Nevin Manimala

PLoS One. 2021 Jul 22;16(7):e0254891. doi: 10.1371/journal.pone.0254891. eCollection 2021.

ABSTRACT

The geographical variation of maternal dietary patterns related to birth outcomes is important for improving the health of mothers and children; however, it is currently unknown. Thus, the objective of the study was to investigate geographical variations of maternal dietary pattern during pregnancy, and evaluate the spatial varying association of maternal dietary patterns in pregnancy with abnormal birth weight. A population-based cross-sectional study was conducted in Shaanxi province in Northwest China in 2013 to evaluate the relationship between abnormal birth weight and dietary pattern using the Geographically Weighted Logistic Regression (GWLR). Three dietary patterns during pregnancy were extracted through factor analysis, explaining approximately 45.8% of the variability of food intake. Approximately 81.6% of mothers with higher scores on the equilibrium pattern was more unlikely to have small for gestational age (SGA) infants, with the lower OR observed in Central and South Shaanxi. The snacks pattern was positively associated with low birth weight (LBW) for 23.2% of participants, with the highest OR in Central Shaanxi. Among about 80.0% of participants with higher scores on the snacks pattern living in South and Central Shaanxi, there was a higher risk for SGA. The OR values tend to descend from South to North Shaanxi. The OR values of the negative association between prudent pattern and LBW decreased from South to North Shaanxi among approximately 59.3% of participants. The prudent pattern was also negatively associated with the increasing risk of fetal macrosomia among 19.2% of participants living mainly in South Shaanxi. The association of maternal dietary patterns during pregnancy with abnormal birth weight varied geographically across Shaanxi province. The findings emphasize the importance of geographical distribution to improve the dietary patterns among disadvantaged pregnant women.

PMID:34293043 | DOI:10.1371/journal.pone.0254891

PLoS One. 2021 Jul 22;16(7):e0254890. doi: 10.1371/journal.pone.0254890. eCollection 2021.

ABSTRACT

BACKGROUND: Poor adherence to antiretroviral therapy in adolescents living with HIV is a global challenge. One of the key strategies to improve adherence is believed to be the use of digital adherence tools. However, evidence is limited in this area. Our objective was to investigate the effectiveness of mobile phone text message reminders in improving ART adherence for adolescents.

METHODS: The preferred reporting item for systematic review and meta-analysis guideline was followed. A literature search was done in five databases (PubMed, Web of Science, Embase, Global Health and Cochrane) in August 2020. Additional searches for studies and grey literature were performed manually. We included studies with quantitative design exploring the effectiveness of text message reminders, targeting adolescents aged 10-19 years. Studies were excluded if the intervention involved phone calls, phone-based applications, or other complex tech services. Mean differences between intervention and standard of care were computed using a random effects model. Subgroup analyses were performed to identify sources of heterogeneity between one-way and two-way text messages.

RESULTS: Of 2517 study titles screened, seven eligible studies were included in the systematic review. The total number of participants in the included studies was 987, and the study sample varied from 14 to 332. Five studies showed a positive impact of text messaging in improving adherence, while no significant difference was found between the intervention and the control (standard of care) group in the remaining two studies. The pooled mean difference between the intervention and the control group was 0.05 (95% CI: -0.08 to 0.17). There was considerable heterogeneity among the studies (I2 = 78%).

CONCLUSION AND RECOMMENDATION: The meta-analysis of text message reminder interventions did not show a statistically significant difference in the improvement of ART adherence among adolescents living with HIV. The included studies were heterogeneous in the reported clinical outcomes, where the effectiveness of the intervention was identified in small studies which had a short follow-up period. Studies with bigger sample size and a longer follow-up period are needed.

PMID:34293033 | DOI:10.1371/journal.pone.0254890

PLoS One. 2021 Jul 22;16(7):e0254928. doi: 10.1371/journal.pone.0254928. eCollection 2021.

