Tag: nevin manimala

PLoS Med. 2022 Jan 5;19(1):e1003887. doi: 10.1371/journal.pmed.1003887. eCollection 2022 Jan.

ABSTRACT

BACKGROUND: Adolescents living with HIV have poor virological suppression and high prevalence of common mental disorders (CMDs). In Zimbabwe, the Zvandiri adolescent peer support programme is effective at improving virological suppression. We assessed the effect of training Zvandiri peer counsellors known as Community Adolescent Treatment Supporters (CATS) in problem-solving therapy (PST) on virological suppression and mental health outcomes.

METHODS AND FINDINGS: Sixty clinics were randomised 1:1 to either normal Zvandiri peer counselling or a peer counsellor trained in PST. In January to March 2019, 842 adolescents aged 10 to 19 years and living with HIV who screened positive for CMDs were enrolled (375 (44.5%) male and 418 (49.6%) orphaned of at least one parent). The primary outcome was virological nonsuppression (viral load ≥1,000 copies/mL). Secondary outcomes were symptoms of CMDs measured with the Shona Symptom Questionnaire (SSQ ≥8) and depression measured with the Patient Health Questionnaire (PHQ-9 ≥10) and health utility score using the EQ-5D. The adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were estimated using logistic regression adjusting for clinic-level clustering. Case reviews and focus group discussions were used to determine feasibility of intervention delivery. At baseline, 35.1% of participants had virological nonsuppression and 70.3% had SSQ≥8. After 48 weeks, follow-up was 89.5% for viral load data and 90.9% for other outcomes. Virological nonsuppression decreased in both arms, but there was no evidence of an intervention effect (prevalence of nonsuppression 14.7% in the Zvandiri-PST arm versus 11.9% in the Zvandiri arm; AOR = 1.29; 95% CI 0.68, 2.48; p = 0.44). There was strong evidence of an apparent effect on common mental health outcomes (SSQ ≥8: 2.4% versus 10.3% [AOR = 0.19; 95% CI 0.08, 0.46; p < 0.001]; PHQ-9 ≥10: 2.9% versus 8.8% [AOR = 0.32; 95% CI 0.14, 0.78; p = 0.01]). Prevalence of EQ-5D index score <1 was 27.6% versus 38.9% (AOR = 0.56; 95% CI 0.31, 1.03; p = 0.06). Qualitative analyses found that CATS-observed participants had limited autonomy or ability to solve problems. In response, the CATS adapted the intervention to focus on empathic problem discussion to fit adolescents’ age, capacity, and circumstances, which was beneficial. Limitations include that cost data were not available and that the mental health tools were validated in adult populations, not adolescents.

CONCLUSIONS: PST training for CATS did not add to the benefit of peer support in reducing virological nonsuppression but led to improved symptoms of CMD and depression compared to standard Zvandiri care among adolescents living with HIV in Zimbabwe. Active involvement of caregivers and strengthened referral structures could increase feasibility and effectiveness.

TRIAL REGISTRATION: Pan African Clinical Trials Registry PACTR201810756862405.

PMID:34986170 | DOI:10.1371/journal.pmed.1003887

PLoS One. 2022 Jan 5;17(1):e0262300. doi: 10.1371/journal.pone.0262300. eCollection 2022.

ABSTRACT

INTRODUCTION: By measuring patients’ satisfaction, providers can gain insight into several elements of health care services, including the effectiveness of their care and the level of empathy they exhibit. The aim of this study was to assess patient satisfaction with pharmaceutical services and associated factors in public hospitals located in Northwestern Ethiopia.

METHODS: An institution-based quantitative cross-sectional study was used. The study was carried out in an outpatient pharmacy from January 1-June 30, 2021. Participants were selected by a systematic sampling technique. The IBM SPSS statistical package (version 23) was used to enter and analyze the collected data. The findings were presented using descriptive statistical methods. To find factors linked to satisfaction, binary logistic regression was used.

RESULTS: The final analysis included a total of 401 samples. More than half of the participants (229, or 55.1%) were female. The overall mean score of satisfaction was 30.6 out of a maximum of 100 scores. By taking this mean score as a cut-off point, 204 (50.9%) of the study participants had satisfaction with the outpatient pharmacists’ service. Participants’ responses scored on the uncomfortable and inconvenient waiting areas [AOR = 0.31; 95%CI, (0.13, 0.49)] were found to be negatively associated with the level of patients’ satisfaction. Also, the unavailability of medications [AOR = 0.12; 95%CI, (0.02, 0.37)] was negatively associated with the respondent satisfaction. Uncomfortable and inconvenient private counseling areas [AOR = 1.37; 95%CI, (0.79, 4.42)] showed a negative association with their satisfaction.

