Nevin Manimala

PLoS One. 2021 May 6;16(5):e0251130. doi: 10.1371/journal.pone.0251130. eCollection 2021.

ABSTRACT

Polar bears are of international conservation concern due to climate change but are difficult to study because of low densities and an expansive, circumpolar distribution. In a collaborative U.S.-Russian effort in spring of 2016, we used aerial surveys to detect and estimate the abundance of polar bears on sea ice in the Chukchi Sea. Our surveys used a combination of thermal imagery, digital photography, and human observations. Using spatio-temporal statistical models that related bear and track densities to physiographic and biological covariates (e.g., sea ice extent, resource selection functions derived from satellite tags), we predicted abundance and spatial distribution throughout our study area. Estimates of 2016 abundance ([Formula: see text]) ranged from 3,435 (95% CI: 2,300-5,131) to 5,444 (95% CI: 3,636-8,152) depending on the proportion of bears assumed to be missed on the transect line during Russian surveys (g(0)). Our point estimates are larger than, but of similar magnitude to, a recent estimate for the period 2008-2016 ([Formula: see text]; 95% CI 1,522-5,944) derived from an integrated population model applied to a slightly smaller area. Although a number of factors (e.g., equipment issues, differing platforms, low sample sizes, size of the study area relative to sampling effort) required us to make a number of assumptions to generate estimates, it establishes a useful lower bound for abundance, and suggests high spring polar bear densities on sea ice in Russian waters south of Wrangell Island. With future improvements, we suggest that springtime aerial surveys may represent a plausible avenue for studying abundance and distribution of polar bears and their prey over large, remote areas.

PMID:33956835 | DOI:10.1371/journal.pone.0251130

PLoS One. 2021 May 6;16(5):e0250692. doi: 10.1371/journal.pone.0250692. eCollection 2021.

ABSTRACT

BACKGROUND: Although abortion is a common gynecological procedure around the globe, we lack synthesis of the known macroeconomic costs and outcomes of abortion care and abortion policies. This scoping review synthesizes the literature on the impact of abortion-related care and abortion policies on economic outcomes at the macroeconomic level (that is, for societies and nation states).

METHODS AND FINDINGS: Searches were conducted in eight electronic databases. We conducted the searches and application of inclusion/exclusion criteria using the PRISMA extension for Scoping Reviews. For inclusion, studies must have examined one of the following macroeconomic outcomes: costs, impacts, benefits, and/or value of abortion care or abortion policies. Quantitative and qualitative data were extracted for descriptive statistics and thematic analysis. Of the 189 data extractions with macroeconomic evidence, costs at the national level are the most frequently reported economic outcome (n = 97), followed by impacts (n = 66), and benefits/value (n = 26). Findings show that post-abortion care services can constitute a substantial portion of national expenditures on health. Public sector coverage of abortion costs is sparse, and individuals bear most of the costs. Evidence also indicates that liberalizing abortion laws can have positive spillover effects for women’s educational attainment and labor supply, and that access to abortion services contributes to improvements in children’s human capital. However, the political economy around abortion legislation remains complicated and controversial.

CONCLUSIONS: Given the highly charged political nature of abortion around the global and the preponderance of rhetoric that can cloud reality in policy dialogues, it is imperative that social science researchers build the evidence base on the macroeconomic outcomes of abortion services and regulations.

PMID:33956826 | DOI:10.1371/journal.pone.0250692

PLoS One. 2021 May 6;16(5):e0251026. doi: 10.1371/journal.pone.0251026. eCollection 2021.

ABSTRACT

BACKGROUND: Major depression is a common comorbidity in cancer patients. Oncology clinics lack practical, objective tools for simultaneous evaluation of cancer and major depression. Fludeoxyglucose F-18 positron emission tomography-computed tomography (FDG PET/CT) is universally applied in modern medicine.

METHODS: We used a retrospective analysis of whole-body FDG PET/CT images to identify brain regional metabolic patterns of major depression in multiple myeloma patients. The study included 134 multiple myeloma (MM) patients, 38 with major depression (group 1) and 96 without major depression (group 2).

RESULTS: In the current study, Statistic Parameter Mapping (SPM) demonstrated that the major depression patient group (n = 38) had significant regional metabolic differences (clusters of continuous voxels) as compared to the non-major depression group (n = 96) with the criteria of height threshold T = 4.38 and extent threshold > 100 voxels. The five significant hypo- and three hyper-metabolic clusters from the computed T contrast maps were localized on the glass-brain view, consistent with published brain metabolic changes in major depression patients. Subsequently, using these clusters as features for classification learner, the fine tree and medium tree algorithms from 25 classification algorithms best fitted our data (accuracy 0.85%; AUC 0.88; sensitivity 79%; and specificity 88%).

CONCLUSION: This study demonstrated that whole-body FDG PET/CT scans could provide added value for screening for major depression in cancer patients in addition to staging and evaluating response to chemoradiation therapies.

PMID:33956824 | DOI:10.1371/journal.pone.0251026

PLoS One. 2021 May 6;16(5):e0250804. doi: 10.1371/journal.pone.0250804. eCollection 2021.

