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Nevin Manimala Statistics

Timing of oxytocin administration to prevent post-partum hemorrhage in women delivered by cesarean section: A systematic review and metanalysis

PLoS One. 2021 Jun 3;16(6):e0252491. doi: 10.1371/journal.pone.0252491. eCollection 2021.

ABSTRACT

BACKGROUND: There is no consensus on the best timing for prophylactic oxytocin administration during cesarean section (CS) to prevent post-partum hemorrhage (PPH).

OBJECTIVES: Assess the effects of administrating prophylactic oxytocin at different times during CS.

METHODS: We searched nine databases to identify relevant randomized controlled trials (RCT). We pooled results and calculated average risk ratios (RR), mean differences (MD), and 95% confidence intervals (CI). We used GRADE to assess the overall evidence certainty.

RESULTS: We screened 13,389 references and included four trials. We found no statistically significant differences between oxytocin given before versus after fetal delivery on PPH (RR 0.60, 95%CI 0.15-2.47; 1 RCT, N = 300) or nausea/vomiting (RR 1.21, 95%CI 0.69-2.13; 1 RCT, N = 300). There was a significant reduction in the need for additional uterotonics when oxytocin was given immediately before uterine incision versus after fetal delivery (RR 0.37, 95%CI 0.18-0.73; I2 = 0%; 2 RCTs; N = 301). Oxytocin given before fetal delivery significantly reduced intra-operative blood loss (MD -146.77mL, 95%CI -168.10 to -125.43; I2 = 0%; 3 RCTs, N = 601) but did not change the incidence of blood transfusion (RR 0.50, 95%CI 0.13-1.95; I2 = 0%; 2 RCTs, N = 301) or hysterectomy (RR 3.00; 95%CI 0.12-72.77; I2 = 0%; 2 RCTs, N = 301). One trial (N = 100) compared prophylactic oxytocin before versus after placental separation and found no significant differences on PPH, additional uterotonics, or nausea/vomiting.

CONCLUSIONS: In women having pre-labor CS, there is limited evidence indicating no significant differences between prophylactic oxytocin given before versus after fetal delivery on PPH, nausea/vomiting, blood transfusion, or hysterectomy. Earlier oxytocin administration may reduce the volume of blood loss and need for additional uterotonics. There is very limited evidence suggesting no significant differences between prophylactic oxytocin given before versus after placental separation on PPH, need for additional uterotonic, or nausea/vomiting. The overall certainty of the evidence was mostly low or very low due to imprecision. Protocol: CRD42020186797.

PMID:34081734 | DOI:10.1371/journal.pone.0252491

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Nevin Manimala Statistics

Mobility for sex work and recent experiences of gender-based violence among female sex workers in Iringa, Tanzania: A longitudinal analysis

PLoS One. 2021 Jun 3;16(6):e0252728. doi: 10.1371/journal.pone.0252728. eCollection 2021.

ABSTRACT

Female sex workers are highly mobile, which may influence their risk of experiencing physical and sexual violence. However, there remains a paucity of research, particularly longitudinal, from Sub-Saharan Africa exploring mobility and gender-based violence among female sex workers. To address this gap, this study examined the longitudinal relationship between work-related mobility and recent experience of physical or sexual gender-based violence from a client or partner among female sex workers in Iringa, Tanzania. A secondary data analysis was conducted using baseline and 18-month follow-up data from Project Shikamana, a community empowerment-based combination HIV prevention intervention. Responses from 387 female sex workers aged 18 years and older participating in both baseline and follow-up were analyzed. Unadjusted and adjusted Poisson regression models with robust variance estimations, accounting for clustering of female sex workers’ responses over time, were fit. Final models adjusted for socio-demographic characteristics and aspects of participants’ living situations and work environments. Recent physical or sexual violence from a client or partner was common (baseline: 40%; follow-up: 29%). Twenty-six percent of female sex workers at baseline, and 11% at follow-up, had recently traveled outside of Iringa for sex work. In the final adjusted longitudinal model, female sex workers recently mobile for sex work had a 25% increased risk of any recent experience of physical or sexual gender-based violence when compared with their non-mobile counterparts (adjusted incidence rate ratio: 1.25; 95% CI: 1.03-1.53; p<0.05). Interventions must identify ways-such as mobile support services, linkages and referrals to health and other social services while traveling, or the use of mobile or digital technology-to address mobile female sex workers’ unique needs while traveling. Future quantitative and qualitative research is needed to understand the context of female sex workers’ mobility and how and why mobility influences risk environments and experiences of gender-based violence.

