Nevin Manimala

PLoS One. 2021 Oct 15;16(10):e0258656. doi: 10.1371/journal.pone.0258656. eCollection 2021.

ABSTRACT

BACKGROUND: Despite the prohibition by the law in 1961, dowry is widely prevalent in India. Dowry stems from the early concept of ‘Stridhana,’ in which gifts were given to the bride by her family to secure some personal wealth for her when she married. However, with the transition of time, the practice of dowry is becoming more common, and the demand for a higher dowry becomes a burden to the bride’s family. Therefore, this study aimed to determine the factors associated with the practice of dowry in Bihar and Uttar Pradesh.

METHODS: We utilized information from 5206 married adolescent girls from the Understanding the lives of adolescents and young adults (UDAYA) project survey conducted in two Indian states, namely, Uttar Pradesh and Bihar. Dowry was the outcome variable of this study. Univariate, bivariate, and multivariate logistic regression analyses were performed to explore the factors associated with dowry payment during the marriage.

RESULTS: The study reveals that dowry is still prevalent in the state of Uttar Pradesh and Bihar. Also, the proportion of dowry varies by adolescent’s age at marriage, spousal education, and household socioeconomic status. The likelihood of paid dowry was 48 percent significantly less likely (OR: 0.52; CI: 0.44-0.61) among adolescents who knew their husbands before marriage compared to those who do not know their husbands before marriage. Adolescents with age at marriage more than equal to legal age had higher odds to pay dowry (OR: 1.60; CI: 1.14-2.14) than their counterparts. Adolescents with mother’s who had ten and above years of education, the likelihood of dowry was 33 percent less likely (OR: 0.67; CI: 0.45-0.98) than their counterparts. Adolescents belonging to the richest households (OR: 1.48; CI: 1.13-1.93) were more likely to make dowry payments than adolescents belonging to poor households.

CONCLUSION: Limitation of the dowry prohibition act is one of the causes of continued practices of dowry, but major causes are deeply rooted in the social and cultural customs, which cannot be changed only using laws. Our study suggests that only the socio-economic development of women will not protect her from the dowry system, however higher dowry payment is more likely among women from better socio-economic class.

PMID:34653223 | DOI:10.1371/journal.pone.0258656

PLoS One. 2021 Oct 15;16(10):e0258620. doi: 10.1371/journal.pone.0258620. eCollection 2021.

ABSTRACT

OBJECTIVES: To determine treatment seeking behaviour in those with opioid use disorder (OUD) in the high-income countries.

METHODS: Five databases were searched in November 2019 for quantitative studies that reported OUD treatment seeking behaviour. Data analysis involved determining an overall pooled proportion estimate of treatment seeking behaviour for the two base groups, lifetime treatment and past 12-month or less treatment using the IVhet effect model. Subgroup analysis included heroin OUD, prescription OUD and general OUD. The sensitivity analysis included removal of outliers, separating adults and adolescents and the metaXL sensitivity analysis (studies are excluded if outside the pooled proportion confidence interval of the base case). Systematic review Prospero database registration number [CRD42020159531].

RESULTS: There were 13 quantitative studies included in the systematic review, with all studies being from the United States of America (USA). IVhet models showed that 40% (95% CI: 23%, 58%) and 21% (95% CI: 16%, 26%) sought treatment in their lifetime and past 12 months respectively. Sub-group analysis found that lifetime treatment seeking for prescription OUD, 29% (95% CI: 27%, 31%), was less than for heroin plus combined OUD, 54% (95% CI: 26%, 82%). Most of the pooled results had high heterogeneity statistics except for results of lifetime treatment seeking for prescription OUD and past 12-month treatment seeking for prescription OUD.

CONCLUSION: All included studies in this meta-analysis were from the USA and indicate modest levels of treatment seeking for those with OUD. In particular, this review found that in the USA one in five people with OUD sought OUD treatment in the previous 12 months and two in five people with OUD sought OUD treatment in their lifetime. Further research is urgently required to explore the barriers and facilitators that can improve this low treatment seeking in those with OUD.

PMID:34653220 | DOI:10.1371/journal.pone.0258620

PLoS One. 2021 Oct 15;16(10):e0258576. doi: 10.1371/journal.pone.0258576. eCollection 2021.

ABSTRACT

INTRODUCTION: Following the introduction of Highly Active Anti Retro Viral Treatment (HAART), the survival of people living with HIV/AIDS (PLHIV) has improved. However, hypertension remains a major challenge for people living with HIV. Very little effort has been made to examine the magnitude of hypertension and its contributing factors among clients receiving HAART, particularly in southern Ethiopia. Hence, the current study aimed at determining the frequency of Hypertension and associated factors among clients receiving HAART at Wachemo University Nigist Eleni Mohammed Memorial Referral Hospital, southern Ethiopia, 2020.

