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Nevin Manimala Statistics

Deployment of the National Notifiable Diseases Surveillance System during the 2022-23 mpox outbreak in the United States-Opportunities and challenges with case notifications during public health emergencies

PLoS One. 2024 Apr 11;19(4):e0300175. doi: 10.1371/journal.pone.0300175. eCollection 2024.

ABSTRACT

Timely case notifications following the introduction of an uncommon pathogen, such as mpox, are critical for understanding disease transmission and for developing and implementing effective mitigation strategies. When Massachusetts public health officials notified the Centers for Disease Control and Prevention (CDC) about a confirmed orthopoxvirus case on May 17, 2023, which was later confirmed as mpox at CDC, mpox was not a nationally notifiable disease. Because existing processes for new data collections through the National Notifiable Disease Surveillance System were not well suited for implementation during emergency responses at the time of the mpox outbreak, several interim notification approaches were established to capture case data. These interim approaches were successful in generating daily case counts, monitoring disease transmission, and identifying high-risk populations. However, the approaches also required several data collection approvals by the federal government and the Council for State and Territorial Epidemiologists, the use of four different case report forms, and the establishment of complex data management and validation processes involving data element mapping and record-level de-duplication steps. We summarize lessons learned from these interim approaches to inform and improve case notifications during future outbreaks. These lessons reinforce CDC’s Data Modernization Initiative to work in close collaboration with state, territorial, and local public health departments to strengthen case-based surveillance prior to the next public health emergency.

PMID:38603766 | DOI:10.1371/journal.pone.0300175

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Nevin Manimala Statistics

Determinants of stillbirth among women who delivered in hospitals of North Wollo Zone, Northeast Ethiopia: A case-control study

PLoS One. 2024 Apr 11;19(4):e0301602. doi: 10.1371/journal.pone.0301602. eCollection 2024.

ABSTRACT

BACKGROUND: Stillbirth is a silent tragedy that shatters the lives of women, families, and nations. Though affecting over 2 million infants globally in 2019, it remains overlooked, with no specific targets dedicated to its reduction in the sustainable development goals. Insufficient knowledge regarding the primary risk factors contributing to stillbirths hinders efforts to reduce its occurrence. Driven by this urgency, this study focused on identifying the determinants of stillbirth among women giving birth in hospitals across North Wollo Zone, Northeast Ethiopia.

METHODOLOGY: This study employed an institution-based unmatched case-control design, involving a randomly selected sample of 412 women (103 cases and 309 controls) who gave birth in hospitals of North Wollo Zone. Data were collected using a structured data extraction checklist. Data entry was conducted using Epi-data version 3.1, and analysis was performed using SPSS version 25.0. Employing a multivariable logistic regression model, we identified independent predictors of stillbirth. The level of statistical significance was declared at a p-value < 0.05.

RESULTS: Our analysis revealed several critical factors associated with an increased risk of stillbirth. Women who experienced premature rupture of membranes (AOR = 5.53, 95% CI: 2.33-9.94), induced labor (AOR = 2.24, 95% CI: 1.24-4.07), prolonged labor exceeding 24 hours (AOR = 3.80, 95% CI: 1.94-7.45), absence of partograph monitoring during labor (AOR = 2.45, 95% CI: 1.41-4.26) were all significantly associated with increased risk of stillbirth. Preterm birth (AOR = 3.46, 95% CI: 1.87-6.39), post-term birth (AOR = 3.47, 95% CI: 1.35-8.91), and carrying a female fetus (AOR = 1.81, 95% CI: 1.02-3.22) were at a higher risk of stillbirth.

CONCLUSION: These findings highlight the importance of early intervention and close monitoring for women experiencing premature rupture of membranes, prolonged labor, or induced labor. Additionally, consistent partograph use and enhanced prenatal care for pregnancies at risk of preterm or post-term birth could potentially contribute to reducing stillbirth rates and improving maternal and neonatal outcomes. Further research is needed to investigate the underlying mechanisms behind the observed association between fetal sex and stillbirth risk.

