Nevin Manimala

PLoS One. 2022 Mar 10;17(3):e0265133. doi: 10.1371/journal.pone.0265133. eCollection 2022.

ABSTRACT

BACKGROUND: The authors sought to compare simultaneous and sequential tympanoplasty and adenoidectomy surgery in pediatric patients.

METHODS: This retrospective single-center study included 65 children (36 males, 29 females; mean age 9.16 ± 3.82 years; range 3-17 years) requiring both tympanoplasty and adenoidectomy. Simultaneous surgeries were performed on the same day, during single general anesthesia, whereas sequential surgeries were separated at least 12 weeks. The groups were compared with regard to restoration of hearing, tympanic membrane status, and utilization of medical resources. All study participants had a 12-months follow-up period after surgery.

RESULTS: No statistically significant differences were observed between the groups regarding pre- and post-operative ABG values and average hearing gains. However, the post-operative ABG was significantly lower than the pre-operative ABG in both groups (p<0.001). There were no significant differences between simultaneous and sequential groups with respect to complete healing rates and complications (all p>0.355). Simultaneous tympanoplasty and adenoidectomy surgery management is associated with a significantly decreased cumulative hospital stay, cumulative operating room time, and cumulative pure surgical time (all p≤0.016).

CONCLUSIONS: The results of first comparative study of simultaneous versus sequential tympanoplasty and adenoidectomy surgery managements demonstrate no advantages for the sequential approach. The same-day surgery can show the clinical outcomes comparable to those in the sequential group. The simultaneous surgery approach appears to be associated with reduced medical resources consumption. Therefore, simultaneous surgery management is an effective and safe option for children with chronic otitis media and adenoid hypertrophy.

PMID:35271666 | DOI:10.1371/journal.pone.0265133

PLoS One. 2022 Mar 10;17(3):e0265266. doi: 10.1371/journal.pone.0265266. eCollection 2022.

ABSTRACT

As an important basis of navigation safety decisions, ship domains have always been a pilot concern. In the past, model parameters were usually obtained from statistics of massive historical cumulative data, but the results were mostly historical analysis and static data, which obviously could not meet the needs of pilots who wish to master the ship domain in real time. To obtain and update the ship domain parameter online in time and meet the real-time needs of maritime applications, this paper obtains CRI as the weight coefficient-based PSO-LSSVM method and proposes to use short-term AIS data accumulation through the risk-weighted least squares method online rolling identification method, which can filter nonhazardous targets and improve the identification accuracy and real-time performance of nonlinear models in the ship domain. The experimental examples show that the method can generate the ship domain dynamically in real time. At the same time, the method can be used to study the dynamic evolution characteristics of the ship domain over the course of navigation, which provides a reference for navigation safety decisions and the analysis of ship navigation behavior.

PMID:35271665 | DOI:10.1371/journal.pone.0265266

PLoS One. 2022 Mar 10;17(3):e0265209. doi: 10.1371/journal.pone.0265209. eCollection 2022.

ABSTRACT

BACKGROUND AND AIMS: The incidence of colorectal cancer (CRC) is increasing in adults younger than 50, and early screening remains challenging due to cost and under-utilization. To identify individuals aged 35-50 years who may benefit from early screening, we developed a prediction model using machine learning and electronic health record (EHR)-derived factors.

METHODS: We enrolled 3,116 adults aged 35-50 at average-risk for CRC and underwent colonoscopy between 2017-2020 at a single center. Prediction outcomes were (1) CRC and (2) CRC or high-risk polyps. We derived our predictors from EHRs (e.g., demographics, obesity, laboratory values, medications, and zip code-derived factors). We constructed four machine learning-based models using a training set (random sample of 70% of participants): regularized discriminant analysis, random forest, neural network, and gradient boosting decision tree. In the testing set (remaining 30% of participants), we measured predictive performance by comparing C-statistics to a reference model (logistic regression).

RESULTS: The study sample was 55.1% female, 32.8% non-white, and included 16 (0.05%) CRC cases and 478 (15.3%) cases of CRC or high-risk polyps. All machine learning models predicted CRC with higher discriminative ability compared to the reference model [e.g., C-statistics (95%CI); neural network: 0.75 (0.48-1.00) vs. reference: 0.43 (0.18-0.67); P = 0.07] Furthermore, all machine learning approaches, except for gradient boosting, predicted CRC or high-risk polyps significantly better than the reference model [e.g., C-statistics (95%CI); regularized discriminant analysis: 0.64 (0.59-0.69) vs. reference: 0.55 (0.50-0.59); P<0.0015]. The most important predictive variables in the regularized discriminant analysis model for CRC or high-risk polyps were income per zip code, the colonoscopy indication, and body mass index quartiles.

