Tag: nevin manimala

PLoS One. 2021 Jul 19;16(7):e0254807. doi: 10.1371/journal.pone.0254807. eCollection 2021.

ABSTRACT

Biologics are recommended in Japan to treat moderate to severe Crohn’s Disease (CD). Although CD is associated with high direct costs in Japan, updated information after ustekinumab’s approval is unavailable. We aimed to evaluate the healthcare resource utilization (HRU) and associated direct costs from the payer’s perspective in Japan. Claims data (2010-2018) were retrospectively analyzed to identify patients with CD. HRU and associated costs were evaluated for 12 months before and after biologic initiation and followed-up till 36 months post-initiation. Outcomes were reported using descriptive statistics. Among the included patients (n = 3,496), 1,783 were on biologics and 1,713 were on non-biologics. Mean (SD) age was 36.4 (13.2) years and patients were predominantly male (76.1%). Patients aged 18-39 years were affected with CD the most (55.3%). Biologic initiation was associated with a reduction in inpatient stay, length of stay, outpatient visits, and associated costs; and an increase in pharmacy costs and total costs after 12 months. Extended follow-up showed a decreasing trend in HRU and costs till 24 months but an increase after 36 months. These findings demonstrated reduction in clinical burden and slight increase in economic burden with biologics. However, indirect costs also need to be evaluated.

PMID:34280242 | DOI:10.1371/journal.pone.0254807

PLoS One. 2021 Jul 19;16(7):e0254661. doi: 10.1371/journal.pone.0254661. eCollection 2021.

ABSTRACT

BACKGROUND: The association between psoriasis and the risk of cancer has been investigated in numerous studies utilising electronic health records (EHRs), with conflicting results in the extent of the association.

OBJECTIVES: To assess concordance and timing of cancer recording between primary care, hospital and death registration data for people with and without psoriasis.

METHODS: Cohort studies delineated using primary care EHRs from the Clinical Practice Research Datalink (CPRD) GOLD and Aurum databases, with linkage to hospital episode statistics (HES), Office for National Statistics (ONS) mortality data and indices of multiple deprivation (IMD). People with psoriasis were matched to those without psoriasis by age, sex and general practice. Cancer recording between databases was investigated by proportion concordant, that being the presence of cancer record in both source and comparator datasets. Delay in recording cancer diagnoses between CPRD and HES records and predictors of discordance were also assessed.

RESULTS: 58,904 people with psoriasis and 350,592 comparison patients were included using CPRD GOLD; whereas 213,400 people with psoriasis and 1,268,998 comparison patients were included in CPRD Aurum. For all cancer records (excluding keratinocyte), concordance between CPRD and HES was greater than 80%. Concordance for same-site cancer records was markedly lower (<68% GOLD-linked data; <72% Aurum-linked data). Concordance of non-Hodgkin lymphoma and liver cancer recording between CPRD and HES was lower for people with psoriasis compared to those without.

CONCLUSIONS: Concordance between CPRD and HES is poor when restricted to cancers of the same site, with greater discordance in people with psoriasis for some cancers of specific sites. The use of linked patient-level data is an important step in reducing misclassification of cancer outcomes in epidemiological studies using routinely collected electronic health records.

PMID:34280213 | DOI:10.1371/journal.pone.0254661

PLoS One. 2021 Jul 19;16(7):e0254824. doi: 10.1371/journal.pone.0254824. eCollection 2021.

ABSTRACT

BACKGROUND: Breastfeeding is the feeding of an infant or young child with breast milk directly from female human breasts. It confers short-term and long-term benefits for both child and mother, including helping to protect children against a variety of acute and chronic disorders. In mothers, breastfeeding (BF) reduces postpartum bleeding, enhances accelerated involution of the uterus, and plays a crucial role in child spacing. Fathers have an important but often neglected role in the promotion of healthy breastfeeding practices. Evidence shows that mothers who have a supportive and encouraging partner are more likely to plan to breastfeed for a longer duration. So, this study was aimed to assess knowledge and associated factors towards breastfeeding practice among fathers.

METHODS: A community-based cross-sectional study was conducted in Gurage Zone among 597 fathers. One stage cluster sampling technique was used to select study participants. An interviewer-administered questionnaire was used to collect the data and it was checked for consistency and completeness and entered into epi data and exported to SPSS for analysis. Bivariate and multivariate logistic regression analysis was done to identify independent predictors. P-value < 0.05 was considered to declare a result as statistically significant.

RESULT: In this study, a total of 585 participants were involved making a response rate of 98%. The overall knowledge status of participants was 341 (58.3%). The mean age of participants was 29.5 (SD±4.5). Urban residence, educational status, exposure to media, having more than one baby at home, and accompany his wife during health-seeking were independent predictors of knowledge status.

