Nevin Manimala

PLoS One. 2022 Jul 19;17(7):e0271319. doi: 10.1371/journal.pone.0271319. eCollection 2022.

ABSTRACT

Socio-economic and geographical inequalities in breast cancer mortality have been widely described in European countries and the United States. To investigate the combined effects of geographic access and socio-economic characteristics on breast cancer outcomes, a systematic review was conducted exploring the relationships between: (i) geographic access to healthcare facilities (oncology services, mammography screening), defined as travel time and/or travel distance; (ii) breast cancer-related outcomes (mammography screening, stage of cancer at diagnosis, type of treatment and rate of mortality); (iii) socioeconomic status (SES) at individuals and residential context levels. In total, n = 25 studies (29 relationships tested) were included in our systematic review. The four main results are: The statistical significance of the relationship between geographic access and breast cancer-related outcomes is heterogeneous: 15 were identified as significant and 14 as non-significant. Women with better geographic access to healthcare facilities had a statistically significant fewer mastectomy (n = 4/6) than women with poorer geographic access. The relationship with the stage of the cancer is more balanced (n = 8/17) and the relationship with cancer screening rate is not observed (n = 1/4). The type of measures of geographic access (distance, time or geographical capacity) does not seem to have any influence on the results. For example, studies which compared two different measures (travel distance and travel time) of geographic access obtained similar results. The relationship between SES characteristics and breast cancer-related outcomes is significant for several variables: at individual level, age and health insurance status; at contextual level, poverty rate and deprivation index. Of the 25 papers included in the review, the large majority (n = 24) tested the independent effect of geographic access. Only one study explored the combined effect of geographic access to breast cancer facilities and SES characteristics by developing stratified models.

PMID:35853035 | DOI:10.1371/journal.pone.0271319

PLoS One. 2022 Jul 19;17(7):e0271491. doi: 10.1371/journal.pone.0271491. eCollection 2022.

ABSTRACT

BACKGROUND: There is little research on how financial incentives and penalties impact national cesarean section rates. In January 2018, Georgia introduced a national cesarean section reduction policy, which imposes a financial penalty on hospitals that do not meet their reduction targets. The aim of this study was to assess the impact of this policy on cesarean section rates, subgroups of women, and selected perinatal outcomes.

METHODS: We included women who gave birth from 2017 to 2019 registered in the Georgian Birth Registry (n = 150 534, nearly 100% of all births in the country during this time). We then divided the time period into pre-policy (January 1, 2017, to December 31, 2017) and post-policy (January 1, 2018, to December 31, 2019). An interrupted time series analysis was used to compare the cesarean section rates (both overall and stratified by parity), neonatal intensive care unit transfer rates, and perinatal mortality rates in the two time periods. Descriptive statistics were used to assess differences in maternal socio-demographic characteristics.

RESULTS: The mean cesarean section rate in Georgia decreased from 44.7% in the pre-policy period to 40.8% in the post-policy period, mainly among primiparous women. The largest decrease in cesarean section births was found among women <25 years of age and those with higher education. There were no significant differences in the neonatal intensive care unit transfer rate or the perinatal mortality rate between vaginal and cesarean section births in the post-policy period.

CONCLUSION: The cesarean section rate in Georgia decreased during the 2-year post-policy period. The reduction mainly took place among primiparous women. The policy had no impact on the neonatal intensive care unit transfer rate or the perinatal mortality rate. The impact of the national cesarean section reduction policy on other outcomes is not known.

PMID:35853028 | DOI:10.1371/journal.pone.0271491

PLoS One. 2022 Jul 19;17(7):e0269950. doi: 10.1371/journal.pone.0269950. eCollection 2022.

ABSTRACT

PURPOSE: Breast cancer is one of the most common tumours in women, nevertheless, it is also one of the cancers that is most usually treated. As a result, early detection is critical, which can be accomplished by routine mammograms. This paper aims to describe, analyze, compare and evaluate three image descriptors involved in classifying breast cancer images from four databases.

