Tag: nevin manimala

Proc Natl Acad Sci U S A. 2024 Dec 3;121(49):e2404313121. doi: 10.1073/pnas.2404313121. Epub 2024 Nov 25.

ABSTRACT

In Europe, the tendency among immigrants and descendants to seek out and interact with other coethnics has raised concern for their integration as it can reduce contact with the ethnic majority. Though policymakers implement large-scale integration programs to counteract these trends, it remains empirically and theoretically ambiguous whether exposure to coethnic peers impedes integration, and causal evidence is more limited for the growing population of migrant children. In this article, I use high-quality Danish administrative panel data over 28 y to investigate whether the ethnic composition experienced in childhood among immigrants and descendants with a non-EU background affects a core behavioral indicator of integration: naturalization. To isolate the causal effect of the childhood ethnic composition, I use the quasi-experimental assignment of siblings into different school grades in the same school. I find that being exposed to coethnic peers in the school grade increases the probability of naturalizing later in life. The main explanation is that exposure to some coethnic peers improves academic skills which are positively correlated with citizenship acquisition. These findings demonstrate the causal importance of non-EU migrant children’s social environment for their later integration into the national community showing that the modest presence of coethnic peers can be a precondition for, not a barrier to, integration.

PMID:39585976 | DOI:10.1073/pnas.2404313121

Stroke. 2024 Dec;55(12):2776-2785. doi: 10.1161/STROKEAHA.124.047210. Epub 2024 Nov 25.

ABSTRACT

BACKGROUND: Restenosis after carotid artery stenting (CAS) is associated with the risk of developing ischemic stroke. We aimed to evaluate the inhibitory effect of cilostazol addition on in-stent restenosis (ISR) in patients treated with CAS.

METHODS: In a randomized, open-label, blind-end point trial, patients with symptomatic and asymptomatic carotid artery stenosis and scheduled for CAS were randomly assigned to adding cilostazol (50 or 100 mg, twice per day) on other antiplatelets from 3 days before CAS or not adding cilostazol. Concomitant use of other antiplatelets was unrestricted. ISR was diagnosed by a peak systolic velocity of at least 1.75 m/s on duplex ultrasonography. The primary outcome was incidence of ISR within 2 years after CAS. Secondary outcomes included occurrences of cardiovascular events or any death and hemorrhagic events.

RESULTS: Participants were recruited from December 2010 to September 2015. Although the sample size was initially set to be 900 (450 in each group), 631 patients (mean age 69.9 years, 558 men, 325 in the cilostazol, and 306 in the noncilostazol group) were included in the primary analysis. Within 2 years’ follow-up, ISR occurred in 31 of 325 patients (cumulative incidence 10.8%) in the cilostazol group and 46 of 306 patients (19.6%) in the noncilostazol group (hazard ratio, 0.64 [95% CI, 0.41-1.0]; P=0.056). In the exploratory analysis, incidence of ISR beyond 30 days after CAS was lower in the cilostazol group than in the noncilostazol group (10.3% versus 19.3%; P=0.040). Incidences of cardiovascular events or any death and hemorrhagic events were similar between the groups (6.2% versus 6.7% and 2.3% versus 1.4%, respectively).

CONCLUSIONS: The addition of cilostazol to other antiplatelet agents could contribute to the reduction of ISR in the chronic stage of patients who underwent CAS, the authenticity of which depends on further studies with sufficient statistical power.

REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01261234.

PMID:39585936 | DOI:10.1161/STROKEAHA.124.047210

PLoS One. 2024 Nov 25;19(11):e0313496. doi: 10.1371/journal.pone.0313496. eCollection 2024.

ABSTRACT

PURPOSE: This study aims to quantitatively analyze the impact of split times on overall performance in standard distance triathlon events. It also examines how environmental factors such as water type, temperature, and altitude affect overall race outcomes.

METHODS: Quantile regression was employed to analyze the race records of 1,580 triathletes participating in 46 standard distance events in China.

