Nevin Manimala

PLoS One. 2021 Aug 4;16(8):e0255073. doi: 10.1371/journal.pone.0255073. eCollection 2021.

ABSTRACT

BACKGROUND: The burden of child under-nutrition still remains a global challenge, with greater severity being faced by low- and middle-income countries, despite the strategies in the Sustainable Development Goals (SDGs). Globally, malnutrition is the one of the most important risk factors associated with illness and death, affecting hundreds of millions of pregnant women and young children. Sub-Saharan Africa is one of the regions in the world struggling with the burden of chronic malnutrition. The 2018 Zambia Demographic and Health Survey (ZDHS) report estimated that 35% of the children under five years of age are stunted. The objective of this study was to analyse the distribution, and associated factors of stunting in Zambia.

METHODS: We analysed the relationships between socio-economic, and remote sensed characteristics and anthropometric outcomes in under five children, using Bayesian distributional regression. Georeferenced data was available for 25,852 children from two waves of the ZDHS, 31% observation were from the 2007 and 69% were from the 2013/14. We assessed the linear, non-linear and spatial effects of covariates on the height-for-age z-score.

RESULTS: Stunting decreased between 2007 and 2013/14 from a mean z-score of 1.59 (credible interval (CI): -1.63; -1.55) to -1.47 (CI: -1.49; -1.44). We found a strong non-linear relationship for the education of the mother and the wealth of the household on the height-for-age z-score. Moreover, increasing levels of maternal education above the eighth grade were associated with a reduced variation of stunting. Our study finds that remote sensed covariates alone explain little of the variation of the height-for-age z-score, which highlights the importance to collect socio-economic characteristics, and to control for socio-economic characteristics of the individual and the household.

CONCLUSIONS: While stunting still remains unacceptably high in Zambia with remarkable regional inequalities, the decline is lagging behind goal two of the SDGs. This emphasises the need for policies that help to reduce the share of chronic malnourished children within Zambia.

PMID:34347795 | DOI:10.1371/journal.pone.0255073

PLoS One. 2021 Aug 4;16(8):e0254340. doi: 10.1371/journal.pone.0254340. eCollection 2021.

ABSTRACT

The COVID-19 pandemic has impelled the majority of schools and universities around the world to switch to remote teaching. One of the greatest challenges in online education is preserving the academic integrity of student assessments. The lack of direct supervision by instructors during final examinations poses a significant risk of academic misconduct. In this paper, we propose a new approach to detecting potential cases of cheating on the final exam using machine learning techniques. We treat the issue of identifying the potential cases of cheating as an outlier detection problem. We use students’ continuous assessment results to identify abnormal scores on the final exam. However, unlike a standard outlier detection task in machine learning, the student assessment data requires us to consider its sequential nature. We address this issue by applying recurrent neural networks together with anomaly detection algorithms. Numerical experiments on a range of datasets show that the proposed method achieves a remarkably high level of accuracy in detecting cases of cheating on the exam. We believe that the proposed method would be an effective tool for academics and administrators interested in preserving the academic integrity of course assessments.

PMID:34347794 | DOI:10.1371/journal.pone.0254340

PLoS One. 2021 Aug 4;16(8):e0255024. doi: 10.1371/journal.pone.0255024. eCollection 2021.

ABSTRACT

Comparison of normality tests based on absolute or average powers are bound to give ambiguous results, since these statistics critically depend upon the alternative distribution which cannot be specified. A test which is optimal against a certain type of alternatives may perform poorly against other alternative distributions. Thus, an invariant benchmark is proposed in the recent normality literature by computing Neyman-Pearson tests against each alternative distribution. However, the computational cost of this benchmark is significantly high, therefore, this study proposes an alternative approach for computing the benchmark. The proposed min-max approach reduces the calculation cost in terms of computing and estimating the Neyman-Pearson tests against each alternative distribution. An extensive simulation study is conducted to evaluate the selected normality tests using the proposed methodology. The proposed min-max method produces similar results in comparison with the benchmark based on Neyman-Pearson tests but at a low computational cost.

PMID:34347791 | DOI:10.1371/journal.pone.0255024

PLoS Negl Trop Dis. 2021 Aug 4;15(8):e0009633. doi: 10.1371/journal.pntd.0009633. eCollection 2021 Aug.

ABSTRACT

Dengue fever virus (DENV) is a global health threat that is becoming increasingly critical. However, the pathogenesis of dengue has not yet been fully elucidated. In this study, we employed bioinformatics analysis to identify potential biomarkers related to dengue fever and clarify their underlying mechanisms. The results showed that there were 668, 1901, and 8283 differentially expressed genes between the dengue-infected samples and normal samples in the GSE28405, GSE38246, and GSE51808 datasets, respectively. Through overlapping, a total of 69 differentially expressed genes (DEGs) were identified, of which 51 were upregulated and 18 were downregulated. We identified twelve hub genes, including MX1, IFI44L, IFI44, IFI27, ISG15, STAT1, IFI35, OAS3, OAS2, OAS1, IFI6, and USP18. Except for IFI44 and STAT1, the others were statistically significant after validation. We predicted the related microRNAs (miRNAs) of these 12 target genes through the database miRTarBase, and finally obtained one important miRNA: has-mir-146a-5p. In addition, gene ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment were carried out, and a protein-protein interaction (PPI) network was constructed to gain insight into the actions of DEGs. In conclusion, our study displayed the effectiveness of bioinformatics analysis methods in screening potential pathogenic genes in dengue fever and their underlying mechanisms. Further, we successfully predicted IFI44L and IFI6, as potential biomarkers with DENV infection, providing promising targets for the treatment of dengue fever to a certain extent.