PMID:38603732 | DOI:10.1371/journal.pone.0301602

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Nevin Manimala Statistics

Rural and urban differences in the prevalence and determinants of Type-2 diabetes in Bangladesh

PLoS One. 2024 Apr 11;19(4):e0298071. doi: 10.1371/journal.pone.0298071. eCollection 2024.

ABSTRACT

OBJECTIVE: To estimate the prevalence of Type 2 Diabetes (T2D) in urban and rural settings and identify the specific risk factors for each location.

METHOD: We conducted this study using data from the 2017-18 Bangladesh Demographic and Health Survey (BDHS), sourced from the DHS website. The survey employed a stratified two-stage sampling method, which included 7,658 women and 7,048 men aged 18 and older who had their blood glucose levels measured. We utilized chi-square tests and ordinal logistic regression to analyze the association between various selected variables in both urban and rural settings and their relationship with diabetes and prediabetes.

RESULTS: The prevalence of T2D was 10.8% in urban areas and 7.4% in rural areas, while pre-diabetes affected 31.4% and 27% of the populations in these respective settings. The study found significant factors influencing diabetes in both urban and rural regions, particularly in the 55-64 age group (Urban: AOR = 1.88, 95% CI [1.46, 2.42]; Rural: AOR = 1.87, 95% CI [1.54, 2.27]). Highly educated individuals had lower odds of T2D, while wealthier and overweight participants had higher odds in both areas. In rural regions, T2D risk was higher among caffeinated drink consumers and those not engaged in occupation-related physical activity, while these factors did not show significant influence in urban areas. Furthermore, urban participants displayed a significant association between T2D and hypertension.

CONCLUSION: Our study outlines a comprehensive strategy to combat the increasing prevalence of T2D in both urban and rural areas. It includes promoting healthier diets to control BMI level, encouraging regular physical activity, early detection through health check-ups, tailored awareness campaigns, improving healthcare access in rural regions, stress management in urban areas, community involvement, healthcare professional training, policy advocacy like sugary drink taxation, research, and monitoring interventions. These measures collectively address the T2D challenge while accommodating the distinct features of urban and rural settings.

PMID:38603719 | DOI:10.1371/journal.pone.0298071

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Nevin Manimala Statistics

Bacterial diversity and composition on the rinds of specific melon cultivars and hybrids from across different growing regions in the United States

PLoS One. 2024 Apr 11;19(4):e0293861. doi: 10.1371/journal.pone.0293861. eCollection 2024.

ABSTRACT

The goal of this study was to characterize the bacterial diversity on different melon varieties grown in different regions of the US, and determine the influence that region, rind netting, and variety of melon has on the composition of the melon microbiome. Assessing the bacterial diversity of the microbiome on the melon rind can identify antagonistic and protagonistic bacteria for foodborne pathogens and spoilage organisms to improve melon safety, prolong shelf-life, and/or improve overall plant health. Bacterial community composition of melons (n = 603) grown in seven locations over a four-year period were used for 16S rRNA gene amplicon sequencing and analysis to identify bacterial diversity and constituents. Statistically significant differences in alpha diversity based on the rind netting and growing region (p < 0.01) were found among the melon samples. Principal Coordinate Analysis based on the Bray-Curtis dissimilarity distance matrix found that the melon bacterial communities clustered more by region rather than melon variety (R2 value: 0.09 & R2 value: 0.02 respectively). Taxonomic profiling among the growing regions found Enterobacteriaceae, Bacillaceae, Microbacteriaceae, and Pseudomonadaceae present on the different melon rinds at an abundance of ≥ 0.1%, but no specific core microbiome was found for netted melons. However, a core of Pseudomonadaceae, Bacillaceae, and Exiguobacteraceae were found for non-netted melons. The results of this study indicate that bacterial diversity is driven more by the region that the melons were grown in compared to rind netting or melon type. Establishing the foundation for regional differences could improve melon safety, shelf-life, and quality as well as the consumers’ health.

PMID:38603714 | DOI:10.1371/journal.pone.0293861

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Nevin Manimala Statistics

Investigating the internal structure of multiple mini interviews-A perspective from Pakistan

PLoS One. 2024 Apr 11;19(4):e0301365. doi: 10.1371/journal.pone.0301365. eCollection 2024.

