Nevin Manimala

J Oral Biol Craniofac Res. 2021 Apr-Jun;11(2):204-208. doi: 10.1016/j.jobcr.2021.01.013. Epub 2021 Jan 29.

ABSTRACT

INTRODUCTION: The present study evaluated a national social marketing campaign (SMC) conducted in 2008, with the ultimate aim of improving control of oral cancer in Sri Lanka. The approach was based on our published Risk Factor Model (RFM).

METHODS: Social marketing tools were developed to educate the public on the major risk factors for oral cancer. A cross-sectional community-based cluster survey was carried out in 2013 by interviewing 491 citizens >25 years of age to assess any improvements to the level of disease awareness in the community. Changes in the number of case presentations were obtained from registrations at Government Hospital Dental Clinics (GHDC) from the year 2008-2015.

RESULTS: A random sample of 491 members of the public was interviewed in 2013. Most (93%) were aware of oral cancer; but only 45.4% of oral potentially malignant disorders (OPMD). Statistically significant improvements were observed on awareness of oral cancer and OPMD and of the risk factors for oral cancer. A marked increase in the detection of oral leukoplakia and of oral cancer occurred in the GHDC surveillance system in the years 2012 and 2013, at the time the SMC campaign was implemented.

CONCLUSION: The improvement in public awareness of oral cancer and of its major risk factors, and the changed public behavior seen in the increased attendance at healthcare facilities for mouth examination, may be attributed, at least in part, to our SMC. Such Risk Factor-based approaches to social marketing are proposed for control of oral cancer.

PMID:33665068 | PMC:PMC7898001 | DOI:10.1016/j.jobcr.2021.01.013

Cureus. 2021 Jan 31;13(1):e13032. doi: 10.7759/cureus.13032.

ABSTRACT

Background Although pancreatic cancer incidence is low at 13.1 per 100,000 people, this cancer is difficult to treat and carries a poor 5-year survival rate. Additionally, pancreatic cancer survival rates vary disproportionately based on age and race. The objective of this study was to evaluate the association between 5-year survival of pancreatic cancer and the basic demographic factors age, race, and sex. Methods Data were retrieved from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) 18 database, spanning from 2000-2017, using SEER*Stat. SPSS was used to calculate descriptive statistics for vital status, age, race, and sex. Odds ratios with confidence intervals were calculated using Epi Info. Case data were used to conduct survival analysis by age, race, and sex using OriginPro. Results Out of a total of 118,581 cases, 79.3% were White (n = 106,887), 12.5% were Black (n = 16,866), 7.4% were Asian or Pacific Islander (n = 9,960), 0.6% were American Indian/Alaskan Native (n = 792), and 0.2% were unknown race (n = 321). The odds ratio (OR) of dying before reaching 5+ survival was lowest for the Asian or Pacific Islander group (OR = 0.70, 95% CI: 0.66 – 0.74), followed by the group of Black patients (OR = 1.07, 95% CI: 1.02 – 1.13), the White patients group (OR = 1.12, 95% CI: 1.08 – 1.17), and the American Indian/Alaskan Native group (OR = 1.12, 95% CI: 0.89 – 1.40). The largest age group was 65-69 years old, comprising 14.7% (n = 19,866) of the dataset. Probability of 5+ year survival for pancreatic cancer patients was highest for the age group 15-19 years (n = 74). In general, 5+ year survival probability declined with age. Risk of death before reaching 5+ year pancreatic cancer survival was slightly higher in men (OR = 1.03, 95% CI: 1.00 – 1.07), who comprised 50.9% (n = 68,628) of the dataset. Discussion Findings from this study corroborate differences by age, race, and sex discussed in the literature. Differences in survival rates by race depart from some findings in literature documenting no significant differences in treatment outcome by race. Controlling for age in a future study in both race and sex survival probability analyses may be helpful. Further, stratifying by sex in survival probability analysis by race would be illuminating. In addition to survival analysis, regression modeling would be a useful next step.

PMID:33665053 | PMC:PMC7924966 | DOI:10.7759/cureus.13032

PeerJ. 2021 Feb 25;9:e10992. doi: 10.7717/peerj.10992. eCollection 2021.

