Tag: nevin manimala

PLoS One. 2025 May 28;20(5):e0322655. doi: 10.1371/journal.pone.0322655. eCollection 2025.

ABSTRACT

BACKGROUND: Blood pressure regulation depends heavily on adherence to antihypertensive medication. Additionally, poor adherence to antihypertensive drugs leads to the development of hypertensive complications. However, little is knowen about the factors affecting antihypertensive medication adherance in Ethiopia, and no study has been conducted in the study settings. Therefore, this study aimed to assess antihypertensive medication adherence and associated factors among adult hypertensive patients in selected public hospitals in East Hararghe Zone, Eastern Ethiopia.

METHODS: A facility-based quantitative cross-sectional study was conducted from August 20 to September 20, 2023, among 364 adult hypertensive patients on follow-up in selected public hospitals of eastern Ethiopia. A simple random sampling method was used to select the study participants. Data were collected through face-to-face interviews using a pretested structured questionnaire. Drug adherence status was assessed using Morisky Medication Adherence Scale-8. Data was analyzed using Epi-Data 3.1 and STATA 17.0, applying bivariate and multivariate logistic regression techniques. The association was declared using p < 0.05.

RESULTS: The overall level of adherence to antihypertensive medications was 59.94% (95% CI: 54.65-65.06). Urban residence (AOR = 1.96; 95% CI: 1.21-3.18), college and higher education level (AOR = 3.41; 95% CI: 1.69-6.87), health insurance coverage user (AOR = 2.00; 95% CI: 1.11-3.59), having knowledge about hypertension (AOR = 1.75; 95% CI: 1.03-2.97), distance to health care facility less than 10 kilometers (AOR = 4.6; 95% CI: 1.97-10.73), having social support (AOR = 1.86; 95% CI: 1.13-3.08), and taking three and above medications (AOR = 0.28; 95% CI: 0.12-0.64) showed a statistically significant association with medication adherence.

CONCLUSION: Adherence to antihypertensive medication was found to be low. This study identified place of residence, educational status, health insurance coverage, social support, knowledge of hypertension, distance from a health care facility, and number of medications as independent predictors of medication adherence. Therefore, improving accessibility of health care facilities, strengthening health insurance coverage, and providing health education about hypertension will improve antihypertensive medication adherence.

PMID:40435367 | DOI:10.1371/journal.pone.0322655

PLoS One. 2025 May 28;20(5):e0323522. doi: 10.1371/journal.pone.0323522. eCollection 2025.

ABSTRACT

BACKGROUND & AIM: Understanding the impact of food exposures outside the home environment is pivotal for helping children establish healthy eating patterns, for the prevention and delay of dental caries and other non-communicable diseases. This study sought to assesses the dietary habits and oral health experiences of primary school children in Johannesburg.

METHODS: This was a cross-sectional analytical study of grade three learners, aged 9-11 years old. The measurement tools used included an observational checklist, a questionnaire, an oral health examination and anthropometric measures for assessing the Body Mass Index (BMI). Correlation and regression analysis were undertaken to determine relationships between sugar intake, calories intake, dmft, DMFT and gingival index.

RESULTS: Of the 107 eligible children participating, 68% were from a school with a feeding scheme and 31.8% with no feeding scheme. The mean (SD) of BMI, dmft, and DMFT were 18.19 (3.59), 3.14 (3.39), and 1.49 (2.10), respectively. The mean sugar content of meals served in schools with a feeding scheme was lower [11.65g (SD 9.6)] than the mean sugar content of food consumed at a schools with no feeding scheme [35.84g (29.9)]. The regression analysis in this population indicated that the low gingival score was associated with high BMI and sugar intake.

CONCLUSION: Although the sugar content of meals served at National School Nutrition Programme (NSNP) schools was less that the sugar content accessed by children at Non-NSNP schools, both the schools had poor controls over sugar consumption and purchasing behaviour of the learners. The low gingival score was attributed to socio-economic status and access to toothbrushes and pastes.

PMID:40435360 | DOI:10.1371/journal.pone.0323522

PLoS One. 2025 May 28;20(5):e0323764. doi: 10.1371/journal.pone.0323764. eCollection 2025.

