: In total 225 patients with median age of 55 (26-96) months were included that 59.56% boys. 57.33% were admitted to the PICU with a median of 7 days (4-10). 95.56% of patients were discharged with recovery and the rest died. All of the patients in our study were included based on the MIS-C criteria. However, some patients had Kawasaki symptoms, so we compared the clinical and epidemiological characteristics of the two groups. Conjunctival injection, cervical lymphadenopathy>1.5 cm diameter, and strawberry tongue in Kawasaki-like MIS-C patients were higher than of MIS-C patients, and this difference was significant(p<0.001). The most common comorbidity was obesity (24.86%). Most patients tested for COVID-19 and about 60% of the patients had a positive test by serology or reverse transcription-polymerase chain reaction (RT-PCR). Gastrointestinal (88.89%) and hematologic signs (84.44%) were most common. Most drugs used in patients were IVIG and steroids. 88.07% and 61.29% of the patients had at least one problem in echocardiography and lung CT, respectively.

CONCLUSIONS: The best outcome was seen in patients who were treated with both IVIG and steroids on the first days of admission. Myocarditis was common in two groups of patients. According to most patients had echocardiography abnormal, screening of heart function is recommended for patients.

PMID:36137147 | DOI:10.1371/journal.pone.0274104

PLoS One. 2022 Sep 22;17(9):e0274965. doi: 10.1371/journal.pone.0274965. eCollection 2022.

ABSTRACT

BACKGROUND: Depression is one of the most serious yet understudied issues among Bangladeshi nurses, bringing health dangers to this workforce. This study aimed to investigate how workplace violence (WPV), bullying, burnout, and job satisfaction are correlated with depression and identify the factors associated with depression among Bangladeshi nurses.

METHODS: For this cross-sectional study, data were collected between February 26, 2021, and July 10, 2021 from the Bangladeshi registered nurses. The Workplace Violence Scale (WPVS), the Short Negative Acts Questionnaire [S-NAQ], the Burnout Measure-Short version (BMS), the Short Index of Job Satisfaction (SIJS-5), and the Patient Health Questionnaire (PHQ-9) were used to measure WPV, bullying, burnout, job satisfaction, and depression, respectively. Inferential statistics include Pearson’s correlation test, t-test, one-way ANOVA test, multiple linear regression, and multiple hierarchal regression analyses were performed.

RESULTS: The study investigated 1,264 nurses (70.02% female) with an average age of 28.41 years (SD = 5.54). Depression was positively correlated with WPV, bullying, and burnout and negatively correlated with job satisfaction (p <0.001). According to the multiple linear regression model, depression was significantly lower among nurses with diploma degrees (β = -1.323, 95% CI = -2.149 to -0.497) and bachelor’s degrees (β = -1.327, 95% CI = -2.131 to- 0.523) compared to the nurses with master’s degree. The nurses who worked extended hours (>48 hours) had a significantly higher depression score (β = 1.490, 95% CI = 0.511 to 2.470) than those who worked ≤ 36 hours. Depression was found to be significantly higher among those who did not receive a timely salary (β = 2.136, 95% CI = 1.138 to 3.134), rewards for good works (β = 1.862, 95% CI = 1.117 to 2.607), and who had no training on WPV (β = 0.895, 95% CI = 0.092 to 1.698).

CONCLUSIONS: Controlling burnout, bullying, and workplace violence, as well as improving the work environment for nurses and increasing job satisfaction, are the essential indicators of reducing depression. This can be accomplished with integrative support from hospital executives, policymakers, and government officials.

PMID:36137141 | DOI:10.1371/journal.pone.0274965

PLoS One. 2022 Sep 22;17(9):e0274813. doi: 10.1371/journal.pone.0274813. eCollection 2022.

ABSTRACT

BACKGROUND: Human papilloma virus is associated with oral and oropharyngeal cancer. Our aim was to examine oral health in patients with oropharyngeal (OPSCC) and oral tongue cancer (OTSCC), expecting better oral health among OPSCC patients.

MATERIAL AND METHODS: Fifty-five OPSCC patients with known HPV status and 59 OTSCC patients were randomly selected from a list of consecutive patients of the Helsinki University Hospital, Finland. Oral health was assessed from panoramic jaw radiographs. Total Dental Index (TDI) summarizing the dental health status was calculated and Finnish population study data were used for comparison. Descriptive statistics were used for analyses.