APPROACH: Multi-Objective Evolutionary Algorithms (MOEAs) prove themselves as being efficient methods for selection and classification problems. This paper aims to study combinations of well-known classification objectives in order to compare the results of their application in solving very specific learning problems. The experimental results undergo empirical analysis which is supported by a statistical approach. The results are illustrated on a collection of medical image databases, but with a focus on the MOEAs’ performance in terms of several well-known measures. The databases were chosen specifically to feature reliable human annotations, so as to measure the correlation between the gold standard classifications and the various MOEA classifications.

RESULTS: We have seen how different statistical tests rank one algorithm over the others in our set as being better. These findings are unsurprising, revealing that there is no single gold standard for comparing diverse techniques or evolutionary algorithms. Furthermore, building meta-classifiers and evaluating them using a single, favorable metric is both extremely unwise and unsatisfactory, as the impact is to skew the results.

CONCLUSIONS: The best method to address these flaws is to select the right set of objectives and criteria. Using accuracy-related objectives, for example, is directly linked to maximizing the number of true positives. If, on the other hand, accuracy is chosen as the generic metric, the primary classification goal is shifted to increasing the positively categorized data points.

PMID:35853014 | DOI:10.1371/journal.pone.0269950

PLoS One. 2022 Jul 19;17(7):e0271480. doi: 10.1371/journal.pone.0271480. eCollection 2022.

ABSTRACT

INTRODUCTION: Parkinson’s disease is a motor disease, the second most common neurodegenerative disorder with cardinal symptoms including bradykinesia, rigidity, and rest tremor accompanied by cognitive difficulties. The caregivers play a crucial role for individuals with Parkinson’s disease; however, many of them may suffer from high caregiver burden and mental health deterioration. This protocol of a systematic review presents a methodology of the review about the impact of cognitive impairment of individuals with Parkinson’s disease on their caregivers’ mental health.

MATERIAL AND METHODS: Research will be identified by combining electronic databases searching and hand searching. The following databases will be included: Medline, PsycInfo, Web of Sciences, Cochrane, CINAHL, Embase and Scopus. The inclusion and exclusion criteria followed to PECOS model. The population of informal caregivers is defined as family members providing care on a patient with Parkinson’s disease. Exposure is linked with the evaluation of a cognitive functioning and outcome is defined as mental health among caregivers of individuals with Parkinson’s disease. We will include two types of studies: observational and intervention. Both, screening and eligibility will be done by two independent reviewers. Study quality will be assessed by two authors independently. Data will be extracted by two reviewers independently and will follow a pre-pilot extraction form. Any discrepancies will be resolved by discussion or/and consultation with another reviewer. The synthesis without meta-analysis (SWiM) guidelines will be used to report on included studies data. The metanalysis with usage the statistical software R version 4.1.2 (2021-11-01) “Bird Hippie” and R metaphor package 3.0-2 of will be conducted if possible.

DISCUSSION: The goal of this systematic review is to present the association between caregivers’ mental health problems and their proteges’ cognitive impairment. It will enable to identify the gaps in literature and its methodology giving the suggestions for further research.

PROTOCOL REGISTRATION: Protocol registration number in PROSPERO: CRD42022296670.

PMID:35853013 | DOI:10.1371/journal.pone.0271480

PLoS One. 2022 Jul 19;17(7):e0268356. doi: 10.1371/journal.pone.0268356. eCollection 2022.

ABSTRACT

BACKGROUND: The use of computers and other Visual Display Terminal (VDT) screens is increasing in Nepal. However, there is a paucity of evidence on the prevalence of Computer Vision Syndrome (CVS) and other occupational health concerns among employees working in front of VDT screens in the Nepalese population.

OBJECTIVES: This study aims to estimate the prevalence of CVS, musculoskeletal and work-related stress among VDT screen users in the office, as well as their understanding and usage of preventive measures.

