Nevin Manimala

PLoS One. 2022 Nov 3;17(11):e0276613. doi: 10.1371/journal.pone.0276613. eCollection 2022.

ABSTRACT

BACKGROUND: First-time mothers are prone to prolonged labor, defined as the crossing of partograph alert or action lines. Prolonged labor may occur among as many as one out of five women, and is associated with a range of adverse birth outcomes. Oxytocin is the standard treatment for prolonged labor, but has a narrow therapeutic window, several adverse effects and limited efficacy. Despite poor evidence, labor wards often use antispasmodic agents to treat prolonged labor. The antispasmodic drug butylscopolamine bromide (Buscopan®) may shorten duration of labor, but studies on prevention of prolonged labor are lacking. In this randomized double-blind placebo-controlled clinical trial, we aim to evaluate the effect of butylscopolamine bromide on duration of labor in first-time mothers showing first signs of slow labor progress by crossing the World Health Organization partograph alert line.

METHODS AND ANALYSIS: The study is a single center study at Oslo University Hospital, Oslo, Norway. We will recruit 250 primiparous women with spontaneous labor start at term. Women are included in the first stage of labor if they show signs of slow labor progress, defined as the crossing of the partograph alert line with a cervical dilation between 3-9 cm. Participants are randomized 1:1 to either 20 mg intravenous butylscopolamine bromide or intravenous placebo (1 mL sodium chlorine 9 mg/mL). We considered a mean difference of 60 minutes in labor duration clinically relevant. The primary outcome is duration of labor from the provision of the investigational medicinal product to vaginal delivery. The secondary outcomes include change in labor pain, use of oxytocin augmentation, delivery mode, and maternal birth experience. The primary data for the statistical analysis will be the full analysis set and will occur on completion of the study as per the prespecified statistical analysis plan. The primary outcome will be analyzed using Weibull regression, and we will treat cesarean delivery as a censoring event.

PMID:36327275 | DOI:10.1371/journal.pone.0276613

PLoS One. 2022 Nov 3;17(11):e0251470. doi: 10.1371/journal.pone.0251470. eCollection 2022.

ABSTRACT

IMPORTANCE: The rapid proliferation of COVID-19 has left governments scrambling, and several data aggregators are now assisting in the reporting of county cases and deaths. The different variables affecting reporting (e.g., time delays in reporting) necessitates a well-documented reliability study examining the data methods and discussion of possible causes of differences between aggregators.

OBJECTIVE: To statistically evaluate the reliability of COVID-19 data across aggregators using case fatality rate (CFR) estimates and reliability statistics.

DESIGN, SETTING, AND PARTICIPANTS: Cases and deaths were collected daily by volunteers via state and local health departments, as primary sources and newspaper reports, as secondary sources. In an effort to begin comparison for reliability statistical analysis, BroadStreet collected data from other COVID-19 aggregator sources, including USAFacts, Johns Hopkins University, New York Times, The COVID Tracking Project.

MAIN OUTCOMES AND MEASURES: COVID-19 cases and death counts at the county and state levels.

RESULTS: Lower levels of inter-rater agreement were observed across aggregators associated with the number of deaths, which manifested itself in state level Bayesian estimates of COVID-19 fatality rates.

CONCLUSIONS AND RELEVANCE: A national, publicly available data set is needed for current and future disease outbreaks and improved reliability in reporting.

PMID:36327273 | DOI:10.1371/journal.pone.0251470

PLoS One. 2022 Nov 3;17(11):e0275532. doi: 10.1371/journal.pone.0275532. eCollection 2022.

ABSTRACT

In this paper, we propose a portmanteau test for whether a graph-structured network dataset without replicates exhibits autocorrelation across units connected by edges. Specifically, the well known Ljung-Box test for serial autocorrelation of time series data is generalized to the network setting using a specially derived central limit theorem for a weakly stationary random field. The asymptotic distribution of the test statistic under the null hypothesis of no autocorrelation is shown to be chi-squared, yielding a simple and easy-to-implement procedure for testing graph-structured autocorrelation, including spatial and spatial-temporal autocorrelation as special cases. Numerical simulations are carried out to demonstrate and confirm the derived asymptotic results. Convergence is found to occur quickly depending on the number of lags included in the test statistic, and a significant increase in statistical power is also observed relative to some recently proposed permutation tests. An example application is presented by fitting spatial autoregressive models to the distribution of COVID-19 cases across counties in New York state.

