Tag: pubmed

PLoS One. 2021 May 14;16(5):e0251624. doi: 10.1371/journal.pone.0251624. eCollection 2021.

ABSTRACT

BACKGROUND: Access to major services, often located in urban centres, is key to the realisation of numerous Sustainable Development Goals (SDGs). In Kenya, there are no up-to-date and localised estimates of spatial access to urban centres. We estimate the travel time to urban centres and identify marginalised populations for prioritisation and targeting.

METHODS: Urban centres were mapped from the 2019 Kenya population census and combined with spatial databases of road networks, elevation, land use and travel barriers within a cost-friction algorithm to compute travel time. Seven travel scenarios were considered: i) walking only (least optimistic), ii) bicycle only, iii) motorcycle only, iv) vehicle only (most optimistic), v) walking followed by motorcycle transport, vi) walking followed by vehicle transport, and vii) walking followed by motorcycle and then vehicle transport (most pragmatic). Mean travel time, and proportion of the population within 1-hour and 2-hours of the urban centres were summarized at sub-national units (counties) used for devolved planning. Inequities were explored and correlations between the proportion of the population within 1-hour of an urban centre and ten SDG indicators were computed.

RESULTS: A total of 307 urban centres were digitised. Nationally, the mean travel time was 4.5-hours for the walking-only scenario, 1.0-hours for the vehicle only (most optimistic) scenario and 1.5-hours for the walking-motorcycle-vehicle (most pragmatic) scenario. Forty-five per cent (21.3 million people) and 87% (41.6 million people) of Kenya’s population resided within 1-hour of the nearest urban centre for the least optimistic and most pragmatic scenarios respectively. Over 3.2 million people were considered marginalised or living outside the 2-hour threshold in the pragmatic scenario, 16.0 million Kenyans for walking only, and 2.2 million for the most optimistic scenario. County-level spatial access was highly heterogeneous ranging between 8%-100% and 32%-100% of people within the 1-hour threshold for the least and most optimistic scenarios, respectively. Counties in northern and eastern parts of Kenya were generally most marginalised. The correlation coefficients for nine SDG indicators ranged between 0.45 to 0.78 and were statistically significant.

CONCLUSION: Travel time to urban centres in Kenya is heterogeneous. Therefore, marginalised populations should be prioritised during resource allocation and policies should be formulated to enhance equitable access to public services and opportunities in urban areas.

PMID:33989356 | DOI:10.1371/journal.pone.0251624

PLoS One. 2021 May 14;16(5):e0251818. doi: 10.1371/journal.pone.0251818. eCollection 2021.

ABSTRACT

As species distribution models, and similar techniques, have emerged in marine ecology, a vast array of predictor variables have been created and diverse methodologies have been applied. Marine fish are vital food resources worldwide, yet identifying the most suitable methodology and predictors to characterize spatial habitat associations, and the subsequent distributions, often remains ambiguous. Our objectives were to identify knowledge gaps in fish guilds, identify research themes, and to determine how data sources, statistics, and predictor variables differ among fish guilds. Data were obtained from an international literature search of peer-reviewed articles (2007-2018; n = 225) and research themes were determined based on abstracts. We tested for differences in data sources and modeling techniques using multinomial regressions and used a linear discriminant analysis to distinguish differences in predictors among fish guilds. Our results show predictive studies increased over time, but studies of forage fish, sharks, coral reef fish, and other fish guilds remain sparse. Research themes emphasized habitat suitability and distribution shifts, but also addressed abundance, occurrence, stock assessment, and biomass. Methodologies differed by fish guilds based on data limitations and research theme. The most frequent predictors overall were depth and temperature, but most fish guilds were distinguished by their own set of predictors that focused on their specific life history and ecology. A one-size-fits-all approach is not suitable for predicting marine fish distributions. However, given the paucity of studies for some fish guilds, researchers would benefit from utilizing predictors and methods derived from more commonly studied fish when similar habitat requirements are expected. Overall, the findings provide a guide for determining predictor variables to test and identifies novel opportunities to apply non-spatial knowledge and mechanisms to models.

