Tag: nevin manimala

PLoS One. 2023 Sep 13;18(9):e0291499. doi: 10.1371/journal.pone.0291499. eCollection 2023.

ABSTRACT

BACKGROUND: Immunization has been promoted as a global strategy aimed at improving child survival. The World Health Organization strives to make immunization services available to everyone, everywhere to save over 50 million lives by 2030. Monitoring the change and identifying the factors contributing to the change in immunization coverage over time and across the nations is imperative for continuing global success in increasing immunization coverage. In this study, we examined the changes and factors that contributed to the change in full immunization coverage over time in Ethiopia (2000 to 2019).

METHODS: We analyzed data on children aged 12-23 months, extracted from the 2000 and 2019 Ethiopian Demographic and Health Survey (EDHS) datasets. A total of 3,072 weighted samples (2,076 in 2000 and 966 in 2019) were included in the analysis. A multivariate decomposition analysis technique was used to determine change and identify factors that contributed to the change over time. Statistical significance was defined at a 95% confidence interval with a p-value of less than 0.05.

RESULTS: There was a 29.56% (95% CI: 24.84, 34.28) change in full immunization coverage between the two surveys. It increased from 14.62% (95% CI: 12.43, 17.11) in 2000 to 44.18% (95% CI: 37.19, 51.41) in 2019. The decomposition analysis showed that about 75% of explained change was attributed to the differences in the composition of explanatory variables (the endowment effect). Particularly, women aged 35-49 years (-2.11%), those who attended four or more antenatal care visits (17.06%), individual who had postnatal care visits (16.90%), households with two or more under-five children (2.50%), and those with a history of child mortality (17.80%) were significantly attributed to the change. The rest, 25% of the explained change was attributed to the difference in the effects of explanatory variables (coefficient). The change in the coefficient for women who had experienced child death (-20.40%) was statistically significant to the change in full immunization coverage over time.

CONCLUSION: The finding of this study revealed that there was a statistically significant change in full immunization coverage over time. The majority of the change was attributed to the differences in the composition of explanatory variables such as antenatal care and postnatal care visits, age of the mother, and number of living children in the household. Therefore, strengthening maternal health services utilization may enhance immunization coverage in Ethiopia. Furthermore, the difference in coefficient of mothers with a history of child death had a substantial counteracting effect on the change, emphasizing the importance of raising awareness and delivering vaccine education to them and the larger community.

PMID:37703252 | DOI:10.1371/journal.pone.0291499

J Fish Biol. 2023 Sep 13. doi: 10.1111/jfb.15564. Online ahead of print.

ABSTRACT

A ten-year monitoring program was developed to quantify the population dynamics of long-snouted seahorse population in the Mar Menor coastal lagoon. Based on 985 underwater visual censuses, we estimated the long-snouted seahorse (Hippocampus guttulatus Cuvier, 1829) population size in the Mar Menor Lagoon and its reduction in size in the last decades, as well as the effect of eutrophication crises in 2016 and 2019 on the species. The annual recruitment for the 2013-2020 period was estimated by comparing the relative abundance of early seahorse life stages in the ichthyoplankton. The density ranged from 0.0458 specimens/m³ at the beginning to 0.0004 at the end of the sampling period, showing a statistically significant difference between the three analysed periods (H_gl=2 =14.0, p=0.001). The long-snouted population from the Mar Menor Lagoon exemplifies the impact of fishing activities and human pressure, especially euxinic episodes and habitat destruction. As a result of this, the Mar Menor population has decreased from several million specimens to a few thousand, in only three decades. This species showed considerable resilience, recovering from fishing activity once that it had abated. In contrast, long-snouted seahorse showed high vulnerability to habitat loss and an episodic flooding event. Adult seahorses showed preferences for highly complex habitats, especially Caulerpa prolifera-Cymodocea nodosa mixed meadows and habitats of high complexity and anthropogenic origin, such as harbours, jetties or breakwaters. In contrast, juvenile sseahorses preferred monotonous seabeds with low complexity, such as sandy beds that are characteristic of the Mar Menor Lagoon littoral. This article is protected by copyright. All rights reserved.

PMID:37703094 | DOI:10.1111/jfb.15564

J Chem Theory Comput. 2023 Sep 13. doi: 10.1021/acs.jctc.3c00651. Online ahead of print.