PMID:36327270 | DOI:10.1371/journal.pone.0275532

PLoS One. 2022 Nov 3;17(11):e0277230. doi: 10.1371/journal.pone.0277230. eCollection 2022.

ABSTRACT

BACKGROUND: External eye infection caused by bacteria can lead to reduced vision and blindness. Therefore, pathogen isolation and antimicrobial susceptibility testing are vital for the prevention and control of ocular diseases.

OBJECTIVE: The main aim of this study was to assess bacterial isolates, their antimicrobial susceptibility pattern, and associated factors of external ocular infection (EOI) among patients attended eye clinic at Debre Markos Comprehensive Specialized Hospital (DMCSH), Northwest Ethiopia.

METHODS: We conducted a cross-sectional study in patients with external ocular infections from January 1, 2021, to June 30, 2021, at DMCSH. Socio-demographic and clinical data were collected using semi-structured questionnaires. Following standard protocols, external ocular swabs were collected and inoculated onto blood agar, chocolate agar, MacConkey agar and mannitol salt agar (MSA). Finally, bacterial isolates were identified by Gram stain, colony morphology, and biochemical tests. Antimicrobial susceptibility testing was done by using the modified Kirby-Bauer disk diffusion technique according to Clinical and Laboratory Standards Institute (CLSI) guideline. Cleaned and coded data were entered into EpiData version 4.2 software and exported to Statistical Packages for Social Sciences (SPSS) version 22 for analysis. Bivariate logistic regression was applied to investigate the association between predictors and outcome variables. P-values ≤ 0.05 with 95% confidence interval were considered statistically significant.

RESULTS: Two hundred seven study participants were enrolled in this study. More than half of them (57.5%, 119/207) were males, and 37.7% (78/207) of them were ≥ 65 years old. A total of 130 (62.8%) bacterial isolates were identified, with Gram-positive bacteria accounting for 78.5% (102/130) of the isolates. Staphylococcus aureus was the most common isolate with a 46.2% (60/130) prevalence. Ciprofloxacin was comparatively effective against Gram-positive and Gram-negative bacteria. The prevalence of culture-confirmed bacteria was significantly associated with age groups 15-24 (AOR: 9.18, 95%CI: 1.01-82.80; P = 0.049) and 25-64 (AOR: 7.47, 95%CI: 1.06-52.31; P = 0.043). Being farmer (AOR: 5.33, 95% CI: 1.04-37.33; P = 0.045), previous history of eye surgery (AOR: 5.39, 95% CI: 1.66-17.48; P = 0.005), less frequency of face washing (AOR: 5.32, 95% CI: 1.31-7.23; P = 0.010) and face washing once a day (AOR: 3.07, 95% CI: 1.13-25.13; P = 0.035) were also significantly associated with the prevalence of culture-confirmed bacteria.

CONCLUSION: The prevalence of culture-confirmed bacteria among patients with EOI was high in the study area. A considerable proportion of bacterial isolates exhibited mono and/or multi-drug resistance. Age (15-64 years), being farmer, previous history of eye surgery and less frequency of face washing were significantly associated with the prevalence of culture-confirmed bacteria. Bacterial isolation and antibiotic susceptibility testing should be routinely performed in the study area to combat the emergence of antibiotic resistance.

PMID:36327266 | DOI:10.1371/journal.pone.0277230

PLoS One. 2022 Nov 3;17(11):e0276695. doi: 10.1371/journal.pone.0276695. eCollection 2022.

ABSTRACT

In many practical situations, there is an interest in modeling bounded random variables in the interval (0, 1), such as rates, proportions, and indexes. It is important to provide new continuous models to deal with the uncertainty involved by variables of this type. This paper proposes a new quantile regression model based on an alternative parameterization of the unit Burr XII (UBXII) distribution. For the UBXII distribution and its associated regression, we obtain score functions and observed information matrices. We use the maximum likelihood method to estimate the parameters of the regression model, and conduct a Monte Carlo study to evaluate the performance of its estimates in samples of finite size. Furthermore, we present general diagnostic analysis and model selection techniques for the regression model. We empirically show its importance and flexibility through an application to an actual data set, in which the dropout proportion of Brazilian undergraduate animal sciences courses is analyzed. We use a statistical learning method for comparing the proposed model with the beta, Kumaraswamy, and unit-Weibull regressions. The results show that the UBXII regression provides the best fit and the most accurate predictions. Therefore, it is a valuable alternative and competitive to the well-known regressions for modeling double-bounded variables in the unit interval.

