Tag: nevin manimala

Int J Womens Health. 2023 May 3;15:665-677. doi: 10.2147/IJWH.S379749. eCollection 2023.

ABSTRACT

PURPOSE: Maternal mortality is one problem that still affects countries like Indonesia and others globally. The World Health Organization (WHO) notes that Southeast Asian countries have a high MMR. Indonesia’s maternal mortality ranks third highest in Southeast Asia, with a 177 maternal mortality rate per 100,000 live births in 2017. In 2018, the maternal mortality rate reached 91.45 per 100,000 live births. Pregnant women’s deaths can be caused inadequate medical care due to how frequently they seek treatment. This study intends to identify and analyze how knowledge, education, and myths affect pregnant women’s attitudes toward seeking health services.

MATERIALS AND METHODS: The study involved 175 pregnant and postpartum women who visited 10 health public centers in two cities in East Java by accidental sampling. Data regarding intrapersonal, interpersonal, and local wisdom were collected through surveys with structured instruments and in-depth interviews. Data statistics used pathway analysis with a p-value of >0.05.

RESULTS: Intrapersonal, interpersonal, and local wisdom variables have a significant direct or indirect effect on utilizing health services. Knowledge was the variable with the greatest influence (t-value, 27.96).

CONCLUSION: Myth and culture as local wisdom and intrapersonal factors significantly affect the pattern of utilizing health services.

PMID:37163191 | PMC:PMC10164391 | DOI:10.2147/IJWH.S379749

HIV AIDS (Auckl). 2023 May 3;15:225-234. doi: 10.2147/HIV.S409152. eCollection 2023.

ABSTRACT

BACKGROUND: Human immunodeficiency virus (HIV) testing coverage among men remains low in Ethiopia; the problem of limited HIV testing coverage is worst in rural areas. Therefore, this study aims to identify factors associated with HIV testing uptake among rural men in Ethiopia.

METHODS: Data from 10,187 rural men was extracted from the 2016 Ethiopian Demography and Health Survey. All analyses were performed using the complex sample analysis procedure to account for the multistage sampling. Bivariable and multivariable regression analyses were performed to identify factors associated with HIV testing uptake. Statistical significance was defined as a 95% Confidence Interval (CI) with a p-value of less than 0.05.

RESULTS: Overall, only 40.3% of rural men have ever been tested for HIV. Being aged 31-44 years (Adjusted Odds Ratio (AOR) =1.12, 95% CI [1.01-1.42]), living in developed regions (AOR=1.43, 95% CI [1.09-1.88]), engaging in non-agricultural activities (AOR = 1.27, 95% CI [1.05-1.52]), being Muslim (AOR = 2.07; 95% CI [1.67-2.67]), having comprehensive knowledge about HIV (AOR =1.31, 95% CI [1.12-1.54]), being from a medium (AOR = 0.56, 95% CI [0.47-0.93]) and rich (AOR = 0.80, 95% CI [0.56-0.80]) households, attending primary (AOR = 0.21, 95% CI [0.16-0.28]) and secondary (AOR = 0.35, 95% CI [0.25-0.35]) school, having their first sexual experience at the age of 17 or younger (AOR = 0.26, 95% CI [0.19-0.93]), having discriminatory attitudes towards HIV patients (AOR = 0.67, 95% CI: 0.47-0.93) and having no health insurance coverage (AOR = 0.54, 95% CI [0.42-0.69]) were significantly associated with HIV testing uptake.

CONCLUSION: HIV testing uptake among rural men was low. Strengthening awareness programmes on HIV and HIV testing, integrating HIV testing with all other healthcare, strengthening partner accompany and HIV testing during pregnancy and delivery, and providing home-based HIV testing may increase HIV testing uptake.

PMID:37163176 | PMC:PMC10164390 | DOI:10.2147/HIV.S409152

Digit Health. 2023 May 4;9:20552076231173306. doi: 10.1177/20552076231173306. eCollection 2023 Jan-Dec.

ABSTRACT

BACKGROUND: Unintended pregnancy has been a major public health and reproductive health issue imposing a great adverse consequence on the mother and child. However, estimates of unintended pregnancy through the appropriate model are lacking. This study is aimed at modeling and assessing the extent of variation and factors associated with unintended pregnancy among women in Ethiopia.

METHODS: A cross-sectional study was conducted based on 2016 Ethiopian Demographic and Health Survey data related to the reproductive health of 1122 currently pregnant women and a multilevel modeling approach was used.