ABSTRACT

The coronavirus (COVID-19) outbreak started in December 2019 and rapidly spread around the world affecting millions of people. With the growth of infection rate, many countries adopted different policies to control the spread of the disease. The UK implemented strict rules instructing individuals to stay at home except in some special circumstances starting from 23 March 2020. Accordingly, this study focuses on sensitivity analysis of transmissibility of the infection as the effects of removing restrictions, for example by returning different occupational groups to their normal working environment and its effect on the reproduction number in the UK. For this reason, available social contact matrices are adopted for the population of UK to account for the average number of contacts. Different scenarios are then considered to analyse the variability of total contacts on the reproduction number in the UK as a whole and each of its four nations. Our data-driven retrospective analysis shows that if more than 38.5% of UK working-age population return to their normal working environment, the reproduction number in the UK is expected to be higher than 1. However, analysis of each nation, separately, shows that local reproduction number in each nation may be different and requires more adequate analysis. Accordingly, we believe that using statistical methods and historical data can provide good estimation of local transmissibility and reproduction number in any region. As a consequence of this analysis, efforts to reduce the restrictions should be implemented locally via different control policies. It is important that these policies consider the social contacts, population density, and the occupational groups that are specific to each region.

PMID:33665041 | PMC:PMC7916534 | DOI:10.7717/peerj.10992

PeerJ. 2021 Feb 22;9:e10881. doi: 10.7717/peerj.10881. eCollection 2021.

ABSTRACT

BACKGROUND: A handheld metal noisemaker known as a “clicker” is widely used to train new behaviors in dogs; however, evidence for their superior efficacy compared to providing solely primary reinforcement or other secondary reinforcers in the acquisition of novel behavior in dogs is largely anecdotal.

METHODS: Three experiments were conducted to determine under what circumstances a clicker secondary reinforcer may result in acquisition of a novel behavior more rapidly or to a higher level compared to other readily available reinforcement methods. In Experiment 1, three groups of 30 dogs each were shaped to emit a novel sit and stay behavior of increasing duration with either the delivery of food alone, a verbal stimulus paired with food, or a clicker with food. The group that received only a primary reinforcer reached a significantly higher criterion of training success than the group trained with a verbal secondary reinforcer. Performance of the group experiencing a clicker as a secondary reinforcer was intermediate between the other two groups, but not significantly different from either. In Experiment 2, three groups of 25 dogs each were shaped to emit a nose targeting behavior and then perform that behavior at increasing distances from the experimenter using the same three methods of positive reinforcement as in Experiment 1. No statistically significant differences between the groups were found. In Experiment 3, three groups of 30 dogs each were shaped to emit a nose-targeting behavior upon an array of wooden blocks with task difficulty increasing throughout testing using the same three methods of positive reinforcement as previously tested. No statistically significant differences between the groups were found.

RESULTS: Overall, the findings suggest that both primary reinforcement alone as well as a verbal or clicker secondary reinforcer can be used successfully in training a dog to perform a novel behavior, but that no positive reinforcement method demonstrated significantly greater efficacy than any other.

PMID:33665026 | PMC:PMC7906040 | DOI:10.7717/peerj.10881

PeerJ. 2021 Feb 22;9:e10839. doi: 10.7717/peerj.10839. eCollection 2021.

ABSTRACT

BACKGROUND: Studies that focus on the relationships of problematic Internet use (PIU), sleep disorders, and behavioral/emotional problems were limited. This study aimed to explore (1) the relationship between PIU and behavioral/emotional problems among Chinese adolescents and (2) whether sleep disorders mediate the relationship between PIU and behavioral/emotional problems.

METHODS: A total of 1,976 adolescents were recruited by cluster sampling from ten secondary schools in Guangzhou between January and April 2019, and 1,956 of them provided valid information (response rate: 98.9% ). Among them, 50.8% were males and the mean age was 13.6±1.5 years, ranging from 11 to 18 years. Data on behavioral/emotional problems, sleep disorders, and PIU were collected using a self-reported questionnaire. Linear regression models and mediation analyses were performed.

RESULTS: Of the participants, 14.5% (284/1,956) reported moderate to severe PIU, and their average score for total difficulties was significantly higher than the score for average users (14.9±5.5 Vs 9.8±4.7). After adjusting for controlled variables, PIU was further proven to be positively related to elevated levels of behavioral/emotional problems (unstandardized β = 0.16, p < 0.05). In addition, sleep disorders partially mediated the forgoing associations.

CONCLUSIONS: Adolescents with problematic Internet habits were at higher risk of developing behavioral and emotional problems than their normal-use peers, and sleep disorders partially mediated the effect. Close attention and effective guidance for adolescents with PIU and behavioral/emotional problems were recommended for parents and schools.

PMID:33665021 | PMC:PMC7906038 | DOI:10.7717/peerj.10839

PeerJ. 2021 Feb 24;9:e10783. doi: 10.7717/peerj.10783. eCollection 2021.

