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Nevin Manimala Statistics

Birth and death notification via mobile devices: a mixed methods systematic review

Cochrane Database Syst Rev. 2021 Jul 16;7:CD012909. doi: 10.1002/14651858.CD012909.pub2.

ABSTRACT

BACKGROUND: Ministries of health, donors, and other decision-makers are exploring how they can use mobile technologies to acquire accurate and timely statistics on births and deaths. These stakeholders have called for evidence-based guidance on this topic. This review was carried out to support World Health Organization (WHO) recommendations on digital interventions for health system strengthening.

OBJECTIVES: Primary objective: To assess the effects of birth notification and death notification via a mobile device, compared to standard practice. Secondary objectives: To describe the range of strategies used to implement birth and death notification via mobile devices and identify factors influencing the implementation of birth and death notification via mobile devices.

SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, the Global Health Library, and POPLINE (August 2, 2019). We searched two trial registries (August 2, 2019). We also searched Epistemonikos for related systematic reviews and potentially eligible primary studies (August 27, 2019). We conducted a grey literature search using mHealthevidence.org (August 15, 2017) and issued a call for papers through popular digital health communities of practice. Finally, we conducted citation searches of included studies in Web of Science and Google Scholar (May 15, 2020). We searched for studies published after 2000 in any language. SELECTION CRITERIA: For the primary objective, we included individual and cluster-randomised trials; cross-over and stepped-wedge study designs; controlled before-after studies, provided they have at least two intervention sites and two control sites; and interrupted time series studies. For the secondary objectives, we included any study design, either quantitative, qualitative, or descriptive, that aimed to describe current strategies for birth and death notification via mobile devices; or to explore factors that influence the implementation of these strategies, including studies of acceptability or feasibility. For the primary objective, we included studies that compared birth and death notification via mobile devices with standard practice. For the secondary objectives, we included studies of birth and death notification via mobile device as long as we could extract data relevant to our secondary objectives. We included studies of all cadres of healthcare providers, including lay health workers; administrative, managerial, and supervisory staff; focal individuals at the village or community level; children whose births were being notified and their parents/caregivers; and individuals whose deaths were being notified and their relatives/caregivers.

DATA COLLECTION AND ANALYSIS: For the primary objective, two authors independently screened all records, extracted data from the included studies and assessed risk of bias. For the analyses of the primary objective, we reported means and proportions, where appropriate. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to assess the certainty of the evidence and we prepared a ‘Summary of Findings’ table. For the secondary objectives, two authors screened all records, one author extracted data from the included studies and assessed methodological limitations using the WEIRD tool and a second author checked the data and assessments. We carried out a framework analysis using the Supporting the Use of Research Evidence (SURE) framework to identify themes in the data. We used the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach to assess our confidence in the evidence and we prepared a ‘Summary of Qualitative Findings’ table.

MAIN RESULTS: For the primary objective, we included one study, which used a controlled before-after study design. The study was conducted in Lao People’s Democratic Republic and assessed the effect of using mobile devices for birth notification on outcomes related to coverage and timeliness of Hepatitis B vaccination. However, we are uncertain of the effect of this approach on these outcomes because the certainty of this evidence was assessed as very low. The included study did not assess resource use or unintended consequences. For the primary objective, we did not identify any studies using mobile devices for death notification. For the secondary objective, we included 21 studies. All studies were conducted in low- or middle-income settings. They focussed on identification of births and deaths in rural, remote, or marginalised populations who are typically under-represented in civil registration processes or traditionally seen as having poor access to health services. The review identified several factors that could influence the implementation of birth-death notification via mobile device. These factors were tied to the health system, the person responsible for notifying, the community and families; and include: – Geographic barriers that could prevent people’s access to birth-death notification and post-notification services – Access to health workers and other notifiers with enough training, supervision, support, and incentives – Monitoring systems that ensure the quality and timeliness of the birth and death data – Legal frameworks that allow births and deaths to be notified by mobile device and by different types of notifiers – Community awareness of the need to register births and deaths – Socio-cultural norms around birth and death – Government commitment – Cost to the system, to health workers and to families – Access to electricity and network connectivity, and compatibility with existing systems – Systems that protect data confidentiality We have low to moderate confidence in these findings. This was mainly because of concerns about methodological limitations and data adequacy.

AUTHORS’ CONCLUSIONS: We need more, well-designed studies of the effect of birth and death notification via mobile devices and on factors that may influence its implementation.