PMID:34347790 | DOI:10.1371/journal.pntd.0009633

PLoS One. 2021 Aug 4;16(8):e0253809. doi: 10.1371/journal.pone.0253809. eCollection 2021.

ABSTRACT

BACKGROUND: Self-harm occurring within pregnancy and the postnatal year (“perinatal self-harm”) is a clinically important yet under-researched topic. Current research likely under-estimates prevalence due to methodological limitations. Electronic healthcare records (EHRs) provide a source of clinically rich data on perinatal self-harm.

AIMS: (1) To create a Natural Language Processing (NLP) tool that can, with acceptable precision and recall, identify mentions of acts of perinatal self-harm within EHRs. (2) To use this tool to identify service-users who have self-harmed perinatally, based on their EHRs.

METHODS: We used the Clinical Record Interactive Search system to extract de-identified EHRs of secondary mental healthcare service-users at South London and Maudsley NHS Foundation Trust. We developed a tool that applied several layers of linguistic processing based on the spaCy NLP library for Python. We evaluated mention-level performance in the following domains: span, status, temporality and polarity. Evaluation was done against a manually coded reference standard. Mention-level performance was reported as precision, recall, F-score and Cohen’s kappa for each domain. Performance was also assessed at ‘service-user’ level and explored whether a heuristic rule improved this. We report per-class statistics for service-user performance, as well as likelihood ratios and post-test probabilities.

RESULTS: Mention-level performance: micro-averaged F-score, precision and recall for span, polarity and temporality >0.8. Kappa for status 0.68, temporality 0.62, polarity 0.91. Service-user level performance with heuristic: F-score, precision, recall of minority class 0.69, macro-averaged F-score 0.81, positive LR 9.4 (4.8-19), post-test probability 69.0% (53-82%). Considering the task difficulty, the tool performs well, although temporality was the attribute with the lowest level of annotator agreement.

CONCLUSIONS: It is feasible to develop an NLP tool that identifies, with acceptable validity, mentions of perinatal self-harm within EHRs, although with limitations regarding temporality. Using a heuristic rule, it can also function at a service-user-level.

PMID:34347787 | DOI:10.1371/journal.pone.0253809

Leadersh Health Serv (Bradf Engl). 2021 Aug 5;ahead-of-print(ahead-of-print). doi: 10.1108/LHS-01-2021-0007.

ABSTRACT

PURPOSE: The Health Service Executive in Ireland seeks to further develop healthcare in the community. It has identified that this reform requires developing leadership amongst the staff. This study aims to identify what kind of leadership staff in community healthcare observe in practice and their leadership preferences. The core objective has been to identify the readiness of the organisation to implement the adopted national policy of integrated community care reform in terms of leadership development.

DESIGN/METHODOLOGY/APPROACH: An online cross-sectional survey was conducted using the Organisational Cultural Assessment Instrument, based on the Competing Values Framework. This tool identifies four overarching leadership types: Clan (Collaborative), Adhocracy (Creative), Market (Competitive) and Hierarchy (Controlling). Participants (n = 445) were a representative sample of regional community health care employees. They were asked to identify presently observed leadership and preferred leadership in practice. The statistical analysis emphasised a comparison of observed and preferred leadership types.

FINDINGS: Participants reported the current prevailing leadership type as Market (M = 34.38, SD = 6.22) and Hierarchical (M = 34.38, SD = 22.62), whilst the preferred or future style was overwhelmingly Clan (M = 40.38, SD = 18.08). Differences were significant (all p‘s < 0.001). The overall outcome indicates a predominance of controlling and competitive leadership and a lack of collaborative leadership to implement the planned reform.

ORIGINALITY/VALUE: During reform in healthcare, leadership in practice must be aligned to the reform strategy, demonstrating collaboration, flexibility and support for innovation. This unique study demonstrates the importance of examining leadership type and competencies to indicate readiness to deliver national community health care reform.

PMID:34346663 | DOI:10.1108/LHS-01-2021-0007

Nurs Open. 2021 Aug 4. doi: 10.1002/nop2.1021. Online ahead of print.

ABSTRACT

AIM: This study aimed to assess the effectiveness of a programme designed to promote global health competency among nursing students.

DESIGN: It used a randomized pre-post-test comparison group design to compare the effects of a global health competency programme among nursing students.

METHODS: Data collection for the pre-test was carried out for 2 days (25-26 October 2018) and that of post-test was conducted for 2 days (23-24 December 2018). A total of 38 fourth-year nursing students participated in this study (14 in the international nursing group, 11 in the transcultural nursing group and 13 in the complementary and alternative medicine group). The participants were from the nursing department of a university in Cheongju.