CONCLUSION: This study has shown the level of knowledge of fathers towards breastfeeding in the study area was low (58.3%). Residence, two or more babies at home, accompany during ANC, and indexed infant illness was independent predictors of knowledge status of fathers towards breastfeeding. Policymakers and possible stack holders should better focus on the improvement of knowledge because the knowledge determines the overall condition of the family including the psychological development of the children that affect their life especially in a country like Ethiopia in which most of the decisions are made by them. Other researchers focus on the interaction of parents and the child and feeding disorders.

PMID:34280223 | DOI:10.1371/journal.pone.0254824

PLoS One. 2021 Jul 19;16(7):e0254403. doi: 10.1371/journal.pone.0254403. eCollection 2021.

ABSTRACT

BACKGROUND: COVID-19 poses a severe threat worldwide. This study analyzes its propagation and evaluates statistically the effect of mobility restriction policies on the spread of the disease.

METHODS: We apply a variation of the stochastic Susceptible-Infectious-Recovered model to describe the temporal-spatial evolution of the disease across 33 provincial regions in China, where the disease was first identified. We employ Bayesian Markov Chain Monte-Carlo methods to estimate the model and to characterize a dynamic transmission network, which enables us to evaluate the effectiveness of various local and national policies.

RESULTS: The spread of the disease in China was predominantly driven by community transmission within regions, which dropped substantially after local governments imposed various lockdown policies. Further, Hubei was only the epicenter of the early epidemic stage. Secondary epicenters, such as Beijing and Guangdong, had already become established by late January 2020. The transmission from these epicenters substantially declined following the introduction of mobility restrictions across regions.

CONCLUSIONS: The spatial transmission network is able to differentiate the effect of the local lockdown policies and the cross-region mobility restrictions. We conclude that both are important policy tools for curbing the disease transmission. The coordination between central and local governments is important in suppressing the spread of infectious diseases.

PMID:34280197 | DOI:10.1371/journal.pone.0254403

PLoS One. 2021 Jul 19;16(7):e0253464. doi: 10.1371/journal.pone.0253464. eCollection 2021.

ABSTRACT

This study examines the relationship between economic growth, renewable energy consumption, and carbon emissions in Iran between 1975-2017, and the bounds testing approach to cointegration and the asymmetric method was used in this study. The results reveal that in the long run increase in renewable energy consumption and CO2 emissions causes an increase in real GDP per capita. Meanwhile, the decrease in renewable energy has the same effect, but GDP per capita reacts more strongly to the rise in renewable energy than the decline. Besides, in the long run, a reduction of CO2 emissions has an insignificant impact on GDP per capita. Furthermore, the results from asymmetric tests suggest that reducing CO2 emissions and renewable energy consumption do not have an essential role in decreasing growth in the short run. In contrast, an increase in renewable energy consumption and CO2 emissions do contribute to boosting the growth. These results may be attributable to the less renewable energy in the energy portfolio of Iran. Additionally, the coefficients on capital and labor are statistically significant, and we discuss the economic implications of the results and propose specific policy recommendations.

PMID:34280209 | DOI:10.1371/journal.pone.0253464

PLoS Genet. 2021 Jul 19;17(7):e1009665. doi: 10.1371/journal.pgen.1009665. Online ahead of print.

ABSTRACT

Wright’s inbreeding coefficient, FST, is a fundamental measure in population genetics. Assuming a predefined population subdivision, this statistic is classically used to evaluate population structure at a given genomic locus. With large numbers of loci, unsupervised approaches such as principal component analysis (PCA) have, however, become prominent in recent analyses of population structure. In this study, we describe the relationships between Wright’s inbreeding coefficients and PCA for a model of K discrete populations. Our theory provides an equivalent definition of FST based on the decomposition of the genotype matrix into between and within-population matrices. The average value of Wright’s FST over all loci included in the genotype matrix can be obtained from the PCA of the between-population matrix. Assuming that a separation condition is fulfilled and for reasonably large data sets, this value of FST approximates the proportion of genetic variation explained by the first (K – 1) principal components accurately. The new definition of FST is useful for computing inbreeding coefficients from surrogate genotypes, for example, obtained after correction of experimental artifacts or after removing adaptive genetic variation associated with environmental variables. The relationships between inbreeding coefficients and the spectrum of the genotype matrix not only allow interpretations of PCA results in terms of population genetic concepts but extend those concepts to population genetic analyses accounting for temporal, geographical and environmental contexts.

PMID:34280184 | DOI:10.1371/journal.pgen.1009665

PLoS Med. 2021 Jul 19;18(7):e1003707. doi: 10.1371/journal.pmed.1003707. eCollection 2021 Jul.