PMID:33989361 | DOI:10.1371/journal.pone.0251818

PLoS One. 2021 May 14;16(5):e0251609. doi: 10.1371/journal.pone.0251609. eCollection 2021.

ABSTRACT

BACKGROUND: Neonates with severe complications at birth or during the neonatal period who nearly died but survived constitute neonatal near miss (NNM) cases. Identifying NNM cases and correcting contributing factors are of the utmost importance to get relevant controls for neonatal deaths. However, limited studies are assessing the prevalence of NNM and associated factors with NNM cases in Ethiopia. So, this study is aimed at assessing the magnitude of neonatal near miss and associated factors among live births in public hospitals of Jimma zone, southwest Ethiopia, 2020.

METHODS: A facility-based cross-sectional study was conducted among 260 neonates from April 1-30 / 2020. Face to face interviewer-administered structured questionnaire was used to collect data from the mothers and a standard checklist was used for their neonates. The data was encoded and entered into Epi-Data version 4.2 and exported to SPSS version 23 for analysis. Independent variables with marginal associations (p-value <0.25) in the bivariable analysis were eligible for multivariable logistic regression analysis to detect an association with outcome variables. Finally, adjusted odds ratios (AOR) with 95% CI were used to estimate the strength of associations, and statistical significance was declared at a p-value < 0.05.

RESULT: The magnitude of NNM was 26.7% with [95%CI: 21.6-32.5]. Hypertension during pregnancy [AOR: 3.4; 95%CI: 1.32-8.88], mode of delivery [AOR: 3.32; 95%CI: 1.48-7.45], Obstructed labor [AOR: 2.95; 95%CI: 1.32-6.45] and non-vertex fetal presentation during delivery [AOR: 4.61; 95%CI: 2.16-9.84] were identified as significantly predictors of NNM.

CONCLUSION AND RECOMMENDATION: Over a quarter of the neonates were with NNM cases, which is relatively higher than the report of studies done in other countries. Hypertension during pregnancy, cesarean delivery, prolonged labor, and non-vertex fetal presentation were all found to increase the likelihood of NNM. Therefore, concerted efforts are needed from local health planners and health care providers to improve maternal health care services especially in early identification of the complications and taking appropriate management.

PMID:33989319 | DOI:10.1371/journal.pone.0251609

PLoS One. 2021 May 14;16(5):e0251131. doi: 10.1371/journal.pone.0251131. eCollection 2021.

ABSTRACT

BACKGROUND: Idiopathic membranous nephropathy (IMN) is one of the most common causes of nephrotic syndrome in adults involving multiple targets and factors. The effect of conservative nonimmunosuppressive or immunosuppressive therapies is unsatisfactory and with many side effects. Traditional Chinese medicine (TCM) can regulate immune function and improve kidney function.

PURPOSE: To evaluate the total effective rate, curative rate, recurrence rate and adverse events of TCM alone or TCM as an adjunctive therapy for IMN.

METHODS: Randomized controlled trials (RCT) comparing either TCM alone or the combination of TCM to western medicine (WM) therapies for patients with IMN were retrieved by searching English and Chinese database. Risk of bias summary was used to assess the methodological quality of eligible studies. Dichotomous data were presented using odds ratios (OR). The primary outcome measure was the total effective rate. Secondary outcomes included curative rate, recurrence rate and adverse events.

RESULTS: 29 RCTs involving 1883 participants met the inclusion criteria. There was no statistically significant difference between the therapy of TCM alone and WM on the total effective rates (OR: 2.00; 95% CI: 0.80-4.98; P = 0.14) and curative rate (OR: 1.66; 95%CI: 0.66-4.22; p = 0.28). However, compared to basic treatment or immunosuppressive therapies alone, results showed that TCM as an adjunctive therapy had beneficial effects on the total effective rate (OR: 2.59; 95% CI: 1.38-4.86; P = 0.003 and OR: 3.01; 95% CI: 2.25-4.04; P < 0.00001) and curative rate (OR: 3.01; 95%CI: 1.24-7.28; p = 0.01 and OR: 1.73; 95%CI: 1.10-2.71; p = 0.02). In addition, the combination of TCM treatment could reduce the recurrence rate (OR: 0.28; 95% CI: 0.12-0.68; P = 0.004) and adverse reactions (OR: 0.38; 95% CI: 0.27-0.54; p < 0.00001).