RESULTS: There were no statistically significant differences between the groups in the pre-test homogeneity test. The international nursing group showed statistically significant improvements between the pre- and post-tests in global health competency, cultural competency, global health confidence and cultural nursing confidence.

PMID:34346566 | DOI:10.1002/nop2.1021

Psychiatry Clin Neurosci. 2021 Aug 4. doi: 10.1111/pcn.13292. Online ahead of print.

ABSTRACT

AIM: To further investigate the neuroanatomical correlates of child sexual offending and disentangle them from the neural correlates of pedophilia, using a multivariate analytical approach in order to minimize loss of statistical power.

METHODS: This study presents structural MRI data on gray matter in an incarcerated, male population of 22 pedophilic and 21 non-pedophilic child sexual offenders, and 20 violent non-sexual offender controls, using a multivariate whole-brain approach using source-based morphometry.

RESULTS: We identify a network of several neuroanatomical regions exhibiting interrelated reduced gray matter in both child sexual offender groups relative to controls, comprising extensive clusters in the bilateral cerebellum and frontal lobe, as well as smaller clusters in the bilateral parietal, temporal, and occipital lobes, the bilateral basal ganglia, the medial cingulate and the hippocampus.

CONCLUSION: Our results speak to the interpretation that there are inter- and possibly connectivity-related brain structural abnormalities in child sexual offenders that are not (only) pertaining to pedophilia per se. Interpretations and limitations of the present data are discussed and recommendations for future works are given. This article is protected by copyright. All rights reserved.

PMID:34346537 | DOI:10.1111/pcn.13292

J Clin Pharm Ther. 2021 Aug 4. doi: 10.1111/jcpt.13505. Online ahead of print.

ABSTRACT

WHAT IS KNOWN AND OBJECTIVE: MTX pharmacology and toxicity involve several metabolizing enzymes and transporters whose functions have been suggested to be altered by genetic polymorphisms. The current study is to investigate the relationship between the genetic variation and MTX-induced adverse drug effects.

METHODS: A total of 80 paediatric patients (aged 1-14 years) were enrolled in this study. Toxicity was assessed according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0 scoring system. Genotyping was performed by MassARRAY Assay method. Data were analysed using Spss statistical package version 17.0 and Plink v1.07 software. The HWE was tested by a chi-square test. The Fisher’s exact test (chi-squaretest) was used to compare the distributions of genotypes between cases and controls. OR and 95%CI were applied to evaluate the association of genetic variants with the presence of mucositis using unconditional logistic regression.

RESULTS AND DISCUSSION: Mucosal inflammatory injuries were found in 28 children. SNPs of rs1128503 (p = 0.0022, OR = 3.04, 95%CI = 1.39-6.64) and rs1045642 (p = 0.0052, OR = 2.38, 95%CI = 1.15-5.00) located in the gene of ABCB1 and SNPs of rs1801133 (p = 0.040, OR = 2.50, 95%CI = 1.06-5.88) located in the gene of MTHFR show marked impacts on the risk of developing mucositis.

WHAT IS NEW AND CONCLUSION: SNPs of ABCB1 rs1128503, rs1045642 and MTHFR rs1801133 can be risk predictor for MTX-induced mucositis in Chinese paediatric patients diagnosed with acute lymphoblastic leukaemia, lymphoma or osteosarcoma.

PMID:34346513 | DOI:10.1111/jcpt.13505

Dev Med Child Neurol. 2021 Aug 4. doi: 10.1111/dmcn.14996. Online ahead of print.

ABSTRACT

AIM: To follow the functional development of a population-based cohort of children with cerebral palsy (CP) in rural Uganda and compare their development with the developmental trajectories of children from high-income countries (HIC).

METHOD: Eighty-one children (33 females, 48 males) aged 2 to 17 years (mean 8y 6mo, SD 4y 6mo) with CP were initially assessed in 2015 and then 4 years later using the 66-item Gross Motor Function Measure (GMFM-66), Pediatric Evaluation of Disability Inventory, Ugandan version (PEDI-UG), and functional classification systems. We calculated actual and reference scores (level of deviation from the developmental trajectories in HIC). A Wilcoxon signed-rank test was used for statistical analyses.

RESULTS: Children and young people with CP in Uganda exhibited no differences in scores between the first and second assessments for the GMFM-66 and PEDI-UG mobility skills, whereas they exhibited increased PEDI-UG social function (p<0.001) and self-care skills scores (p<0.001). Reference scores were more negative at the second assessment than at the first for the GMFM-66 (p=0.002) and PEDI-UG mobility (p=0.036) but not for PEDI-UG self-care. The increased difference in reference scores over the 4 years was primarily driven by younger children (2-5y) and children with milder impairments.

INTERPRETATION: The increased difference in reference scores between assessments suggests that children with CP in Uganda develop motor skills at a slower rate than peers in HIC. Limited access to health care and rehabilitation likely contributed to the lower scores and slower rate of development.

PMID:34346507 | DOI:10.1111/dmcn.14996