ABSTRACT

Relative entropy minimization, a statistical-mechanics approach for finding potential energy functions that produce target structural ensembles, has proven to be a powerful strategy for the inverse design of nanoparticle self-assembly. For a given target structure, the gradient of the relative entropy with respect to the adjustable parameters of the potential energy function is computed by performing a simulation, and then these parameters are updated using iterative gradient-based optimization. Small parameter updates per iteration and many iterations can be required for numerical stability, but this incurs considerable computational expense because a new simulation must be performed to reevaluate the gradient at each iteration. Here, we investigate the use of surrogate modeling to decouple the process of minimizing the relative entropy from the computationally demanding process of determining its gradient. We approximate the relative-entropy gradient using Chebyshev polynomial interpolation on Smolyak sparse grids. Our approach potentially increases the robustness and computational efficiency of using the relative entropy for inverse design, primarily for physically informed potential energy functions that have a small number of adjustable parameters.

PMID:37703086 | DOI:10.1021/acs.jctc.3c00651

J Med Internet Res. 2023 Sep 13;25:e44016. doi: 10.2196/44016.

ABSTRACT

BACKGROUND: Up to one-third of young people live with chronic physical conditions (eg, diabetes, asthma, and autoimmune disease) that frequently involve recurrent pain, fatigue, activity limitations, stigma, and isolation. These issues may be exacerbated as young people transition through adolescence. Accordingly, young people with chronic illness are at a high risk of psychological distress. Accessible, evidence-based interventions for young people with chronic illnesses are urgently needed to improve well-being, support adaptation, and enhance daily functioning. Self-compassion, which is an adaptive means of relating to oneself during times of difficulty, is a promising intervention target for this population.

OBJECTIVE: This study aims to test the efficacy of a 4-week, self-guided, web-based self-compassion training program for improving well-being among young Australians (aged 16-25 years) living with a chronic medical condition. The primary outcomes were self-compassion, emotion regulation difficulties, and coping; the secondary outcomes were well-being, distress, and quality of life. We also sought to test whether changes in primary outcomes mediated changes in secondary outcomes and gather feedback about the strengths and limitations of the program.

METHODS: We conducted a single-blind, parallel-group, randomized controlled trial comparing a 4-week, fully automated, web-based self-compassion training program with a waitlist control. Participants were recruited via the internet, and outcomes were self-assessed at 4 (T1) and 12 weeks (T2) after the baseline time point via a web-based survey. A mixed methods approach was used to evaluate the program feedback.

RESULTS: Overall, 151 patients (age: mean 21.15, SD 2.77 years; female patients: n=132, 87.4%) were randomized to the intervention (n=76, 50.3%) and control (n=75, 49.7%) groups. The loss-to-follow-up rate was 47.4%, and program use statistics indicated that only 29% (22/76) of young people in the experimental group completed 100% of the program. The main reported barrier to completion was a lack of time. As anticipated, treatment effects were observed for self-compassion (P=.01; partial η²=0.05; small effect); well-being (P≤.001; partial η²=0.07; medium effect); and distress (P=.003; partial η²=0.054; small-medium effect) at the posttest time point and maintained at follow-up. Contrary to our hypotheses, no intervention effects were observed for emotion regulation difficulties or maladaptive coping strategies. Improvements in adaptive coping were observed at the posttest time point but were not maintained at follow-up. Self-compassion, but not emotion regulation difficulties or coping, mediated the improvements in well-being.

CONCLUSIONS: Minimal-contact, web-based self-compassion training can confer mental health benefits on young people with chronic conditions. This group experiences substantial challenges to participation in mental health supports, and program engagement and retention in this trial were suboptimal. Future work should focus on refining the program content, engagement, and delivery to optimize engagement and treatment outcomes for the target group.

TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry 12619000572167; https://tinyurl.com/5n6hevt.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s12889-020-8226-7.

PMID:37703081 | DOI:10.2196/44016

ACS Synth Biol. 2023 Sep 13. doi: 10.1021/acssynbio.3c00201. Online ahead of print.