PMID:34271590 | DOI:10.1002/14651858.CD012909.pub2

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Nevin Manimala Statistics

Knowledge of osteopathic manipulative medicine and osteopathic physicians in a New York South Asian community

J Osteopath Med. 2021 Jul 16. doi: 10.1515/jom-2021-0060. Online ahead of print.

ABSTRACT

CONTEXT: Research regarding patient awareness of osteopathic manipulative medicine (OMM) can help identify barriers and factors limiting patient knowledge. Levels of knowledge about OMM and osteopathic physicians have been studied in New York’s Chinese and Korean populations, but have not previously been investigated in the South Asian population.

OBJECTIVES: To assess the knowledge of OMM and osteopathic physicians within a South Asian community of New York.

METHODS: A cross-sectional study was designed in which a culturally appropriate survey, provided in both English and Hindi, was administered to study participants in order to measure knowledge of osteopathic medicine. The study utilized convenience sampling and distributed surveys to individuals who identified themselves of South Asian descent at high traffic sites in Hicksville, New York. The survey contained 10 questions, assessing the individual’s knowledge of osteopathic medicine. The Kruskal-Wallis and Chi-Square tests were employed to determine statistical significance of the data obtained from the surveys.

RESULTS: The survey was conducted on 100 participants in Hicksville, New York. The respondent demographics included 53 males and 47 females with an average age of 41.2 ± 16.3 years old. There were 34 (34%) participants who had heard of osteopathic manipulative medicine (OMM) and 26 (26%) participants who had knowledge of doctor of osteopathic medicine (DO) physicians. Respondents were found more likely to have knowledge of DOs if they were born in the United States (US) vs. other countries (US, 8 of 14 [57.1%] vs. others, 18 of 86 [20.9%]; p=0.006) or lived longer in the US (11 of 26 [42.3%], p=0.039). Participants who spoke a non-English primary language were also found less likely to have knowledge of DOs as they made up 46 of the 58 respondents who indicated no knowledge (79.3%, p=0.042).

CONCLUSIONS: A general lack of knowledge of DOs and OMM exists within the South Asian community of Hicksville, New York and lower levels of awareness were found among participants who were male, born outside the US, had a language other than English as their primary language, and had spent less time in the US. Additional educational resources may be implemented to increase awareness of DOs and OMM among this and similar communities.

PMID:34271600 | DOI:10.1515/jom-2021-0060

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Nevin Manimala Statistics

Inference of ventricular activation properties from non-invasive electrocardiography

Med Image Anal. 2021 Jun 23;73:102143. doi: 10.1016/j.media.2021.102143. Online ahead of print.

ABSTRACT

The realisation of precision cardiology requires novel techniques for the non-invasive characterisation of individual patients’ cardiac function to inform therapeutic and diagnostic decision-making. Both electrocardiography and imaging are used for the clinical diagnosis of cardiac disease. The integration of multi-modal datasets through advanced computational methods could enable the development of the cardiac ‘digital twin’, a comprehensive virtual tool that mechanistically reveals a patient’s heart condition from clinical data and simulates treatment outcomes. The adoption of cardiac digital twins requires the non-invasive efficient personalisation of the electrophysiological properties in cardiac models. This study develops new computational techniques to estimate key ventricular activation properties for individual subjects by exploiting the synergy between non-invasive electrocardiography, cardiac magnetic resonance (CMR) imaging and modelling and simulation. More precisely, we present an efficient sequential Monte Carlo approximate Bayesian computation-based inference method, integrated with Eikonal simulations and torso-biventricular models constructed based on clinical CMR imaging. The method also includes a novel strategy to treat combined continuous (conduction speeds) and discrete (earliest activation sites) parameter spaces and an efficient dynamic time warping-based ECG comparison algorithm. We demonstrate results from our inference method on a cohort of twenty virtual subjects with cardiac ventricular myocardial-mass volumes ranging from 74 cm3 to 171 cm3 and considering low versus high resolution for the endocardial discretisation (which determines possible locations of the earliest activation sites). Results show that our method can successfully infer the ventricular activation properties in sinus rhythm from non-invasive epicardial activation time maps and ECG recordings, achieving higher accuracy for the endocardial speed and sheet (transmural) speed than for the fibre or sheet-normal directed speeds.

PMID:34271532 | DOI:10.1016/j.media.2021.102143

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Retrograde ejaculation following anterior lumbar surgery: a systematic review and pooled analysis

J Neurosurg Spine. 2021 Jul 16:1-10. doi: 10.3171/2020.12.SPINE201101. Online ahead of print.