RESULTS: Swim time significantly influences race performance among the top 50% of elite athletes (p < 0.05). For slower elite athletes, bike time is more critical. Temperature has a positive effect on race times, while altitude also shows a significant positive impact, with race times decreasing as altitude increases (up to 1,600 meters in this study’s dataset). River water enhances race times compared to still water, whereas sea water generally slows athletes down.

CONCLUSION: The influence of split times and environmental factors on overall race rime varies according to the athletes’ performance levels. To optimize results, training plans and race strategies should be tailored to each athlete’s capabilities. Additionally, understanding and adapting to environmental conditions in advance is crucial.

PMID:39585923 | DOI:10.1371/journal.pone.0313496

PLoS Pathog. 2024 Nov 25;20(11):e1012740. doi: 10.1371/journal.ppat.1012740. Online ahead of print.

ABSTRACT

The molecular clock hypothesis assumes that mutations accumulate on an organism’s genome at a constant rate over time, but this assumption does not always hold true. While modelling approaches exist to accommodate deviations from a strict molecular clock, assumptions about rate variation may not fully represent the underlying evolutionary processes. There is considerable variability in rabies virus (RABV) incubation periods, ranging from days to over a year, during which viral replication may be reduced. This prompts the question of whether modelling RABV on a per infection generation basis might be more appropriate. We investigate how variable incubation periods affect root-to-tip divergence under per-unit time and per-generation models of mutation. Additionally, we assess how well these models represent root-to-tip divergence in time-stamped RABV sequences. We find that at low substitution rates (<1 substitution per genome per generation) divergence patterns between these models are difficult to distinguish, while above this threshold differences become apparent across a range of sampling rates. Using a Tanzanian RABV dataset, we calculate the mean substitution rate to be 0.17 substitutions per genome per generation. At RABV’s substitution rate, the per-generation substitution model is unlikely to represent rabies evolution substantially differently than the molecular clock model when examining contemporary outbreaks; over enough generations for any divergence to accumulate, extreme incubation periods average out. However, measuring substitution rates per-generation holds potential in applications such as inferring transmission trees and predicting lineage emergence.

PMID:39585914 | DOI:10.1371/journal.ppat.1012740

PLoS Negl Trop Dis. 2024 Nov 25;18(11):e0012691. doi: 10.1371/journal.pntd.0012691. Online ahead of print.

ABSTRACT

BACKGROUND: Intestinal schistosomiasis caused by Schistosoma mansoni continues to be a significant public health problem in Ethiopia. This study investigated the prevalence and intensity of S.mansoni infection, and contributing factors in Alamata district of Tigray Region, Northern Ethiopia.

METHODS: A community-based cross-sectional study was conducted and 1762 participants were enrolled from five clusters in Alamata district. A questionnaire was used to collect socio-demographic data and risk factors. Stool samples were examined using Kato-katz technique to determine the prevalence and intensity of infection. The data were analyzed using SPSS version 25. Median, inter quartile range (IQR), mean, frequency, and percentage were used to descriptively summarize data. The Wilcoxon Mann-Whitney and Kruskal-Wallis tests were used to compare the differences in mean rank of egg load between different groups. Bivariate and multivariable logistic regression models were used to investigate the association between the odds of being infected with S.mansoni and the different socio-demographic and other factors. The strength of these associations was reported using odds ratio with corresponding 95% confidence intervals, and a P-value below 5% was used to report statistical significance.

RESULTS: Out of 1762 residents included in the study 941 (53.4%) were females. The age varied from 5-80 years, with a median age of 25 years (IQR = 27), the overall prevalence of S.mansoni was 21.5% with males accounting for 26% (204/821) of the infections. The proportion of infection was higher among the age groups of 15-19 and 20-29 years at 32.7% and 33.1%, respectively. The mean egg count among the infected study participants was 146.82 eggs per gram of feces (epg) ± (243.17 SD). Factors significantly associated with increased odds of infection were living in Waja cluster (AOR:8.9; 95% CI, 3.5-23.2; P< 0.001); being in the age groups 10-14 (AOR:6.0, 95% CI: 3.1-11.7, P<0.001), 15-19 (AOR:5.8, 95% CI:2.8-12.2, P<0.001), and 20-29 (AOR:3.5, 95% CI:1.8-6.8; P<0.001) years; having direct contact with water while crossing river (AOR: 2.4, 95% CI: 1.5-3.8, P<0.001); and swimming (AOR: 1.4, 95% CI: 1.01-2.0, P = 0.035).