RESULTS: The proportion of unintended current pregnancies was 20.1%. According to random intercept with a fixed slope model, women who had 1 to 3 living children and those who had 4 and above were more likely to be unintended (OR = 3.54, 95% CI: 1.985-6.332) and (OR = 5.47, 95% CI: 2.67-11.227), respectively, compared to women with no living children. Also, married women were less likely to be unintended (OR = 0.14, 95% CI: 0.065-0.304) compared to unmarried women. In addition, women having work were more likely to be unintended (OR = 1.56, 95% CI: 1.079-2.255). Furthermore, women who intend to use contraceptive methods were less likely to be unintended (OR = 0.54, 95% CI: 0.362-0.796) compared to women who do not intend.

CONCLUSION: The number of living children, current marital status, the intention of contraceptive use, and respondents’ working status were found to have a significant effect. Giving attention to regional variations and intention of contraceptive use is important to reduce unintended current pregnancies in Ethiopia.

PMID:37163173 | PMC:PMC10164261 | DOI:10.1177/20552076231173306

Digit Health. 2023 May 4;9:20552076231173528. doi: 10.1177/20552076231173528. eCollection 2023 Jan-Dec.

ABSTRACT

OBJECTIVE: This paper characterizes levels of mental distress among adults living in Canada amid the COVID-19 pandemic and examines the extent of virtual mental health resource use, including reasons for non-use, among adults with moderate to severe distress.

METHODS: Data are drawn from a cross-sectional monitoring survey (29 November to 7 December 2021) on the mental health of adults (N = 3030) in Canada during the pandemic. Levels of mental distress were assessed using the Kessler Psychological Distress Scale. Descriptive statistics were used to examine virtual mental health resource use among participants with moderate to severe distress, including self-reported reasons for non-use.

RESULTS: Levels of mental distress were classified as none to low (48.8% of participants), moderate (36.6%), and severe (14.6%). Virtual mental health resource use was endorsed by 14.2% of participants with moderate distress and 32% of those with severe distress. Participants with moderate to severe distress reported a range of reasons for not using virtual mental health resources, including not feeling as though they needed help (37.4%), not thinking the supports would be helpful (26.2%), and preferring in-person supports (23.4%), among other reasons.

CONCLUSIONS: This study identified a high burden of mental distress among adults in Canada during the COVID-19 pandemic alongside an apparent mismatch between actual and perceived need for support, including through virtual mental health resources. Findings on virtual mental health resource use, and reasons for non-use, offer directions for mental health promotion and health communication related to mental health literacy and the awareness and appropriateness of virtual mental health resources.

PMID:37163172 | PMC:PMC10164262 | DOI:10.1177/20552076231173528

Therap Adv Gastroenterol. 2023 May 5;16:17562848231170484. doi: 10.1177/17562848231170484. eCollection 2023.

ABSTRACT

BACKGROUND: With a 15% incidence, KRAS is one of the most common mutations in biliary tract cancer (BTC) and is a poor prognostic factor. Immune checkpoint inhibitors (ICIs) as salvage therapy have modest activity in BTC.

OBJECTIVES: There are limited data on the efficacy of ICIs according to KRAS mutation in BTC. We evaluated the efficacy of ICIs in BTC patients with or without KRAS mutations.

DESIGN: Retrospective observational study.

METHODS: We conducted molecular profiling in BTC patients who received ICIs as salvage therapy. The expression of programmed death ligand 1 (PD-L1) on tumor cells was assessed using immunohistochemistry. The TruSight^TM Oncology 500 assay from Illumina was used as a cancer panel. We analyzed overall survival (OS) and progression-free survival (PFS) of ICI in BTC patients according to KRAS mutation and PD-L1 expression.

RESULTS: A total of 62 patients were included in this analysis. The median age was 68.0 years; 47 patients (75.8%) received pembrolizumab and 15 (24.2%) received nivolumab as salvage therapy. All patients received gemcitabine plus cisplatin as the frontline therapy, and 53.2% received fluoropyrimidine plus oxaliplatin (FOLFOX) before ICI. The median number of lines of prior chemotherapy was 2.5. The KRAS mutation was found in 13 patients (19.1%), and 28 patients (45.2%) showed 1% or more of tumor cells out of visible tumor cells positive for PD-L1. There was no statistical correlation between KRAS mutation and PD-L1 expression. The median OS and PFS with ICI were 5.6 [interquartile range (IQR): 3.3-8.0] and 3.8 (IQR: 3.0-4.5) months, respectively. There were no statistically significant differences in PFS with ICIs according to KRAS mutation (mutant type versus wild type) and PD-L1 expression (positive versus negative). In subgroup analysis, patients with both KRAS mutation and PD-L1 positivity had longer PFS compared with patients with KRAS mutation and PD-L1 negativity (10.1 versus 2.6 months, p = 0.047). This finding was not shown in patients with wild-type KRAS.