RESULTS: Patients with HPV-positive OPSCC had higher periapical lesion index compared with HPV-negative OPSCC patients or with OTSCC patients. Residual roots were more common among OPSCC patients compared with OTSCC patients, because of their higher occurrence among HPV-negative OPSCC patients compared with OTSCC patients. Similarly, modified TDI score was significantly higher among OPSCC patients than among OTSCC patients, because of higher TDI score among HPV-negative OPSCC patients compared with OTSCC patients. OPSCC patients more often used a removable prosthesis than OTSCC patients. Dental health of the cancer patients was poorer when compared with the population data.

CONCLUSIONS: Our study hypothesis was only partly confirmed. Periapical lesions were more prevalent among HPV-positive OPSCC patients, compared with the other groups. The number of residual roots was higher among HPV-negative subgroup. Thus, OPSCC patients had worse oral health parameters than OTSCC patients.

PMID:36137133 | DOI:10.1371/journal.pone.0274813

PLoS One. 2022 Sep 22;17(9):e0274769. doi: 10.1371/journal.pone.0274769. eCollection 2022.

ABSTRACT

Participatory research approaches have developed in response to the growing emphasis on translation of research evidence into practice. However, there are few published examples of stakeholder engagement strategies, and little guidance specific to larger ongoing research programs or those with a rural focus. This paper describes the evolution, structure, and processes of an annual Rural Dementia Summit launched in 2008 as an engagement strategy for the Rural Dementia Action Research (RaDAR) program and ongoing for more than 10 years; and reports findings from a parallel mixed-methods study that includes stakeholder and researcher perspectives on the Summit’s value and impact. Twelve years of stakeholder evaluations were analyzed. Rating scale data were summarized with descriptive statistics; open-ended questions were analyzed using an inductive thematic analysis. A thematic analysis was also used to analyze interviews with RaDAR researchers. Rating scale data showed high stakeholder satisfaction with all aspects of the Summit. Five themes were identified in the qualitative data: hearing diverse perspectives, building connections, collaborating for change, developing research and practice capacity, and leaving recharged. Five themes were identified in the researcher data: impact on development as a researcher, understanding stakeholder needs, informing research design, deepening commitment to rural dementia research, and building a culture of engagement. These findings reflect the key principles and impacts of stakeholder engagement reported in the literature. Additional findings include the value stakeholders place on connecting with stakeholders from diverse backgrounds, how the Summit was revitalizing, and how it developed stakeholder capacity to support change in their communities. Findings indicate that the Summit has developed into a community of practice where people with a common interest come together to learn and collaborate to improve rural dementia care. The Summit’s success and sustainability are linked to RaDAR’s responsiveness to stakeholder needs, the trust that has been established, and the value that stakeholders and researchers find in their participation.

PMID:36137130 | DOI:10.1371/journal.pone.0274769

PLoS One. 2022 Sep 22;17(9):e0275170. doi: 10.1371/journal.pone.0275170. eCollection 2022.

ABSTRACT

BACKGROUND: Obstructed labour is a type of abnormal labour that is one of the causes of obstetric complications such as maternal and fetal mortality and morbidity. Early detection is the key to reducing complications.

OBJECTIVE: This study aimed to assess the prevalence, causes, and factors associated with obstructed labor among mothers who gave birth at public health facilities in Mojo Town, Central Ethiopia.

METHODS: An institution-based cross-sectional study was conducted from November 10 to December 30, 2019 among 318 women who gave birth at public health facilities in Mojo Town. Face-to-face interviews and participants’ medical record reviews were utilized to gather data. The collected data were checked, coded, and entered into EpiData version 3.1 and then exported to SPSS version 23 for analysis. A binary logistic regression model was used to test the association between the dependent and independent variables. In bivariate analysis, all variables with a p-value less than 0.25 were included in multivariate analysis. Finally, a significant statistical association was declared at a p-value less than 0.05.