ABSTRACT

Epitopes are specific regions on an antigen’s surface that the immune system recognizes. Epitopes are usually protein regions on foreign immune-stimulating entities such as viruses and bacteria, and in some cases, endogenous proteins may act as antigens. Identifying epitopes is crucial for accelerating the development of vaccines and immunotherapies. However, mapping epitopes in pathogen proteomes is challenging using conventional methods. Screening artificial neoepitope libraries against antibodies can overcome this issue. Here, we applied conventional sequence analysis and methods inspired in natural language processing to reveal specific sequence patterns in the linear epitopes deposited in the Immune Epitope Database (www.iedb.org) that can serve as building blocks for the design of universal epitope libraries. Our results reveal that amino acid frequency in annotated linear epitopes differs from that in the human proteome. Aromatic residues are overrepresented, while the presence of cysteines is practically null in epitopes. Byte pair encoding tokenization shows high frequencies of tryptophan in tokens of 5, 6, and 7 amino acids, corroborating the findings of the conventional sequence analysis. These results can be applied to reduce the diversity of linear epitope libraries by orders of magnitude.

PMID:37703075 | DOI:10.1021/acssynbio.3c00201

JMIR Mhealth Uhealth. 2023 Sep 13;11:e47502. doi: 10.2196/47502.

ABSTRACT

BACKGROUND: Nonspecific low back pain (NSLBP) carries significant socioeconomic relevance and leads to substantial difficulties for those who are affected by it. The effectiveness of app-based treatments has been confirmed, and clinicians are recommended to use such interventions. As 88.8% of the German population uses smartphones, apps could support therapy. The available apps in mobile app stores are poorly regulated, and their quality can vary. Overviews of the availability and quality of mobile apps for Australia, Great Britain, and Spain have been compiled, but this has not yet been done for Germany.

OBJECTIVE: We aimed to provide an overview of the availability and content-related quality of apps for the treatment of NSLBP in the German language.

METHODS: A systematic search for apps on iOS and Android was conducted on July 6, 2022, in the Apple App Store and Google Play Store. The inclusion and exclusion criteria were defined before the search. Apps in the German language that were available in both stores were eligible. To check for evidence, the apps found were assessed using checklists based on the German national guideline for NSLBP and the British equivalent of the National Institute for Health and Care Excellence. The quality of the apps was measured using the Mobile Application Rating Scale. To control potential inaccuracies, a second reviewer resurveyed the outcomes for 30% (3/8) of the apps and checked the inclusion and exclusion criteria for these apps. The outcomes, measured using the assessment tools, are presented in tables with descriptive statistics. Furthermore, the characteristics of the included apps were summarized.

RESULTS: In total, 8 apps were included for assessment. Features provided with different frequencies were exercise tracking of prefabricated or adaptable workout programs, educational aspects, artificial intelligence-based therapy or workout programs, and motion detection. All apps met some recommendations by the German national guideline and used forms of exercises as recommended by the National Institute for Health and Care Excellence guideline. The mean value of items rated as “Yes” was 5.75 (SD 2.71) out of 16. The best-rated app received an answer of “Yes” for 11 items. The mean Mobile Application Rating Scale quality score was 3.61 (SD 0.55). The highest mean score was obtained in “Section B-Functionality” (mean 3.81, SD 0.54).

CONCLUSIONS: Available apps in the German language meet guideline recommendations and are mostly of acceptable or good quality. Their use as a therapy supplement could help promote the implementation of home-based exercise protocols. A new assessment tool to obtain ratings on apps for the treatment of NSLBP, combining aspects of quality and evidence-based best practices, could be useful.

TRIAL REGISTRATION: Open Science Framework Registries sq435; https://osf.io/sq435.

PMID:37703072 | DOI:10.2196/47502

Int J Gynaecol Obstet. 2023 Sep 13. doi: 10.1002/ijgo.15073. Online ahead of print.

ABSTRACT

OBJECTIVE: We provide an overview of the safety of messenger RNA and inactivated coronavirus disease 2019 (COVID-19) vaccine and monitoring of pregnant women after COVID-19 vaccination. The vaccine safety outcome profile is beneficial for further recommendations of COVID-19 vaccination in pregnancy.

METHODS: This research was conducted as descriptive research. Sampling was performed using an online questionnaire to be filled out voluntarily and distributed to all pregnant women in Indonesia who received the COVID-19 vaccination. Data collection was performed and descriptive statistics were obtained.