ABSTRACT

BACKGROUND: Healthcare professionals require many personal attributes in addition to cognitive abilities and psychomotor skills for competent practice. Multiple Mini- Interviews are being employed globally to assess personality attributes of candidates for selection in health professions education at all level of entry; these attributes are namely, communication skills, critical thinking, honesty, responsibility, health advocacy, empathy and sanctity of life. Considering the high stakes involved for students, faculty, institutions and the society, rigorous quality assurance mechanisms similar to those used for student assessment must be employed for student selection, throughout the continuum of medical education. It is a difficult undertaking as these psychological constructs are difficult to define and measure. Though considered to yield reliable and valid scores, studies providing multiple evidences of internal structure especially dimensionality of Multiple Mini-Interviews are sparse giving rise to questions if they are measuring a single or multiple constructs and even if they are measuring what they are purported to be measuring.

OBJECTIVE: The main objective is to provide statistical support of the multi-dimensional nature of our Multiple Mini Interviews, hypothesized a-priori, through CFA. Another objective is to provide multiple evidences for the internal structure. Our study highlights the link between content and internal structure evidences of the constructs, thus establishing that our Multiple Mini Interviews measure what they were intended to measure.

METHOD: After securing permission from the Institutional review board, an a-priori seven factor-model was hypothesized based on the attributes considered most essential for the graduating student of the institution. After operationally defining the attributes through extensive literature search, scenarios were constructed to assess them. A 5-point rating scale was used to rate each item on the station. A total 259 students participated in the multiple mini interviews over a period of three days. A training workshop had been arranged for the participating faculty.

RESULTS: The reliability coefficient using Cronbach’s alpha were calculated (range from 0.73 to 0.94), Standard Error of Measurement (ranged from 0.80 to1.64), and item to station-total correlation ranged from 0.43-0.50 to 0.75-0.83. Inter-station correlation was also determined. Confirmatory factor analysis endorsed the results of Exploratory factor analysis in the study revealing a seven model fit with multiple indices of Goodness-of-fit statistics such as Root mean square error of approximation (RMSEA) value 0.05, Standardized root mean square residual (SRMR) value with less than 0.08. All these indices showed that model fit is good. The Confirmatory factor analysis confirmed the multi-dimensional nature of our MMIs and also confirmed that our stations measured the attributes that they were supposed to measure.

CONCLUSION: This study adds to the validity evidence of Multiple Mini-Interviews, in selection of candidates, with required personality traits for healthcare profession. It provides the evidence for the multi-dimensional structure of Multiple Mini interviews administered with multiple evidences for its internal structure and demonstrates the independence of different constructs being measured.

PMID:38603708 | DOI:10.1371/journal.pone.0301365

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Nevin Manimala Statistics

Validation of the shortened version of the Canine Behavioral Assessment and Research Questionnaire (C-BARQ) using participants from the Dog Aging Project

PLoS One. 2024 Apr 11;19(4):e0299973. doi: 10.1371/journal.pone.0299973. eCollection 2024.

ABSTRACT

The Canine Behavioral Assessment and Research Questionnaire (C-BARQ) is a 100-item owner-completed survey instrument used for assessing behavior and temperament of companion dogs. The shortened version of the C-BARQ (C-BARQ(S)) consists of 42 items of the long C-BARQ. We aimed to validate the shortened C-BARQ(S) by comparing it with the long questionnaire in the same human-dog pair. We examined data from a nationwide cohort of companion dogs enrolled in the large-scale longitudinal Dog Aging Project (DAP) study. Among 435 participating owners who completed both the long and shortened versions of the C-BARQ within 60 days of each other, agreement between individual questions of the long and shortened C-BARQ using an unweighted kappa statistic and percent agreement was examined. Associations between the two questionnaires for mean behavior and temperament domain scores and mean miscellaneous category scores were assessed using Pearson correlation coefficients. Of 435 dogs in the study, the mean (SD) age was 7.3 (4.3) years and 216 (50%) were female. Kappa values between the long and shortened C-BARQ for individual questions within the 14 behavior and temperament domains and a miscellaneous category ranged from fair to moderate (0.23 to 0.40 for 21 items and 0.41 to 0.58 for 26 items, respectively). Pearson correlation coefficients above 0.60 between both questionnaires for 12 of the 14 mean behavior and temperament domain scores and a category of miscellaneous items were observed. Kappa values for individual questions between the long and shortened C-BARQ ranged from fair to moderate and correlations between mean domain scores ranged from moderate to strong.