CONCLUSION: The study indicates a notable S.mansoni burden in the area, driven by various risk factors. To effectively address this, enhancing diagnostics, implementing targeted mass drug administration, and conducting comprehensive health education campaigns on disease transmission routes are imperative.

PMID:39585912 | DOI:10.1371/journal.pntd.0012691

PLoS One. 2024 Nov 25;19(11):e0314185. doi: 10.1371/journal.pone.0314185. eCollection 2024.

ABSTRACT

BACKGROUND: Cognitive impairment (CI) in HIV is often of multifactorial causation, and remains a prominent issue in the age of effective combination antiretroviral therapy (cART), affecting approximately 14% of people living with HIV. Despite the 2018 BHIVA directive stating the importance of commencing rehabilitation strategies in people living with HIV with CI, no types of cognitive rehabilitations or other non-pharmaceutical interventions are specifically recommended. This scoping review aimed to describe the types of and evidence relating to the non-pharmaceutical interventions which have been examined in people living with HIV with CI.

METHODS: Studies were identified from five electronic databases. Criteria for study inclusion were studies describing a non-pharmaceutical intervention published after 1st January 2000 in English, in a population of adults living with HIV with CI detected at baseline, without significant psychiatric or substance-misuse co-morbidity.

RESULTS: Fourteen studies met the criteria for inclusion, with the Frascati criteria most commonly used to define CI within participant populations. The median intervention length was 12 weeks (IQR = 6.5). Nine studies investigated interventions with some component of computerised cognitive training (CCT); other interventions included diet, exercise and goal management training. Studies most commonly examined neurocognitive outcomes, but also considered other outcomes including quality of life, depressive symptomatology, intervention acceptability and cART adherence. Eight studies observed improvement in cognition with CCT, with effects often maintained for several weeks post-intervention, however, results were not always statistically significant. Self-reported cognitive improvement and intervention acceptability was high amongst participants completing CCT.

CONCLUSIONS: There was heterogeneity across studies not only in intervention type, but in diagnostic tools used, the chosen outcome measures and cognitive batteries, making comparison difficult. Findings, however, indicate that CCT interventions may produce benefits in cognition and are acceptable to patients. Further research is required in larger samples, alongside identifying specific intervention components that improve outcomes.

PMID:39585885 | DOI:10.1371/journal.pone.0314185

PLoS One. 2024 Nov 25;19(11):e0311299. doi: 10.1371/journal.pone.0311299. eCollection 2024.

ABSTRACT

BACKGROUND: About 70% of maternal fatalities (202,000) occurred in Sub-Saharan Africa alone. ANC lowers the morbidity and death rates for mothers and perinatals. The study aimed to determine the number of antenatal care and associated factors in the rural part of Ethiopia.

METHODS: We performed secondary data analysis for the 2019 intermediate EDHS, utilizing weighted data from a total of 2896.7 pregnant women. A zero-inflated Poisson regression analysis was executed using Stata version 17.0. Using the incident rate ratio and odds ratio with a 95% confidence interval, the intensity of the link and direction were shown.