ABSTRACT

The industrial goods and services sector is crucial for the advancement of the Vietnamese economy in terms of its substantial economic contribution and positive impact on employment. Performance evaluation has become critical in this industry, which has constantly developed and had an intensive rivalry. This paper aims to analyze the performance of industrial goods and services firms during and after COVID-19 using an objective integrated multi-criteria decision-making technique. This study suggests a three-phase model. Criteria Importance Through Intercriteria Correlation (CRITIC) eliminates human judgment errors, increases accuracy, and maintains objectivity in the evaluation variable weighting phase. Then, Evaluation based on Distance from Average Solution (EDAS) and Technique of Order Preference Similarity to the Ideal Solution (TOPSIS) are used as effective cross-validation techniques to evaluate and rank forty-five Vietnam Stock Exchanges-listed firms for each year from 2020 to 2022. The reliability of the CRITIC-based weights is verified by the Statistical Variance Procedure. The research results reveal that the debt term structure is the most vital among the fifteen financial research indicators reflecting a business’s solvency, profitability, growth, operating efficiency, and capital structure. Additionally, the research findings indicate discrepancies in the rankings produced by EDAS and TOPSIS. However, the disparities are not grave, and the top and bottom positions, in particular, remain consistent between the two approaches. PDN was the best firm during COVID-19 and was succeeded by CIA after the pandemic. Pursuing digital transformation, sustainable development, and keeping inventory turnover at high levels are common characteristics of successful businesses in this industry. For the first time, the article provides a performance analysis of Vietnamese industrial goods and services firms. It is a significant reference for domestic and international investors in portfolio selection, financial institutions in loan approval, managers and policymakers in planning and policy development, and researchers conducting investigations within this domain.

PMID:40435355 | DOI:10.1371/journal.pone.0323764

PLoS One. 2025 May 28;20(5):e0324559. doi: 10.1371/journal.pone.0324559. eCollection 2025.

ABSTRACT

Accurate estimation of the finite population mean is a fundamental challenge in survey sampling, especially when dealing with large or complex populations. Traditional methods like simple random sampling may not always provide reliable or efficient estimates in such cases. Motivated by this, the current study explores complex sampling techniques to improve the precision and accuracy of mean estimators. Specifically, we employ two-stage and three-stage cluster sampling methods to develop unbiased estimators for the finite population mean. Building upon these, the next phase of the study formulates unbiased mean estimators using stratified two- and three-stage cluster sampling. To further enhance the precision of these estimators, a ranked-set sampling strategy is applied to the secondary and tertiary sampling stages. Additionally, unbiased variance estimators corresponding to the proposed mean estimators are derived. Real-world datasets are utilized to demonstrate the application of these complex survey sampling methodologies, with results showing that the mean estimates derived using ranked set sampling are more accurate than those obtained via simple random sampling.

PMID:40435354 | DOI:10.1371/journal.pone.0324559

PLoS One. 2025 May 28;20(5):e0316508. doi: 10.1371/journal.pone.0316508. eCollection 2025.

ABSTRACT

INTRODUCTION: The use of health research evidence is essential for informed decision-making and effective health planning. Despite its importance, there is limited understanding of the determinants for the use of such evidence in planning processes, particularly in lower-middle-income countries (LMICs) like Tanzania. This study aims to investigate the proportion and determinants that affect the use of health research evidence in health planning in Tanzania.

MATERIALS AND METHODS: This quantitative study employed a cross-sectional design. Data on health research evidence and the factors influencing its use were collected using a structured questionnaire from 422 healthcare workers involved in planning within 9 regions of Tanzania from October to December 2023. The association between categorical variables was assessed using a chi-square test, while regression analysis was conducted to identify determinants, both at a 95% confidence level.

RESULTS: The study revealed that 270 (66.2%) of health planning team members strongly agreed that they use health research evidence during planning. Several key determinants were significantly associated with the level of research evidence utilization. These included limited dissemination of research findings (74.5%), inadequate human and non-human resources (70.0%), and insufficient knowledge and training in research (63.7%). A multivariate regression analysis confirmed significant associations between the determinants and the use of research evidence (p<0.05). Descriptive statistics revealed that over 70% of respondents identified the presence of research coordinators, partnerships with universities, availability of research budgets, and internet access as important factors in their research. Inferential analysis indicated that these factors were statistically significantly associated with the use of health research evidence. In addition, more than half of the participants stated motivational factors, such as the presence of continuous quality improvement initiatives, the availability of short- and long-term training programs, on-the-job training opportunities, and incentives like extra duty allowances, as contributors to the enhanced use of research evidence. Bottom of Form.

CONCLUSION: The study found that planning team members used health research evidence in planning, but several determinants, such as lack of dissemination, resource shortages, and inadequate training, persisted. Interventions should focus on improving dissemination, resources, and training. Future research should explore strategies for enhancing these interventions.

