Nevin Manimala

PLoS One. 2021 Aug 31;16(8):e0256607. doi: 10.1371/journal.pone.0256607. eCollection 2021.

ABSTRACT

Animal cognition research aims to understand animal minds by using a diverse range of methods across an equally diverse range of species. Throughout its history, the field has sought to mitigate various biases that occur when studying animal minds, from experimenter effects to anthropomorphism. Recently, there has also been a focus on how common scientific practices might affect the reliability and validity of published research. Usually, these issues are discussed in the literature by a small group of scholars with a specific interest in the topics. This study aimed to survey a wider range of animal cognition researchers to ask about their attitudes towards classic and contemporary issues facing the field. Two-hundred and ten active animal cognition researchers completed our survey, and provided answers on questions relating to bias, replicability, statistics, publication, and belief in animal cognition. Collectively, researchers were wary of bias in the research field, but less so in their own work. Over 70% of researchers endorsed Morgan’s canon as a useful principle but many caveated this in their free-text responses. Researchers self-reported that most of their studies had been published, however they often reported that studies went unpublished because they had negative or inconclusive results, or results that questioned “preferred” theories. Researchers rarely reported having performed questionable research practices themselves-however they thought that other researchers sometimes (52.7% of responses) or often (27.9% of responses) perform them. Researchers near unanimously agreed that replication studies are important but too infrequently performed in animal cognition research, 73.0% of respondents suggested areas of animal cognition research could experience a ‘replication crisis’ if replication studies were performed. Consistently, participants’ free-text responses provided a nuanced picture of the challenges animal cognition research faces, which are available as part of an open dataset. However, many researchers appeared concerned with how to interpret negative results, publication bias, theoretical bias and reliability in areas of animal cognition research. Collectively, these data provide a candid overview of barriers to progress in animal cognition and can inform debates on how individual researchers, as well as organizations and journals, can facilitate robust scientific research in animal cognition.

PMID:34464406 | DOI:10.1371/journal.pone.0256607

PLoS One. 2021 Aug 31;16(8):e0256729. doi: 10.1371/journal.pone.0256729. eCollection 2021.

ABSTRACT

This paper aims to demonstrate the importance of studying interactions among various sociodemographic risk factors of childhood stunting in Bangladesh with the help of an interpretable machine learning method. Data used for the analyses are extracted from the Bangladesh Demographic and Health Survey (BDHS) 2014 and pertain to a sample of 6,170 under-5 children. Social and economic determinants such as wealth, mother’s decision making on healthcare, parental education are considered in addition to geographic divisions and common demographic characteristics of children including age, sex and birth order. A classification tree was first constructed to identify important interaction-based rules that characterize children with different profiles of risk for stunting. Then binary logistic regression models were fitted to measure the importance of these interactions along with the individual risk factors. Results revealed that, as individual factors, living in Sylhet division (OR: 1.57; CI: 1.26-1.96), being an urban resident (OR: 1.28; CI: 1.03-1.96) and having working mothers (OR: 1.21; CI: 1.02-1.44) were associated with higher likelihoods of childhood stunting, whereas belonging to the richest households (OR: 0.56; CI: 0.35-0.90), higher BMI of mothers (OR: 0.68 CI: 0.56-0.84) and mothers’ involvement in decision making about children’s healthcare with father (OR: 0.83, CI: 0.71-0.97) were linked to lower likelihoods of stunting. Importantly however, risk classifications defined by the interplay of multiple sociodemographic factors showed more extreme odds ratios (OR) of stunting than single factor ORs. For example, children aged 14 months or above who belong to poor wealth class, have lowly educated fathers and reside in either Dhaka, Barisal, Chittagong or Sylhet division are the most vulnerable to stunting (OR: 2.52, CI: 1.85-3.44). The findings endorse the need for tailored-intervention programs for children based on their distinct risk profiles and sociodemographic characteristics.

PMID:34464402 | DOI:10.1371/journal.pone.0256729

PLoS One. 2021 Aug 31;16(8):e0256064. doi: 10.1371/journal.pone.0256064. eCollection 2021.