PMID:36327245 | DOI:10.1371/journal.pone.0276695

PLoS One. 2022 Nov 3;17(11):e0277098. doi: 10.1371/journal.pone.0277098. eCollection 2022.

ABSTRACT

OBJECTIVE: To determine the expression profile of microRNAs in the peripheral blood of pregnant women with preterm premature rupture of membranes (PPROM) compared to that of healthy pregnant women.

STUDY DESIGN: This was a pilot study with case-control design in pregnant patients enrolled between January 2017 and June 2019. Patients with healthy pregnancies and those affected by PPROM between 20- and 33+6 weeks of gestation were matched by gestational age and selected for inclusion to the study. Patients were excluded for multiple gestation and presence of a major obstetrical complication such as preeclampsia, diabetes, fetal growth restriction and stillbirth. A total of ten (n = 10) controls and ten (n = 10) patients with PPROM were enrolled in the study. Specimens were obtained before administration of betamethasone or intravenous antibiotics. MicroRNA expression was analyzed for 800 microRNAs in each sample using the NanoString nCounter Expression Assay. Differential expression was calculated after normalization and log2- transformation using the false discovery rate (FDR) method at an alpha level of 5%.

RESULTS: Demographic characteristics were similar between the two groups. Of the 800 miRNAs analyzed, 116 were differentially expressed after normalization. However, only four reached FDR-adjusted statistical significance. Pregnancies affected by PPROM were characterized by upregulation of miR-199a-5p, miR-130a-3p and miR-26a-5p and downregulation of miR-513b-5p (FDR adjusted p-values <0.05). The differentially expressed microRNAs participate in pathways associated with altered collagen and matrix metalloprotease expression in the extracellular matrix.

CONCLUSION: Patients with PPROM have a distinct peripheral blood microRNA profile compared to healthy pregnancies as measured by the NanoString Expression Assay.

PMID:36327243 | DOI:10.1371/journal.pone.0277098

PLoS One. 2022 Nov 3;17(11):e0277103. doi: 10.1371/journal.pone.0277103. eCollection 2022.

ABSTRACT

OBJECTIVE: The medical history of injury given by parents of infants and toddlers with head trauma may not be accurate or completely true. The purpose of this study was to examine the relationship between subdural hematoma (SDH) due to nonaccidental injury and mechanisms of injury provided by caregivers.

METHODS: Our multicenter study group retrospectively reviewed the clinical records of children younger than 4 years with head trauma who have been diagnosed with any finding on head computed tomography (CT) and/or magnetic resonance imaging (MRI). A total of 84 cases of subdural hematomas with retinal findings, including cases reported to the child guidance center and traffic and birth injuries, were included in the study. They were classified by the mechanism of injury provided by the caregivers. Clinical findings were reviewed and classified into nonaccidental and accidental groups. The mechanisms of the injuries were examined by multivariable analysis to identify which ones were statistically associated with nonaccidental injuries.

RESULTS: Of the 84 patients with SDHs, 51 were classified into the nonaccidental group, and 33 children were classified into the accidental group. In 19 patients with a chief complaint of convulsion who had SDH but no episode of trauma, 18 were classified into the nonaccidental group. On multivariable analysis, unexplained convulsions (odds ratio: 12.04, 95% confidence interval: 1.44-100.49) were significantly associated with increased odds of nonaccidental injury.

CONCLUSIONS: In the present study, there was a relationship between nonaccidental injury and unexplained SDH with a chief complaint of convulsion.

PMID:36327242 | DOI:10.1371/journal.pone.0277103

PLoS One. 2022 Nov 3;17(11):e0277062. doi: 10.1371/journal.pone.0277062. eCollection 2022.

ABSTRACT

AIMS: Psychological First Aid is a brief intervention based on international guidance from the World Health Organisation. Free to access online training in the intervention was introduced during the COVID-19 pandemic in UK. We aimed to determine the uptake of Psychological First Aid training among healthcare workers in care homes in the UK and to assess its effects on their wellbeing.

DESIGN: This was a sequential mixed methods design.

METHODS: Healthcare workers (nurses and carers) working in care homes in the UK were surveyed about their uptake of Psychological First Aid, their stress, coping efficacy and the key concepts of Psychological First Aid (safety, calmness, hopefulness, connectedness, and accomplishment). Those that completed the Psychological First Aid training were asked to share their experiences via qualitative survey. Data collection was conducted between June and October 2021. Analyses included descriptive statistics and regression analysis. A six step thematic analysis was used to interpret the qualitative data.