DISCUSSION: Machine learning can predict CRC risk in adults aged 35-50 using EHR with improved discrimination. Further development of our model is needed, followed by validation in a primary-care setting, before clinical application.

PMID:35271664 | DOI:10.1371/journal.pone.0265209

PLoS One. 2022 Mar 10;17(3):e0265221. doi: 10.1371/journal.pone.0265221. eCollection 2022.

ABSTRACT

BACKGROUND: Sarcopenia is characterized by the age-associated loss of skeletal muscle mass and strength that develops progressively and plays an important role in the disability of the elderly. It has received growing attention over the last decade and has been implicated as both a cause and consequence of type 2 diabetes mellitus (T2DM). The existence of T2DM could increase the risk of developing sarcopenia through multiple mechanisms including advanced glycation end-product accumulation. Meanwhile, sarcopenia would alter glucose disposal and may contribute to the development and progression of T2DM due to reduced muscle mass.

METHODS: We implemented transcriptomic analysis of skeletal muscle biopsy specimens in sarcopenia patients and proliferating myoblasts or differentiated myotubes from individuals with T2DM. Related microarray data were selected from Gene Expression Omnibus (GEO) to screen the genes, which were differentially expressed for sarcopenia and T2DM. Multiple combinatorial statistical methods and bioinformatics tools were used to analyze the common DEGs. Meanwhile, functional enrichment analysis was also carried out. Furthermore, we constructed the protein-protein interaction (PPI), as well as transcription factor (TF)-gene interactions network and TF-miRNA coregulatory network. Finally, based on the common DEGs, drug compounds were speculated using the Drug Signatures database (DSigDB).

RESULTS: A total of 1765 and 2155 DEGs of sarcopenia and T2DM were screened, respectively. 15 common genes (LXN, CIB2, PEA15, KANK2, FGD1, NMRK1, PLCB1, SEMA4G, ADARB1, UPF3A, CSTB, COL3A1, CD99, ETV3, FJX1) correlated with sarcopenia and T2DM simultaneously were then identified, and 3 genes (UPF3A, CSTB and PEA15) of them were regarded as hub genes. Functional enrichment analysis revealed several shared pathways between two diseases. In addition, according to the TF-gene interactions network and TF-miRNA coregulatory network, part of TF and miRNA may be identified as key regulator in sarcopenia and T2DM at the same time (e.g., CREM and miR-155). Notably, drug compounds for T2DM and sarcopenia were also suggested, such as coenzyme Q10.

CONCLUSION: This study revealed that sarcopenia and T2DM may share similar pathogenesis and provided new biological targets and ideas for early diagnosis and effective treatment of sarcopenia and T2DM.

PMID:35271662 | DOI:10.1371/journal.pone.0265221

PLoS One. 2022 Mar 10;17(3):e0265085. doi: 10.1371/journal.pone.0265085. eCollection 2022.

ABSTRACT

BACKGROUND: Hyperthyroidism affects about 0.2%-2.7% of all pregnancies, and is generally treated with propylthiouracil (PTU). However, previous studies about the effects of propylthiouracil on maternal or foetal are contentious.

OBJECTIVE: This meta-analysis was carried out to investigate the safety and efficacy of propylthiouracil during pregnancy.

MATERIALS AND METHODS: PubMed, EBSCO, Embase, Scopus, Web of Science, Cochrane, CNKI, Wanfang and VIP database were searched from inception until August 31, 2021 for all available randomized controlled trials (RCTs) or cohort studies that evaluated the efficacy of propylthiouracil and its effects on pregnancy outcomes. Odds ratio (OR) and 95% confidence interval (CI) were used for binary variables, weighted mean difference (WMD) and 95% confidence interval (CI) were used for continuous variables. RevMan5.4 and Stata 16.0 were used for performing the meta-analysis.

RESULTS: The researchers examined data from 13 randomized controlled trials and cohort studies involving 18948 infants. Congenital anomalies were not significantly associated with PTU in the pooled results (OR = 1.03, 95%CI: 0.84-1.25, P = 0.80, I2 = 40.3%). There were no statistically significant differences in neonatal hypothyroidism (OR = 0.55, 95%CI: 0.06-4.92, P = 0.593, I2 = 57.0%) or hepatotoxicity (OR = 0.34, 95%CI: 0.08-1.48, P = 0.151, I2 = 0.0%) exposed to PTU compared to the control group. The serum levels of FT3, FT4, TT3, and TT4 were significantly lower in the propylthiouracil group compared to the control group.