ABSTRACT

Identifying the factors controlling the spatial variability of soil metal elements could be a challenge task due to the interaction of environmental attributes and human activities. This study aimed to investigate the critical explanatory variables controlling total Ca, Cd, Cr, Cu, Zn, Fe, Mn, Mg, Pb, and Zn variations in the arable topsoil using classical statistics, principal component analysis, and random forest techniques. The work was conducted in the core region of the Three Gorges Reservoir of China. The explanatory variables included soil, topography, climate, vegetation, land use type, and distance-related parameters. Average concentrations of the metal elements were in order of Fe > Mg > Ca > Mn > Zn > Cr > Ni > Pb > Cu > Cd. Soil Cr, Fe, and Pb showed low variability while others presented medium variability. Average concentrations of Cr, Fe, Cd, and Mg exceeded their corresponding background values. There were highly positive correlations between all metal elements except Pb, Cd and Cr. The principal component analysis further demonstrated that the sources of Pb, Cd, and Cr differed with other elements. The results of random forest suggested that soil properties followed by topography were critical parameters affecting the variations of Ca, Mg, Mn, Fe, Ni, Zn, and Cu. Agricultural activities and soil properties were major factors controlling the variations of Pb, Cr, and Cd. Further study should be conducted to understand the relations between the metal elements and soil properties.

PMID:34293020 | DOI:10.1371/journal.pone.0254928

PLoS One. 2021 Jul 22;16(7):e0254878. doi: 10.1371/journal.pone.0254878. eCollection 2021.

ABSTRACT

Musculoskeletal injuries, a public health priority also in the military context, are ascribed to several risk factors, including: increased reaction forces; low/reduced muscle strength, endurance, body mass, Vitamin D level, and bone density; inadequate lifestyles and environment. The MOVIDA Project-funded by the Italian Ministry of Defence-aims at developing a transportable toolkit (assessment instrumentation, assessment protocols and reference/risk thresholds) which integrates motor function assessment with biological, environmental and behavioural factors to help characterizing the risk of stress fracture, stress injury or muscle fatigue due to mechanical overload. The MOVIDA study has been designed following the STROBE guidelines for observational cross-sectional studies addressing healthy adults, both militaries and civilians, with varying levels of physical fitness (sedentary people, recreational athletes, and competitive athletes). The protocol of the study has been designed and validated and is hereby reported. It allows to collect and analyse anamnestic, diagnostic and lifestyle-related data, environmental parameters, and functional parameters measured through portable and wearable instrumentation during adapted 6 minutes walking test. The t-test, one and two-way ANOVA with post-hoc corrections, and ANCOVA tests will be used to investigate relevant differences among the groups with respect to biomechanical parameters; non-parametric statistics will be rather used for non-normal continuous variables and for quantitative discrete variables. Generalized linear models will be used to account for risk and confounding factors.

PMID:34293019 | DOI:10.1371/journal.pone.0254878

PLoS One. 2021 Jul 22;16(7):e0254752. doi: 10.1371/journal.pone.0254752. eCollection 2021.

ABSTRACT

The significant resource investment in research on ecosystems for development of the Global South does not necessarily result in high levels of research knowledge utilisation (RKU). Understanding the factors associated with various levels of RKU can inform funding agencies and researchers developing new projects. We applied a combination of a questionnaire survey and follow up interviews with members of research teams of multiple, broadly comparable projects to make an assessment of achieved RKU levels using a combination of quantitative statistical hypothesis testing and narrative description of survey responses. Research knowledge dissemination by members of the project team who work for non-academic institutions or champions, e.g. particularly motivated people that promote and facilitate implementation or adoption of the project results, and via television was associated with higher research knowledge utilization. By contrast, dissemination by members of the project team working for academic institutions and via peer-reviewed journals was associated with lower RKU. The achieved level of RKU was consistently lower than the targeted level of RKU across spatial scales. The discrepancy between the perceived level of RKU and the evidence provided by survey respondents indicates the need for better monitoring the utilisation of research knowledge in development pathways. Our results further suggest that three years project duration is too short to achieve high levels of RKU in socio-ecological systems. We recommend involvement of non-academic members of the project team in project design, leadership and dissemination for increasing RKU.

PMID:34293005 | DOI:10.1371/journal.pone.0254752

PLoS One. 2021 Jul 22;16(7):e0254896. doi: 10.1371/journal.pone.0254896. eCollection 2021.

ABSTRACT

IMPORTANCE: When caregivers cannot attend the clinic visit for the person they provide care for, patients are the predominant source of clinic visit information; however, poor patient recall inhibits the quality of information shared, resulting in poor caregiver preparedness and contributing to caregiver morbidity. Technological solutions exist to sharing clinic visit information, but their effectiveness is unclear.

OBJECTIVES: To assess if and how technology is being used to connect informal caregivers to patient clinic visit information when they cannot otherwise attend, and its impact on caregiver and patient outcomes.