ABSTRACT

BACKGROUND: Drug resistance tuberculosis (DR-TB) patients’ mortality and loss to follow-up (LTF) from treatment and care is a growing worry in Ethiopia. However, little is known about predictors of mortality and LTF among drug-resistant tuberculosis patients in Oromia region, Ethiopia. The current study aimed to identify predictors of mortality and loss to follow-up among drug resistance tuberculosis patients in Oromia Hospitals, Ethiopia.

METHODS: A retrospective follow up study was carried out from 01 November 2012 to 31 December 2017 among DR-TB patients after calculating sample size using single proportion population formula. Mean, median, Frequency tables and bar charts were used to describe patients’ characteristics in the cohort. The Kaplan-Meier curve was used to estimate the probability of death and LTF after the treatment was initiated. The log-rank test was used to compare time to death and time to LTF. The Cox proportional hazard model was used to determine predictors of mortality and LTF after DR-TB diagnosis. The Crude and adjusted Cox proportional hazard ratio was used to measure the strength of association whereas p-value less than 0.05 were used to declare statistically significant predictors.

RESULT: A total of 406 DR-TB patients were followed for 7084 person-months observations. Among the patients, 71 (17.5%) died and 32 (7.9%) were lost to follow up (LTF). The incidence density of death and LTF in the cohort was 9.8 and 4.5 per 1000 person-months, respectively. The median age of the study participants was 28 years (IQR: 27.1, 29.1). The overall cumulative survival probability of patients at the end of 24 months was 77.5% and 84.5% for the mortality and LTF, respectively. The independent predictors of death was chest radiographic findings (AHR = 0.37, 95% CI: 0.17-0.79) and HIV serostatus 2.98 (95% CI: 1.72-5.19). Drug adverse effect (AHR = 6.1; 95% CI: 2.5, 14.34) and culture test result (AHR = 0.1; 95% CI: 0.1, 0.3) were independent predictors of LTF.

CONCLUSION: This study concluded that drug-resistant tuberculosis mortality and LTF remains high in the study area. Continual support of the integration of TB/HIV service with emphasis and work to identified predictors may help in reducing drug-resistant tuberculosis mortality and LTF.

PMID:33956812 | DOI:10.1371/journal.pone.0250804

PLoS One. 2021 May 6;16(5):e0250784. doi: 10.1371/journal.pone.0250784. eCollection 2021.

ABSTRACT

Scholars have offered multiple theoretical resolutions to explain inconsistent findings about the relationship of state repression and protests, but this repression-dissent puzzle remains unsolved. We simulate the spread of protest on social networks to suggest that the repression-dissent puzzle arises from the nature of statistical sampling. Even though the paper’s simulations construct repression so it can only decrease protest size, the strength of repression sometimes correlates with a decrease, increase, or no change in protest size, regardless of the type of network or sample size chosen. Moreover, the results are most contradictory when the repression rate most closely matches that observed in real-world data. These results offer a new framework for understanding state and protester behavior and suggest the importance of collecting network data when studying protests.

PMID:33956806 | DOI:10.1371/journal.pone.0250784

Pediatr Infect Dis J. 2021 Jun 1;40(6):590-596. doi: 10.1097/INF.0000000000003111.

ABSTRACT

BACKGROUND: Evidence on vaccine effectiveness (VE) may encourage vaccination and help fight the reemergence of measles and mumps in Europe. However, limited data exist on real-life effectiveness of individual measles, mumps and rubella (MMR) vaccines. This study evaluated VE of GSK’s MMR vaccine (“Priorix”) against measles and mumps.

METHODS: This retrospective, case-control study used UK data from the Clinical Practice Research Datalink GOLD linked to the Hospital Episode Statistics database to identify children 1-13 years old diagnosed with measles or mumps from January 2006 to December 2018. Cases were matched to controls according to birth month/year and practice region. Cases were identified using clinical codes (without laboratory confirmation). “Priorix” exposure was identified using vaccine batch identifiers. Children exposed to other MMR vaccines were excluded. Adjusted VE was estimated for ≥1 vaccine dose in all children, and for 1 dose and ≥2 doses in children ≥4 years at diagnosis.

RESULTS: Overall, 299 measles cases matched with 1196 controls (87.6% <4 years old), and 243 mumps cases matched with 970 controls (74.2% <4 years old) were considered. VE for ≥1 dose in all children was 78.0% (97.5% confidence interval: 67.2%-85.3%) for measles and 66.7% (48.1%-78.6%) for mumps. In children ≥4 years old, VE after 1 dose was 74.6% (-21.7% to 94.7%) for measles and 82.3% (32.7%-95.3%) for mumps, and VE after ≥2 doses was 94.4% (79.7%-98.5%) for measles and 86.5% (64.0%-94.9%) for mumps.

CONCLUSIONS: “Priorix” is effective in preventing measles and mumps in real-life settings.

PMID:33956757 | DOI:10.1097/INF.0000000000003111

Pediatr Infect Dis J. 2021 Jun 1;40(6):556-562. doi: 10.1097/INF.0000000000003058.