CONCLUSION: Patients’ satisfaction levels with pharmacy service were found to be greater than 50%. The socio-demographic characteristics of patients have no association with their level of satisfaction, but their perception of uncomfortable private counseling areas and waiting areas was negatively associated with their satisfaction.

PMID:34986179 | DOI:10.1371/journal.pone.0262300

PLoS Comput Biol. 2022 Jan 5;18(1):e1009770. doi: 10.1371/journal.pcbi.1009770. eCollection 2022 Jan.

ABSTRACT

[This corrects the article DOI: 10.1371/journal.pcbi.1009118.].

PMID:34986151 | DOI:10.1371/journal.pcbi.1009770

PLoS Negl Trop Dis. 2022 Jan 5;16(1):e0010049. doi: 10.1371/journal.pntd.0010049. Online ahead of print.

ABSTRACT

BACKGROUND: Estimation of malaria prevalence in very low transmission settings is difficult by even the most advanced diagnostic tests. Antibodies against malaria antigens provide an indicator of active or past exposure to these parasites. The prominent malaria species within Haiti is Plasmodium falciparum, but P. vivax and P. malariae infections are also known to be endemic.

METHODOLOGY/PRINCIPAL FINDINGS: From 2014-2016, 28,681 Haitian children were enrolled in school-based serosurveys and were asked to provide a blood sample for detection of antibodies against multiple infectious diseases. IgG against the P. falciparum, P. vivax, and P. malariae merozoite surface protein 19kD subunit (MSP119) antigens was detected by a multiplex bead assay (MBA). A subset of samples was also tested for Plasmodium DNA by PCR assays, and for Plasmodium antigens by a multiplex antigen detection assay. Geospatial clustering of high seroprevalence areas for P. vivax and P. malariae antigens was assessed by both Ripley’s K-function and Kulldorff’s spatial scan statistic. Of 21,719 children enrolled in 680 schools in Haiti who provided samples to assay for IgG against PmMSP119, 278 (1.27%) were seropositive. Of 24,559 children enrolled in 788 schools providing samples for PvMSP119 serology, 113 (0.46%) were seropositive. Two significant clusters of seropositivity were identified throughout the country for P. malariae exposure, and two identified for P. vivax. No samples were found to be positive for Plasmodium DNA or antigens.

CONCLUSIONS/SIGNIFICANCE: From school-based surveys conducted from 2014 to 2016, very few Haitian children had evidence of exposure to P. vivax or P. malariae, with no children testing positive for active infection. Spatial scan statistics identified non-overlapping areas of the country with higher seroprevalence for these two malarias. Serological data provides useful information of exposure to very low endemic malaria species in a population that is unlikely to present to clinics with symptomatic infections.

PMID:34986142 | DOI:10.1371/journal.pntd.0010049

PLoS Comput Biol. 2022 Jan 5;18(1):e1009731. doi: 10.1371/journal.pcbi.1009731. Online ahead of print.

ABSTRACT

Operon prediction in prokaryotes is critical not only for understanding the regulation of endogenous gene expression, but also for exogenous targeting of genes using newly developed tools such as CRISPR-based gene modulation. A number of methods have used transcriptomics data to predict operons, based on the premise that contiguous genes in an operon will be expressed at similar levels. While promising results have been observed using these methods, most of them do not address uncertainty caused by technical variability between experiments, which is especially relevant when the amount of data available is small. In addition, many existing methods do not provide the flexibility to determine the stringency with which genes should be evaluated for being in an operon pair. We present OperonSEQer, a set of machine learning algorithms that uses the statistic and p-value from a non-parametric analysis of variance test (Kruskal-Wallis) to determine the likelihood that two adjacent genes are expressed from the same RNA molecule. We implement a voting system to allow users to choose the stringency of operon calls depending on whether your priority is high recall or high specificity. In addition, we provide the code so that users can retrain the algorithm and re-establish hyperparameters based on any data they choose, allowing for this method to be expanded as additional data is generated. We show that our approach detects operon pairs that are missed by current methods by comparing our predictions to publicly available long-read sequencing data. OperonSEQer therefore improves on existing methods in terms of accuracy, flexibility, and adaptability.