CONCLUSION: Our analysis suggested that PD-L1 expression might be a useful biomarker for ICIs in BTC patients with KRAS mutation but not in those with wild-type KRAS.

PMID:37163165 | PMC:PMC10164250 | DOI:10.1177/17562848231170484

Glob J Health Sci. 2021;13(6):69-80. doi: 10.5539/gjhs.v13n6p69. Epub 2021 May 8.

ABSTRACT

INTRODUCTION: Despite growing attention to structural approaches to HIV prevention, including economic empowerment interventions for key populations, few studies examine the financial lives of women engaged in sex work (WESW) and even fewer examine the financial lives of those who also use drugs. The purpose of this paper is to examine the financial status, sex work involvement, and individual and structural vulnerabilities of women involved in sex work and drug use in Kazakhstan.

METHODS: We used baseline data from Project Nova, a cluster-randomized controlled trial that tested the efficacy of a combined HIV risk reduction and microfinance intervention for WESW in two cities in Kazakhstan. We collected data on income, savings, debt, sex work, drug use, homelessness, food insecurity, HIV status, attitudes towards safety, and financial knowledge from 400 participants through computer-assisted self-interview techniques. Descriptive statistics were utilized to describe and characterize the sample and aforementioned measures.

RESULTS: Findings illustrate the paradoxical nature of sex work, wherein women may achieve economic independence despite the great adversities they encounter in their daily lives and work. The majority of women (65%) in this study reported being the highest income earner in the household, caring for up to 3 dependents, and demonstrated entrepreneurial characteristics and aspirations for the future. However, many were still living below the poverty line (72.5%), as well as experiencing high levels of homelessness (58%) and food insecurity (89.5%).

CONCLUSION: Study findings underscore the need for better understanding of the existing capabilities of WESW and those who use drugs, including financial autonomy and community supports, that may guide the design of programs that most effectively promote women’s economic well-being and ensure that it is not at the expense of wellness and safety. Designing such programs requires incorporating a social justice lens into social work and public health interventions, including HIV prevention, and attention to the human rights of the most marginalized and highest risk populations, including WESW and those who use drugs.

PMID:37163144 | PMC:PMC10165725 | DOI:10.5539/gjhs.v13n6p69

Psychol Res Behav Manag. 2023 May 3;16:1615-1629. doi: 10.2147/PRBM.S408591. eCollection 2023.

ABSTRACT

BACKGROUND: With the popularization of higher education, the problems of academic adaptability and learning burnout among college students have become increasingly prominent. The purpose of this study was to investigate the relationship between academic adaptability, learning burnout, self-esteem and self-efficacy of college students and their underlying mechanisms.

METHODS: The study was conducted on 2110 college students using the College Student Learning Adjustment Scale, the Learning Burnout Undergraduates Scale, the Self-Esteem Scale, and the Self-Efficacy Scale to establish a mediating model of adjustment. SPSS 26.0 was used for descriptive statistics and Pearson correlation analysis. Model 4 and Model 14 in the process plug-in prepared by Hayes (2017) were used for mediating effects analysis and moderating mediator analysis respectively, and the significance of the mediating effects was tested using the bias-corrected percentile Bootstrap method.

RESULTS: (1) academic adaptability significantly and positively predicted self-esteem; (2) self-esteem significantly and negatively predicted learning burnout; (3) academic adaptability significantly and negatively predicted learning burnout; (4) self-esteem partially mediated the effect of academic adaptability on learning burnout; and (5) self-efficacy moderated the latter half of the mediation process of academic adaptability-self-esteem-learning burnout.

CONCLUSION: These findings are useful for college educators and related researchers to better understand the mechanisms underlying the relationship between academic adaptability and learning burnout, thus providing practical and effective operational suggestions on the prevention and intervention of learning burnout in college students.

PMID:37163132 | PMC:PMC10164379 | DOI:10.2147/PRBM.S408591

bioRxiv. 2023 Apr 24:2023.04.23.537988. doi: 10.1101/2023.04.23.537988. Preprint.

