Tag: nevin manimala

PLoS One. 2021 Sep 2;16(9):e0257040. doi: 10.1371/journal.pone.0257040. eCollection 2021.

ABSTRACT

OBJECTIVES: To study abnormality of spirometry, six-minute walk distance, and chest radiograph among patients recovered from Coronavirus Disease 2019 (COVID-19).

METHODS AND STUDY DESIGN: A prospective cohort study was conducted in 87 COVID-19 confirmed cases who recovered and discharged from a medical school hospital in Thailand. At the follow-up visit on day 60 after onset of symptoms, patients underwent an evaluation by spirometry (FVC, FEV1, FEV1/FVC, FEF25-75, and PEF), a six-minute-walk test (6MWT), and a chest radiograph.

RESULTS: There were 35 men and 52 women, with a mean age of 39.6±11.8 years and the mean body mass index (BMI) was 23.8±4.3 kg/m2. Of all, 45 cases had mild symptoms; 35 had non-severe pneumonia, and 7 had severe pneumonia. Abnormality in spirometry was observed in 15 cases (17.2%), with 8% of restrictive defect and 9.2% of obstructive defect. Among the patients with an abnormal spirometry, the majority of the cases were in the severe pneumonia group (71.4%), compared with 15.6% in the non-severe pneumonia group, and 10.2% in the mild symptom group (p = 0.001). The mean six-minute-walk distance (6MWD) in the mild symptom and non-severe pneumonia groups was 538±56.8 and 527.5±53.5 meters, respectively. Although the severe pneumonia group tended to have a shorter mean 6-min walking distance, but this was not statistically significant (p = 0.118). Twelve patients (13.8%) had abnormal chest radiographs that showed residual fibrosis. This abnormality was more common in the severe pneumonia group (85.7%) and in others (7.5%) (p<0.001).

CONCLUSIONS: Abnormal spirometry was noted in 17.2% of COVID-19 survivors with both restrictive and obstructive defects. Severe COVID-19 pneumonia patients had higher prevalence rates of abnormal spirometry and residual fibrosis on the chest radiographs when compared to patients in the mild symptom and non-severe pneumonia groups.

PMID:34473811 | DOI:10.1371/journal.pone.0257040

Age Ageing. 2021 Aug 28:afab169. doi: 10.1093/ageing/afab169. Online ahead of print.

ABSTRACT

OBJECTIVES: To reduce infections with Clostridioides difficile (CDI) in geriatric patients by interventions easily implementable in standard clinical care.

METHODS: Prevalence and incidence of CDI between January 2015 and February 2020 were analysed (n = 25,311 patients). Pre-intervention status was assessed from April 2016 to March 2017 (n = 4,922). Between May 2017 and August 2019, a monocentric interventional crossover study (n = 4,655) was conducted including standard care and three interventions: (A) sporicidal cleaning of hospital wards, (B) probiotics and (C) improvement in personal hygiene for CDI patients. This was followed by a multicentric comparison of the interventional bundle (A + B + C) between September 2019 and February 2020 (n = 2,593) with the pre-intervention phase. In 98 CDI cases and matched controls individual risk factors for the development of CDI were compared.

RESULTS: Time series analyses of CDI cases revealed a reduction in the prevalence of CDI in all three participating centres prior to the multicentric intervention phase. In the monocentric phase, no effect of individual interventions on CDI prevalence was identified. However, an aggregated analysis of CDI cases comparing the pre-intervention and the multicentric phase revealed a significant reduction in CDI prevalence. Risk factors for the development of CDI included use of antibiotics, anticoagulants, previous stay in long-term care facilities, prior hospital admissions, cardiac and renal failure, malnutrition and anaemia.

CONCLUSIONS: The observed reduction in CDI may be attributed to heightened awareness of the study objectives and specific staff training. Individual interventions did not appear to reduce CDI prevalence. A further randomised trial would be necessary to confirm whether the bundle of interventions is truly effective.

PMID:34473822 | DOI:10.1093/ageing/afab169

PLoS One. 2021 Sep 2;16(9):e0256956. doi: 10.1371/journal.pone.0256956. eCollection 2021.

ABSTRACT

This study investigates the topology and dynamics of collaboration networks that exist between inventors and their patent co-authors for patents granted by the USPTO from 2007-2019 (2,241,201 patents and 1,879,037 inventors). We study changes in the configurations of different technology fields via the power-law, small-world, preferential attachment, shrinking diameter, densification law, and gelling point hypotheses. Similar to the existing literature, we obtain mixed results. Based on network statistics, we argue that the sudden rise of large networks in six technology sectors can be understood as a phase transition in which small, isolated networks form one giant component. In two other technology sectors, such a transition occurred much later and much less dramatically. The examination of inventor networks over time reveals the increased complexity of all technology sectors, regardless of the individual characteristics of the network. Therefore, we introduce ideas associated with the technological diversification of inventors to complement our analysis, and we find evidence that inventors tend to diversify into new fields that are less mature. This behavior appears to be correlated with the compliance of some of the expected network rules and has implications for the emerging patterns among the different collaboration networks under consideration here.