ABSTRACT

BACKGROUND: Peer recovery coaches (PRCs) have become a critical tool in addiction treatment in many areas of the world. Despite this fact, no identified research has examined the process or impact of PRC training. Furthermore, no scales were identified to measure trainee confidence in various PRC techniques. The goal of this article is to analyze the process and immediate impact of PRC training of twelve American Indians (AIs) in a culturally-specific program. We focus most specifically on trainee confidence levels.

METHODS: No written consent was obtained and completion of the assessment was considered consent. Trainees completed self-assessments before and after the training. The self-assessment examined nine areas ranging from understanding the role of PRCs to knowledge of effective PRC techniques. Paired t-tests were used to assess for changes in individual trainee responses between the pre- and post-assessments.

RESULTS: Pre-training responses ranged from moderate to high. Questions with the lowest average confidence levels address PRC activities or specific techniques to facilitate recovery. All nine questions showed statistically significant mean improvements in the post-training self-assessments. Questions regarding specific PRC activities and techniques showed the greatest improvement. Questions relating to helping people more generally showed the smallest improvement. Average post-training responses fell within a very narrow range indicating relatively consistent confidence levels across skills. Analysis indicates participants were possibly over-confident in certain areas (i.e., maintaining boundaries). This small pilot represents an initial attempt to measure confidence levels of PRC trainees. The findings may inform future training by identifying certain areas where emphasis might be most helpful for trainees. In addition, it is hoped that this work will encourage more systematic analysis of the impact of PRC training on individuals.

PMID:33665010 | PMC:PMC7912601 | DOI:10.7717/peerj.10783

PeerJ. 2021 Feb 23;9:e10734. doi: 10.7717/peerj.10734. eCollection 2021.

ABSTRACT

BACKGROUND: The number of children with obesity has increased in Saudi Arabia, which is a significant public health concern. Early diagnosis of childhood obesity and screening of the prevalence is needed using a simple in situ method. This study aims to generate statistical equations to predict body fat percentage (BF%) for Saudi children by employing machine learning technology and to establish gender and age-specific body fat reference range.

METHODS: Data was combined from two cross-sectional studies conducted in Saudi Arabia for 1,292 boys and girls aged 8-12 years. Body fat was measured in both studies using bio-electrical impedance analysis devices. Height and weight were measured and body mass index was calculated and classified according to CDC 2,000 charts. A total of 603 girls and 374 boys were randomly selected for the learning phase, and 153 girls and 93 boys were employed in the validation set. Analyses of different machine learning methods showed that an accurate, sensitive model could be created. Two regression models were trained and fitted with the construction samples and validated. Gradient boosting algorithm was employed to achieve a better estimation and produce the equations, then the root means squared error (RMSE) equation was performed to decrease the error. Body fat reference ranges were derived for children aged 8-12 years.

RESULTS: For the gradient boosting models, the predicted fat percentage values were more aligned with the true value than those in regression models. Gradient boosting achieved better performance than the regression equation as it combined multiple simple models into a single composite model to take advantage of that weak classifier. The developed predictive model archived RMSE of 3.12 for girls and 2.48 boys. BF% and Fat mass index charts were presented in which cut-offs for 5th, 75th and 95th centiles are used to define ‘under-fat’, ‘normal’, ‘overfat’ and ‘subject with obesity’.

CONCLUSION: Machine learning models could represent a significant advancement for investigators studying adiposity-related issues in children. These models and newly developed centile charts could be useful tools for the estimation and classification of BF%.

PMID:33665006 | PMC:PMC7908871 | DOI:10.7717/peerj.10734

Southwest J Pulm Crit Care. 2021;22(2):58-68. doi: 10.13175/swjpcc015-20. Epub 2021 Feb 13.

ABSTRACT

BACKGROUND: Uranium workers are at risk of developing lung disease, characterized by low forced expiratory volume in one second (FEV1) and/or forced vital capacity (FVC). Previous studies have found an association between decreased lung function and depressive symptoms in patients with pulmonary pathologies, but this association has not been well examined in occupational cohorts, especially uranium workers.

METHODS: This cross-sectional study evaluated the association between spirometric measures and depressive symptoms in a sample of elderly former uranium workers screened by the New Mexico Radiation Exposure Screening & Education Program (NM-RESEP). Race- and ethnicity-specific reference equations were used to determine predicted spirometric indices (predictor variable). At least one depressive symptom [depressed mood and/or anhedonia, as determined by a modified Patient Health Questionnaire-2 (PHQ-2)], was the outcome variables. Chi-square tests and multivariable logistic regression models were used for statistical analyses.