PMID:34081739 | DOI:10.1371/journal.pone.0252728

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Nevin Manimala Statistics

Assessing the appropriateness of the Moving Epidemic Method and WHO Average Curve Method for the syndromic surveillance of acute respiratory infection in Mauritius

PLoS One. 2021 Jun 3;16(6):e0252703. doi: 10.1371/journal.pone.0252703. eCollection 2021.

ABSTRACT

INTRODUCTION: Mauritius introduced Acute respiratory infection (ARI) syndromic surveillance in 2007. The Moving Epidemic Method (MEM) and the World Health Organization Average Curve Method (WHO ACM) have been used widely in several countries to establish thresholds to determine the seasonality of acute respiratory infections. This study aimed to evaluate the appropriateness of these tools for ARI syndromic surveillance in Mauritius, where two or more waves are observed.

METHOD: The proportion of attendance due to acute respiratory infections was identified as the transmissibility indicator to describe seasonality using the Moving Epidemic Method and the WHO Average Curve Method. The proportion was obtained from weekly outpatient data between 2012 and 2018 collected from the sentinel acute respiratory infections surveillance. A cross-validation analysis was carried out. The resulting indicators of the goodness of fit model were used to assess the robustness of the seasonal/epidemic threshold of both the Moving Epidemic Method and WHO Average Curve Method. Additionally, a comparative analysis examined the integrity of the thresholds without the year 2017.

RESULT: The cross-validation analysis demonstrated no statistically significant differences between the means scores of the indicators when comparing the two waves/seasons curves of WHO ACM and MEM. The only exception being that the Wilcoxon sign rank test strongly supported that the specificity mean score of the two waves/seasons curve for WHO ACM outweighed that of its corresponding wave model for the MEM (P = 0.002). The comparative analysis with 2017 data showed the value of the epidemic threshold remained the same regardless of the methods and the number of seasonal waves.

CONCLUSION: The two waves models of the Moving Epidemic Method and WHO Average Curve Method could be deployed for acute respiratory infection syndromic surveillance in Mauritius, considering that two or more activity peaks are observed in a season.

PMID:34081752 | DOI:10.1371/journal.pone.0252703

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Nevin Manimala Statistics

Spatial distribution and geographical heterogeneity factors associated with poor consumption of foods rich in vitamin A among children age 6-23 months in Ethiopia: Geographical weighted regression analysis

PLoS One. 2021 Jun 3;16(6):e0252639. doi: 10.1371/journal.pone.0252639. eCollection 2021.

ABSTRACT

INTRODUCTION: Vitamin A deficiency is a major public health problem in poor societies. Dietary consumption of foods rich in vitamin A was low in Ethiopia. This study aimed to assess the spatial distribution and spatial determinants of dietary consumption of foods rich in vitamin A among children aged 6-23 months in Ethiopia.

METHODS: Ethiopian 2016 demographic and health survey dataset using a total of 3055 children were used to conduct this study. The data were cleaned and weighed by STATA version 14.1 software and Microsoft Excel. Children who consumed foods rich in vitamin A (Egg, Meat, Vegetables, Green leafy vegetables, Fruits, Organ meat, and Fish) at least one food item in the last 24 hours were declared as good consumption. The Bernoulli model was fitted using Kuldorff’s SaTScan version 9.6 software. ArcGIS version 10.7 software was used to visualize spatial distributions for poor consumption of foods rich in vitamin A. Geographical weighted regression analysis was employed using MGWR version 2.0 software. A P-value of less than 0.05 was used to declare statistically significant predictors spatially.

RESULTS: Overall, 62% (95% CI: 60.56-64.00) of children aged 6-23 months had poor consumption of foods rich in vitamin A in Ethiopia. Poor consumption of foods rich in vitamin A highly clustered in Afar, eastern Tigray, southeast Amhara, and the eastern Somali region of Ethiopia. Spatial scan statistics identified 142 primary spatial clusters located in Afar, the eastern part of Tigray, most of Amhara and some part of the Oromia Regional State of Ethiopia. Children living in the primary cluster were 46% more likely vulnerable to poor consumption of foods rich in vitamin A than those living outside the window (RR = 1.46, LLR = 83.78, P < 0.001). Poor wealth status of the household, rural residence and living tropical area of Ethiopia were spatially significant predictors.

CONCLUSION: Overall, the consumption of foods rich in vitamin A was low and spatially non-random in Ethiopia. Poor wealth status of the household, rural residence and living tropical area were spatially significant predictors for the consumption of foods rich in vitamin A in Ethiopia. Policymakers and health planners should intervene in nutrition intervention at the identified hot spot areas to reduce the poor consumption of foods rich in vitamin A among children aged 6-23 months.

PMID:34081718 | DOI:10.1371/journal.pone.0252639

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Nevin Manimala Statistics

Protocol for analysing the epidemiology of maternal mortality in Zimbabwe: A civil registration and vital statistics trend study

PLoS One. 2021 Jun 3;16(6):e0252106. doi: 10.1371/journal.pone.0252106. eCollection 2021.