ABSTRACT

Relating brain activity associated with a complex stimulus to different properties of that stimulus is a powerful approach for constructing functional brain maps. However, when stimuli are naturalistic, their properties are often correlated (e.g., visual and semantic features of natural images, or different layers of a convolutional neural network that are used as features of images). Correlated properties can act as confounders for each other and complicate the interpretability of brain maps, and can impact the robustness of statistical estimators. Here, we present an approach for brain mapping based on two proposed methods: stacking different encoding models and structured variance partitioning . Our stacking algorithm combines encoding models that each use as input a feature space that describes a different stimulus attribute. The algorithm learns to predict the activity of a voxel as a linear combination of the outputs of different encoding models. We show that the resulting combined model can predict held-out brain activity better or at least as well as the individual encoding models. Further, the weights of the linear combination are readily interpretable; they show the importance of each feature space for predicting a voxel. We then build on our stacking models to introduce structured variance partitioning, a new type of variance partitioning that takes into account the known relationships between features. Our approach constrains the size of the hypothesis space and allows us to ask targeted questions about the similarity between feature spaces and brain regions even in the presence of correlations between the feature spaces. We validate our approach in simulation, showcase its brain mapping potential on fMRI data, and release a Python package. Our methods can be useful for researchers interested in aligning brain activity with different layers of a neural network, or with other types of correlated feature spaces.

PMID:37163111 | PMC:PMC10168225 | DOI:10.1101/2023.04.23.537988

bioRxiv. 2023 Apr 30:2023.04.27.538299. doi: 10.1101/2023.04.27.538299. Preprint.

ABSTRACT

OBJECTIVE: The performances of popular Genome-wide association study (GWAS) models haven’t been examined yet in a consistent manner under the scenario of genetic admixture, which introduces several challenging aspects such as heterogeneity of minor allele frequency (MAF), a wide spectrum of case-control ratio, and varying effect sizes etc.

METHODS: We generated a cohort of synthetic individuals (N=19,234) that simulates 1) a large sample size; 2) two-way admixture [Native American-European ancestry] and 3) a binary phenotype. We then examined the inflation factors produced by three popular GWAS tools: GMMAT, SAIGE, and Tractor. We also computed power calculations under different MAFs, case-control ratios, and varying ancestry percentages. Then, we employed a cohort of Peruvians (N=249) to further examine the performances of the testing models on 1) real genetic data and 2) small sample sizes. Finally, we validated these findings using an independent Peruvian cohort (N=109) included in 1000 Genome project (1000G).

RESULT: In the synthetic cohort, SAIGE performed better than GMMAT and Tractor in terms of type-I error rate, especially under severe unbalanced case-control ratio. On the contrary, power analysis identified Tractor as the best method to pinpoint ancestry-specific causal variants, but showed decreased power when no adequate heterogeneity of the true effect sizes was simulated between ancestries. The real Peruvian data showed that Tractor is severely affected by small sample sizes, and produced severely inflated statistics, which we replicated in the 1000G Peruvian cohort.

DISCUSSION: The current study illustrates the limitations of available GWAS tools under different scenarios of genetic admixture. We urge caution when interpreting results under complex population scenarios.

PMID:37163101 | PMC:PMC10168347 | DOI:10.1101/2023.04.27.538299

bioRxiv. 2023 Apr 27:2023.04.26.538501. doi: 10.1101/2023.04.26.538501. Preprint.

ABSTRACT

A single gene may be regulated by multiple enhancers, but how they work in concert to regulate transcription is poorly understood. Prior studies have mostly examined enhancers at single loci and have reached inconsistent conclusions about whether epistatic-like interactions exist between them. To analyze enhancer interactions throughout the genome, we developed a statistical framework for CRISPR regulatory screens that utilizes negative binomial generalized linear models that account for variable guide RNA (gRNA) efficiency. We reanalyzed a single-cell CRISPR interference experiment that delivered random combinations of enhancer-targeting gRNAs to each cell and interrogated interactions between 3,808 enhancer pairs. We found that enhancers act multiplicatively with one another to control gene expression, but our analysis provides no evidence for interaction effects between pairs of enhancers regulating the same gene. Our findings illuminate the regulatory behavior of multiple enhancers and our statistical framework provides utility for future analyses studying interactions between enhancers.

PMID:37163096 | PMC:PMC10168320 | DOI:10.1101/2023.04.26.538501