RESULT: From the weighted pregnant women, 1086(37.47%) used four or more antenatal care during the current pregnancy. About 848 (29.29%) women do not attend antenatal care during pregnancy. The highest percentage (29.65%) of antenatal care visits was observed from 25 to 29 age. In comparison to women without formal education, the frequency of prenatal visits was 1.1(IRR = 1.1, 95% CI: 1.0425, 1.175) and 1.2 (IRR = 1.2, 95% CI: 1.093, 1.308) times higher among women enrolled in primary, and secondary & above education, respectively. Orthodox followers had 13% (IRR = 0.87, 95% CI: .813, 0.935) and 31% (IRR = 0.69, 95% CI: .552, 0.870) times more prenatal care visits than Protestant and other religions’ followers, respectively. Prenatal care was substantially more common among women living in wealthy households (IRR = 1.12, 95% CI: 1.051, 1.189). In the zero-inflated model, educational status, household wealth index, region, and religion show significant association with antenatal care service utilization uptake becomes zero.

CONCLUSION: In rural Ethiopia, the rate of antenatal care service utilization has been lower than the respective current national statistics. A significant proportion of mothers who received antenatal care did not receive enough visits. Living in developing regions, following the Orthodox faith, being educated, and having a better home wealth position reduces the likelihood of skipping antenatal treatment.

PMID:39585883 | DOI:10.1371/journal.pone.0311299

JMIR Form Res. 2024 Nov 25;8:e60574. doi: 10.2196/60574.

ABSTRACT

BACKGROUND: With a growing older adult population, the number of persons with dementia is expected to rise. Consequently, the number of persons needing decision-making capacity assessments (DMCA) will increase. The COVID-19 pandemic has impacted how we deliver patient care including DMCAs with a much more rapid shift to virtual assessments. Virtual DMCAs offer patients and health care professionals distinct advantages over in-person delivery by improving reach, access, and timely provision of health care. However, questions have arisen as to whether DMCAs can be effectively conducted virtually.

OBJECTIVE: This study aimed to determine the characteristics, barriers, and facilitators of conducting virtual DMCA during the COVID-19 pandemic.

METHODS: We conducted an online survey among health care providers who perform DMCAs in Alberta from March 2022 to February 2023. The survey consisted of 25 questions on demographics, preferences, and experience in conducting DMCAs virtually, and risks and barriers to doing virtual DMCAs. The data were analyzed using descriptive statistics.

RESULTS: There were 31 respondents with a mean age of 51.1 (SD 12.7) years. The respondents consisted of physicians (45.2%, 14/31), occupational therapists (29%, 9/31), and social workers (16.1%, 5/31), with a majority (93.6%, 29/31) based in Edmonton. The mean number of years of experience conducting DMCAs was 12.3 (SD 10.7), with a median of 8 DMCAs (IQR 18.5) conducted per year. Most respondents conduct capacity interviews, with a majority (55.2%, 16/29) being associated primarily with acute care services. Furthermore, 54.8% (17/31) were interested in conducting DMCAs virtually; however, only 25.8% (8/31) had administered DMCAs virtually. Barriers and facilitators to virtual DMCAs relate to patients’ characteristics and environment (such as communication difficulties, hearing or visual impairment, language barriers, ease of use of technology, or cognitive impairment), technology and technical support (need for technical support in both the client’s and assessor’s sides, the unreliability of internet connection in rural settings, and the availability of high-fidelity equipment), and assessors’ ability to perform DMCA’s virtually (ability to observe body language, interact with the client physically when needed, and build rapport can all be affected when conducting a DMCA virtually). In terms of implications for clinical practice, it is recommended that the patient or caregiver be familiar with technology, have a stable internet connection, use a private room, not be recorded, use a standardized assessment template, and have a backup plan in case of technical difficulties.

CONCLUSIONS: Conducting DMCAs virtually is a relatively infrequent undertaking. Barriers and facilitators to adequate assessment need to be addressed given that virtual assessments are time-saving and expand reach.

PMID:39585735 | DOI:10.2196/60574

Bioinformatics. 2024 Nov 25:btae707. doi: 10.1093/bioinformatics/btae707. Online ahead of print.