PMID:38603705 | DOI:10.1371/journal.pone.0299973

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Nevin Manimala Statistics

Inhibitory control mediates the association between body mass index and math performance in children: A cross-sectional study

PLoS One. 2024 Apr 11;19(4):e0296635. doi: 10.1371/journal.pone.0296635. eCollection 2024.

ABSTRACT

BACKGROUND: Overweight and obesity affect more than 18% of children and adolescents in the world. Obesity-related associations with brain morphology might be associated with reduced efficiency of inhibitory control. This association highlights a possible mechanism by which obesity impacts intelligence and academic achievement. Prior work indicates a mediating effect of inhibitory control on the relationship between body mass index (BMI) and intelligence and academic achievement. However, although obesity is associated with impaired math performance, we do not know whether inhibitory control also mediates the relationship between BMI and math performance. This study tests the hypothesis that inhibitory control statistically mediates the relationship between BMI and math performance.

METHODS: 161 children (9 to 13 years old, 80 female) participated in the present study. We evaluated BMI; math performance, in a test composed of 20 arithmetic equations of the type x = (a × b) – c; and inhibitory control through the Flanker test. We carried out Spearman correlation tests, hierarchical multiple linear regression, and tested the confidence of the model where inhibitory control statistically mediates the indirect association between BMI and math performance. Mediation analysis in this cross-sectional study aimed to improve understanding of indirect relationships and offer insights into possible causal connections.

RESULTS: Better math performance and lower BMI were associated with greater accuracy on the inhibitory control test and greater accuracy on the inhibitory control test was associated with better performance on math test. We found an indirect association between higher BMI in children and impairments in math performance, that was mediated by inhibitory control (a: -0.008, p = 0.025; b: 7.10, p = 0.0004; c: 0.05, p = 0.592; c’: 0.11, p = 0.238; Indirect Effect: -0.0599, 95% CI: -0.13, -0.005).

CONCLUSIONS: An indirect association between higher body mass indices in children and impairments in math performance was detected, through the impact that BMI has on inhibitory control.

PMID:38603699 | DOI:10.1371/journal.pone.0296635

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Nevin Manimala Statistics

Assessing the impact of different contact patterns on disease transmission: Taking COVID-19 as a case

PLoS One. 2024 Apr 11;19(4):e0300884. doi: 10.1371/journal.pone.0300884. eCollection 2024.

ABSTRACT

Human-to-human contact plays a leading role in the transmission of infectious diseases, and the contact pattern between individuals has an important influence on the intensity and trend of disease transmission. In this paper, we define regular contacts and random contacts. Then, taking the COVID-19 outbreak in Yangzhou City, China as an example, we consider age heterogeneity, household structure and two contact patterns to establish discrete dynamic models with switching between daytime and nighttime to depict the transmission mechanism of COVID-19 in population. We studied the changes in the reproduction number with different age groups and household sizes at different stages. The effects of the proportion of two contacts patterns on reproduction number were also studied. Furthermore, taking the final size, the peak value of infected individuals in community and the peak value of quarantine infected individuals and nucleic acid test positive individuals as indicators, we evaluate the impact of the number of random contacts, the duration of the free transmission stage and summer vacation on the spread of the disease. The results show that a series of prevention and control measures taken by the Chinese government in response to the epidemic situation are reasonable and effective, and the young and middle-aged adults (aged 18-59) with household size of 6 have the strongest transmission ability. In addition, the results also indicate that increasing the proportion of random contact is beneficial to the control of the infectious disease in the phase with interventions. This work enriches the content of infectious disease modeling and provides theoretical guidance for the prevention and control of follow-up major infectious diseases.