ABSTRACT

OBJECTIVE: The present systematic review and pooled analysis aims to assess the incidence and risk factors for the development of retrograde ejaculation (RE) following first-time open anterior lumbar surgery.

METHODS: A systematic MEDLINE review via PubMed was performed, identifying 130 clinical papers relating to the topic. Eighteen publications were selected according to predetermined inclusion and exclusion criteria and were used to determine the incidence of RE. Only the publications that provided data on surgical risk factors present specifically in the men in the study were included in the analysis of risk factors.

RESULTS: Of the 2503 men included, there were 57 reported events of RE (2.3%). Of the cases for which long-term data were provided, 45.8% had resolved by final follow-up. There was a statistically significant increased risk associated with a transperitoneal as opposed to a retroperitoneal approach (8.6% vs 3.2%), as well as with the use of recombinant human bone morphogenetic protein-2 (rhBMP-2) in anterior lumbar interbody fusion (ALIF) as opposed to ALIF with bone graft or arthroplasty in controls (5.0% vs 1.8%). However, when excluding from analysis the patients operated on prior to the FDA’s 2008 warning that commented on the drug’s neuroinflammatory properties, there was no significant difference in rates of RE in patients receiving rhBMP-2 versus the control group (2.4% vs 2.5%). There was no significant difference in risk based on single- versus multilevel procedure or on ALIF versus arthroplasty.

CONCLUSIONS: In a pooled analysis of currently published data on men undergoing first-time open anterior lumbar surgery, this study found an overall incidence of RE of 2.3%. Nearly half of these patients recovered, reporting resolution of symptoms anywhere between 3 months and 48 months. Analysis of risk factors was limited by a paucity of published literature segregating data by sex. However, there was an increased risk associated with rhBMP-2 only when including data collected prior to the FDA warning on its detrimental properties. The authors therefore posit that the risk of RE is probably overestimated in the literature, given that the vast majority of the data available were collected prior to this warning and given the subsequent implementation of precautions when handling rhBMP-2.

PMID:34271542 | DOI:10.3171/2020.12.SPINE201101

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Nevin Manimala Statistics

The effect of anthropogenic activities on the environmental fate of chlorinated paraffins in surface soil in an urbanized zone of northern China

Environ Pollut. 2021 Jul 10;288:117766. doi: 10.1016/j.envpol.2021.117766. Online ahead of print.

ABSTRACT

Chlorinated paraffins (CPs) have been widely used as halogenated flame retardants and plasticizers since the mid-20th century. The prevalence of CPs in soil has been widely reported, but the distribution pattern of CPs in urbanized zones and their association with multiple socioeconomic variables have not been adequately explored. Herein, short-chain and medium-chain chlorinated paraffins (SCCPs and MCCPs) were investigated in surface soil samples from Tianjin, China, a typical urbanized area. The concentration distributions of SCCPs and MCCPs showed similar trends in different administrative divisions and land use types: urban areas > suburbs > outer suburbs (p < 0.001) and residential areas > greenbelts > agricultural areas (p < 0.001). The CP congeners in residential surface soils mainly included those with longer carbon chains and high degree of chlorination, while the CP congeners in agricultural surface soils mainly consisted of those with shorter carbon chains and fewer chlorine substituents. Multiple statistical approaches were used to explore the association between socioeconomic factors and CP distribution. CP concentration was significantly correlated to population density and gross domestic product (GDP) (p < 0.001), and structural equation models incorporating administrative regional planning showed an indirect impact on the distribution of MCCP concentration due to the influence of regional planning on population density. These results highlight the association between CP contamination and the degree of urbanization, and this paper provides useful information toward mitigating the exposure risk of CPs for urban inhabitants.

PMID:34271520 | DOI:10.1016/j.envpol.2021.117766

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Aging biological markers in a cohort of antipsychotic-naïve first-episode psychosis patients

Psychoneuroendocrinology. 2021 Jul 2;132:105350. doi: 10.1016/j.psyneuen.2021.105350. Online ahead of print.