ABSTRACT

SUMMARY: LEfSe is a widely used Python package and Galaxy module for metagenomic biomarker discovery and visualization, utilizing the Kruskal-Wallis test, Wilcoxon Rank-Sum test, and Linear Discriminant Analysis. R/Bioconductor provides a large collection of tools for metagenomic data analysis but has lacked an implementation of this widely-used algorithm, hindering benchmarking against other tools and incorporation into R workflows. We present the lefser package to provide comparable functionality within the R/Bioconductor ecosystem of statistical analysis tools, with improvements to the original algorithm for performance, accuracy, and reproducibility. We benchmark the performance of lefser against the original algorithm using human and mouse metagenomic datasets.

AVAILABILITY AND IMPLEMENTATION: Our software, lefser, is distributed through the Bioconductor project (https://www.bioconductor.org/packages/release/bioc/html/lefser.html), and all the source code is available in the GitHub repository https://github.com/waldronlab/lefser.

CONTACT: Institute for Implementation Science in Population Health, Department of Epidemiology and Biostatistics, City University of New York School of Public Health, New York, NY, United States. E-mail: [email protected] (S.O.).

SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

PMID:39585730 | DOI:10.1093/bioinformatics/btae707

JAMA Neurol. 2024 Nov 25. doi: 10.1001/jamaneurol.2024.4058. Online ahead of print.

ABSTRACT

IMPORTANCE: Long-term exposure to total fine particulate matter (PM2.5) is a recognized dementia risk factor, but less is known about wildfire-generated PM2.5, an increasingly common PM2.5 source.

OBJECTIVE: To assess the association between long-term wildfire and nonwildfire PM2.5 exposure and risk of incident dementia.

DESIGN, SETTING, AND PARTICIPANTS: This open cohort study was conducted using January 2008 to December 2019 electronic health record (EHR) data among members of Kaiser Permanente Southern California (KPSC), which serves 4.7 million people across 10 California counties. KPSC members aged 60 years or older were eligible for inclusion. Members were excluded if they did not meet eligibility criteria, if they had a dementia diagnosis before cohort entry, or if EHR data lacked address information. Data analysis was conducted from May 2023 to May 2024.

EXPOSURES: Three-year rolling mean wildfire and nonwildfire PM2.5 in member census tracts from January 2006 to December 2019, updated quarterly and estimated via monitoring and remote-sensing data and statistical techniques.

MAIN OUTCOME AND MEASURES: The primary outcome was incident dementia, identified using diagnostic codes in the EHR. Odds of dementia diagnoses associated with 3-year mean wildfire and nonwildfire PM2.5 exposure were estimated using a discrete-time approach with pooled logistic regression. Models adjusted for age, sex, race and ethnicity (considered as a social construct rather than as a biological determinant), marital status, smoking status, calendar year, and census tract-level poverty and population density. Stratified models assessed effect measure modification by age, sex, race and ethnicity, and census tract-level poverty.

RESULTS: Among 1.64 million KPSC members aged 60 years or older during the study period, 1 223 107 members were eligible for inclusion in this study. The study population consisted of 644 766 female members (53.0%). In total, 319 521 members identified as Hispanic (26.0%), 601 334 members identified as non-Hispanic White (49.0%), and 80 993 members received a dementia diagnosis during follow-up (6.6%). In adjusted models, a 1-μg/m3 increase in the 3-year mean of wildfire PM2.5 exposure was associated with an 18% increase in the odds of dementia diagnosis (odds ratio [OR], 1.18; 95% CI, 1.03-1.34). In comparison, a 1-μg/m3 increase in nonwildfire PM2.5 exposure was associated with a 1% increase (OR, 1.01; 95% CI, 1.01-1.02). For wildfire PM2.5 exposure, associations were stronger among members less than 75 years old upon cohort entry, members from racially minoritized subgroups, and those living in high-poverty vs low-poverty census tracts.

CONCLUSIONS AND RELEVANCE: In this cohort study, after adjusting for measured confounders, long-term exposure to wildfire and nonwildfire PM2.5 over a 3-year period was associated with dementia diagnoses. As the climate changes, interventions focused on reducing wildfire PM2.5 exposure may reduce dementia diagnoses and related inequities.

PMID:39585704 | DOI:10.1001/jamaneurol.2024.4058