PMID:38603698 | DOI:10.1371/journal.pone.0300884

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Nevin Manimala Statistics

Building consensus on priority areas for Sub-Saharan Africa’s ageing population research: An e-Delphi study protocol

PLoS One. 2024 Apr 11;19(4):e0298541. doi: 10.1371/journal.pone.0298541. eCollection 2024.

ABSTRACT

BACKGROUND: Improvement in medico-social services has increased life expectancy and population ageing in Sub-Saharan Africa (SSA). It was estimated that about 163 million people aged 65 and older will be resident in SSA by 2050. There is inadequate ageing research capacity in SSA which necessitates this study to (a) identify a decade-long ageing research opportunities, challenges, and solutions, and (b) prioritize critical ageing research areas and methodologies relevant to the SSA.

METHODS: We designed an e-Delphi protocol following the Reporting Guideline for Priority Setting of Health Research with Stakeholder. The stakeholders will be researchers, practitioners, older adults, and caregivers purposively selected through snowballing quota sampling to complete three rounds of e-Delphi surveys. Round 1 will involve open-ended questions derived from the study objectives. Responses from round 1 will be prepared as a checklist for stakeholders to rate during rounds 2 & 3, using a 9-point scale: low priority (1-3), moderate priority (4-6), and high priority (7-9). The criterion for reaching a consensus will be ≥ 70% of stakeholders rating an item “high priority” and ≤ 15% as “low priority.” Quantitative data will be analysed using descriptive statistics, Wilcoxon matched-pairs signed-rank test will be used to assess the stability of stakeholders’ responses, and qualitative comments will be analysed using content analysis.

DISCUSSION AND IMPLICATIONS: Setting aging research/practice priorities will help maximize the benefits of research investment and provide valuable direction for allocating public and private research funds to areas of strategic importance.

PMID:38603688 | DOI:10.1371/journal.pone.0298541

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Nevin Manimala Statistics

Robustness of radiomic features in 123I-ioflupane-dopamine transporter single-photon emission computer tomography scan

PLoS One. 2024 Apr 11;19(4):e0301978. doi: 10.1371/journal.pone.0301978. eCollection 2024.

ABSTRACT

Radiomic features are usually used to predict target variables such as the absence or presence of a disease, treatment response, or time to symptom progression. One of the potential clinical applications is in patients with Parkinson’s disease. Robust radiomic features for this specific imaging method have not yet been identified, which is necessary for proper feature selection. Thus, we are assessing the robustness of radiomic features in dopamine transporter imaging (DaT). For this study, we made an anthropomorphic head phantom with tissue heterogeneity using a personal 3D printer (polylactide 82% infill); the bone was subsequently reproduced with plaster. A surgical cotton ball with radiotracer (123I-ioflupane) was inserted. Scans were performed on the two-detector hybrid camera with acquisition parameters corresponding to international guidelines for DaT single photon emission tomography (SPECT). Reconstruction of SPECT was performed on a clinical workstation with iterative algorithms. Open-source LifeX software was used to extract 134 radiomic features. Statistical analysis was made in RStudio using the intraclass correlation coefficient (ICC) and coefficient of variation (COV). Overall, radiomic features in different reconstruction parameters showed a moderate reproducibility rate (ICC = 0.636, p <0.01). Assessment of ICC and COV within CT attenuation correction (CTAC) and non-attenuation correction (NAC) groups and within particular feature classes showed an excellent reproducibility rate (ICC > 0.9, p < 0.01), except for an intensity-based NAC group, where radiomic features showed a good repeatability rate (ICC = 0.893, p <0.01). By our results, CTAC becomes the main threat to feature stability. However, many radiomic features were sensitive to the selected reconstruction algorithm irrespectively to the attenuation correction. Radiomic features extracted from DaT-SPECT showed moderate to excellent reproducibility rates. These results make them suitable for clinical practice and human studies, but awareness of feature selection should be held, as some radiomic features are more robust than others.

PMID:38603674 | DOI:10.1371/journal.pone.0301978