PMID:40435352 | DOI:10.1371/journal.pone.0316508

PLoS One. 2025 May 28;20(5):e0323829. doi: 10.1371/journal.pone.0323829. eCollection 2025.

ABSTRACT

BACKGROUND: To explore the safety and effectiveness of partial splenic embolization (PSE) in patients with hypersplenism and hepatocellular carcinoma (HCC) and to compare the efficacy of superselective and non-superselective embolization of splenic artery branches.

PROCEDURE: We retrospectively analyzed 64 patients with HCC who underwent PSE between August 2020 and December 2022. The patients were categorized into two groups based on different treatment plans: Group A (n=33) underwent superselective embolization and Group B (n=31) underwent non-superselective embolization of the splenic artery branches. The safety and effectiveness of the two methods were evaluated along with changes in peripheral blood cells [mainly white blood cells (WBC) and red blood cells (RBC)] and platelet (PLT) counts at different time points after PSE. Postoperative adverse events were also compared between the two groups.

RESULTS: The technical success rate was 100% for both procedures. The PLT and WBC counts of the two groups significantly increased one week after PSE (P<0.05), and there was no statistically significant difference in the RBC count changes. At follow-up (4, 16, and 24 weeks), the PLT and WBC counts remained consistent at levels which were significantly different from those before PSE (P<0.05). However, the RBC counts were not significantly different (P>0.05). An independent sample t-test was used to compare the differences in blood counts between the two groups at the same time point. There were no statistically significant differences in PLT, WBC, and RBC counts between Group A and Group B at any time point after PSE (P>0.05). The incidence of fever and pain in Group B was significantly higher than that in Group A (P<0.05).

CONCLUSION: Partial splenic artery embolization is a safe and effective treatment option for hypersplenism. Both splenic artery branch superselective and non-superselective embolization strategies demonstrated comparable outcomes. However, superselective embolization exhibited a lower incidence of postprocedural complications than non-superselective embolization.

PMID:40435313 | DOI:10.1371/journal.pone.0323829

PLoS One. 2025 May 28;20(5):e0323897. doi: 10.1371/journal.pone.0323897. eCollection 2025.

ABSTRACT

In this article, the effect of the parameters in the properties of a well-known distribution called q-extended extreme value with linear normalization is discussed. Moreover, these parameters are estimated by both maximum likelihood and Bayesian approaches using type-II progressive censoring. The removals of type-II progressive censoring are considered under three well-known random removals (Fixed, discrete uniform, and binomial). Finding effective numerical techniques is a typical challenge for statisticians when estimating MLE parameters for distributions with many parameters. So one of our aims in this article is to show how the metaheuristic optimization like the particle swarm optimization, can handle this problem. Furthermore, the interval estimation for the parameters is calculated using the Fisher information matrix. The Bayesian approach is utilized for both the informative and non-informative under two different loss functions (square error and Linex loss functions) using Lindley’s approximation. Moreover, home price data in California represent a good fit for the q-extended extreme value distribution with linear normalization. By using this fitting some of California’s future home prices are predicted by using the return level function.

PMID:40435305 | DOI:10.1371/journal.pone.0323897

PLoS One. 2025 May 28;20(5):e0320914. doi: 10.1371/journal.pone.0320914. eCollection 2025.

ABSTRACT

BACKGROUND: Frequent ambulance dispatches is a common challenge in developed countries. Several factors have been identified as contributing to increase in dispatches, but no stipulation has explained the particular shift observed in Japan since 1995. This study examined ambulance dispatches in view of changes in a macroeconomic indicator.

METHODS: This longitudinal ecological study covered all annual ambulance dispatch incidents in Japan between 1980 and 2021 (42 years). The regression model comprised the active job openings-to-applicants ratio during deflation, the active job openings-to-applicants ratio during inflation, aging population trend, and mean ambient temperature, with the Japanese total population as an offset variable.

RESULTS: There were a total of 177,042,244 ambulance dispatches during the study period. The active job openings-to-applicants ratio during deflation showed statistical significance in the regression analysis (generalized estimation equations estimate: 0.165, 95% confidence interval: 0.087 to 0.243) whereas the active job openings-to-applicants ratio during inflation did not (0.019, -0.021 to 0.059).

CONCLUSION: The active job openings-to-applicants ratio during deflationary periods was associated with increased ambulance dispatches.

PMID:40435300 | DOI:10.1371/journal.pone.0320914

J Med Econ. 2025 May 28:1-16. doi: 10.1080/13696998.2025.2510814. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the effects of Liposomal Bupivacaine (LB) and provider LB use rate for 6 months after discharge on service utilization, clinical outcomes, and Medicare expenditures among Fee for Service (FFS) beneficiaries who have undergone hospital outpatient department (HOPD) procedures.