METHODS: The study was a cross-sectional descriptive study among 319 VDT users in office settings in Kathmandu Metropolitan City, Nepal, using a semi-structured self-administered questionnaire. Multivariate logistic regression analysis was conducted to identify the associated factors at 95% CI. P-value <0.05 was considered as statistically significant.

RESULTS: The prevalence of CVS was 89.4%. More than eight out of ten study participants reported at least one visual and musculoskeletal symptom. Work-related stress, which was moderate-difficult to handle, was present in 36.7% of the study population. The mean±SD computer usage per day was 7.9±1.9 hours. Tired eye (63.3%), feeling of dry eye (57.8%), headache (56.9%) were the common visual symptoms of CVS reported. Total computer use/day > = 8 hours OR 2.6, improper viewing distance OR 3.2, Not using an anti-glare screen OR 2.6, not using eye-drops, and not wearing protective goggles OR 3.1 were significantly associated with the presence of CVS. There was no statistically significant association between visual symptoms of CVS, musculoskeletal symptoms, and stress with gender.

CONCLUSION: CVS was substantially related to not employing preventive measures, working longer hours, and having an incorrect viewing distance. With more hours per day spent in front of a VDT screen, work-related stress and musculoskeletal complaints were also found to be important correlates. Similarly, work-related stress was found more among those who had less than five years of job.

PMID:35853006 | DOI:10.1371/journal.pone.0268356

PLoS One. 2022 Jul 19;17(7):e0270360. doi: 10.1371/journal.pone.0270360. eCollection 2022.

ABSTRACT

Existing methods for evaluating in vivo placental function fail to reliably detect pregnancies at-risk for adverse outcomes prior to maternal and/or fetal morbidity. Here we report the results of a prospective dual-site longitudinal clinical study of quantitative placental T2* as measured by blood oxygen-level dependent magnetic resonance imaging (BOLD-MRI). The objectives of this study were: 1) to quantify placental T2* at multiple time points across gestation, and its consistency across sites, and 2) to investigate the association between placental T2* and adverse outcomes. 797 successful imaging studies, at up to three time points between 11 and 38 weeks of gestation, were completed in 316 pregnancies. Outcomes were stratified into three groups: (UN) uncomplicated/normal pregnancy, (PA) primary adverse pregnancy, which included hypertensive disorders of pregnancy, birthweight <5th percentile, and/or stillbirth or fetal death, and (SA) secondary abnormal pregnancy, which included abnormal prenatal conditions not included in the PA group such as spontaneous preterm birth or fetal anomalies. Of the 316 pregnancies, 198 (62.6%) were UN, 70 (22.2%) PA, and 48 (15.2%) SA outcomes. We found that the evolution of placental T2* across gestation was well described by a sigmoid model, with T2* decreasing continuously from a high plateau level early in gestation, through an inflection point around 30 weeks, and finally approaching a second, lower plateau in late gestation. Model regression revealed significantly lower T2* in the PA group than in UN pregnancies starting at 15 weeks and continuing through 33 weeks. T2* percentiles were computed for individual scans relative to UN group regression, and z-scores and receiver operating characteristic (ROC) curves calculated for association of T2* with pregnancy outcome. Overall, differences between UN and PA groups were statistically significant across gestation, with large effect sizes in mid- and late- pregnancy. The area under the curve (AUC) for placental T2* percentile and PA pregnancy outcome was 0.71, with the strongest predictive power (AUC of 0.76) at the mid-gestation time period (20-30 weeks). Our data demonstrate that placental T2* measurements are strongly associated with pregnancy outcomes often attributed to placental insufficiency. Trial registration: ClinicalTrials.gov: NCT02749851.

PMID:35853003 | DOI:10.1371/journal.pone.0270360

PLoS One. 2022 Jul 19;17(7):e0269185. doi: 10.1371/journal.pone.0269185. eCollection 2022.