RESULTS: The prevalence of obstructed labour in this study was 51 (16%), and cephalo-pelvic disproportion (66%), mal-presentation (22%), and mal-position (12%) were reported as causes of obstructed labour. Primgravidity (AOR = 7.74: 95%CI = 2.13, 18.2) and a one-time antenatal care follow-up (AOR = 9.50: 95%CI: 1.91, 33.07) were found to be associated factors with obstructed labour, while labour duration of 12-24 hours (AOR = 0.20: 95%CI = 0.17, 0.87) was identified as a factor decreasing the risk of obstructed labour.

CONCLUSION: The prevalence of obstructed labour in this study was higher than in the majority of previous similar local and global studies. In this study setting, cephalo-pelvic disproportion, mal-presentation, and mal-position were found to be the causes of obstetric labour. Additionally, factors such as gravidity, frequency of antenatal follow-up, and duration of labour were significantly associated with obstructed labour. Therefore, the concerned entities need to work to curb young age pregnancy as well as to strengthen counselling mothers on the importance of subsequent antenatal-follows in the prevention of obstructed labour.

PMID:36137119 | DOI:10.1371/journal.pone.0275170

PLoS One. 2022 Sep 22;17(9):e0275025. doi: 10.1371/journal.pone.0275025. eCollection 2022.

ABSTRACT

Defunctioning stomas (ileostomy and colostomy) may be used prior to commencement of neoadjuvant therapy in patients with locally advanced colon or rectal cancer, in order to prevent clinical large bowel obstruction caused by radiotherapy associated oedema or progression of disease in patients who are not obstructed. However, the exact rate of clinical obstruction in patients undergoing neoadjuvant therapy who do not receive a defunctioning stoma is not known. Furthermore, it is not clear which factors predispose patients to developing clinical large bowel obstruction. Given that defunctioning stomas are associated with post operative and intra-operative risks, it is not currently possible to tailor defunctioning stomas to patients who have the greatest risk of developing obstruction. This systematic review which is in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement (PRISMA), aims to define the role of defunctioning stomas in prevention of obstruction patients with locally advanced colon or rectal cancer while undergoing neoadjuvant therapy. Two researchers will perform the literature search which will include all published and “in process” articles published in the English language between 2002-2022 in the following databases: EMBASE (OVID), MEDLINE (EBSCO), CINHAL complete, Web of Science, Cochrane Central Registry of Controlled Trials, Clinical Trials Registry. The full text of the selected articles will be independently screened by two researchers against the inclusion criteria. Data will be extracted from each article regarding: study design, participants, type of intervention and outcomes. The effect size will be expressed in incidence rates and when appropriate in relative risk with 95% confidence intervals. If possible, we will perform a meta-analysis. Heterogeneity will be assessed using I2 statistics. We will pool the data extracted from the randomised controlled trials to perform a meta-analysis using the Review Manager 5 software (RevMan 5). The Grades of Recommendation, Assessment, Development and Evaluation (GRADE) system will be used to assess the certainty of the evidence.

PMID:36137109 | DOI:10.1371/journal.pone.0275025

PLoS One. 2022 Sep 22;17(9):e0274171. doi: 10.1371/journal.pone.0274171. eCollection 2022.

ABSTRACT

The clinical course of COVID-19 is highly variable. It is therefore essential to predict as early and accurately as possible the severity level of the disease in a COVID-19 patient who is admitted to the hospital. This means identifying the contributing factors of mortality and developing an easy-to-use score that could enable a fast assessment of the mortality risk using only information recorded at the hospitalization. A large database of adult patients with a confirmed diagnosis of COVID-19 (n = 15,628; with 2,846 deceased) admitted to Spanish hospitals between December 2019 and July 2020 was analyzed. By means of multiple machine learning algorithms, we developed models that could accurately predict their mortality. We used the information about classifiers’ performance metrics and about importance and coherence among the predictors to define a mortality score that can be easily calculated using a minimal number of mortality predictors and yielded accurate estimates of the patient severity status. The optimal predictive model encompassed five predictors (age, oxygen saturation, platelets, lactate dehydrogenase, and creatinine) and yielded a satisfactory classification of survived and deceased patients (area under the curve: 0.8454 with validation set). These five predictors were additionally used to define a mortality score for COVID-19 patients at their hospitalization. This score is not only easy to calculate but also to interpret since it ranges from zero to eight, along with a linear increase in the mortality risk from 0% to 80%. A simple risk score based on five commonly available clinical variables of adult COVID-19 patients admitted to hospital is able to accurately discriminate their mortality probability, and its interpretation is straightforward and useful.