ABSTRACT

Risk factor studies on male-perpetrated intimate partner homicide (IPH) are often compared with studies on intimate partner violence (IPV) or non-partner homicide perpetrators. This not only excludes female perpetrators, but also fails to take socio-demographic and psychosocial differences between perpetrators and the general population into consideration. The aim of this study was to examine male- and female-perpetrated IPH cases, and to compare socio-demographic factors in IPH perpetrators and in matched controls from the general population. Data were retrieved from preliminary inquiries, court records and national registers for 48 men and 10 women, who were perpetrators of IPH committed in 2000-2016 and residing in Region Västra Götaland, Sweden. The control group consisted of 480 men and 100 women matched for age, sex and residence parish. Logistic regression, yielding odds ratios (OR) with 95% confidence intervals (CI), was performed for male perpetrators and male controls to investigate associations for selected socio-demographic and psychosocial characteristics. This was not performed for females due to the small sample size. Female perpetrators were convicted of murder to a lesser extent than male perpetrators. No woman was sentenced to life imprisonment while five men were. Jealousy and separation were the most common motivational factors for male perpetration while the predominant factor for female perpetrators was subjection to IPV. Statistically significant differences were found between male perpetrators and male controls in unemployment rate (n = 47.9%/20.6%; OR 4.4; 95% CI 2.2-8.6), receiving benefits (n = 20.8%/4.8%; OR 5.2; 95% CI 2.3-11.7) and annual disposable income (n = 43.8%/23.3% low income; OR 5.2; 95% CI 1.9-14.2) one year prior to the crime. Female IPH perpetrators were less educated than female controls (≤ 9-year education 30%/12%) and were more often unemployed (70%/23%) one year before the crime. Male and female IPH perpetrators were socio-economically disadvantaged, compared with controls from the general population.

PMID:34464394 | DOI:10.1371/journal.pone.0256064

PLoS Comput Biol. 2021 Aug 31;17(8):e1009250. doi: 10.1371/journal.pcbi.1009250. Online ahead of print.

ABSTRACT

Effective and powerful survival mediation models are currently lacking. To partly fill such knowledge gap, we particularly focus on the mediation analysis that includes multiple DNA methylations acting as exposures, one gene expression as the mediator and one survival time as the outcome. We proposed IUSMMT (intersection-union survival mixture-adjusted mediation test) to effectively examine the existence of mediation effect by fitting an empirical three-component mixture null distribution. With extensive simulation studies, we demonstrated the advantage of IUSMMT over existing methods. We applied IUSMMT to ten TCGA cancers and identified multiple genes that exhibited mediating effects. We further revealed that most of the identified regions, in which genes behaved as active mediators, were cancer type-specific and exhibited a full mediation from DNA methylation CpG sites to the survival risk of various types of cancers. Overall, IUSMMT represents an effective and powerful alternative for survival mediation analysis; our results also provide new insights into the functional role of DNA methylation and gene expression in cancer progression/prognosis and demonstrate potential therapeutic targets for future clinical practice.

PMID:34464378 | DOI:10.1371/journal.pcbi.1009250

Pol Merkur Lekarski. 2021 Aug 16;49(292):255-265.

ABSTRACT

The original antiviral drug Proteflazid® has been used in clinical practice since the early 2000s for the etiotropic treatment of acute respiratory viral diseases, due to its property of blocking viral RNA and DNA polymerases. Considering that at the beginning of the global COVID- 19 pandemic, caused by RNA-containing virus of SARS-CoV-2 species in 2020, the ability of the drug active substance to inhibit the activity of 3CL- protease of the SARS-CoV-2 coronavirus was shown by molecular docking and, subsequently, to confirm the property of the active substance to block the reproduction of the SARS-CoV-2 virus in cell cultures in vitro. It was extremely important to test the effectiveness of the drug Proteflazid, drops for the prevention and treatment of COVID-19 disease at “off labell use”.

AIM: The aim of the study was to provide a statistical assessment of the effectiveness of the drug Proteflazid®, drops in terms of COVID-19 pandemic.