METHODS: A hospital-based cross-sectional study took place from January 20- March 20, 2020. A systematic sampling technique was employed in the selection of 397 clients. Interviewer administered pretested structured questionnaire was used for data collection. Blood pressure and anthropometric parameters of PLHIV were measured. The data was encoded and entered using Epi Data Version 3.1 and exported to SPSS version 23 for analysis. Then bivariable and multivariable logistic regression analyses were used to identify associated factors. Adjusted Odds Ratio (AOR) with 95% CI was used to present the estimated effect size and declare the presence of statistically significant association respectively.

RESULTS: The magnitude of hypertension among clients on HAART was 11.0% 95% CI [7.93, 14.04]. Being on HAART for at least 60 months (AOR: 2.57, 95% CI: 1.24-5.21), being on TDF/3TC/EFV combination (AOR: 4.61, 95% CI: 2.52-8.3), and high alcohol consumption (AOR: 4.31, 95% CI: 1.84-10.02) were identified as significant predictors of hypertension among clients on HAART.

CONCLUSION AND RECOMMENDATION: The magnitude of hypertension in the study area was in a considerable state to plan and implement intervention measures. For those clients who have received TDF/3TC/EFV and TDF/3TC/NVP and those who have been on HAART for 60 months, a strong emphasis should be placed on planning a strict follow-up. A concerted effort among health care providers is needed through counseling and education to discourage the habit of high alcohol consumption among clients.

PMID:34653207 | DOI:10.1371/journal.pone.0258576

PLoS One. 2021 Oct 15;16(10):e0258447. doi: 10.1371/journal.pone.0258447. eCollection 2021.

ABSTRACT

BACKGROUNDS: Many breast cancer patients experience significant distress immediately following the completion of primary treatment. Women who report low levels of quality of life (QOL) early in this phase of transitional survivorship tend to experience diminished long-term adjustment. However, since most of the prior studies on survivors were conducted on patients at various times, studies on QOL of women during the end of primary treatment have been insufficient. This study aimed to identify determinants of QOL in women with breast cancer immediately following the completion of treatment.

METHODS: A cross-sectional study was conducted on 140 disease-free breast cancer patients who had completed therapy in the past 1 month at university hospitals. Functional Assessment of Cancer Therapy-Breast (FACT-B), Memorial Symptom Assessment Scale-Short Form (MSAS-SF), Self-Efficacy Scale for Self-Management of Breast Cancer (SESSM-B), and Interpersonal Support Evaluation List-12 (ISEL-12) scales were used to assess predictors and QOL. The data were analyzed using the Pearson correlation, t-test, ANOVA, and hierarchical multiple regression.

RESULTS: The mean score of QOL for breast cancer survivors was 97.23 (±20.01). Chemotherapy and perceived economic status were significantly associated with QOL in terms of sociodemographic and disease/treatment-related characteristics. Physical and psychological symptoms and social support had a significant association with QOL. The regression analyses showed that physical and psychological symptoms and belonging support were statistically significant in predicting the QOL of breast cancer survivors.

CONCLUSIONS: The variables of symptom experience and social support must be acknowledged when improving women’s QOL immediately after their completion of primary breast cancer treatment. Greater focus on the reduction of symptom distress and increasing a sense of belonging could improve QOL among breast cancer survivors.

PMID:34653187 | DOI:10.1371/journal.pone.0258447

PLoS One. 2021 Oct 15;16(10):e0258330. doi: 10.1371/journal.pone.0258330. eCollection 2021.

ABSTRACT

BACKGROUND: Null Hypothesis Significance Testing (NHST) is the most familiar statistical procedure for making inferences about population effects. Important problems associated with this method have been addressed and various alternatives that overcome these problems have been developed. Despite its many well-documented drawbacks, NHST remains the prevailing method for drawing conclusions from data. Reasons for this have been insufficiently investigated. Therefore, the aim of our study was to explore the perceived barriers and facilitators related to the use of NHST and alternative statistical procedures among relevant stakeholders in the scientific system.

METHODS: Individual semi-structured interviews and focus groups were conducted with junior and senior researchers, lecturers in statistics, editors of scientific journals and program leaders of funding agencies. During the focus groups, important themes that emerged from the interviews were discussed. Data analysis was performed using the constant comparison method, allowing emerging (sub)themes to be fully explored. A theory substantiating the prevailing use of NHST was developed based on the main themes and subthemes we identified.