PMID:34473792 | DOI:10.1371/journal.pone.0256956

PLoS One. 2021 Sep 2;16(9):e0256997. doi: 10.1371/journal.pone.0256997. eCollection 2021.

ABSTRACT

INTRODUCTION: Degenerative Cervical Myelopathy (DCM) is a common and disabling condition, with a relatively modest research capacity. In order to accelerate knowledge discovery, the AO Spine RECODE-DCM project has recently established the top priorities for DCM research. Uptake of these priorities within the research community will require their effective dissemination, which can be supported by identifying key opinion leaders (KOLs). In this paper, we aim to identify KOLs using artificial intelligence. We produce and explore a DCM co-authorship network, to characterise researchers’ impact within the research field.

METHODS: Through a bibliometric analysis of 1674 scientific papers in the DCM field, a co-authorship network was created. For each author, statistics about their connections to the co-authorship network (and so the nature of their collaboration) were generated. Using these connectedness statistics, a neural network was used to predict H-Index for each author (as a proxy for research impact). The neural network was retrospectively validated on an unseen author set.

RESULTS: DCM research is regionally clustered, with strong collaboration across some international borders (e.g., North America) but not others (e.g., Western Europe). In retrospective validation, the neural network achieves a correlation coefficient of 0.86 (p<0.0001) between the true and predicted H-Index of each author. Thus, author impact can be accurately predicted using only the nature of an author’s collaborations.

DISCUSSION: Analysis of the neural network shows that the nature of collaboration strongly impacts an author’s research visibility, and therefore suitability as a KOL. This also suggests greater collaboration within the DCM field could help to improve both individual research visibility and global synergy.

PMID:34473796 | DOI:10.1371/journal.pone.0256997

PLoS One. 2021 Sep 2;16(9):e0257014. doi: 10.1371/journal.pone.0257014. eCollection 2021.

ABSTRACT

OBJECTIVES: Official data on birth is important to monitor the specific targets of SDGs. About 2.7 million children under age five years do not have official birth registration document in India. Unavailability of birth registration document may deprive the children from access to government-aided essential services such as fixed years of formal education, healthcare, and legal protection. This study examines the effect of socioeconomic, demographic and health care factors on birth registration in India. We also examined the spatial pattern of completeness of birth registration that could be useful for district level intervention.

METHODS: We used data from the National Family Health Survey (NFHS-4), 2015-16. We carried out the descriptive statistics and bivariate analysis. Besides, we used multilevel binary logistic regression to identify significant covariates of birth registration at the individual, district, and state levels. We used GIS software to do spatial mapping of completeness of birth registration at district level.

RESULTS: The birth registration level was lower than national average (80.21%) in the 254 districts. In Uttar Pradesh, 12 out of 71 districts recorded lower than 50% birth registration. Also, some districts from Arunachal Pradesh, J&K, and Rajasthan recorded lower than 50% birth registration. We also found a lower proportion of children are registered among children of birth order three and above (62.83%) and rural resident (76.62%). Children of mothers with no formal education, no media exposure, poorest wealth quintile, OBC and muslims religion have lower level of birth registration. Multilevel regression result showed 25 percent variation in birth registration lie between states while the remaining 75 percent variation lie within states. Moreover, children among illiterate mother (AOR = 0.57, CI [0.54, 0.61], p<0.001), Muslims households (AOR = 0.90, CI [0.87, 0.94], p<0.001), and poorest wealth quintile (AOR = 0.38, CI [0.36, 0.41], p<0.001) showed lower odds for child’s birth registration.

CONCLUSION: We strongly suggest linking the birth registration facilities with health institutions.

PMID:34473807 | DOI:10.1371/journal.pone.0257014

PLoS One. 2021 Sep 2;16(9):e0257018. doi: 10.1371/journal.pone.0257018. eCollection 2021.

ABSTRACT

BACKGROUND: The COVID-19 pandemic has presented emergency medical services (EMS) worldwide with the difficult task of identifying patients with COVID-19 and predicting the severity of their illness. The aim of this study was to investigate whether physiological respiratory parameters in pre-hospital patients with COVID-19 differed from those without COVID-19 and if they could be used to aid EMS personnel in the prediction of illness severity.

