Nevin Manimala

Int J Gynaecol Obstet. 2021 Jul 1. doi: 10.1002/ijgo.13807. Online ahead of print.

ABSTRACT

OBJECTIVE: To introduce a new handmade device, the double Foley catheter (DFC), and compare it to the Foley catheter (FC) and Cook catheter for its effectiveness in labor induction.

METHODS: This prospective randomised controlled trial included 222 patients with unfavourable cervices. The patients were randomly allocated to the DFC, FC, and Cook catheter groups (n = 74 patients per group). The outcomes were evaluated using IBM SPSS Statistics 23 program.

RESULTS: The Bishop scores successfully increased with all three methods (p = 0.000 for all groups), and the rates of vaginal delivery within 24 h and 48 h were similar (p = 0.101 and p = 0.390, respectively). The pain scores of the DFC and Cook catheter groups were similar, but were lower than those of the FC group (p = 0.011). The overall maternal satisfaction scores of the DFC and Cook group balloons were not significantly different but were higher than those of the FC group (p = 0.014).

CONCLUSION: The maternal safety and success rate of labor induction were comparable between groups. However, the FC group had a higher pain score during catheter insertion and a lower maternal satisfaction rate. Moreover, considering the high cost of the Cook catheter, the DFC has an advantage, especially in low-resource countries.

PMID:34197641 | DOI:10.1002/ijgo.13807

Nucleic Acids Res. 2021 Jul 1:gkab547. doi: 10.1093/nar/gkab547. Online ahead of print.

ABSTRACT

A growing amount of evidence in literature suggests that germline sequence variants and somatic mutations in non-coding distal regulatory elements may be crucial for defining disease risk and prognostic stratification of patients, in genetic disorders as well as in cancer. Their functional interpretation is challenging because genome-wide enhancer-target gene (ETG) pairing is an open problem in genomics. The solutions proposed so far do not account for the hierarchy of structural domains which define chromatin three-dimensional (3D) architecture. Here we introduce a change of perspective based on the definition of multi-scale structural chromatin domains, integrated in a statistical framework to define ETG pairs. In this work (i) we develop a computational and statistical framework to reconstruct a comprehensive map of ETG pairs leveraging functional genomics data; (ii) we demonstrate that the incorporation of chromatin 3D architecture information improves ETG pairing accuracy and (iii) we use multiple experimental datasets to extensively benchmark our method against previous solutions for the genome-wide reconstruction of ETG pairs. This solution will facilitate the annotation and interpretation of sequence variants in distal non-coding regulatory elements. We expect this to be especially helpful in clinically oriented applications of whole genome sequencing in cancer and undiagnosed genetic diseases research.

PMID:34197622 | DOI:10.1093/nar/gkab547

PLoS One. 2021 Jul 1;16(7):e0254098. doi: 10.1371/journal.pone.0254098. eCollection 2021.

ABSTRACT

Many affective computing studies have developed automatic emotion recognition models, mostly using emotional images, audio and videos. In recent years, virtual reality (VR) has been also used as a method to elicit emotions in laboratory environments. However, there is still a need to analyse the validity of VR in order to extrapolate the results it produces and to assess the similarities and differences in physiological responses provoked by real and virtual environments. We investigated the cardiovascular oscillations of 60 participants during a free exploration of a real museum and its virtualisation viewed through a head-mounted display. The differences between the heart rate variability features in the high and low arousal stimuli conditions were analysed through statistical hypothesis testing; and automatic arousal recognition models were developed across the real and the virtual conditions using a support vector machine algorithm with recursive feature selection. The subjects’ self-assessments suggested that both museums elicited low and high arousal levels. In addition, the real museum showed differences in terms of cardiovascular responses, differences in vagal activity, while arousal recognition reached 72.92% accuracy. However, we did not find the same arousal-based autonomic nervous system change pattern during the virtual museum exploration. The results showed that, while the direct virtualisation of a real environment might be self-reported as evoking psychological arousal, it does not necessarily evoke the same cardiovascular changes as a real arousing elicitation. These contribute to the understanding of the use of VR in emotion recognition research; future research is needed to study arousal and emotion elicitation in immersive VR.