RESULTS: Among 31 977 pregnant women, 24 212 (75.7%) received the first dose, 7619 (23.8%) received the second dose, and 146 (4.5%) received the third dose of the COVID-19 vaccine. Sinovac vaccine is the most administered vaccine to pregnant women (27 122 [84%]). Most pregnant women (78.7%) who were vaccinated had no adverse effects after immunization, while the most reported adverse effects were mild symptoms.

CONCLUSION: The current study contributed evidence that COVID-19 vaccination during pregnancy has minimal adverse effects. These findings may help pregnant women and healthcare providers to make informed decisions regarding vaccination.

PMID:37703057 | DOI:10.1002/ijgo.15073

J Geriatr Phys Ther. 2023 Sep 13. doi: 10.1519/JPT.0000000000000395. Online ahead of print.

ABSTRACT

BACKGROUND: The purpose of this study is to stratify the age at which older adults are most likely to sustain injuries and major complications resulting from low-energy falls so that fall prevention strategies may be targeted to more susceptible age groups.

METHODS: A consecutive series of 12 709 patients older than 55 years enrolled in an orthopedic trauma registry from October 2014 to April 2021 were reviewed for demographic factors, hospital quality measures, and outcomes. Patients were grouped by age brackets in 5-year intervals. Comparative analyses were conducted across age groups with an additional post hoc analysis comparing the 75- to 79-year-old cohort with others. All statistical analyses were conducted utilizing a Bonferroni-adjusted alpha.

RESULTS: Of the 12 709 patients, 9924 patients (78%) sustained a low-energy fall. The mean age of the cohort was 75.3 (range: 55-106) years and the median number of complications per person was 1.0 (range: 0-7). The proportion of females increased across each age group. The mean Charlson Comorbidity Index increased across each age group, except in the cohort of 90+ years of age. There was a varied distribution of fractures among age groups with the incidence of hip fractures most prominently increasing with age. Complication rates varied significantly between all age groups. Between the ages of 70 to 74 years and 80 to 84 years, there was a 2-fold increase in complication rate, and between the ages of 70 to 74 years and 75 to 79 years, there was a near 2×/1.5×/1.4× increase in inpatient, 30-day, and 1-year mortality rate, respectively. When controlling for confounding demographic variables between age groups, the rates of complications and mortality still differed.

CONCLUSIONS: Fall prevention interventions, while applicable to all older adult patients, could improve outcomes by offering additional resources particularly for individuals between 70 and 80 years of age. These additional resources can help minimize excessive hospitalizations, prolonged lengths of stay, and the detrimental complications that frequently coincide with falls. Although hip fractures are the most common fracture as patients get older, other fractures still occur with frequency, and fall prevention strategies should account for prevention of these injuries as well.

PMID:37703046 | DOI:10.1519/JPT.0000000000000395

JAMA Netw Open. 2023 Sep 5;6(9):e2333526. doi: 10.1001/jamanetworkopen.2023.33526.

ABSTRACT

IMPORTANCE: Broad efforts to improve access to early psychosis intervention (EPI) services may not address health disparities in pathways to care and initial engagement in treatment.

OBJECTIVE: To understand factors associated with referral from acute hospital-based settings and initial engagement in EPI services.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study used electronic medical record data from all patients aged 16 to 29 years who were referred to a large EPI program between January 2018 and December 2019. Statistical analysis was performed from March 2022 to February 2023.

EXPOSURES: Patients self-reported demographic information in a structured questionnaire. The main outcome for the first research question (referral source) was an exposure for the second research question (initial attendance).

MAIN OUTCOMES AND MEASURES: Rate of EPI referral from acute pathways compared with other referral sources, and rate of attendance at the consultation appointment.