METHODS: 100% Medicare Research Identifiable Files data from 2019 to 2023 was utilized. Medicare FFS beneficiaries with the top 100 HOPD surgical procedures where LB was utilized were included in the study and divided into two cohorts: received LB (treatment) and did not receive LB (comparison) during the surgical procedure. An Inverse Probability Treatment Weighting Propensity Score model was estimated to balance treatment and control groups. We estimated Emergency Department (ED) admission, Short Term Acute Care Hospitals (STACH) admission, mortality, Opioid Use Disorder (OUD) and Opioid prescription fill events, and spending metrics.

RESULTS: LB use contributed to significant reductions in ED admission (9%; 23.28% vs. 25.69%), STACH admission (8%; 11.61% vs. 12.65%), mortality (39%; 0.67% vs. 1.1%) and opioid prescription fills (6%; 1.8 vs. 1.92) within 180-days post-discharge. Total Medicare expenditures (180-day episode) were $245 lower for the LB user ($9,645 vs. $9,891). For each 10-percentage point increase in provider LB use-rate, the likelihood of ED admission, STACH admission, mortality, and OUD decreased by 0.1, 0.15, 0.01 and 0.02 percentage points, respectively. Total Medicare expenditures (180-day episode) were reduced by $258 for every one percentage point increase in LB use-rate.

CONCLUSION: Use of LB and provider LB use rate are associated with improved patient clinical, service utilization, and expenditure outcomes.

PMID:40434805 | DOI:10.1080/13696998.2025.2510814

JAMA Netw Open. 2025 May 1;8(5):e2510808. doi: 10.1001/jamanetworkopen.2025.10808.

ABSTRACT

IMPORTANCE: Innovative approaches to address interpersonal risk factors for suicide attempts and suicidal ideation may help reduce persistently elevated suicide rates in the US.

OBJECTIVE: To determine whether Peers for Valued Living (PREVAIL), a posthospital peer support intervention, reduces suicide attempts and suicidal ideation among adults psychiatrically hospitalized for suicide risk.

DESIGN, SETTING, AND PARTICIPANTS: This single-masked, randomized clinical trial recruited adult psychiatric inpatients aged 18 years or older from 3 Michigan-based facilities between June 22, 2018, and December 30, 2022. The study compared 3 months of the PREVAIL intervention plus enhanced usual care with enhanced usual care only, with 3 months of postintervention follow-up.

INTERVENTION: One-on-one support from a peer specialist initiated during hospital admission and continued 3 months after discharge.

MAIN OUTCOMES AND MEASURES: Suicide attempts were measured using the Columbia Suicide Severity Rating Scale, and suicidal ideation was measured using the Beck Scale for Suicidal Ideation at 3 and 6 months after randomization.

RESULTS: Of 5310 patients screened, 455 were randomized using a minimization algorithm. A total of 229 participants were randomized to the PREVAIL peer mentorship arm (mean [SD] age, 32.4 [14.0] years, 134 women [58.5%]), and 226 were randomized to the enhanced usual care arm (mean [SD] age, 31.6 [13.5] years; 139 women [61.5%]). In the intention-to-treat sample with nonmissing data, the percentage of participants with any suicide attempt over 6 months (including participants who only completed 3-month follow-up assessments) was 17.2% (28 of 163) for enhanced usual care and 14.9% (24 of 161 with 2 deaths by suicide) for PREVAIL. Mean (SD) suicidal ideation scores were 4.3 (95% CI, 3.2-5.3) for enhanced usual care and 4.9 (95% CI, 3.7-6.1) for PREVAIL at 6 months. There were no statistically significant effects of the intervention for either outcome in the primary analyses. In post hoc analyses, the interaction between study arm and the COVID-19 pandemic was statistically significant. The enhanced usual care arm had a mean (SD) 6-month suicidal ideation score of 3.5 (6.1) before and 6.1 (7.4) after the pandemic vs the PREVAIL arm (mean [SD] scores, 5.0 [7.7] and 4.5 [6.6], respectively). There were 2 study-related adverse events, with 1 resulting in participant withdrawal from the intervention arm.

CONCLUSIONS AND RELEVANCE: In this randomized clinical trial, the peer-delivered PREVAIL intervention up to 3 months after discharge did not significantly differ from enhanced usual care in terms of reducing subsequent suicide attempts or suicidal ideation.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03373916.

PMID:40434775 | DOI:10.1001/jamanetworkopen.2025.10808