CONCLUSION: The results indicate that TCM is well-tolerated for the treatment of IMN. However, there remains a need for large-scale and high-quality trials.

PMID:33989325 | DOI:10.1371/journal.pone.0251131

PLoS One. 2021 May 14;16(5):e0251842. doi: 10.1371/journal.pone.0251842. eCollection 2021.

ABSTRACT

Electroencephalography (EEG) microstate analysis is a method wherein spontaneous EEG activity is segmented at sub-second levels to analyze quasi-stable states. In particular, four archetype microstates and their features are known to reflect changes in brain state in neuropsychiatric diseases. However, previous studies have only reported differences in each microstate feature and have not determined whether microstate features are suitable for schizophrenia classification. Therefore, it is necessary to validate microstate features for schizophrenia classification. Nineteen microstate features, including duration, occurrence, and coverage as well as thirty-one conventional EEG features, including statistical, frequency, and temporal characteristics were obtained from resting-state EEG recordings of 14 patients diagnosed with schizophrenia and from 14 healthy (control) subjects. Machine-learning based multivariate analysis was used to evaluate classification performance. EEG recordings of patients and controls showed different microstate features. More importantly, when differentiating among patients and controls, EEG microstate features outperformed conventional EEG ones. The performance of the microstate features exceeded that of conventional EEG, even after optimization using recursive feature elimination. EEG microstate features applied with conventional EEG features also showed better classification performance than conventional EEG features alone. The current study is the first to validate the use of microstate features to discriminate schizophrenia, suggesting that EEG microstate features are useful for schizophrenia classification.

PMID:33989352 | DOI:10.1371/journal.pone.0251842

PLoS One. 2021 May 14;16(5):e0251416. doi: 10.1371/journal.pone.0251416. eCollection 2021.

ABSTRACT

Excessive home cage aggression often results in severe injury and subsequent premature euthanasia of male laboratory mice. Aggression can be reduced by transferring used nesting material during cage cleaning, which is thought to contain aggression appeasing odors from the plantar sweat glands. However, neither the composition of plantar sweat nor the deposits on used nesting material have been evaluated. The aims of this study were to (1) identify and quantify volatile compounds deposited in the nest site and (2) determine if nest and sweat compounds correlate with social behavior. Home cage aggression and affiliative behavior were evaluated in 3 strains: SJL, C57BL/6N, and A/J. Individual social rank was assessed via the tube test, because ranking may influence compound levels. Sweat and urine from the dominant and subordinate mouse in each cage, plus cage level nest samples were analyzed for volatile compound content using gas chromatography-mass spectrometry. Behavior data and odors from the nest, sweat, and urine were statistically analyzed with separate principal component analyses (PCA). Significant components, from each sample analysis, and strain were run in mixed models to test if odors were associated with behavior. Aggressive and affiliative behaviors were primarily impacted by strain. However, compound PCs were also impacted by strain, showing that strain accounts for any relationship between odors and behavior. C57BL/6N cages displayed the most allo-grooming behavior and had high scores on sweat PC1. SJL cages displayed the most aggression, with high scores on urine PC2 and low scores on nest PC1. These data show that certain compounds in nesting material, urine, and sweat display strain specific patterns which match strain specific behavior patterns. These results provide preliminary information about the connection between home cage compounds and behavior. Salient compounds will be candidates for future controlled studies to determine their direct effect on mouse social behavior.

PMID:33989318 | DOI:10.1371/journal.pone.0251416

PLoS One. 2021 May 14;16(5):e0251177. doi: 10.1371/journal.pone.0251177. eCollection 2021.

ABSTRACT

BACKGROUND: Significant progress has been made addressing adolescent health needs in New Zealand, but some areas, such as mental health issues remain, particularly for rangatahi Māori (indigenous Māori young people). Little is known about how contemporary Māori whānau (families) and communities influence health outcomes, health literacy and access to services. Previous nationally representative secondary school surveys were conducted in New Zealand in 2001, 2007 and 2012, as part of the Youth2000 survey series. This paper focuses on a fourth survey conducted in 2019 (https://www.youth19.ac.nz/). In 2019, the survey also included kura kaupapa Māori schools (Māori language immersion schools), and questions exploring the role of family connections in health and wellbeing. This paper presents the overall study methodology, and a weighting and calibration framework in order to provide estimates that reflect the national student population, and enable comparisons with the previous surveys to monitor trends.