ABSTRACT

BACKGROUND: Sub-Saharan Africa (SSA) carries the highest burden of maternal mortality, yet, the accurate maternal mortality ratios (MMR) are uncertain in most SSA countries. Measuring maternal mortality is challenging in this region, where civil registration and vital statistics (CRVS) systems are weak or non-existent. We describe a protocol designed to explore the use of CRVS to monitor maternal mortality in Zimbabwe-an SSA country.

METHODS: In this study, we will collect deliveries and maternal death data from CRVS (government death registration records) and health facilities for 2007-2008 and 2018-2019 to compare MMRs and causes of death. We will code the causes of death using classifications in the maternal mortality version of the 10th revision to the international classification of diseases. We will compare the proportions of maternal deaths attributed to different causes between the two study periods. We will also analyse missingness and misclassification of maternal deaths in CRVS to assess the validity of their use to measure maternal mortality in Zimbabwe.

DISCUSSION: This study will determine changes in MMR and causes of maternal mortality in Zimbabwe over a decade. It will show whether HIV, which was at its peak in 2007-2008, remains a significant cause of maternal deaths in Zimbabwe. The study will recommend measures to improve the quality of CRVS data for future use to monitor maternal mortality in Zimbabwe and other SSA countries of similar characteristics.

PMID:34081727 | DOI:10.1371/journal.pone.0252106

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Nevin Manimala Statistics

Compulsive and compensative buying among online shoppers: An empirical study

PLoS One. 2021 Jun 3;16(6):e0252563. doi: 10.1371/journal.pone.0252563. eCollection 2021.

ABSTRACT

The present study examines the phenomenon of compensative and compulsive buying among online shoppers. Firstly, the obtained empirical data make it possible to estimate the prevalence of compensative and compulsive buying among the general population of Poles aged 15 years old and over, with the sample split into users and non-users of the e-commerce market offer. Secondly, the conducted analysis shows to what extent the prevalence of compulsive and compensative buying is differentiated by the frequency of online shopping, by the extent of the expenditures on online shopping compared with offline shopping, by attitudes towards online shopping, and by sociodemographic conditions (gender, age, monthly net income of household). The findings come from a survey conducted in 2019 based on a nationwide statistically representative sample of 1,000 Poles aged 15 years old and over. Drawing on this survey based on the German Compulsive Buying Indicator (GCBI), the prevalence of compulsive buying is observed at about 3% and compensative buying at about 12%. Dividing the general population into online and offline shoppers, one can see serious differences between both target groups; the share of compulsive and compensative buyers in the segment of online shoppers amounts to 3.6% and 16.9%, while among non-online shoppers- 3.3% and 10.1%. The strongest susceptibility to compulsive buying is characteristic of female online shoppers having very positive attitudes towards online shopping and doing online shopping very frequently.

PMID:34081731 | DOI:10.1371/journal.pone.0252563

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Nevin Manimala Statistics

Patterns of recent natural selection on genetic loci associated with sexually differentiated human body size and shape phenotypes

PLoS Genet. 2021 Jun 3;17(6):e1009562. doi: 10.1371/journal.pgen.1009562. eCollection 2021 Jun.

ABSTRACT

Levels of sex differences for human body size and shape phenotypes are hypothesized to have adaptively reduced following the agricultural transition as part of an evolutionary response to relatively more equal divisions of labor and new technology adoption. In this study, we tested this hypothesis by studying genetic variants associated with five sexually differentiated human phenotypes: height, body mass, hip circumference, body fat percentage, and waist circumference. We first analyzed genome-wide association (GWAS) results for UK Biobank individuals (~194,000 females and ~167,000 males) to identify a total of 114,199 single nucleotide polymorphisms (SNPs) significantly associated with at least one of the studied phenotypes in females, males, or both sexes (P<5×10-8). From these loci we then identified 3,016 SNPs (2.6%) with significant differences in the strength of association between the female- and male-specific GWAS results at a low false-discovery rate (FDR<0.001). Genes with known roles in sexual differentiation are significantly enriched for co-localization with one or more of these SNPs versus SNPs associated with the phenotypes generally but not with sex differences (2.73-fold enrichment; permutation test; P = 0.0041). We also confirmed that the identified variants are disproportionately associated with greater phenotype effect sizes in the sex with the stronger association value. We then used the singleton density score statistic, which quantifies recent (within the last ~3,000 years; post-agriculture adoption in Britain) changes in the frequencies of alleles underlying polygenic traits, to identify a signature of recent positive selection on alleles associated with greater body fat percentage in females (permutation test; P = 0.0038; FDR = 0.0380), directionally opposite to that predicted by the sex differences reduction hypothesis. Otherwise, we found no evidence of positive selection for sex difference-associated alleles for any other trait. Overall, our results challenge the longstanding hypothesis that sex differences adaptively decreased following subsistence transitions from hunting and gathering to agriculture.