PMID:34197553 | DOI:10.1371/journal.pone.0254098

PLoS One. 2021 Jul 1;16(7):e0253817. doi: 10.1371/journal.pone.0253817. eCollection 2021.

ABSTRACT

Weight-loss is an integral part of Huntington’s disease (HD) that can start before the onset of motor symptoms. Investigating the underlying pathological processes may help in the understanding of this devastating disease as well as contribute to its management. However, the complex behavior and associations of multiple biological factors is impractical to be interpreted by the conventional statistics or human experts. For the first time, we combine a clinical dataset, expert knowledge and machine intelligence to model the multi-dimensional associations between the potentially relevant factors and weight-loss activity in HD, specifically at the premanifest stage. The HD dataset is standardized and transformed into required knowledge base with the help of clinical HD experts, which is then processed by the class rule mining and self-organising maps to identify the significant associations. Statistical results and experts’ report indicate a strong association between severe weight-loss in HD at the premanifest stage and measures of certain cognitive, psychiatric functional ability factors. These results suggest that the mechanism underlying weight-loss in HD is, at least partly related to dysfunction of certain areas of the brain, a finding that may have not been apparent otherwise. These associations will aid the understanding of the pathophysiology of the disease and its progression and may in turn help in HD treatment trials.

PMID:34197537 | DOI:10.1371/journal.pone.0253817

PLoS One. 2021 Jul 1;16(7):e0253899. doi: 10.1371/journal.pone.0253899. eCollection 2021.

ABSTRACT

BACKGROUND: The Geriatric Depression Scale (GDS) is a widely used instrument to assess depression in older adults. The short GDS versions that have four (GDS-4) and five items (GDS-5) represent alternatives for depression screening in limited-resource settings. However, their accuracy remains uncertain.

OBJECTIVE: To assess the accuracy of the GDS-4 and GDS-5 versions for depression screening in older adults.

METHODS: Until May 2020, we systematically searched PubMed, PsycINFO, Scopus, and Google Scholar; for studies that have assessed the sensitivity and specificity of GDS-4 and GDS-5 for depression screening in older adults. We conducted meta-analyses of the sensitivity and specificity of those studies that used the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases-10 (ICD-10) as reference standard. Study quality was assessed with the QUADAS-2 tool. We performed bivariate random-effects meta-analyses to calculate the pooled sensitivity and specificity with their 95% confidence intervals (95% CI) at each reported common cut-off. For the overall meta-analyses, we evaluated each GDS-4 version or GDS-5 version separately by each cut-off, and for investigations of heterogeneity, we assessed altogether across similar GDS versions by each cut-off. Also, we assessed the certainty of evidence using the GRADE methodology.

RESULTS: Twenty-three studies were included and meta-analyzed, assessing eleven different GDS versions. The number of participants included was 5048. When including all versions together, at a cut-off 2, GDS-4 had a pooled sensitivity of 0.77 (95% CI: 0.70-0.82) and a pooled specificity of 0.75 (0.68-0.81); while GDS-5 had a pooled sensitivity of 0.85 (0.80-0.90) and a pooled specificity of 0.75 (0.69-0.81). We found results for more than one GDS-4 version at cut-off points 1, 2, and 3; and for more than one GDS-5 version at cut-off points 1, 2, 3, and 4. Mostly, significant subgroup differences at different test thresholds across versions were found. The accuracy of the different GDS-4 and GDS-5 versions showed a high heterogeneity. There was high risk of bias in the index test domain. Also, the certainty of the evidence was low or very low for most of the GDS versions.

CONCLUSIONS: We found several GDS-4 and GDS-5 versions that showed great heterogeneity in estimates of sensitivity and specificity, mostly with a low or very low certainty of the evidence. Altogether, our results indicate the need for more well-designed studies that compare different GDS versions.

PMID:34197527 | DOI:10.1371/journal.pone.0253899

PLoS One. 2021 Jul 1;16(7):e0253908. doi: 10.1371/journal.pone.0253908. eCollection 2021.