CONCLUSION: This meta-analysis confirmed the beneficial effects of propylthiouracil treatment, namely the risks of adverse pregnancy outcomes were not increased, and it also proved PTU’s efficacy in the treatment of pregnant women with hyperthyroidism. The findings supported the use of propylthiouracil during pregnancy with hyperthyroidism in order to improve clinical pregnancy outcomes in patients with thyroid dysfunction.

PMID:35271661 | DOI:10.1371/journal.pone.0265085

PLoS One. 2022 Mar 10;17(3):e0264956. doi: 10.1371/journal.pone.0264956. eCollection 2022.

ABSTRACT

BACKGROUND: COVID-19 has inundated the entire world disrupting the lives of millions of people. The pandemic has stressed the healthcare system of India impacting the psychological status and functioning of health care workers. The aim of this study is to determine the burnout levels and factors associated with the risk of psychological distress among healthcare workers (HCW) engaged in the management of COVID 19 in India.

METHODS: A cross-sectional study was conducted from 1 September 2020 to 30 November 2020 by telephonic interviews using a web-based Google form. Health facilities and community centres from 12 cities located in 10 states were selected for data collection. Data on socio-demographic and occupation-related variables like age, sex, type of family, income, type of occupation, hours of work and income were obtained was obtained from 967 participants, including doctors, nurses, ambulance drivers, emergency response teams, lab personnel, and others directly involved in COVID 19 patient care. Levels of psychological distress was assessed by the General health Questionnaire -GHQ-5 and levels of burnout was assessed using the ICMR-NIOH Burnout questionnaire. Multivariable logistic regression analysis was performed to identify factors associated with the risk of psychological distress. The third quartile values of the three subscales of burnout viz EE, DP and PA were used to identify burnout profiles of the healthcare workers.

RESULTS: Overall, 52.9% of the participants had the risk of psychological distress that needed further evaluation. Risk of psychological distress was significantly associated with longer hours of work (≥ 8 hours a day) (AOR = 2.38, 95% CI(1.66-3.41), income≥20000(AOR = 1.74, 95% CI, (1.16-2.6); screening of COVID-19 patients (AOR = 1.63 95% CI (1.09-2.46), contact tracing (AOR = 2.05, 95% CI (1.1-3.81), High Emotional exhaustion score (EE ≥16) (AOR = 4.41 95% CI (3.14-6.28) and High Depersonalisation score (DP≥7) (AOR = 1.79, 95% CI (1.28-2.51)). About 4.7% of the HCWs were overextended (EE>18); 6.5% were disengaged (DP>8) and 9.7% HCWs were showing signs of burnout (high on all three dimensions).

CONCLUSION: The study has identified key factors that could have been likely triggers for psychological distress among healthcare workers who were engaged in management of COVID cases in India. The study also demonstrates the use of GHQ-5 and ICMR-NIOH Burnout questionnaire as important tools to identify persons at risk of psychological distress and occurrence of burnout symptoms respectively. The findings provide useful guide to planning interventions to mitigate mental health problems among HCW in future epidemic/pandemic scenarios in the country.

PMID:35271652 | DOI:10.1371/journal.pone.0264956

PLoS One. 2022 Mar 10;17(3):e0264811. doi: 10.1371/journal.pone.0264811. eCollection 2022.

ABSTRACT

BACKGROUND: This study investigated the associations between socio-economic deprivation and tuberculosis (TB) treatment outcomes, alongside well-known TB risk factors. The effects of healthcare expenditures and their growth on trends in TB incidence from 2009 to 2013 were also assessed.

METHODS: Secondary data analysis was performed on data obtained from various sources including governmental, non-governmental and research institutions. Indicators for TB treatment outcomes included TB death rate, TB rate among the household contacts of the Index TB cases, TB treatment failure, HIV associated TB death rate, TB defaulter rate, and new TB smear positive cases. Analysis of variance (ANOVA) and Turkey’s tests for post-hoc analysis were used to compare means of variables of interest considering a type I error rate of 0.05. Regression models and canonical discriminant analysis (CDA) were used to explore the associations between trends in TB incidence and independent TB predictors. During CDA, Fischer’s linear functions, Eigen values, and Mahalanobis distances were determined with values of Wilk’s Lambda closer to zero being the evidence for well discriminated patient groups. Data analysis was performed using SPSS® statistical software version 23.0 (Chicago, IL).