PMID:34081690 | DOI:10.1371/journal.pgen.1009562

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Nevin Manimala Statistics

Evaluation of candidate reference genes for gene expression analysis in the brassica leaf beetle, Phaedon brassicae (Coleoptera: Chrysomelidae)

PLoS One. 2021 Jun 3;16(6):e0251920. doi: 10.1371/journal.pone.0251920. eCollection 2021.

ABSTRACT

The brassica leaf beetle Phaedon brassicae is a notorious defoliator of cruciferous vegetables. However, few molecular studies of this pest have been conducted due to limited sequence data. Recently, RNA sequencing has offered a powerful platform to generate numerous transcriptomic data, which require RT-qPCR to validate target gene expression. The selection of reliable reference genes to normalize RT-qPCR data is a prerequisite for gene expression analysis. In the present study, the expression stabilities of eight candidate reference genes under biotic conditions (development stages and various tissues) and abiotic perturbations (thermal stress and pesticide exposure) were evaluated using four different statistical algorithms. The optimal suites of reference genes were recommended for the respective experimental conditions. For tissue expression analysis, RPL32 and EF-1α were recommended as the suitable reference genes. RPL19 and TBP were the optimal reference genes across different developmental stages. RPL32 and TBP were identified as the most suitable references for thermal stress. Furthermore, RPL32 and RPL19 were ranked as the best references for insecticide exposure. This work provides a systematic exploration of the optimal reference genes for the respective experimental conditions, and our findings would facilitate molecular studies of P. brassicae.

PMID:34081693 | DOI:10.1371/journal.pone.0251920

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Nevin Manimala Statistics

Successful contact tracing systems for COVID-19 rely on effective quarantine and isolation

PLoS One. 2021 Jun 3;16(6):e0252499. doi: 10.1371/journal.pone.0252499. eCollection 2021.

ABSTRACT

Models of contact tracing often over-simplify the effects of quarantine and isolation on disease transmission. We develop a model that allows us to investigate the importance of these factors in reducing the effective reproduction number. We show that the reduction in onward transmission during quarantine and isolation has a bigger effect than tracing coverage on the reproduction number. We also show that intuitively reasonable contact tracing performance indicators, such as the proportion of contacts quarantined before symptom onset, are often not well correlated with the reproduction number. We conclude that provision of support systems to enable people to quarantine and isolate effectively is crucial to the success of contact tracing.

PMID:34081709 | DOI:10.1371/journal.pone.0252499

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Nevin Manimala Statistics

Evaluating and Assessing Radon Testing in Multifamily Housing

J Public Health Manag Pract. 2021 Jun 1. doi: 10.1097/PHH.0000000000001392. Online ahead of print.

ABSTRACT

CONTEXT: To determine if radon mitigation is needed to protect occupants of multifamily housing, reliable testing procedures are needed. Yet, protocols on how many ground-contact housing units must be tested vary from 10% to 25% to 100%.

OBJECTIVES: To estimate the probability of failing to identify a building containing at least one unit with elevated radon level when all ground-contact units are not tested.

DESIGN: Retrospective analysis of previously collected data from licensed (ie, certified) radon measurement professionals using hypergeometric and Monte Carlo statistical methods to estimate the confidence that there are no units with radon levels of 4 picoCuries/liter of air (pCi/L) or more based on various testing percentages.

SETTING: Testing data were obtained from 29 US states for 7892 ground-contact units in 687 multifamily buildings, primarily 5 to 20 units per building.

MAIN OUTCOME MEASURE: Probability of failing to identify elevated radon levels in untested units.

RESULTS: About 15% (n = 1163) of the units had radon levels of more than 4 pCi/L (the EPA action level); 59 units had more than 20 pCi/L (maximum of 96 pCi/L). For building sizes of 5 to 20 ground-contact units, the 2018 federal testing protocols that currently require testing of 10% and 25% of ground-contact units in each building failed to identify 47%-69% and 32%-46% of the units, respectively, depending on building size.

CONCLUSIONS: Measurement of 90% of the ground-contact units in buildings with 5 to 20 ground-contact units results in up to 4% of the units with elevated radon levels being missed. To achieve 95% confidence that no units in the building have radon levels of 4 pCi/L or more in buildings up to 20 units, 100% sampling is required. For the vast majority of multifamily buildings, all ground-contact units in multifamily buildings should be tested for radon.

PMID:34081671 | DOI:10.1097/PHH.0000000000001392