ABSTRACT

BACKGROUND: Vancomycin has been a first-line treatment for Gram-positive infections for decades. However, strategies for therapeutic drug monitoring (TDM) and dose-optimization in pediatrics remain controversial. In this study, we analyzed the impact of specific antibiotic stewardship interventions on efficacy and safety of vancomycin therapy.

METHODS: From September 2014 to May 2017, we conducted a prospective study to compare a control and a TDM intervention group in our tertiary care center. As part of an antibiotic stewardship program, we implemented internal guidelines on correct vancomycin dosing, TDM timing, as well as targeted trough level range and installed a pharmacokinetic (PK) consultation service to adapt vancomycin dosing to individually calculated PK parameters. As primary clinical outcomes, the percentage of patients with sustained therapeutic vancomycin trough levels and treatment days with therapeutic vancomycin trough levels, that is, 10-15 mg/L were analyzed. Secondary outcomes included nephrotoxicity, readmission rate and mortality. Median daily dose required to achieve therapeutic trough levels was examined.

RESULTS: Clinical outcomes for 90 control patients were compared with outcomes for 19 patients guided by a PK consultation service. Percentage of patients with sustained therapeutic vancomycin trough levels increased from 17.8% to 94.7% (P < 0.001) and percentage of treatment days with therapeutic vancomycin trough levels increased from 18.4% (117/637) to 665% (155/233, P < 0.001). Readmission rate decreased from 24.4% to 5.3% (P = 0.07). No differences in nephrotoxicity or mortality rate were observed between groups. A median daily dose of 72 mg/kg/d was required to achieve therapeutic trough levels.

CONCLUSIONS: Our data demonstrate that implementation of internal guidelines and a PK consultation service was associated with a profound improvement of vancomycin therapy and, therefore, patient safety.

PMID:33956756 | DOI:10.1097/INF.0000000000003058

Med Sci Sports Exerc. 2021 Jan 1;53(1):246. doi: 10.1249/01.mss.0000725668.35113.c4.

NO ABSTRACT

PMID:33956727 | DOI:10.1249/01.mss.0000725668.35113.c4

J Infect Dev Ctries. 2021 Apr 30;15(4):573-578. doi: 10.3855/jidc.12646.

ABSTRACT

INTRODUCTION: The increasing resistance to antibiotics is a public health problem and an imminent therapeutic challenge in hospitals. In this report we aimed to analyze the relationship between antimicrobial resistance and antibiotic consumption in a third-level pediatric hospital.

METHODOLOGY: A cross-sectional analysis was conducted using the information from the microbiology and pharmacy databases of the Pediatric Hospital “Doctor Silvestre Frenk Freund”, during the period 2015-2018. Prevalence of antimicrobial resistance by microorganisms and dispensed grams of selected antibiotics were calculated annually. Antibiotic resistance trend over the time was evaluated using the Chi-square trends test and to assess the correlation between the dispensed grams of antibiotics with their antimicrobial resistance prevalence, we calculated the Pearson’s coefficient (r).

RESULTS: A total of 4,327 isolated bacterial samples were analyzed (56.5% Gram-positive and 44.5% Gram-negative). Most frequently isolated microorganisms were coagulase-negative staphylococci (CoNS), E. coli, K. pneumoniae, P. aeruginosa and S. aureus. We found a significant increase in resistance to clindamycin and oxacillin for CoNS and significant decrease in nitrofurantoin and amikacin resistance for E. coli and K. pneumoniae. We observed a strong positive and statistically significant correlation between amikacin resistance prevalence and amikacin dispensed grams for P. aeruginosa (r = 0.95, p = 0.05).

CONCLUSIONS: The antibiotic resistance profile showed by our study highlights the need of an appropriate antibiotic control use in the Hospital setting.

PMID:33956659 | DOI:10.3855/jidc.12646

J Infect Dev Ctries. 2021 Apr 30;15(4):552-558. doi: 10.3855/jidc.11885.

ABSTRACT

INTRODUCTION: The increasing number of persons > 65 years of age form a special population at risk for nosocomial and other health care-associated infections. Nosocomial infections are major problems in terms of morbidity and mortality as well as prolonged hospitalization and increased costs. The aim of the present study was determination of nurses’ awareness of hospital-acquired infection risks of the geriatric patients.

METHODOLOGY: This descriptive and cross-sectional study was conducted at a university hospital in North Cyprus. A total of 164 voluntary nurses composed the sample of the study. A questionnaire that was developed by the researchers based on the literature was used as data collection tool. After the ethical approval, data were collected using a questionnaire in September and October 2017 with self-completion method. The methods used to analyze the data include an analysis of descriptive statistic variables such as frequency and percentages for the categorical variables and the Pearson’s Chi-square test for comparisons.

RESULTS: Results of the study showed inadequate awareness among nurses on hospital-acquired infection risks of the geriatric patients. It was also determined that there were the statistically significant differences in term of education levels and experiences of nurses with different items on hospital-acquired infection risks of the geriatric patients.

CONCLUSIONS: Based on the results of the study, implementations of comprehensive, systematic, and continuous educational programs to enhance awareness of the nurses on health care-associated infections was recommended.

PMID:33956656 | DOI:10.3855/jidc.11885