METHODS: Youth19 was a cross sectional, self-administered health and wellbeing survey of New Zealand high school students. The target population was the adolescent population of New Zealand (school years 9-13). The study population was drawn from three education regions: Auckland, Tai Tokerau (Northland) and Waikato. These are the most ethnically diverse regions in New Zealand. The sampling design was two-stage clustered stratified, where schools were the clusters, and strata were defined by kura schools and educational regions. There were four strata, formed as follows: kura schools (Tai Tokerau, Auckland and Waikato regions combined), mainstream-Auckland, mainstream-Tai Tokerau and mainstream-Waikato. From each stratum, 50% of the schools were randomly sampled and then 30% of students from the selected schools were invited to participate. All students in the kura kaupapa schools were invited to participate. In order to make more precise estimates and adjust for differential non-response, as well as to make nationally relevant estimates and allow comparisons with the previous national surveys, we calibrated the sampling weights to reflect the national secondary school student population.

RESULTS: There were 45 mainstream and 4 kura schools included in the final sample, and 7,374 mainstream and 347 kura students participated in the survey. There were differences between the sampled population and the national secondary school student population, particularly in terms of sex and ethnicity, with a higher proportion of females and Asian students in the study sample than in the national student population. We calculated estimates of the totals and proportions for key variables that describe risk and protective factors or health and wellbeing factors. Rates of risk-taking behaviours were lower in the sampled population than what would be expected nationally, based on the demographic profile of the national student population. For the regional estimates, calibrated weights yield standard errors lower than those obtained with the unadjusted sampling weights. This leads to significantly narrower confidence intervals for all the variables in the analysis. The calibrated estimates of national quantities provide similar results. Additionally, the national estimates for 2019 serve as a tool to compare to previous surveys, where the sampling population was national.

CONCLUSIONS: One of the main goals of this paper is to improve the estimates at the regional level using calibrated weights to adjust for oversampling of some groups, or non-response bias. Additionally, we also recommend the use of calibrated estimators as they provide nationally adjusted estimates, which allow inferences about the whole adolescent population of New Zealand. They also yield confidence intervals that are significantly narrower than those obtained using the original sampling weights.

PMID:33989300 | DOI:10.1371/journal.pone.0251177

PLoS One. 2021 May 14;16(5):e0250303. doi: 10.1371/journal.pone.0250303. eCollection 2021.

ABSTRACT

Multiple studies have successfully used Facebook’s advertising platform to recruit study participants. However, very limited methodological discussion exists regarding the magnitude of low effort responses from participants recruited via Facebook and African samples. This study describes a quasi-random study that identified and enrolled young adults in Kenya, Nigeria, and South Africa between 22 May and 6 June 2020, based on an advertisement budget of 9,000.00 ZAR (US $521.44). The advertisements attracted over 900,000 views, 11,711‬ unique clicks, 1190 survey responses, and a total of 978 completed responses from young adults in the three countries during the period. Competition rates on key demographic characteristics ranged from 82% among those who attempted the survey to about 94% among eligible participants. The average cost of the advertisements was 7.56 ZAR (US $0.43) per survey participant, 8.68 ZAR (US $0.50) per eligible response, and 9.20 ZAR (US $0.53) per complete response. The passage rate on the attention checks varied from about 50% on the first question to as high as 76% on the third attention check question. About 59% of the sample passed all the attention checks, while 30% passed none of the attention checks. Results from a truncated Poisson regression model suggest that passage of attention checks was significantly associated with demographically relevant characteristics such as age and sex. Overall, the findings contribute to the growing body of literature describing the strengths and limitations of online sample frames, especially in developing countries.

PMID:33989304 | DOI:10.1371/journal.pone.0250303

J Pediatr Orthop. 2021 May 13. doi: 10.1097/BPO.0000000000001844. Online ahead of print.