METHODS: Patients with suspected COVID-19 were included by EMS personnel in Uppsala, Sweden. A portable respiratory monitor based on pneumotachography was used to sample the included patient’s physiological respiratory parameters. A questionnaire with information about present symptoms and background data was completed. COVID-19 diagnoses and hospital admissions were gathered from the electronic medical record system. The physiological respiratory parameters of patients with and without COVID-19 were then analyzed using descriptive statistical analysis and logistic regression.

RESULTS: Between May 2020 and January 2021, 95 patients were included, and their physiological respiratory parameters analyzed. Of these patients, 53 had COVID-19. Using adjusted logistic regression, the odds of having COVID-19 increased with respiratory rate (95% CI 1.000-1.118), tidal volume (95% CI 0.996-0.999) and negative inspiratory pressure (95% CI 1.017-1.152). Patients admitted to hospital had higher respiratory rates (p<0.001) and lower tidal volume (p = 0.010) compared to the patients who were not admitted. Using adjusted logistic regression, the odds of hospital admission increased with respiratory rate (95% CI 1.081-1.324), rapid shallow breathing index (95% CI 1.006-1.040) and dead space percentage of tidal volume (95% CI 1.027-1.159).

CONCLUSION: Patients taking smaller, faster breaths with less pressure had higher odds of having COVID-19 in this study. Smaller, faster breaths and higher dead space percentage also increased the odds of hospital admission. Physiological respiratory parameters could be a useful tool in detecting COVID-19 and predicting hospital admissions, although more research is needed.

PMID:34473782 | DOI:10.1371/journal.pone.0257018

PLoS One. 2021 Sep 2;16(9):e0256934. doi: 10.1371/journal.pone.0256934. eCollection 2021.

ABSTRACT

INTRODUCTION: Chronic kidney disease (CKD) patients are at an extremely high risk of silent myocardial ischemia (SMI). However, there is a dearth of evidence on the worldwide prevalence of this very lethal and yet unrecognizable complication of CKD. The proposed systematic review and meta-analysis aims to estimate the global prevalence of SMI among CKD patients.

METHODS AND ANALYSES: This protocol was conceived according to the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) statement. The systematic review will involve all observational studies and clinical trials published until April 30, 2021, and reporting on the prevalence of SMI in CKD patients. Electronic sources including MEDLINE, Embase, Web of Science, and Cochrane database of systematic reviews will be perused for potentially eligible studies, restricted to only studies published in English or French. Two investigators will independently select studies and use a pre-pilot tested form to extract data. Further, they will independently perform a qualitative assessment of the risk of bias and overall quality of the selected studies, followed by a quantitative assessment using funnel plots and Egger’s tests. The heterogeneity between studies will be assessed with the Cochrane’s Q statistic, and the I2 statistic will measure the percentage of variation across studies that is due to their heterogeneity rather than chance; the I2 will decide if a meta-analysis can be conducted. In case it cannot be conducted, a descriptive analysis will be performed. Otherwise, study-specific estimates will be pooled using either a fixed-effects or a random-effects model, depending on the value of the I2 statistic. Subgroup and random effects meta-regression analyses will further investigate the potential sources of heterogeneity. Finally, sensitivity analyses will be performed to measure the impact of low-quality studies on the results of the meta-analysis, and power calculations will determine the probability that we will detect a true effect if it does exist.

PROSPERO REGISTRATION NUMBER: CRD42020211929.

STRENGTHS AND LIMITATIONS OF THIS STUDY: The intended systematic review and meta-analysis will fill the knowledge gap on the global prevalence of silent myocardial ischemia (SMI) in CKD patients. The eligible studies will be identified through a methodic literature search followed by a rigorous screening process; we will then use robust meta-analysis tools to pool the data and provide reliable estimates of the global prevalence of SMI in CKD patients. Two major limitations could be: the predominance of clinical trials that might limit the generalizability of the findings, given that some informative patients might have been sidelined by the strict inclusion criteria of these studies; the high probability of type 1 error originating from the important number of subgroup and sensitivity analyses.

PMID:34473787 | DOI:10.1371/journal.pone.0256934

PLoS One. 2021 Sep 2;16(9):e0256918. doi: 10.1371/journal.pone.0256918. eCollection 2021.