RESULTS: In total, 62 400 records of TB notification were analyzed for the period 2009-2013. The average TB incidence rate over a 5-year period was 298 cases per 100,000 inhabitants per year. The incidence of TB was reduced by 79.70% at the end of the evaluation as compared to the baseline data in 2009. Multiple linear regression analysis showed that the Expenditure per patient day equivalent (PDE) and PHC expenditure per capita were significantly and independently associated with the decline of TB incidence (adjusted R2 = 60%; ρ = 0.002) following the equation: Y = (- 209× Expenditure per PDE) + (- 0.191 × PHC expenditure per capita). CDA showed that in the most socio-economically deprived communities (quintile 1), HIV associated TB death rates were significantly more likely to be higher as compared to the least socio-economically deprived group (quintile 5) [Eigen value (12.95), function coefficient (1.49) > (.77); Wilk’s Lambda = .019, p < .0001].

CONCLUSIONS: Although TB control programs in OR Tambo district have averted thousands of TB incident cases, their effects on HIV associated TB deaths among the most deprived communities remain insignificant. There is an urgent need for strengthening integration of TB/HIV services in most deprived settings.

PMID:35271649 | DOI:10.1371/journal.pone.0264811

PLoS One. 2022 Mar 10;17(3):e0264970. doi: 10.1371/journal.pone.0264970. eCollection 2022.

ABSTRACT

OBJECTIVE: This study was conducted to examine the relationship between fear of COVID-19, psychological well-being, and satisfaction with life in nursing students.

METHODS: A descriptive and cross-sectional design was used in this study. The study was carried out at a university Faculty of Health Sciences Department of Nursing between May 17 and June 25, 2021. The JASP 0.14.1. Software was used for statistical analysis. Kruskal-Wallis test was used for the comparison of three or more groups, Mann-Whitney U test was used for the comparisons of two groups, and Bonferroni-corrected Mann-Whitney U test was used for post hoc analysis. To determine the risk factors for “The Fear of COVID-19 Scale,” linear regression analysis with backward stepwise modeling was used.

RESULTS: The mean score of the students was 18.48±6.87 from the Fear of COVID-19 Scale, 38.42±12.60 from the Psychological Well-Being Scale, and 13.12±4.97 from the Satisfaction with Life Scale. According to the results of the regression model established, independent variables explained 12.5% of the dependent variables, but the regression model established was found to be statistically significant. A one-unit increase in the satisfaction with life scale increased the fear of COVID-19 scale score by 0.224 units, and this increase was found statistically significant (p = 0.030) as a result of linear regression analysis used with backward stepwise modeling.

CONCLUSION: In conclusion, it was found that the students’ fear of COVID-19 was below the medium level, their psychological well-being was above the medium level, and that their life satisfaction was below the medium level.

PMID:35271645 | DOI:10.1371/journal.pone.0264970

PLoS One. 2022 Mar 10;17(3):e0264825. doi: 10.1371/journal.pone.0264825. eCollection 2022.

ABSTRACT

Poly(lactic-co-glycolic acid) is one of the most used polymers for drug delivery systems (DDSs). It shows excellent biocompatibility, biodegradability, and allows spatio-temporal control of the release of a drug by altering its chemistry. In spite of this, few formulations have reached the market. To characterize and optimize the drug release process, mathematical models offer a good alternative as they allow interpreting and predicting experimental findings, saving time and money. However, there is no general model that describes all types of drug release of polymeric DDSs. This study aims to perform a statistical comparison of several mathematical models commonly used in order to find which of them best describes the drug release profile from PLGA particles synthesized by nanoprecipitation method. For this purpose, 40 datasets extracted from scientific articles published since 2016 were collected. Each set was fitted by the models: order zero to fifth order polynomials, Korsmeyer-Peppas, Weibull and Hyperbolic Tangent Function. Some data sets had few observations that do not allow to apply statistic test, thus bootstrap resampling technique was performed. Statistic evidence showed that Hyperbolic Tangent Function model is the one that best fit most of the data.

PMID:35271644 | DOI:10.1371/journal.pone.0264825

PLoS One. 2022 Mar 10;17(3):e0264984. doi: 10.1371/journal.pone.0264984. eCollection 2022.

ABSTRACT

More than 700,000 people lose their lives to suicide each year and evidence suggests that the current COVID-19 pandemic is leading to increases in risk factors for suicide and suicide-related behaviour, in particular among young people. It is widely documented that some sectors of the population are over-represented in the suicide statistics. It is also well established that the pathways that lead someone to a suicidal crisis are complex and differ across regions and sectors of the population; as such a multi-faceted approach to prevention is required. Many of us would also argue that novel approaches, that combine broad population-based strategies with individual interventions, and approaches that capitalise on new technologies and methodologies are also required. For these reasons, when bringing together this collection, we deliberately sought studies that focused upon those groups who are over-represented in the suicide statistics yet under-represented in research. We also called for studies that reported on novel approaches to suicide prevention and for studies that reflected the voices of people with lived experience of suicide, also often unheard in research efforts.

PMID:35271638 | DOI:10.1371/journal.pone.0264984