ABSTRACT

Coronavirus Disease (COVID-19) was declared a pandemic by WHO in March 2020. Since then, additional novel coronavirus variants have emerged challenging the current healthcare system worldwide. There is an increased need for hospital care, especially intensive care unit (ICU), for the patients severely affected by the disease. Most of the studies analyzed COVID-19 infected patients in the hospitals and established the positive correlation between clinical parameters such as high levels of D-dimer, C-reactive protein, and ferritin to the severity of infection. However, little is known about the course of the ICU admission. The retrospective study carried out at University Hospital Sharjah, UAE presented here reports an integrated analysis of the biochemical and radiological factors among the newly admitted COVID-19 patients to decide on their ICU admission. The descriptive statistical analysis revealed that patients with clinical presentations such as acute respiratory distress syndrome (ARDS) (p<0.0001) at the time of admission needed intensive care. The ROC plot indicated that radiological factors including high chest CT scores (>CO-RADS 4) in combination with biochemical parameters such as higher levels of blood urea nitrogen (>6.7 mg/dL;66% sensitivity and 75.8% specificity) and ferritin (>290 μg/mL, 71.4% sensitivity and 77.8% specificity) may predict ICU admission with 94.2% accuracy among COVID-19 patients. Collectively, these findings would benefit the hospitals to predict the ICU admission amongst COVID-19 infected patients.

PMID:35852999 | DOI:10.1371/journal.pone.0269185

PLoS One. 2022 Jul 19;17(7):e0271275. doi: 10.1371/journal.pone.0271275. eCollection 2022.

ABSTRACT

BACKGROUND: Women in rural settings particularly in schools suffer more from stigma and lack of services and facilities during menstruation. However, the issue has not received proper attention from school water sanitation and hygiene programs. And this study was aimed to identify knowledge and practice of menstrual hygiene, and associated factors.

METHOD: Institution based cross-sectional study was employed among 441 school girls in Mekidela city. EpiData Version 4.6 and the Statistical Package for the Social Sciences Version 25.0 were used for data entry and analysis, respectively. Bivariable and multivariable logistic regression was employed to identify factors associated with the outcome variables. Variables with a p-value<0.25 in the bivariable analysis were a candidate for multivariable logistic regression and p-value<0.05 in the multivariable analysis was used to declare significant association.

RESULTS: Of the respondents, 64.9% reported good knowledge of menstrual hygiene management. In multivariable analysis; grade level (grade 11 & 12) [adjusted odds ratio (AOR) = 2.23, 95% C.I (1.19-4.16)], age ≥ 19 years [AOR = 3.45, 95% C.I (1.78-6.69)], residence [AOR = 1.90, 95% C.I: (1.12-3.23)], know sanitary pads [AOR = 2.67, 95% CI: (1.19-6.00)] and learned about menstrual hygiene [AOR = 1.71, 95% CI: (1.02-2.87)] found to be associated with knowledge. About 62.4% have good menstrual hygiene practices. Knowledge on menstrual hygiene [AOR = 1.73, 95% C.I (1.07-2.80)], know about reproductive tract/sexually transmitted infections [AOR = 2.46, 95% CI: (1.37-4.43)], having private shower [AOR = 2.04, 95% C.I 2.04(1.24-3.37)] and residence [AOR = 3.76, 95% C.I:(2.18-6.51)] were factors associated with practice.

CONCLUSION: Overall nearly two-third of respondents had good knowledge and good practice of menstrual hygiene management. Factors significantly associated with their knowledge included age, grade level, residence, learning on menstrual hygiene, and knowledge of sanitary pads. Residence, knowledge on menstrual hygiene, know about sexually transmitted infections and having a private shower were found to be associated with practice of menstrual hygiene management. In general, our finding indicates that menstrual hygiene was unsatisfactory among adolescent school girls and more should be done on the factors identified.