ABSTRACT

Plant species distribution is constrained by both dynamic and static environmental variables. However, relative contribution of dynamic and static variables in determining species distributions is not clear and has far reaching implications for range change dynamics in a changing world. Prunus eburnea (Spach) Aitch. & Hemsl. is an endemic and medicinal plant species of Iran. It has rendered itself as ecologically important for its functions and services and is currently in need of habitat conservation measures requiring investigation of future potential distribution range. We conducted sampling of 500 points that cover most of Iran plateau and recorded the P. eburnea presence and absence during the period 2015-2017. In this study, we evaluated impacts of using only climatic variables versus combined with topographic and edaphic variables on accuracy criteria and predictive ability of current and future habitat suitability of this species under climate change (CCSM4, RCP 2.6 in 2070) by generalized linear model and generalized boosted model. Models’ performances were evaluated using area under the curve, sensitivity, specificity and the true skill statistic. Then, we evaluated here, driving environmental variables determining the distribution of P. eburnea by using principal component analysis and partitioning methods. Our results indicated that prediction with high accuracy of the spatial distribution of P. eburnea requires both climate information, as dynamic primary factors, but also detailed information on soil and topography variables, as static factors. The results emphasized that environmental variable grouping influenced the modelling prediction ability strongly and the use of only climate variables would exaggerate the predicted distribution range under climate change. Results supported using both dynamic and static variables improved accuracy of the modeling and provided more realistic prediction of species distribution under influence of climate change.

PMID:34473770 | DOI:10.1371/journal.pone.0256918

PLoS One. 2021 Sep 2;16(9):e0256948. doi: 10.1371/journal.pone.0256948. eCollection 2021.

ABSTRACT

BACKGROUND: According to the World Health Organization, optimal adherence to Antiretroviral Therapy (ART) improves quality of life. Patients who use ART have varying characteristics in terms of where they live. The effect of place of residence on ART adherence is unclear in Ethiopia. Therefore, the aim of this systematic review and meta-analysis was to estimate the pooled association between place of residence and adherence to ART.

METHODS: Articles were retrieved from PubMed, Scopus, African Journals Online (AJOL), Journal Storage (JSTOR), and Web of Science. The data was extracted using Microsoft Excel 2016 spreadsheet. Review Manager 5.3 and STATA version 14 were used for the analysis. The Cochrane Q statistic was used to assess between-study heterogeneity. I2 was used to quantify between-study heterogeneity. A weighted inverse variance random-effects model was used to calculate the pooled odds ratio with 95% confidence interval.

RESULTS: Seven studies were included in this systematic review and meta-analysis. The Begg’s test (Z = 0.15, P = 0.881) and Egger’s test (t = 0.14, P = 0.894) revealed no evidence of publication bias. Urban residence was associated with an increased likelihood of good adherence (OR 2.07, 95%CI 1.22-3.51).

CONCLUSIONS: The study recommends that policy-makers should enact policies that increase access to ART services in a rural area in order to improve adherence. It is recommended that implementation studies be conducted in order to identify practical and affordable interventions.

PMID:34473774 | DOI:10.1371/journal.pone.0256948

PLoS One. 2021 Sep 2;16(9):e0256683. doi: 10.1371/journal.pone.0256683. eCollection 2021.

ABSTRACT

INTRODUCTION: In 2014, the Navajo Nation Healthy Diné Nation Act (HDNA) was passed, combining a 2% tax on foods of ‘minimal-to-no-nutritional value’ and waiver of 5% sales tax on healthy foods, the first-ever such tax in the U.S. and globally among a sovereign tribal nation. The aim of this study was to measure changes in pricing and food availability in stores on the Navajo Nation following the implementation of the HDNA.

METHODS: Store observations were conducted in 2013 and 2019 using the Nutrition Environment Measurement Survey-Stores (NEMS-S) adapted for the Navajo Nation. Observations included store location, type, whether healthy foods or HDNA were promoted, and availability and pricing of fresh fruits and vegetables, canned items, beverages, water, snacks and traditional foods. Differences between 2013 and 2019 and by store type and location were tested.

RESULTS: The matched sample included 71 stores (51 in the Navajo Nation and 20 in border towns). In 2019, fresh produce was available in the majority of Navajo stores, with 71% selling at least 3 types of fruit and 65% selling at least 3 types of vegetables. Compared with border town convenience stores, Navajo convenience stores had greater availability of fresh vegetables and comparable availability of fresh fruit in 2019. The average cost per item of fresh fruit decreased by 13% in Navajo stores (from $0.88 to $0.76) and increased in border stores (from $0.63 to $0.73), resulting in comparable prices in Navajo and border stores in 2019. While more Navajo stores offered mutton, blue corn and wild plants in 2019 compared to 2013, these changes were not statistically significant.

DISCUSSION: The findings suggest modest improvements in the Navajo store environment and high availability of fruits and vegetables. Navajo stores play an important role in the local food system and provide access to local, healthy foods for individuals living in this rural, tribal community.

PMID:34473739 | DOI:10.1371/journal.pone.0256683