ABSTRACT

BACKGROUND: Angiotensin receptor blockers (ARBs) may have protective effects against dementia occurrence in patients with hypertension (HTN). However, whether telmisartan, an ARB with peroxisome proliferator-activated receptor γ (PPAR-γ)-modulating effects, has additional benefits compared to other ARBs remains unclear.

METHODS AND FINDINGS: Between 1997 and 2013, 2,166,944 type 2 diabetes mellitus (T2DM) patients were identified from the National Health Insurance Research Database of Taiwan. Patients with HTN using ARBs were included in the study. Patients with a history of stroke, traumatic brain injury, or dementia were excluded. Finally, 65,511 eligible patients were divided into 2 groups: the telmisartan group and the non-telmisartan ARB group. Propensity score matching (1:4) was used to balance the distribution of baseline characteristics and medications. The primary outcome was the diagnosis of dementia. The secondary outcomes included the diagnosis of Alzheimer disease and occurrence of symptomatic ischemic stroke (IS), any IS, and all-cause mortality. The risks between groups were compared using a Cox proportional hazard model. Statistical significance was set at p < 0.05. There were 2,280 and 9,120 patients in the telmisartan and non-telmisartan ARB groups, respectively. Patients in the telmisartan group had a lower risk of dementia diagnosis (telmisartan versus non-telmisartan ARBs: 2.19% versus 3.20%; HR, 0.72; 95% CI, 0.53 to 0.97; p = 0.030). They also had lower risk of dementia diagnosis with IS as a competing risk (subdistribution HR, 0.70; 95% CI, 0.51 to 0.95; p = 0.022) and with all-cause mortality as a competing risk (subdistribution HR, 0.71; 95% CI, 0.53 to 0.97; p = 0.029). In addition, the telmisartan users had a lower risk of any IS (6.84% versus 8.57%; HR, 0.79; 95% CI, 0.67 to 0.94; p = 0.008) during long-term follow-up. Study limitations included potential residual confounding by indication, interpretation of causal effects in an observational study, and bias caused by using diagnostic and medication codes to represent real clinical data.

CONCLUSIONS: The current study suggests that telmisartan use in hypertensive T2DM patients may be associated with a lower risk of dementia and any IS events in an East-Asian population.

PMID:34280191 | DOI:10.1371/journal.pmed.1003707

Am J Trop Med Hyg. 2021 Jul 19:tpmd210266. doi: 10.4269/ajtmh.21-0266. Online ahead of print.

ABSTRACT

Annually, about 2.7 million snakebite envenomings occur worldwide, primarily affecting those living in rural regions. Effective treatment exists but is scarce, and traditional treatments are commonly used. To inform context-specific policies in Kenya, this study aimed to determine the health-seeking behavior and the health, social, and economic burden of snakebites in rural communities. Nonprobability sampling was used to survey 382 respondents from four snakebite-endemic counties, from February to August 2020, using a structured questionnaire. Descriptive statistics, Fisher’s exact tests, binary logistic regressions, and Mantel-Haenszel tests were used for analysis. Life-time experience with snakebites included 13.1% of respondents who reported being personally bitten and 37.4% who reported knowing of a community member being bitten. Respondents reported death after a snakebite in 9.1% of bitten community members and in 14.6% of bitten family members. Risk of snakebite was not significantly associated with sex, educational level, or occupation. Snakebite victims were most often walking (38%) or farming (24%) when bitten. Of those bitten, 58% went to a health facility, 30% sought traditional treatment, and 12% first went to a traditional healer before visiting a facility. Significant differences existed in perceptions on the financial consequences of snakebites among those who had been personally bitten and those who had observed a snakebite. Most commonly mentioned preventive measures were wearing shoes and carrying a light in the dark. Community engagement, including engagement with traditional healers, is needed to reduce snakebites. This should be done through education and sensitization to improve used preventive measures and effective health-seeking behavior.

PMID:34280130 | DOI:10.4269/ajtmh.21-0266

J Med Internet Res. 2021 Jul 9. doi: 10.2196/28975. Online ahead of print.

ABSTRACT

BACKGROUND: The use of the Internet and web-based platforms to obtain public health information and manage health-related issues has become widespread in this digital age. The practice is so pervasive that the first reaction to obtaining health information is to ‘google it.’ As SARS-CoV-2 broke out in Wuhan, China, in December 2019, and quickly spread worldwide, people flocked to the Internet to learn about the novel coronavirus and the disease, COVID-19. Lagged response by governments and public health agencies to prioritize the Internet and the World Wide Web to disseminate information about the coronavirus outbreak and building trust gave room for others to quickly populate the social media, online blogs, news outlets, and websites with misinformation and conspiracy theories about the COVID-19 pandemic resulting in people’s deviant behaviors towards public health safety measures.