RESULTS: Twenty-nine interviews and six focus groups were conducted. Several interrelated facilitators and barriers associated with the use of NHST and alternative statistical procedures were identified. These factors were subsumed under three main themes: the scientific climate, scientific duty, and reactivity. As a result of the factors, most participants feel dependent in their actions upon others, have become reactive, and await action and initiatives from others. This may explain why NHST is still the standard and ubiquitously used by almost everyone involved.

CONCLUSION: Our findings demonstrate how perceived barriers to shift away from NHST set a high threshold for actual behavioral change and create a circle of interdependency between stakeholders. By taking small steps it should be possible to decrease the scientific community’s strong dependence on NHST and p-values.

PMID:34653185 | DOI:10.1371/journal.pone.0258330

PLoS One. 2021 Oct 15;16(10):e0258560. doi: 10.1371/journal.pone.0258560. eCollection 2021.

ABSTRACT

BACKGROUND: Priapism impairs quality of life and has a predilection for males with sickle cell disease (SCD). The Priapism Impact Profile (PIP) is a novel 12-item instrument designed to measure general health-related impact of priapism. The aim of the study was to evaluate the validity and reliability of the PIP in a Jamaican cohort of SCD patients experiencing priapism.

METHODS: One hundred SCD patients with a history of priapism were recruited from a sickle cell clinic in Kingston, Jamaica and administered the PIP questionnaire. Patients rated each item of the PIP for clarity and importance. Statistical testing was employed to evaluate the psychometric performance of the PIP. Content validation was assessed based on patient descriptive rating of the items based on clarity, and importance and criterion-oriented validity were assessed by evaluating the PIP’s ability to distinguish between patient subgroups. Test-retest repeatability was assessed in 20 of the 100 patients.

RESULTS: Patients were stratified into active (54) and remission (46) priapism groups based on their experience of priapism within the past year. Patients in the active priapism group were younger (p = 0.011), had a shorter duration of disease (p = 0.023), and had more frequent priapism episodes (p = 0.036) than the remission group. PIP questionnaire scores differed significantly with respect to priapism activity (p < 0.001) and prevalence of erectile dysfunction (p < 0.05) but not by priapism severity (p = 0.62). The PIP questionnaire had good content validity, with questions rated as having medium or high clarity and importance by an average of 82.8% and 69.2% of patients, respectively.

CONCLUSION: The PIP questionnaire was successfully validated in a Jamaican cohort of SCD patients and adequately discriminated patients with active priapism from those in remission. The instrument may be utilized in routine clinical management of patients with SCD-associated priapism. Further clinical investigations are warranted in other populations.

PMID:34653184 | DOI:10.1371/journal.pone.0258560

Opt Lett. 2021 Oct 15;46(20):5260-5263. doi: 10.1364/OL.428761.

ABSTRACT

Unitary learning is a backpropagation (BP) method that serves to update unitary weights in fully connected deep complex-valued neural networks, meeting a prior unitary in an active modulation diffractive deep neural network. However, the square matrix characteristic of unitary weights in each layer results in its learning belonging to a small-sample training, which produces an almost useless network that has a fairly poor generalization capability. To alleviate such a serious over-fitting problem, in this Letter, optical random phase dropout is formulated and designed. The equivalence between unitary forward and diffractive networks deduces a synthetic mask that is seamlessly compounded with a computational modulation and a random sampling comb called dropout. The dropout is filled with random phases in its zero positions that satisfy the Bernoulli distribution, which could slightly deflect parts of transmitted optical rays in each output end to generate statistical inference networks. The enhancement of generalization benefits from the fact that massively parallel full connection with different optical links is involved in the training. The random phase comb introduced into unitary BP is in the form of conjugation, which indicates the significance of optical BP.

PMID:34653167 | DOI:10.1364/OL.428761

Surg Laparosc Endosc Percutan Tech. 2021 Oct 14. doi: 10.1097/SLE.0000000000001015. Online ahead of print.

ABSTRACT

BACKGROUND: The use of nonradiation endoscopic retrograde cholangiopancreatography (NR-ERCP) for choledocholithiasis is still limited. Hereby, we introduced our experience of digital cholangioscopy (DCS)-assisted NR-ERCP for retrieval of common bile duct stones.

METHODS: Altogether, data of 132 patients who underwent DCS-assisted NR-ERCP for choledocholithiasis were collected. Procedure details, complications, and short-term follow-up were reviewed and analyzed and were compared with those of conventional endoscopic retrograde cholangiopancreatography (ERCP).