ABSTRACT

Schizophrenia is a severe and multifactorial disorder with an unknown causative pathophysiology. Abnormalities in neurodevelopmental and aging processes have been reported. Relative telomere length (RTL) and DNA methylation age (DMA), well-known biomarkers for estimating biological age, are both commonly altered in patients with schizophrenia compared to healthy controls. However, few studies investigated these aging biomarkers in first-episode psychosis (FEP) and in antipsychotic-naïve patients. To cover the existing gap regarding DMA and RTL in FEP and antipsychotic treatment, we aimed to verify whether those aging markers could be associated with psychosis and treatment response. Thus, we evaluated these measures in the blood of FEP antipsychotic-naïve patients and healthy controls (HC), as well as the response to antipsychotics after 10 weeks of treatment with risperidone. RTL was measured in 392 subjects, being 80 FEP and 312 HC using qPCR, while DMA was analyzed in a subset of 60 HC, 60 FEP patients (antipsychotic-naïve) and 59 FEP-10W (after treatment) using the “Multi-tissue Predictor”and the Infinium HumanMethylation450 BeadChip Kit. We observed diminished DMA and longer RTL in FEP patients before treatment compared to healthy controls, indicating a decelerated aging process in those patients. We found no statistical difference between responder and non-responder patients at baseline for both markers. An increased DMA was observed in patients after 10 weeks of treatment, however, after adjusting for blood cell composition, no significant association remained. Our findings indicate a decelerated aging process in the early phases of the disease.

PMID:34271521 | DOI:10.1016/j.psyneuen.2021.105350

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A comparison of three sampling approaches for detecting PRRSV in suckling piglets

Prev Vet Med. 2021 Jul 8;194:105427. doi: 10.1016/j.prevetmed.2021.105427. Online ahead of print.

ABSTRACT

Determining whether porcine reproductive and respiratory syndrome virus (PRRSV) is circulating within a breeding herd is a longstanding surveillance challenge. Most commonly, piglets in farrowing rooms are sampled to infer the PRRSV status of the sow herd, with sample size based on the expectation of hypergeometric distribution and piglet selection based on simple random sampling (SRS), i.e., randomly selecting individuals from a population in a manner that all individuals have equal chance of being selected. Conceptually straightforward, the assumptions upon which it is based (homogeneous population and independence of individuals) rarely hold in modern swine facilities. Alternative approaches for sample selection include two-stage stratified sampling (2SS), i.e., randomly selecting litters (first stratum) and randomly selecting piglets (second stratum) within selected litters, and risk-based sampling (RBS), i.e., selecting litters with a higher risk of having viremic piglets, and randomly selecting pigs within those litters. The objectives of this study were to 1) characterize the pattern of distribution of PRRSV-viremic piglets in farrowing rooms and 2) compare the efficiency of SRS, 2SS, and RBS for the detection of PRRSV-viremic piglets. In 12 sow farms, serum samples were collected from all 4510 piglets in 422 litters housed in 23 farrowing rooms and tested for PRRSV RNA. At the population level, the distribution of PRRSV-viremic pigs was analyzed for population homogeneity and spatial clustering. At the litter level, litter size and sow parity were evaluated as risk factors. A non-homogeneous distribution of PRRSV-viremic piglets was observed in nearly all farrowing rooms (15/16), and spatial clustering detected on 11 occasions (11/16). Simulated sampling based on farrowing room data determined that 2SS required 1-to-25 fewer samples than SRS to detect ≥ 1 viremic piglet in 13 of 16 rooms and the same number of samples in 3 rooms. RBS required 1-to-7 fewer samples than 2SS to detect ≥ 1 viremic piglet in 7 of 16 rooms, the same number of samples in 6 rooms, and 1 more sample in 3 rooms. Notably, SRS was less efficient than either 2SS or RBS in detecting PRRSV-viremic piglets in farrowing rooms, regardless of the confidence level. It may be concluded that the core assumptions upon which most current surveillance methods are based do not hold in modern farrowing room facilities. Simulation-based sample size tables for SRS and 2SS are provided.

PMID:34271476 | DOI:10.1016/j.prevetmed.2021.105427

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Identifying the maturity of co-compost of olive mill waste and natural mineral materials: Modelling via ANN and multi-objective optimization

Bioresour Technol. 2021 Jul 8;338:125516. doi: 10.1016/j.biortech.2021.125516. Online ahead of print.

ABSTRACT

In this study, olive mill waste (OMW) and natural mineral amendments were co-composted to evaluate the compost maturity efficiency. The results were modelled by Feed-Forward Neural Networks (FF-NN) and Elman-Recurrent Neural Networks (ER-NN) and compared Response Surface Methodology (RSM). According to RSM produced a prediction error of more than 10% while Neural Networks (NNs) models were <2%. From, multi-objective optimization, the most suitable materials were expanded vermiculite and pumice with overall desirabilities of 0.60 and 0.56, respectively. The optimum amendment ratios were achieved with 14.3% of expanded vermiculite and 16.0% of pumice for OMW composting. Multivariate Analysis of Variance (MANOVA) results indicated that the materials had a strong effect on composting in parallel with the optimization results. NNs were predictors with superior properties to model the composting processes, can be used as modeling tools in many areas that are difficult and costly to perform new experiments.