RESULTS: 388 participants responded to the survey. The uptake of Psychological First Aid training was 37 (9.5%). Psychological first aid was a significant predictor for coping efficacy (β = 17.54, p = .001). Participants with a physical or mental health condition experienced higher stress and lower coping regardless of PFA training. Four themes were identified from the qualitative analysis: self-awareness and growth, relationships with others, overcoming stress and accessibility.

CONCLUSION: While this study suggests some benefits to healthcare workers in care home settings undergoing PFA the poor uptake of the training warrants further investigation.

IMPACT: Care home staff need psychological support. This gap remains as few completed PFA training. This is the first study in UK and worldwide to look at the effects of psychological first aid on stress and coping in this population and it warrants further investigation.

PMID:36327237 | DOI:10.1371/journal.pone.0277062

PLoS One. 2022 Nov 3;17(11):e0276782. doi: 10.1371/journal.pone.0276782. eCollection 2022.

ABSTRACT

BACKGROUND: The COVID-19 pandemic has led nucleic acid collection and detection became a measure to ensure normal life in China. Considering the huge detection demand, it has emerged that robots replace manual sample collection. However, the cost-effectiveness of nucleic acid collection by robots instead of humans remain unknown.

METHODS: This study was approved by the Ethics Committee of the Shenzhen Luohu District People’s Hospital, number 2021-LHQRMYY-KYLL-031a. All participants signed the written informed consent of this study. 273 volunteers were recruited on December 1st 2021 from Shenzhen and divided into six groups: one group to be sampled by robots and the others to be sampled manually with varying specifications for swab rotation and insertion time. Questionnaires were distributed to the robot group to ask them sampling feeling. The effectiveness and safety of sampling were evaluated through the sampling efficiency, adverse events and sampling feeling of different groups. The economics of the different methods were judged by comparing the sampling cost for each.

RESULTS: The sampling efficiency of the robot group was 96.9%, and there was no statistically significant difference between the other five manually sampled groups (p = 0.586). There were no serious adverse events in any of the six groups, but nasal soreness and tearing did occur in all group. Of the volunteers who underwent robotic sampling, 85.94% reported that the experience was either no different or more comfortable than the manual sampling. In economic terms, a single robot used to replace medical staff for sample collection becomes economically advantageous when the working time is ≥ 455 days. If multiple robots are used to replace twice the number of manual collections, it becomes more economical at 137 days and remains so as long as the robot is used.

CONCLUSIONS: It appears safe and effective for robots to replace manual sampling method. Implementation of robotic sampling is economical and feasible, and can significantly save costs when working over a long term.

PMID:36327236 | DOI:10.1371/journal.pone.0276782

Rev Esp Salud Publica. 2022 Nov 3;96:e202211085.

ABSTRACT

OBJECTIVE: Energy drinks generally contain caffeine and other stimulants, commercially aimed at young people. Previous research suggests that its effects on adolescents health are dangerous. The aim of the study was to evaluate the effect of taurine and caffeine consumption from energy drinks on adolescent health and to identify patterns of consumption and, their association with physiological symptoms.

METHODS: A cross-sectional study of a convenience sample of students (n=135) aged 16 to 17 years was conducted in the State of Hidalgo, Mexico. A self-administered online questionnaire was used from September to November 2020 to report energy drink consumption patterns, perceived effects, and psychophysiological symptoms. The statistical analysis of questionnaire content was made by interjudges evaluation. A concordance index (Cohen-Fleiss Kappa coefficient) was applied for consumption patterns, bivariate correlation tests, Pearson correlation coefficients for levels (very high, moderate, low) of caffeine and taurine were used in the items applied to the target population and Spearmans rho for physiological and psychological effects.

RESULTS: The participants (mean age: 16 years; 57.8% of women) reported having consumed energy drinks at least once. Only 26.7% of adolescents (n=36) reported that they had never consumed. The average consumption of energy drinks was once per month (24.4%). A statistically significant correlation was found between the consumption of drinks with taurine and the physical effects (tremors and chest pain) and caffeinated beverages with psychophysiological (fatigue, excessive urination, insomnia, and feeling of lack of rest).

CONCLUSIONS: The study findings indicate associations between energy drink consumption and the presence of adverse psychological and physical symptoms in adolescents.

PMID:36325955