RESULTS: At least one depressive symptom was self-reported by 7.6% of uranium workers. Depressed mood was reported over twice as much as anhedonia (7.2% versus 3.3%). Abnormal FVC was associated with at least one depressive symptom after adjustment for covariates. There was no significant interaction between race/ethnicity and spirometric indices on depressive symptoms.

CONCLUSIONS: Although depressive symptoms are uncommonly reported in uranium workers, they are an important comorbidity due to their overall clinical impact. Abnormal FVC was associated with depressive symptoms. Race/ethnicity was not found to be an effect modifier for the association between abnormal FVC and depressive symptoms. To better understand the mechanism underlying this association and determine if a causal relationship exists between spirometric indices and depressive symptoms in occupational populations at risk for developing lung disease, larger longitudinal studies are required. We recommend screening for depressive symptoms for current and former uranium workers as part of routine health surveillance of this occupational cohort. Such screening may help overcome workers’ reluctance to self-report and seek treatment for depression and may avoid negative consequences to health and safety from missed diagnoses.

PMID:33664988 | PMC:PMC7929482 | DOI:10.13175/swjpcc015-20

World J Mens Health. 2021 Feb 24. doi: 10.5534/wjmh.200155. Online ahead of print.

ABSTRACT

PURPOSE: Male infertility is a worldwide problem with limitations in the treatment. Phosphodiesterase-5 inhibitors (PDE5is) is the first choice for the treatment of erectile dysfunction, more and more studies show that it has a certain effect on male infertility in recent years. But there was currently no high quality of systematic review to evaluate the effects of PDE5is on semen quality.

MATERIALS AND METHODS: We retrieved the electronic databases of MEDLINE, PubMed, Web of Science, EMBASE, etc. Related randomized controlled trials (RCTs) were collected and selected up to May 20, 2020. We have searched literature with terms “male infertility”, “phosphodiesterase-5 inhibitors”, “PDE5i”, “Tadalafil”, “Sildenafil”, “Vardenafil”, “Udenafil”, “Avanafil”, “semen”, and “sperm”. Mean value and its standard deviation were used to perform quantitative analysis. All statistical analyses were conducted by RevMan 5.3 and Stata software.

RESULTS: There were a total of 1,121 participants in the nine included studies. There was a statistically significant improvement treated with PDE5is compared with sham therapy, which including sperm concentration (mean difference [MD]=1.96, 95% confidence interval [CI]=1.70-2.21, p<0.001; MD=3.22, 95% CI=1.96-4.48, p<0.001), straight progressive motility (%) Grade A (MD=3.71, 95% CI=2.21-5.20, p<0.001), sperm motility (MD=8.09, 95% CI=7.83-8.36, p<0.001), morphologically normal spermatozoa (%) (MD=0.67, 95% CI=0.20-1.15, p=0.005; MD=1.27, 95% CI=0.02-2.52, p=0.05), sperm abnormalities (%) (MD=-0.64, 95% CI=-0.81–0.47, p<0.001), and progressive motile sperm (MD=5.34, 95% CI=3.87-6.81, p<0.001).

CONCLUSIONS: In this meta-analysis of nine RCTs, treatment with PDE5is could improve some indicators of male sperm.

PMID:33663030 | DOI:10.5534/wjmh.200155

Psychogeriatrics. 2021 Mar 4. doi: 10.1111/psyg.12673. Online ahead of print.

ABSTRACT

BACKGROUND: The changes that occur during the ageing process affect the mental health of individuals and their adaptation to old age. In this study, it was aimed to evaluate the effect of progressive muscle relaxation (PMR) exercises on the depression level of elderly women and their adaptation to old age.

METHODS: A randomised controlled trial design was used. The sample consisted of 49 elderly women (21 intervention and 28 controls) from a family health centre of a city in Turkey. The research data were collected using the introductory information form, Mini-Mental State Examination, Barthel index, Geriatric Depression-15 Scale, and Assessment Scale of Adaptation Difficulty for the Elderly. Two home visits were made to women in the first and eighth week of the application. PMR was applied by women in the intervention group in 28 min sessions three times a week for 8 weeks. During the 8 weeks the women were called by the researcher once a week and PMR was reminded.

RESULTS: As a result of the PMR exercises performed for 8 weeks, it was determined that there was a statistically significant difference in the mean Geriatric Depression-15 Scale and Assessment Scale of Adaptation Difficulty for the Elderly scores of the women in the intervention group compared to the control group (P < 0.05).

CONCLUSION: In this study, it was found that PMR exercises reduce the depression level of elderly women and increase their adaptation to old age.

PMID:33663021 | DOI:10.1111/psyg.12673