ABSTRACT

The primary aim of this study is to propose a potential landscape value assessment from different dimensions rather than the traditional approach of a composite indicator. The method used in this study is the combination of data collection from stakeholder survey, score measurement for landscape value dimensions using Structural Equation Modeling (SEM), and spatial representation with the support of Geographic Information System (GIS). From a large-scale (n = 400) investigation in the Moc Chau district, the statistical data extracted from the survey provides input data for the score determination process. SEM analysis shows that each landscape site has 11 determinants influencing the landscape value assessment. Using the RMSE comparison (for validation) with different interpolation methods, the ordinary kriging method is chosen to model the aggregation landscape value map of Moc Chau District. About 24.97% total area of the study area has great potential for tourism development, being mainly distributed in the center of a high mountainous area. This approach can be used as a model to advocate local and regional assessment and enhance value-based management in other territories in Vietnam and beyond.

PMID:34197520 | DOI:10.1371/journal.pone.0253908

PLoS One. 2021 Jul 1;16(7):e0253892. doi: 10.1371/journal.pone.0253892. eCollection 2021.

ABSTRACT

INTRODUCTION: Osteoporosis and metabolic syndrome (MetS) are diseases that have serious public health consequences, reducing the quality of life of patients and increasing morbidity and mortality, with substantial healthcare expenditures.

OBJECTIVE: To evaluate the impact of MetS on bone mineral density (BMD) and biochemical markers of bone formation and resorption in adolescents with excess weight.

METHOD: A descriptive and analytical cross-sectional study was performed that evaluated 271 adolescents of both sexes (10 to 16 years). From the total sample, 42 adolescents with excess weight and the presence of MetS (14%) were selected. A further 42 adolescents with excess weight and without MetS were chosen, matched for chronological age, bone age, and pubertal developmental criteria to those with MetS, for each sex. Anthropometric measurements, blood pressure collection, and biochemical tests were performed in all adolescents, as well as evaluation of BMD and the bone biomarkers osteocalcin (OC), bone alkaline phosphatase (BAP), and carboxy-terminal telopeptide (S-CTx).

RESULTS: The adolescents with excess weight and MetS exhibited significantly lower transformed BMD and concentrations of BAP, OC, and S-CTx compared to the matched group, except for OC in boys. A negative and significant correlation was observed between total body BMD and BAP (r = -0.55568; p = 0.005), OC (r = -0.81760; p = < .000), and S-CTx (r = -0.53838; p = 0.011) in girls.

CONCLUSION: Metabolic syndrome may be associated with reduced bone mineral density and biochemical markers of bone formation and resorption in adolescents with excess weight.

PMID:34197518 | DOI:10.1371/journal.pone.0253892

PLoS One. 2021 Jul 1;16(7):e0253746. doi: 10.1371/journal.pone.0253746. eCollection 2021.

ABSTRACT

BACKGROUND: Treatment seeking delay is defined as the time interval between the onset of the major symptoms of tuberculosis (TB) and the first visit to the formal health care facility. The patient was said to be delayed if the patient visited the health-facility after 3 weeks onset of major symptoms. However, in low-income countries like Ethiopia, the delay in treatment-seeking among tuberculosis patients contributes to a widespread transmission and high prevalence of tuberculosis.

METHODS: Studies were retrieved from PubMed, Cochrane Database, Cinahl, Scopus, Mednar, and Google Scholar by employing a combination of search terms with Boolean operators. Heterogeneity across studies was assessed using the Cochrane Q test. A funnel plot was used for visual assessment of publication bias. Subgroup analyses were performed to explore the possible causes of heterogeneity. Egger’s weighted regression test at a p-value < 0.05 was used to assess the presence of publication bias. Sensitivity analysis was performed to judge whether the pooled effect size was influenced by individual study. STATA software version 14 was used for all statistical analyses.