PMID:34986143 | DOI:10.1371/journal.pcbi.1009731

J Pediatr Hematol Oncol. 2022 Jan 1;44(1):e199-e203. doi: 10.1097/MPH.0000000000002306.

ABSTRACT

BACKGROUND AND AIM: Oral mucositis (OM) is a common side effect of systemic chemotherapy (CT) in cancer patients. The aim was to evaluate the effect of low-level laser therapy (LLLT) for the treatment of CT-induced OM children.

PATIENTS AND METHODS: The study was carried out in 40 pediatric patients 3 to 18 years of age, who were hospitalized for the diagnosis of leukemia and underwent CT between June 1, 2019, and December 31, 2019. They were randomly divided into 2 groups with 20 cases in each group. The LLLT group was treated with GaAlAs diode laser (l): 830 nm (infrared), power: 150 mW, dose: 4.5 J/cm2 and the control group underwent bicarbonate treatment. Patients received intervention for 3 days. The grade of OM was clinically assessed by the World Health Organization (WHO) Common Toxicity Criteria Scale. Visual Analog Scale was used on the same days with OM grade to evaluate the pain status.

RESULTS: While there was no significant difference between the groups in terms of OM grade at the beginning of the treatment and on the first, second, fourth, and 11th days of the treatment, the average OM grade of the LLLT group was found to be statistically significantly lower on the third, fifth, sixth, and seventh days of the treatment. The Visual Analog Scale score of the LLLT group was statistically significantly lower compared with the control group at all examinations starting from the first day of treatment (P<0.05).

CONCLUSION: In the treatment of oral OM that occurs in children after CT, both standard care and LLLT treatment improve the grade and pain of OM.

PMID:34986132 | DOI:10.1097/MPH.0000000000002306

Acta Med Port. 2021 Nov 2;34(11):761-766. doi: 10.20344/amp.16209. Epub 2021 Nov 2.

ABSTRACT

INTRODUCTION: In March 2020, the World Health Organization declared COVID-19 as a pandemic, and Portugal reported its initial cases. In this study, we aimed to determine the impact of COVID-19 on Portuguese individuals aged over 60 years old.

MATERIAL AND METHODS: We performed a cross-sectional study using data from the Survey of Health, Ageing and Retirement in Europe (SHARE 8: COVID-19 Survey). We selected a sample of 1080 noninstitutional Portuguese individuals aged ≥ 60 years.

RESULTS: The study sample consisted of 605 (56%) women and 475 (44%) men, with a mean age of 70 ± 9.1 years. In total, 80% of the participants experienced higher levels of anxiety, 73% felt more depressed and 30% experienced additional sleep problems comparedto the period before the pandemic. Interestingly, there were no statistically significant differences between the sexes or the two selected age groups (60 – 74 and over 75 years old) regarding the incidence of these changes. Only 23%, of those that were interviewed maintained their walking routines. In addition, only 8% of the participants continued visiting family members as frequently as before. While 8% of the participants were refused some form of medical treatment, 56% claimed that they experienced healthcare delays. However,only 15% of the participants reported that their health status worsened during the pandemic.

DISCUSSION: The pandemic has had a significant impact on Portuguese individuals aged ≥ 60 years; which is in agreement with the findings of previous international studies. It changed the participants’ routines and increased their anxiety and depression levels. Despite the deterioration of healthcare services, most participants did not experience worsening of their health status.

CONCLUSION: In conclusion, a COVID-19 pandemic had a significant impact on the elderly population, particularly regarding their mental health.

PMID:34986084 | DOI:10.20344/amp.16209

IEEE J Biomed Health Inform. 2022 Jan 5;PP. doi: 10.1109/JBHI.2022.3140531. Online ahead of print.