EVIDENCE REVIEW: MEDLINE, Cochrane, Scopus, and CINAHL were searched through 5/3/2020 with no language restrictions or limits. ClinicalTrials.gov and other reference lists were included in the search. Randomized controlled trials (RCTs) and nonrandomized trials that involved using a technological medium e.g., video or the electronic health record, to communicate visit information to a non-attending caregiver were included. Data were collected and screened using a standardized data collection form. Cochrane’s Risk of Bias 2.0 and the Newcastle-Ottawa Scale were used for RCTs and nonrandomized trials, respectively. All data were abstracted by two independent reviewers, with disagreements resolved by a third reviewer.

FINDINGS: Of 2115 studies identified in the search, four met criteria for inclusion. Two studies were randomized controlled trials and two were nonrandomized trials. All four studies found positive effects of their intervention on caregiver outcomes of interest, and three out of four studies found statistically significant improvements in key outcomes for caregivers receiving visit information. Improved outcomes included caregiver happiness, caregiver activation, caregiver preparedness, and caregiver confidence in managing patient health.

CONCLUSIONS AND RELEVANCE: Our review suggests that using technology to give a caregiver access to clinical visit information could be beneficial to various caregiver outcomes. There is an urgent need to address the lack of research in this area.

PMID:34293002 | DOI:10.1371/journal.pone.0254896

PLoS One. 2021 Jul 22;16(7):e0254782. doi: 10.1371/journal.pone.0254782. eCollection 2021.

ABSTRACT

BACKGROUND: In Bangladesh, riverbank erosion is a major problem that regularly displaces millions of people and affects their mental health every year.

OBJECTIVES: The primary objective is to explore the effects of riverbank erosion on mental health problems such as depression, anxiety, and stress in Bangladesh.

METHODS: We conducted a household survey from August 2019 to November 2019 on randomly selected adult respondents from Rajbari District located along the Ganges River and Tangail District located along the Brahmaputra River. The respondents were divided into two groups: exposed and non-exposed to riverbank erosion. All participants were asked to complete self-reported questionnaires on the Depression, Anxiety and Stress Scale-21, and other socio-demographic, economic and riverbanks erosion-related factors. We performed Chi-squared test and multiple logistic regression analysis to explore the significant risk factors (P<0.05) of mental illness (depression, anxiety and stress).

RESULTS: We surveyed 611 households, of whom 410 were from Rajbari and 201 were from Tangail. Among 611 respondents, 509 (83.31%) were exposed by riverbank erosion whereas 102 (16.69%) were non-exposed. The prevalence of depression, anxiety and stress (DAS) was 38.30%, 76.60%, 32.41%, respectively, and they were significantly higher among the exposed group than the non-exposed group (depression: 45.19% versus 3.92%, P<0.001; anxiety: 82.71% versus 46.08%, P<0.001; stress: 38.11% versus 3.92%, P<0.001). The respondents exposed to river erosion were respectively 8.28, 2.26 and 5.09 times more likely to develop DAS disorder compared to their non-exposed counterparts (ORD = 8.28, 95% CI = 2.75-24.89; ORA = 2.26, 95% CI = 1.31-3.88; ORS = 5.09, 95% CI = 1.64-15.76). Females and those who lost their houses and displaced, were more likely to have DAS disorder compared to their respective counterparts.

CONCLUSIONS: The exposed people were more likely to experience mental health problem and demand some social safety net programs with special focus on female and those who lost houses and displaced.

PMID:34292997 | DOI:10.1371/journal.pone.0254782

PLoS One. 2021 Jul 22;16(7):e0254214. doi: 10.1371/journal.pone.0254214. eCollection 2021.

ABSTRACT

INTRODUCTION: Since 2017, Uganda has been implementing five differentiated antiretroviral therapy (ART) delivery models to improve the quality of HIV care and to achieve health-system efficiencies. Community-based models include Community Client-Led ART Delivery and Community Drug Distribution Points. Facility-based models include Fast Track Drug Refill, Facility Based Group and Facility Based Individual Management. We set out to assess the extent of uptake of these ART delivery models and to describe barriers to uptake of either facility-based or community-based models.

METHODS: Between December 2019 and February 2020, we conducted a mixed-methods study entailing a cross-sectional health facility survey (n = 116) and in-depth interviews (n = 16) with ART clinic managers in ten case-study facilities as well as six focus group discussions (56 participants) with patients enrolled in differentiated ART models. Facilities were selected based on the 10 geographic sub-regions of Uganda. Statistical analyses were performed in STATA (v13) while qualitative data were analysed by thematic approach.