RESULT: A total of 12 studies with 5122 total sample size were included. The national pooled prevalence of treatment seeking delay was 44.29% (95% CI: 39.805, 48.771). The visual inspection of the funnel plot showed the asymmetrical distribution, and the Egger test showed insignificant (P = 0.348). Patients who did not seek formal health care providers on a first contact had about 7 times more likely to delay than patients who sought formal health care provider on a first contact (OR: 7.192 ((95% CI 5.587-9.257), P = 0.001, I2: 85%). The others independent predictors of delay were rural residence (OR: 3.459 ((95% CI 1.469-8.148), P ≤ 0.001), extra pulmonary TB (OR: 2.520 ((95% CI 1.761-3.605), 0.180), lower educational level (OR 11.720 ((95% CI 1.006-2.938), P <0.001), and distance more than 10km from health facility (OR: 1.631 ((95% CI (10.858-3.101), P = 0.001).

CONCLUSION: In this review, we identified a substantial treatment seeking delay among TB patients in Ethiopia. And, the independent predictors of delay were treatment sought before formal health care provider, residence of the patient, type of TB, educational level, and distance from a health facility. Thus, we recommend health extension workers, health professionals and other stakeholders to focus on patient education, and to continuously mobilize the whole communities on early treatment seeking with a special emphasis given to where treatment sought before formal health care provider, rural resident, extra pulmonary TB, and a patient living farther than 10km distance from health facility.

PMID:34197515 | DOI:10.1371/journal.pone.0253746

PLoS One. 2021 Jul 1;16(7):e0253872. doi: 10.1371/journal.pone.0253872. eCollection 2021.

ABSTRACT

Technologies and practices that reduce the environmental impacts of US agriculture are well documented. Less is known about how best to encourage their adoption. We report on the results of a large randomized controlled trial conducted with nearly 10,000 agricultural producers in the United States. The experiment was embedded in US Department of Agriculture outreach efforts to improve soil conservation practices. USDA varied the content of mailings to test two sets of competing theories about outreach to agricultural producers. Contrary to conventional wisdom, we find no evidence that acknowledging the link between climate change and agricultural production discourages conservation action. Furthermore, we find that producers who were invited to a webinar were less likely to take any action to learn more about conservation practices than producers who were not told about the webinar, a result that runs counter to the popular wisdom that offering more options leads to more action.

PMID:34197511 | DOI:10.1371/journal.pone.0253872

PLoS One. 2021 Jul 1;16(7):e0253653. doi: 10.1371/journal.pone.0253653. eCollection 2021.

ABSTRACT

PURPOSE: To facilitate the demonstration of the prognostic value of radiomics, multicenter radiomics studies are needed. Pooling radiomic features of such data in a statistical analysis is however challenging, as they are sensitive to the variability in scanner models, acquisition protocols and reconstruction settings, which is often unavoidable in a multicentre retrospective analysis. A statistical harmonization strategy called ComBat was utilized in radiomics studies to deal with the “center-effect”. The goal of the present work was to integrate a transfer learning (TL) technique within ComBat-and recently developed alternate versions of ComBat with improved flexibility (M-ComBat) and robustness (B-ComBat)-to allow the use of a previously determined harmonization transform to the radiomic feature values of new patients from an already known center.

MATERIAL AND METHODS: The proposed TL approach were incorporated in the four versions of ComBat (standard, B, M, and B-M ComBat). The proposed approach was evaluated using a dataset of 189 locally advanced cervical cancer patients from 3 centers, with magnetic resonance imaging (MRI) and positron emission tomography (PET) images, with the clinical endpoint of predicting local failure. The impact performance of the TL approach was evaluated by comparing the harmonization achieved using only parts of the data to the reference (harmonization achieved using all the available data). It was performed through three different machine learning pipelines.

RESULTS: The proposed TL technique was successful in harmonizing features of new patients from a known center in all versions of ComBat, leading to predictive models reaching similar performance as the ones developed using the features harmonized with all the data available.

CONCLUSION: The proposed TL approach enables applying a previously determined ComBat transform to new, previously unseen data.

PMID:34197503 | DOI:10.1371/journal.pone.0253653