PMID:35852998 | DOI:10.1371/journal.pone.0271275

PLoS Comput Biol. 2022 Jul 19;18(7):e1010273. doi: 10.1371/journal.pcbi.1010273. eCollection 2022 Jul.

ABSTRACT

Temporal synchrony between facial motion and acoustic modulations is a hallmark feature of audiovisual speech. The moving face and mouth during natural speech is known to be correlated with low-frequency acoustic envelope fluctuations (below 10 Hz), but the precise rates at which envelope information is synchronized with motion in different parts of the face are less clear. Here, we used regularized canonical correlation analysis (rCCA) to learn speech envelope filters whose outputs correlate with motion in different parts of the speakers face. We leveraged recent advances in video-based 3D facial landmark estimation allowing us to examine statistical envelope-face correlations across a large number of speakers (∼4000). Specifically, rCCA was used to learn modulation transfer functions (MTFs) for the speech envelope that significantly predict correlation with facial motion across different speakers. The AV analysis revealed bandpass speech envelope filters at distinct temporal scales. A first set of MTFs showed peaks around 3-4 Hz and were correlated with mouth movements. A second set of MTFs captured envelope fluctuations in the 1-2 Hz range correlated with more global face and head motion. These two distinctive timescales emerged only as a property of natural AV speech statistics across many speakers. A similar analysis of fewer speakers performing a controlled speech task highlighted only the well-known temporal modulations around 4 Hz correlated with orofacial motion. The different bandpass ranges of AV correlation align notably with the average rates at which syllables (3-4 Hz) and phrases (1-2 Hz) are produced in natural speech. Whereas periodicities at the syllable rate are evident in the envelope spectrum of the speech signal itself, slower 1-2 Hz regularities thus only become prominent when considering crossmodal signal statistics. This may indicate a motor origin of temporal regularities at the timescales of syllables and phrases in natural speech.

PMID:35852989 | DOI:10.1371/journal.pcbi.1010273

Vopr Pitan. 2022;91(3):64-72. doi: 10.33029/0042-8833-2022-91-3-64-72. Epub 2022 May 4.

ABSTRACT

The growing prevalence of overweight and obesity is an urgent problem not only in adults but also in children in both developed and developing countries. The purpose of this study was to analyze the prevalence of overweight and obesity and other forms of nutritional disorders in Russian children. Material and methods. The nutritional status of 17 329 children aged 2-18 years was assessed on the basis of anthropometric data, obtained by the Federal State Statistics Service during the “Sample Survey of the Population’s Diet” in 2018. The prevalence of various forms of malnutrition was assessed by the Z-score categories: underweight, stunted growth (short stature), thinness, overweight, obesity. Results. Population mean and median values of Z-scores in all sex-age groups do not exceed ±0.5 in relation to WHO standards, which indicates the applicability of the standards to assessing the nutritional status of Russian children population. High body weight (WAZ>2) occurs in 7.6% of children, underweight in 2.6%. The incidence of short stature in boys and girls is 7.0 and 6.8%, respectively. The prevalence of overweight and obesity in boys is 20.4 and 10.4%, respectively, while in girls, 15.4 and 7.6%. In general, in the population of children 2-18 years old, the prevalence of overweight is 18%, and obesity is 9.1%. The index of malnutrition, including the sum of the frequency of various combinations of low Z-scores (<-2), characterizing underweight, short stature, thinness, and their combinations was 8.0%. The multilevel logistic regression showed that overweight and obesity inversely depend on age; the risk of developing these conditions is lower in the city, but higher in male children compared to female children. Conclusion. The population of children 2-18 years old in the Russian Federation is characterized by a low incidence of forms of malnutrition, such as underweight and thinness. However, the prevalence of overweight and obesity is higher than in European countries.

PMID:35852979 | DOI:10.33029/0042-8833-2022-91-3-64-72