ABSTRACT

INTRODUCTION: Orthopaedic surgery remains a male-dominated specialty. To date there has not been a focused analysis of gender in authorship within the pediatric orthopaedic literature.

METHODS: The electronic table of contents from 2011 to 2020 of 3 major pediatric orthopaedic journals [Journal of Children’s Orthopedics (JCO), Journal of Pediatric Orthopedics (JPO), and Journal of Pediatric Orthopedics Part B (JPO-B)] were reviewed. Publications were reviewed for the number of articles with at least 1 female author and the number of articles with women listed as first authors. These were compared over the 10-year study period, and by individual year of publication. Statistical analysis included a general linear model with factorial one-way anslysis of variance and Bonferroni post hoc testing.

RESULTS: A total of 4097 articles were reviewed. In 2020, there was a significantly higher percentage of articles with a female author when compared with 2011 (64% to 42%, P=0.010). A female was listed as first author in significantly more publications in 2020 as compared with 2011 (23% to 10%, P=0.031). During the 10-year study period, the highest mean proportion of articles with at least 1 female author was seen in JPO (60%), with similar findings in JCO (55%). Significantly fewer articles in JPO-B contained a female author (37%, P=0.001). The highest percentage of publications with a female first author across 10 years was in JCO (22%), followed by JPO (20%). Significantly fewer articles with a female first author were found in JPO-B (9%, P=0.001).

CONCLUSION: There is an increasing proportion of publications in the pediatric orthopaedic literature with female authors and female first authors from 2011 to 2020. In addition, there was a statistical difference in female authorship when comparing specific publications, which should be investigated further.

LEVEL OF EVIDENCE: Level IV.

PMID:33989256 | DOI:10.1097/BPO.0000000000001844

J Pediatr Orthop. 2021 May 13. doi: 10.1097/BPO.0000000000001845. Online ahead of print.

ABSTRACT

BACKGROUND: Transverse myelitis (TM) is a rare inflammatory disorder of the spinal cord. It can have a heterogeneous presentation with sensory, motor, and autonomic dysfunction. Neurological sequelae of TM include autonomic dysfunction, motor weakness, and/or spasticity. Studies describing orthopaedic deformities and treatments associated with TM are nonexistent. This purpose of this study was to describe the orthopaedic manifestations of TM in children.

METHODS: A multicenter retrospective review was conducted of patients, 0 to 21 years of age, with TM presenting over a 15-year period at 4 academic children’s hospitals. Those with confirmed diagnosis of TM and referred to an orthopaedic surgeon were included. Demographics, orthopaedic manifestations, operative/nonoperative treatments, and complications were recorded. Descriptive statistics were used for data reporting.

RESULTS: Of 119 patients identified with TM, 37 saw an orthopaedic surgeon. By etiology, 23 were idiopathic (62%), 10 infectious (27%), 3 (8%) inflammatory/autoimmune, and 1 (3%) vascular. The mean age at diagnosis was 6.7 (SD: 5.5) years and at orthopaedic presentation was 8.4 (SD: 5.2) years. Orthopaedic manifestations included scoliosis in 13 (35%), gait abnormalities in 7 (19%), foot deformities in 7 (19%), upper extremity issues in 7 (19%), symptomatic spasticity in 6 (16%), lower extremity muscle contractures in 6 (16%), fractures in 6 (16%), hip displacement in 3 (8%), pain in 2 (5%), and limb length discrepancy in 2 (5%) patients. Seven children (19%) were seen for establishment of care. In all, 14 (38%) underwent operative intervention, mainly for soft-tissue and scoliosis management. Four patients had baclofen pump placement for spasticity management. Postoperative complications occurred in 36% of cases, most commonly because of infection. Neither topographic pattern nor location of lesion had a significant relationship with need for hip or spine surgery.

CONCLUSIONS: This report describes the orthopaedic manifestations associated with TM in children, nearly 40% of whom required operative intervention(s). Understanding the breadth of musculoskeletal burden incurred in TM can help develop surveillance programs to identify and treat these deformities in a timely manner.

LEVEL OF EVIDENCE: Level IV.

PMID:33989257 | DOI:10.1097/BPO.0000000000001845