MATERIALS AND METHODS: The analysis has been performed including the letters-references from medical institutions from different regions of Ukraine about the effectiveness of the drug Proteflazid®, drops. Methods of statistical analysis have been focused on dynamics and structure analysis, meta-analysis, generalization, etc.

RESULTS: 90 letters-references about the effectiveness of the drug Proteflazid®, drops, during the prevention and treatment of acute respiratory viral infections, including COVID-19 diseases were analyzed. The study used references that contained the most complete information. The number of deleted letters-references is 11. Lettersreferences from 79 medical institutions from different cities and regions of Ukraine were analyzed. The period of starting taking the drug by employees and patients of medical institutions began on February 27, 2020. Final information – October 01, 2020. The vast majority of letters from medical institutions indicated that medical staff were in contact with patients potentially suffering from COVID-19. This means a high risk of being infected with Coronavirus infection. Total number of patients who took Proteflazid® for preventive purpose was 8,572, including 7,444 medical workers and 1,128 ordinary patients. Indicator “Number of fatalities” for the medical institutions providing such information was “0”. Total number of patients who took Proteflazid® for therapeutic purposes was 433, including 23 medical workers and 410 ordinary patients. Indicator “Number of fatalities” for the medical institutions providing such information was “0”. The total number of medical personnel and patients who used Proteflazid drops for preventive and therapeutic purposes was 9005 people.

CONCLUSIONS: The statistical analysis confirmed the effectiveness of the drug Proteflazid® for the prevention and treatment of COVID-19, as, when compared with official actual data, regarding the main indicators of the incidence of COVID-19: there were no fatalities; the average treatment period decreased (1.8 times); the proportion of recovered increased (at least 1.5 times); the proportion of sick medical workers in the total population of sick medical workers decreased (2.2 times); the proportion of patients with a severe course decreased (3.3 times). It can be argued that the drug Proteflazid®, drops has shown high effectiveness in the prevention and treatment of acute respiratory viral infections, including COVID-19, among medical personnel and patients.

PMID:34464364

Am J Speech Lang Pathol. 2021 Aug 31:1-11. doi: 10.1044/2021_AJSLP-21-00026. Online ahead of print.

ABSTRACT

Purpose A large knowledge gap related to dysphagia treatment adherence was identified by a recent systematic review: Few existing studies report on adherence, and current adherence tracking relies heavily on patient self-report. This study aimed to report weekly adherence and dysphagia-specific quality of life following home-based swallowing therapy in head and neck cancer (HNC). Method This was a quasi-experimental pretest-posttest design. Patients who were at least 3 months post-HNC treatment were enrolled in swallowing therapy using a mobile health (mHealth) swallowing system equipped with surface electromyography (sEMG) biofeedback. Participants completed a home dysphagia exercise program across 6 weeks, with a target of 72 swallows per day split between three different exercise types. Adherence was calculated as percent trials completed of trials prescribed. The M. D. Anderson Dysphagia Inventory (MDADI) was administered before and after therapy. Results Twenty participants (75% male), with an average age of 61.9 years (SD = 8.5), completed the study. The majority had surgery ± adjuvant (chemo)radiation therapy for oral (10%), oropharyngeal (80%), or other (10%) cancers. Using an intention-to-treat analysis, adherence to the exercise regimen remained high from 84% in Week 1 to 72% in Week 6. Radiation therapy, time since cancer treatment, medical difficulties, and technical difficulties were all found to be predictive of poorer adherence at Week 6. A statistically significant improvement was found for composite, emotional, and physical MDADI subscales. Conclusions When using an mHealth system with sEMG biofeedback, adherence rates to home-based swallowing exercise remained at or above 72% over a 6-week treatment period. Dysphagia-specific quality of life improved following this 6-week treatment program.

PMID:34463544 | DOI:10.1044/2021_AJSLP-21-00026

Inquiry. 2021 Jan-Dec;58:469580211036283. doi: 10.1177/00469580211036283.