PMID:34271499 | DOI:10.1016/j.biortech.2021.125516

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Faster speed of onset of the depressive episode is associated with lower cytokine serum levels (IL-2, -4, -6, -10, TNF-α and IFN-γ) in patients with major depression

J Psychiatr Res. 2021 Jul 8;141:287-292. doi: 10.1016/j.jpsychires.2021.06.033. Online ahead of print.

ABSTRACT

INTRODUCTION: Cytokines might play a key role in the pathophysiology of major depressive disorder (MDD). The speed of onset of depressive episodes has been discussed as an important clinical parameter in MDD. The aim of this study was to investigate a potential influence of the speed of onset of the depressive episode on cytokine serum levels.

METHOD: Serum level of the cytokines interleukin (IL)-2, IL-4, IL-6, IL-8, IL-10, tumor necrosis factor alpha (TNF-α), interferon-gamma (IFN-γ) granulocyte and monocyte colony stimulating factor (GM-CSF) were measured in a total of 92 patients with MDD that did not respond to at least one previous antidepressant treatment. Patients were retrospectively divided in two groups: Faster (≤4 weeks) and slower (>4 weeks) onset of the depressive episode defined as the time passing from the first depressive symptoms to a full-blown depressive episode by using information from a clinical interview.

RESULTS: We found significantly lower serum levels of IL-2, IL-4, IL-6, IL-10, TNF-α and IFN-γ in patients with a faster onset compared to patients with a slower onset of the depressive episodes. Furthermore, lower cytokine serum levels of IL-2, IL-8, IL-10 and IFN-γ were found in patients with a shorter duration (less than 6 months) compared to a longer duration (6-24 months) of the current depressive episode. This effect on cytokines was independent from the effect of the speed of onset of the depressive episode.

CONCLUSIONS: Patients with faster onset of the depressive episode might represent a biological subtype of MDD with lower serum levels of IL-2, IL-4, IL-6, IL-10, TNF-α and IFN-γ.

PMID:34271459 | DOI:10.1016/j.jpsychires.2021.06.033

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Global prevalence of mental health problems among healthcare workers during the Covid-19 pandemic: A systematic review and meta-analysis

Int J Nurs Stud. 2021 Jun 13;121:104002. doi: 10.1016/j.ijnurstu.2021.104002. Online ahead of print.

ABSTRACT

BACKGROUND: Healthcare workers are at high risk of developing mental health issues during the coronavirus disease 2019 (COVID-19) pandemic. However, there is a need for a full picture of mental health problems with comprehensive analysis among healthcare workers during the COVID-19 pandemic.

OBJECTIVE: This review aimed to systematically identify the mental health problems among healthcare workers in various countries during the COVID-19 pandemic.

DESIGN: Systematic review and meta-analysis.

METHODS: A systematic literature search was performed of the following databases: PubMed, Academic Search Complete, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, MEDLINE Complete, and SocINDEX. The last date of our search was November 2, 2020. We included all cohort, case-control and cross-sectional studies and used the Joanna Briggs Institute tool to assess their quality. A meta-analysis was performed to synthesize the pooled prevalence of mental health problems using a random-effects model. Heterogeneity was measured using the I2 statistic and Egger’s test was used to assess publication bias.

RESULTS: A total of 38 studies were identified that reported the mental health problems of healthcare workers during the COVID-19 pandemic. The distribution of healthcare workers analyzed in this review included 27.9% doctors, 43.7% nurses, and 7.0% allied health workers. The pooled prevalence of mental health problems for post-traumatic stress disorder, anxiety, depression, and distress was 49% (95% confidence interval [CI]: 22-75%), 40% (95% CI: 29-52%), 37% (95% CI: 29-45%), and 37% (95% CI: 25-50%), respectively.

CONCLUSION: This review yielded evidence that estimated the global prevalence of mental health problems among healthcare workers during the COVID-19 pandemic. Post-traumatic stress disorder was the most common mental health disorder reported by healthcare workers during the COVID-19 pandemic, followed by anxiety, depression, and distress. Additional studies remain necessary to assess the appropriate management strategies for treating and preventing mental health disorders among healthcare workers during the pandemic.

PMID:34271460 | DOI:10.1016/j.ijnurstu.2021.104002