RESULTS: Routine stone extraction and laser lithotripsy were planned in 116 and 16 patients, respectively. Biliary access was successfully achieved by standard biliary cannulation and by advanced techniques in 99 and 33 patients, respectively. Complete stone removal was achieved in a single session in all patients. Routine stone extraction was performed in 117 patients, and laser lithotripsy was applied in 15 patients, among whom 14 patients with planned lithotripsy and 1 unexpected impacted stone found during the procedure. Unexpected right localized intrahepatic stones and purulent cholecystitis were found in 1 and 3 patients, respectively. Three mild and 1 moderate pancreatitis, 5 cases of hyperamylasemia, and 2 cases of leukocytosis occurred as complications. Short-term follow-up revealed no stone residual. Procedure details, technical success, and complications were not statistically different than conventional ERCP.

CONCLUSIONS: DCS-assisted NR-ERCP is technically feasible, efficient, and safe for retrieval of common bile duct stones. This novel method is superior to conventional ERCP on detecting unexpected concomitant biliary diseases.

PMID:34653113 | DOI:10.1097/SLE.0000000000001015

J Orthop Trauma. 2021 Oct 12. doi: 10.1097/BOT.0000000000002290. Online ahead of print.

ABSTRACT

OBJECTIVE: Vital signs and laboratory values are used to guide decisions to use damage control techniques in lieu of early definitive fracture fixation. Prior models attempted to predict mortality risk but have limited utility. There is a need for a dynamic model that captures evolving physiologic changes during a trauma patient’s hospital course.

METHODS: The Parkland Trauma Index of Mortality (PTIM) is a machine-learning algorithm that uses electronic medical record (EMR) data to predict mortality within 48 hours during the first 3 days of hospitalization. It updates every hour, re-calculating as physiology changes. The model was developed using 1,935 trauma patient encounters from 2009-2014 and validated on 516 patient encounters from 2015-2016. Model performance was evaluated statistically. Data was collected retrospectively on its performance after one year of clinical use.

RESULTS: In the validation data set, PTIM accurately predicted 52 of 63 12-hour time intervals within 48 hours of mortality, for sensitivity of 82.5% (95% CI 73.1% – 91.9%). Specificity was 93.6% (95% CI 92.5% – 94.8%), and PPV was 32.5% (95% CI 25.2% – 39.7%). PTIM predicted survival for 1,608 time intervals and was incorrect only 11 times, yielding a NPV of 99.3% (95% CI 98.9% – 99.7%). AUC of the ROC curve was 0.94.During the first year of clinical use, when used in 776 patients, the last PTIM score accurately predicted 20 of the 23 12-hour time intervals within 48 hours of mortality, for a sensitivity of 86.9% (95% CI 73% – 100%). Specificity was 94.7% (95% CI 93% – 96%), and the PPV was 33.3% (95% CI 21.4% – 45%). The model predicted survival for 716 time intervals and was incorrect 3 times, yielding a NPV of 99.6% (95% CI 99.1% – 100%). AUC of the ROC curve was 0.97.

CONCLUSION: By adapting with the patient’s physiologic response to trauma and relying on EMR data alone, the PTIM overcomes many of the limitations of prior models. It may help inform decision-making for trauma patients early in their hospitalization.

LEVEL OF EVIDENCE: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

PMID:34653106 | DOI:10.1097/BOT.0000000000002290

J Cataract Refract Surg. 2021 Sep 20. doi: 10.1097/j.jcrs.0000000000000821. Online ahead of print.

ABSTRACT

PurposeTo compare axial length (AL) measurements in long eyes by two swept-source optical coherence tomography (SS-OCT) biometers, one based on the group refractive index (IOLMaster 700, Zeiss) and the other based on sum of segments (Argos, Movu), and compare these measurements to previously published methods to optimize AL.SettingI.R.C.C.S. – G.B. Bietti Foundation, Rome, ItalyDesignProspective case seriesMethodsAL was measured with both optical biometers in myopic patients (AL > 24.00 mm) and compared to the values obtained with Wang-Koch adjustment, polynomial equations for the Holladay 1 and 2 formulas and Cooke modified AL (CMAL).ResultsIn 102 eyes of 55 subjects, a statistically significant difference (p<0.0001) was found among the 6 AL values. Post-test revealed that Argos measurements (26.90 ±1.61 mm) were significantly lower compared to those provided by all methods (p <0.001) but CMAL, whereas IOLMaster 700 measurements (27.01 ±1.65) were higher (p <0.001). No difference was found between the two Holladay equations. CMAL values did not reveal any difference compared to those of the Argos, but a proportional bias showed that in longer eyes CMAL provided smaller values (p <0.0001, r = -0.7221). AL overestimation by the IOLMaster 700 AL compared to the Argos was higher the longer the eye was (p <0.0001, r = 0.6959, r2 = 0.4842).ConclusionThe SS-OCT optical biometer based on the group refractive index overestimates AL compared to the device using segmented AL. CMAL provides the measurements closest to those of the device using segmented AL.

PMID:34653096 | DOI:10.1097/j.jcrs.0000000000000821