ABSTRACT

PURPOSE: The study aimed to determine the impact of pharmacist-led interventions on diabetes management at a community pharmacy in Pakistan.

METHODS: A one-month follow-up, randomized controlled trial (RCT) was carried out between December 1, 2016 and June 30, 2017. Sampling population consisted of patients diagnosed with type 2 diabetes mellitus (T2DM). The study population was randomized to a control group or an intervention group to determine the impact of a community pharmacist intervention on glycemic control fasting blood glucose (FBG) and random blood glucose (RBG), medication adherence (MMAS), and health-related quality of life (HRQoL) (EQ-5D-3L). Both non-pharmacological and pharmacological interventional tools were used that consist of array of charts and verbal communication by pharmacist. Outcomes for continuous variables were analyzed using paired sample t-test for time effect and one sample t-test to evaluate the study group effect. Independent sample t-test was used to compare each independent variable with dependent variable. A P-value of <.05 was considered statistically significant.

RESULTS: The control and intervention groups showed significant improvement (P-value < .05) in glycemic control, medication adherence, and HRQoL. However, the difference between the control and intervention groups was not statistically significant in terms of blood glucose levels and HRQoL (time trade off, TTO). There was a clinically significant association between pharmacist intervention and predefined glycemic control among the study participants (FBG: P-value < .001 and RBG: P-value = .04). A clinically significant association was also found between pharmacist intervention and medication adherence at the end of the trial compared with baseline values (P-value < .001). Similarly, a clinically significant association was found between pharmacist intervention and predefined HRQoL [TTO: P-value = .002 and EQ-VAS: P-value = .001].

CONCLUSION: A significant proportion of T2DM patients in the intervention group achieved predefined glycemic control, medication adherence, and health related quality of life.

PMID:34463538 | DOI:10.1177/00469580211036283

J Speech Lang Hear Res. 2021 Aug 31:1-10. doi: 10.1044/2021_JSLHR-21-00082. Online ahead of print.

ABSTRACT

Purpose The aim of this study was to use the Daily Phonotrauma Index (DPI) to quantify group-based changes in the daily voice use of patients with phonotraumatic vocal hyperfunction (PVH) after receiving voice therapy as the sole treatment. This is part of an ongoing effort to validate an updated theoretical framework for PVH. Method A custom-designed ambulatory voice monitor was used to collect 1 week of pre- and posttreatment data from 52 female patients with PVH. Normative weeklong data were also obtained from 52 matched controls. Each week was represented by the DPI, which is a combination of neck-surface acceleration magnitude skewness and the standard deviation of the difference between the first and second harmonic magnitudes. Results Compared to pretreatment, the DPI statistically decreased towards normal in the patient group after treatment (Cohen’s d = -0.25). The posttreatment patient group’s DPI was still significantly higher than the control group (d = 0.68). Conclusions The DPI showed the pattern of improved ambulatory voice use in a group of patients with PVH following voice therapy that was predicted by the updated theoretical framework. Per the prediction, voice therapy was associated with a decreased potential for phonotrauma in daily voice use, but the posttreatment patient group data were still significantly different from the normative control group data. This posttreatment difference is interpreted as reflecting the impact on voice use of the persistence of phonotrauma-induced structural changes to the vocal folds. Further validation of the DPI is needed to better understand its potential clinical use.

PMID:34463536 | DOI:10.1044/2021_JSLHR-21-00082

Am J Speech Lang Pathol. 2021 Aug 31:1-17. doi: 10.1044/2021_AJSLP-20-00382. Online ahead of print.