PMID:36137106 | DOI:10.1371/journal.pone.0274171

PLoS One. 2022 Sep 22;17(9):e0270182. doi: 10.1371/journal.pone.0270182. eCollection 2022.

ABSTRACT

Governments have implemented different interventions and response models to combat the spread of COVID-19. The necessary intensity and frequency of control measures require us to project the number of infected cases. Three short-term forecasting models were proposed to predict the total number of infected cases in Canada for a number of days ahead. The proposed models were evaluated on how their performance degrades with increased forecast horizon, and improves with increased historical data by which to estimate them. For the data analyzed, our results show that 7 to 10 weeks of historical data points are enough to produce good fits for a two-weeks predictive model of infected case numbers with a NRMSE of 1% to 2%. The preferred model is an important quick-deployment tool to support data-informed short-term pandemic related decision-making at all levels of governance.

PMID:36137098 | DOI:10.1371/journal.pone.0270182

PLoS One. 2022 Sep 22;17(9):e0273393. doi: 10.1371/journal.pone.0273393. eCollection 2022.

ABSTRACT

This article presents the results of a study conducted on Polish university students to verify how they assess the probability of environmental risks and their potential impact on the socio-economic situation in Poland. To this end, 703 students of public universities in Warsaw were asked to complete risk assessment questionnaires. According to the respondents, of all identified types of threats, technological risks were found to be the most probable, with the environmental ones carrying the most significant social and economic impact. Among those risks, climate change was recognised as the most probable, while environmental contamination was perceived as having the strongest potential impact on Poland. No statistically significant differences were found in the views of women and men on the probability of environmental risks and their impact on the country’s socio-economic situation. Compared with students of technical and economic faculties, students of natural sciences, education, and nursing assessed the probability of environmental risks and the strength of their potential impact in Poland as much higher. The results of the study can be used to develop a communication strategy dedicated to young people in the education of environmental risks.

PMID:36137076 | DOI:10.1371/journal.pone.0273393

PLoS One. 2022 Sep 22;17(9):e0272379. doi: 10.1371/journal.pone.0272379. eCollection 2022.

ABSTRACT

PURPOSE: Genetic variants identified through population-based genome-wide studies are generally of high frequency, exerting their action in the central part of the refractive error spectrum. However, the power to identify associations with variants of lower minor allele frequency is greatly reduced, requiring considerable sample sizes. Here we aim to assess the impact of rare variants on genetic variation of refractive errors in a very large general population cohort.

METHODS: Genetic association analyses of non-cyclopaedic autorefraction calculated as mean spherical equivalent (SPHE) used whole-exome sequence genotypic information from 50,893 unrelated participants in the UK Biobank of European ancestry. Gene-based analyses tested for association with SPHE using an optimised SNP-set kernel association test (SKAT-O) restricted to rare variants (minor allele frequency < 1%) within protein-coding regions of the genome. All models were adjusted for age, sex and common lead variants within the same locus reported by previous genome-wide association studies. Potentially causal markers driving association at significant loci were elucidated using sensitivity analyses by sequentially dropping the most associated variants from gene-based analyses.

RESULTS: We found strong statistical evidence for association of SPHE with the SIX6 (p-value = 2.15 x 10-10, or Bonferroni-Corrected p = 4.41×10-06) and the CRX gene (p-value = 6.65 x 10-08, or Bonferroni-Corrected p = 0.001). The SIX6 gene codes for a transcription factor believed to be critical to the eye, retina and optic disc development and morphology, while CRX regulates photoreceptor specification and expression of over 700 genes in the retina. These novel associations suggest an important role of genes involved in eye morphogenesis in refractive error.

CONCLUSION: The results of our study support previous research highlighting the importance of rare variants to the genetic risk of refractive error. We explain some of the origins of the genetic signals seen in GWAS but also report for the first time a completely novel association with the CRX gene.

PMID:36137074 | DOI:10.1371/journal.pone.0272379