OBJECTIVE: To determine what people learned about the COVID-19 pandemic through “web search;” examine any association between what people learned about COVID-19 and behavior towards the public health guidelines; and analyze the impact of misinformation and conspiracy theories about the COVID-19 pandemic on people’s behavior towards public health measures.

METHODS: This paper undertakes an infodemiology study using the Google trends worldwide search index covering the first six months after the SARS-CoV-2 outbreak (January 1st, to June 30th, 2020) when the public scrambled for information about the pandemic. Data analysis employed statistical trends, correlation and regression, principal component analysis, and predictive models.

RESULTS: (i). The principal components analysis identifies two latent variables comprising past coronavirus epidemics (pastCoVepidemics) and the ongoing COVID-19 pandemic (presCoVpandemic). Both principal components (PCs) were utilized significantly to learn about SARS-CoV-2 and COVID-19 and explained 88.78% variability. (ii). Three (3) PCs fuelled misinformation about COVID-19 [Misinformation(“Biological Weapon,” “VirusHoax,” “CommonCold,” “COVID-19Hoax,” “ChinaVirus”); ConspTheory1(“@5G”); ConspTheory1(“IngestBleach”)]. These PCs explained 84.85% of the variability, (iii). Two (2) PCs identified two components of public health measures [PubHealthMes1(“Social Distancing,” “WashHand,” “Isolation,” “Quarantine.”); PubHealthMes2(“WearMask”), which explained 84.7% of the variability. (iv). Based on the PCA results, log-linear, and predictive models [ConspTheory1(@5G)] is identified as a predictor of people’s behavior towards public health measures (PubHealthMes2). Although (r=0.83), (r=-0.11) for Misinformation(COVID-19Hoax, VirusHoax, CommonCold, and more) and ConspTheory2 (Ingestbleach), respectively, with PubHealthMes1(social dist, handwash, isolation, and more), both were not statistically significant with (p=0.267), (p=0.13), respectively.

CONCLUSIONS: Several studies focus on the impacts of social media and related platforms on spreading misinformation and conspiracy theories. This study provides the first empirical evidence to the mainly anecdotal discourse on the use of web search to learn about SARS-CoV-2 and COVID-19.

PMID:34280117 | DOI:10.2196/28975

J Med Internet Res. 2021 Jul 14. doi: 10.2196/30709. Online ahead of print.

ABSTRACT

BACKGROUND: In response to the COVID-19 pandemic, experts in mental health science emphasized the importance of developing and evaluating approaches to support and maintain the mental health of older adults.

OBJECTIVE: To assess whether a group-based exercise program relative to a personal exercise program (both delivered online) and wait-list control (WLC) can improve the psychological health of previously low active older adults during the early stages of the COVID-19 pandemic.

METHODS: The Seniors COvid-19 Pandemic and Exercise (SCOPE) Trial was a 3-arm, parallel randomized controlled trial conducted between May and September 2020 in which low active older adults (aged ≥ 65 years) were recruited via media outlets and social media. After baseline assessments, consented participants were randomized to one of two 12-week exercise programs (delivered online by older adult instructors) or a waitlist control condition. 241 older adults (n= 187 women) provided baseline measures (via online questionnaires), were randomized (Ngroup = 80, Npersonal = 82 Ncontrol = 79), and completed measures every two weeks for the duration of the trial. The trial’s primary outcome was psychological flourishing. Secondary outcomes included global measures of mental and physical health, life satisfaction and depression symptoms.

RESULTS: The results of latent growth modeling revealed no intervention effects for flourishing, life satisfaction, or depression symptoms (Ps> .05). Participants in the group condition displayed improved mental health relative to WLC participants over the first 10 weeks (ES = .288 to .601), and although the week 12 effect (ES = .375) was in the same direction the difference was not statistically significant (P >. 05). Participants in the personal condition displayed improved mental health, when compared to WLC participants, in the same medium effect size range (ES = .293 to .565) over the first 8 weeks, and while the effects were of a similar magnitude at weeks 10 (ES = .455) and 12 (ES = .258) they were not statistically significant (P >.05). In addition, participants in the group condition displayed improvements in physical health when compared to the WLC (ES = .079 to .496) across all 12 weeks of the study following baseline. No differences were observed between the personal exercise condition and WLC for physical health (P>.05).

CONCLUSIONS: There were no intervention effects for the trial’s primary outcome, psychological flourishing. It is possible that the high levels of psychological flourishing at baseline may have limited the extent to which those indicators could continue to improve further through intervention (i.e., potential ceiling effects). However, the intervention effects for mental and physical health point to the potential capacity of low-cost and scalable at-home programs to support the mental and physical health of previously inactive adults in the COVID-19 pandemic.

CLINICALTRIAL: ClinicalTrials.gov Identifier: NCT04412343, https://clinicaltrials.gov/ct2/show/NCT04412343.

PMID:34280121 | DOI:10.2196/30709