ABSTRACT

Purpose Variation within languages, including dialects, takes on an indexical function, marking belonging and connection. Meanwhile, attitudes toward these speech varieties become marked by linguistic bias. Within the speech-language pathology profession, research evidence, assessment tools, and intervention programs have largely been designed for and by the White, English-speaking middle class. As such, linguistic bias with a preference for standardized dialects is prevalent in the training and practice of the speech-language pathology profession, resulting in discriminatory and racialized practices. Method To investigate the influence of linguistic bias upon speech-language pathologists’ (SLPs’) clinical decision making, data were collected from 129 Australian SLPs via an online survey. Inferential statistics were used to investigate the relationship between clinical decision making and SLPs’ attitudes toward nonstandard dialects as well as personal and professional factors. A content analysis of extended responses was conducted to identify themes in clinical decision making. Results SLPs with more years of experience and those who had received professional development were significantly more likely to seek out more information before making a diagnosis, while those with more negative attitudes toward linguistic diversity were significantly more likely to identify a disorder than a difference. SLPs provided a range of justifications for their clinical decision making, but few acknowledged the influence of their own attitudes and bias upon their decision making. Conclusions SLPs’ linguistic bias towards speakers of nonstandard dialects has the potential to impact upon their clinical judgment of difference versus disorder and lead to inequality of service provision for speakers who do not express themselves in standardized forms. Before the profession can truly move toward an antiracist approach of equitable service provision for all, SLPs must engage in critical self-reflection to disrupt the adherence of the speech-language pathology profession to standardized “White” norms of communication.

PMID:34463535 | DOI:10.1044/2021_AJSLP-20-00382

ACR Open Rheumatol. 2021 Aug 31. doi: 10.1002/acr2.11338. Online ahead of print.

ABSTRACT

OBJECTIVE: Voclosporin, a novel calcineurin inhibitor approved for the treatment of adults with lupus nephritis (LN), improved complete renal response rates in patients with LN in a phase 2 trial. This study aimed to evaluate the efficacy and safety of voclosporin for the treatment of LN.

METHODS: This multicenter, double-blind, randomized phase 3 trial was done in 142 hospitals and clinics across 27 countries. Patients with a diagnosis of systemic lupus erythematosus and LN, according to the American College of Rheumatology criteria, who had undergone a kidney biopsy within 2 years that showed class III, IV, or V (alone or in combination with class III or IV) were eligible for this study. Patients were randomly assigned (1:1) to receive oral voclosporin (23.7 mg twice daily) or a placebo, on a background of mycophenolate mofetil (1 g twice daily) and rapidly tapered low-dose oral steroids, by use of an interactive web response system. The primary endpoint was complete renal response at 52 weeks, defined as a composite of urine protein creatinine ratio of 0.5 mg/mg or less, stable renal function (defined as estimated glomerular filtration rate [eGFR] ≥60 ml/min/1.73m² or no confirmed decrease from baseline in eGFR of > 20%), no administration of rescue medication, and no more than 10 mg prednisone equivalent per day for 3 or more consecutive days or 7 or more days during Week 44 through Week 52 (just before the primary endpoint assessment). Safety was also assessed. Efficacy analysis was by intention to treat, and safety analysis was by randomized patients receiving at least one dose of study treatment.

RESULTS: Between April 13, 2017, and October 10, 2019, 179 patients were assigned to the voclosporin group and 178 were assigned to the placebo group. The primary endpoint of complete renal response at Week 52 was achieved in significantly more patients in the voclosporin group than in the placebo group (73 [41%] of 179 patients vs 40 [23%] of 178 patients; odds ratio, 2.65; 95% confidence interval [CI] 1.64-4.27; P < 0·0001). The adverse event profile was balanced between the two groups; serious adverse events occurred in 37 (21%) of 178 patients in the voclosporin group and 38 (21%) of 178 patients in the placebo group. The most frequent serious adverse event involving infection was pneumonia, occurring in seven (4%) patients in the voclosporin group and in eight (4%) patients in the placebo group. A total of six patients died during the study or study follow-up period (one [<1%] patient in the voclosporin group and five [3%] patients in the placebo group). None of the events leading to death were considered by the investigators to be related to the study treatments.

CONCLUSION: Voclosporin in combination with mycophenolate mofetil (MMF) and low-dose steroids led to a clinically and statistically superior complete renal response rate versus MMF and low-dose steroids alone, with a comparable safety profile. This finding is an important advancement in the treatment of patients with active LN.

PMID:34463434 | DOI:10.1002/acr2.11338