ABSTRACT

Functional near-infrared spectroscopy (fNIRS) is a promising neuroimaging technology. The fNIRS classification problem has always been the focus of the brain-computer interface (BCI). Inspired by the success of Transformer based on self-attention mechanism in the fields of natural language processing and computer vision, we propose an fNIRS classification network based on Transformer, named fNIRS-T. We explore the spatial-level and channel-level representation of fNIRS signals to improve data utilization and network representation capacity. Besides, a preprocessing module, which consists of one-dimensional average pooling and layer normalization, is designed to replace filtering and baseline correction of data preprocessing. It makes fNIRS-T an end-to-end network, called fNIRS-PreT. Compared with traditional machine learning classifiers, convolutional neural network (CNN), and long short-term memory (LSTM), the proposed models obtain the best accuracy on three open-access datasets. Specifically, in the most extensive ternary classification task (30 subjects) that includes three types of overt movements, fNIRS-T, CNN, and LSTM obtain 75.49%, 72.89%, and 61.94% on test sets, respectively. Compared to traditional classifiers, fNIRS-T is at least 27.41% higher than statistical features and 6.79% higher than well-designed features. In the individual subject experiment of the ternary classification task, fNIRS-T achieves an average subject accuracy of 78.22% and surpasses CNN and LSTM by a large margin of +4.75% and +11.33%. fNIRS-PreT using raw data also achieves competitive performance to fNIRS-T. Therefore, the proposed models improve the performance of fNIRS-based BCI significantly.

PMID:34986110 | DOI:10.1109/JBHI.2022.3140531

Acta Med Port. 2021 Nov 2;34(11):724-732. doi: 10.20344/amp.14004. Epub 2021 Nov 2.

ABSTRACT

INTRODUCTION: Urinary incontinence affects up to one third of women in Portugal. Exercise can be a precipitating/aggravating factor but also protective, if appropriate. The aim of this study was to determine the prevalence of urinary incontinence in women who practice recreational exercise, to assess its relationship with the type of exercise and other coexisting risk factors, and assess whether the topic is addressed in gyms.

MATERIAL AND METHODS: Cross-sectional study using self-reported questionnaires in gyms in Porto and Vila Nova de Gaia, Portugal.

RESULTS: Two hundred and ninety women completed the questionnaires. From these, 67.6% were under 40 years old, 25.2% reported incontinence, and 53.4% had at least one risk factor unrelated to exercise. There was a statistically significant association (p < 0.05) between incontinence, obesity and constipation. High impact exercises were included in the training of 62.1% continent and 50.9% incontinent women. The topic of incontinence and strengthening of the pelvic floor muscles was addressed in only 5.5% in the initial assessment, 9.7% in collective training, and in 13.5% of the 37 women with individualized training.

DISCUSSION: The higher proportion of continent women – compared to incontinent – who practiced strenuous exercise suggests that this might be a provocative factor for some, although there was no statistically significant association between incontinence and type of exercise.

CONCLUSION: Urinary incontinence affects women who practice recreational exercise, regardless of age and exercise characteristics. It is rarely addressed in gyms, and it is necessary to raise the awareness of professionals to enhance the preventive/therapeutic effects of exercise on the function of the pelvic floor and in the control of modifiable risk factors.

PMID:34986083 | DOI:10.20344/amp.14004

Comput Methods Biomech Biomed Engin. 2022 Jan 5:1-13. doi: 10.1080/10255842.2021.2021194. Online ahead of print.

ABSTRACT

The hydrothermal features of unsteady, incompressible, and laminar hybrid nanofluid motion through a porous capillary are analytically studied in the magnetic field presence. The hybrid nanofluid (GO + ZnO + Blood) is synthesized by blending nanomaterials of graphene oxide and zinc oxide with blood acting as the host fluid. The mathematical model of the flow comprises of a coupled nonlinear set of partial differential equations (PDEs) satisfying appropriate boundary conditions. These equations are reduced to ordinary differential equations (ODEs) by using similarity transformations and then solved with homotopy analysis method (HAM). The impacts of various pertinent physical parameters over the hybrid nanofluid state functions are examined by displaying 2 D graphs. It has been observed that the fluid velocity mitigates with the varying strength of M, A₀, N₀, and N₁. The enhancing buoyancy parameter ϵ augments the fluid velocity. The increasing Prandtl number causes to reduce, while the enhancing A₀, B, and N₂ augment the hybrid nanofluid temperature. The fluid concentration mitigates with the higher Schmidt number values and A₀, and augments with the increasing Soret number strength. The augmenting magnetic field strength causes to enhance the fluid friction, whereas the convective heat transfer increases with the Prandtl number rising values. The rising Sherwood number drops the mass transfer rate of the fluid. The achieved results are validated due to the agreement with the published results. The results of this computation will find applications in biomedicine, nanotechnology, and fluid dynamics.

PMID:34986079 | DOI:10.1080/10255842.2021.2021194