RESULTS: Most facilities 63 (57%) commenced implementation of differentiated ART delivery in 2018. Fast Track Drug Delivery was the most common facility-based model (implemented in 100 or 86% of health facilities). Community Client-Led ART Delivery was the most popular community model (63/116 or 54%). Community Drug Distribution Points had the lowest uptake with only 33 (24.88%) facilities implementing them. By ownership-type, for-profit facilities reported the lowest uptake of differentiated ART models. Barriers to enrolment in community-based models include HIV-related stigma and low enrolment of adult males in community models.

CONCLUSION: To the best of our knowledge this is the first study reporting national coverage of differentiated ART delivery models in Uganda. Overall, there has been a higher uptake of facility-based models. Interventions for enhancing the uptake of differentiated ART models in for-profit facilities are recommended.

PMID:34292984 | DOI:10.1371/journal.pone.0254214

Autism Res. 2021 Jul 22. doi: 10.1002/aur.2582. Online ahead of print.

ABSTRACT

Several studies demonstrated biological effects of cortisol, brain-derived neurotrophic factor (BDNF) and tissue plasminogen activator (tPA) on human metabolism and central nervous system. Our study investigated the serum levels of tPA along with BDNF and cortisol in children with autism spectrum disorder (ASD). Thirty three male children with ASD ranging in age from 2 to 15 years were selected for the study group and 27 age-matched healthy male children were selected for the control group. The ASD severity was determined by the score on the Autism Behavior Checklist (ABC). The mean cortisol levels for the study group and the control group were 79.1 ± 30.2 ng/ml and 60.0 ± 25.1 ng/ml, respectively. The mean BDNF levels for the study group and the control group were 5.9 ± 2.8 ng/ml and 3.7 ± 1.8 ng/ml, respectively. The mean tPA levels for the study group and the control group were 32.9 ± 18.5 ng/ml and 25.5 ± 15.1 ng/ml, respectively. Cortisol, BDNF and tPA levels were significantly higher in the study group compared to the control group (p < 0.001). There was no statistically significant effect in terms of age, ABC total and subscale scores on serum cortisol, BDNF and tPA levels in the study group (p > 0.05). It may be suggested that elevations may indicate a role in the pathogenesis of ASD or it may be the case that ASD may alter the levels or pathways of these metabolic factors. LAY SUMMARY: The underlying mechanism or a specific metabolic target relevant to autism spectrum disorder (ASD) has not yet been identified. Cortisol, brain-derived neurotrophic factor (BDNF) and tissue plasminogen activator (tPA) have biological effects on neuroplasticity but little is known about the role of cortisol and tPA-BDNF pathway in ASD. In the present study focused on male children with ASD, we have found higher blood levels of cortisol, BDNF and tPA than their healthy peers. This is the first clinical study to evaluate the serum tPA levels along with BDNF and cortisol in ASD. The results suggest that several neurotrophic and other related markers should be born in mind while examining children with ASD.

PMID:34291889 | DOI:10.1002/aur.2582

Vet Med Sci. 2021 Jul 22. doi: 10.1002/vms3.585. Online ahead of print.

ABSTRACT

The consideration of the descendance is indispensable in the preservation of endangered animal breeds. The authors compared mitochondrial DNA (mtDNA) control region sequence in three descendant breeds of the extinct Zaupel sheep, firstly. Their investigation was carried out in order to prove the common origin of Waldschaf (Austria), Bovec sheep (Slovenia) and Cikta (Hungary). A total of 118 biological samples were taken from non-related representatives of the three breeds between 2015 and 2017. A newly designed primer pair was also used to amplify the segment (1180 bp) to be tested. The total number of haplotypes in the whole study population was 49. The majority of which fell into haplogroup B. The significant negative value of the Fu’s Fs statistic (Fs statistic = -3.296, p = 0.013) based on haplotype frequencies demonstrated a moderate foreign gene flow. As a novel observation haplogroups C and D appeared in Cikta and Bovec sheep, respectively. The Tajima D-test value in the entire study population was -0.914 (p > 0.10), meaning that the separation of the three descendant breeds did not cause genetic drift, these are collectively in genetic equilibrium. The genetic information confirmed the common origin of the breeds known from the breed history.

PMID:34291885 | DOI:10.1002/vms3.585