RESULTS: The final study population included 999 unique patient referrals. At referral, patients were a mean (SD) age of 22.5 (3.5) years; 654 (65.5%) identified as male, 323 (32.3%) female, and 22 (2.2%) transgender, 2-spirit, nonbinary, do not know, or prefer not to answer; 199 (19.9%) identified as Asian, 176 (17.6%) Black, 384 (38.4%) White, and 167 (16.7%) other racial or ethnic groups, do not know, or prefer not to answer. Participants more likely to be referred to EPI services from inpatient units included those who were older (relative risk ratio [RRR], 1.10; 95% CI, 1.05-1.15) and those who identified as Black (RRR, 2.11; 95% CI, 1.38-3.22) or belonging to other minoritized racial or ethnic groups (RRR, 1.79; 95% CI, 1.14-2.79) compared with White participants. Older patients (RRR, 1.16; 95% CI, 1.11-1.22) and those who identified as Black (RRR, 1.67; 95% CI, 1.04-2.70) or belonging to other minoritized racial or ethnic groups (RRR, 2.11; 95% CI, 1.33-3.36) were more likely to be referred from the emergency department (ED) compared with White participants, whereas participants who identified as female (RRR, 0.51 95% CI, 0.34-.74) had a lower risk of ED referral compared with male participants. Being older (odds ratio [OR], 0.95; 95% CI, 0.90-1.00) and referred from the ED (OR, 0.40; 95% CI, 0.27-0.58) were associated with decreased odds of attendance at the consultation appointment.

CONCLUSIONS AND RELEVANCE: In this cohort study of patients referred to EPI services, disparities existed in referral pathways and initial engagement in services. Improving entry into EPI services may help facilitate a key step on the path to recovery among youths and young adults with psychosis.

PMID:37703014 | DOI:10.1001/jamanetworkopen.2023.33526

JAMA Cardiol. 2023 Sep 13. doi: 10.1001/jamacardio.2023.2934. Online ahead of print.

ABSTRACT

IMPORTANCE: Allocating resources to increase survival after cardiac arrest requires survivors to have a good quality of life, but long-term data are lacking.

OBJECTIVE: To determine the quality of life of survivors of out-of-hospital cardiac arrest from 2001 to 2019.

DESIGN, SETTING, AND PARTICIPANTS: This survey study used the EuroQol Health Questionnaire, 12-Item Short Form Health Survey (SF-12), and Hospital Anxiety and Depression Scale (HADS) to assess the health-related quality of life of all adult survivors of out-of-hospital cardiac arrest included in the Danish Cardiac Arrest Registry between June 1, 2001, and August 31, 2019, who were alive in October 2020 (follow-up periods, 0-1, >1-2, >2-4, >4-6, >6-8, >8-10, >10-15, and >15-20 years since arrest). The survey was conducted from October 1, 2020, through May 31, 2021.

EXPOSURE: All patients who experienced an out-of-hospital cardiac arrest.

MAIN OUTCOME AND MEASURES: Self-reported health was measured using the EuroQol Health Questionnaire index (EQ index) score and EQ visual analog scale. Physical and mental health were measured using the SF-12, and anxiety and depression were measured using the HADS. Descriptive statistics were used for the analysis.

RESULTS: Of 4545 survivors, 2552 (56.1%) completed the survey, with a median follow-up since their event of 5.5 years (IQR, 2.9-8.9 years). Age was comparable between responders and nonresponders (median [IQR], 67 [58-74] years vs 68 [56-78] years), and 2075 responders (81.3%) were men and 477 (18.7%) women (vs 1473 male [73.9%] and 520 female [26.1%] nonresponders). For the shortest follow-up (0-1 year) and longest follow-up (>15-20 years) groups, the median EQ index score was 0.9 (IQR, 0.7-1.0) and 0.9 (0.8-1.0), respectively. For all responders, the mean (SD) SF-12 physical health score was 43.3 (12.3) and SF-12 mental health score, 52.9 (8.3). All 3 scores were comparable to a general Danish reference population. Based on HADS scores, a low risk for anxiety was reported by 73.0% (54 of 74) of 0- to 1-year survivors vs 89.3% (100 of 112) of greater than 15- to 20-year survivors; for symptoms of depression, these proportions were 79.7% (n = 59) and 87.5% (n = 98), respectively. Health-related quality of life was similar in survivor groups across all follow-up periods.

CONCLUSIONS AND RELEVANCE: Among this survey study’s responders, who comprised more than 50% of survivors of out-of-hospital cardiac arrest in Denmark, long-term health-related quality of life up to 20 years after their event was consistently high and comparable to that of the general population. These findings support resource allocation and efforts targeted to increasing survival after out-of-hospital cardiac arrest.

PMID:37703007 | DOI:10.1001/jamacardio.2023.2934