Tag: pubmed

PLoS One. 2022 Oct 27;17(10):e0276884. doi: 10.1371/journal.pone.0276884. eCollection 2022.

ABSTRACT

Reference intervals (RIs) help physicians in differentiating healthy from sick individuals. The prothrombin time (PT) and International normalized ratio (INR) fluctuate in coagulation pathway defects and have interlaboratory variability due to the instrument/reagent used. As direct method is difficult in children, we chose an indirect data mining method for the determining PT/INR RIs. The indirect method overcomes the substantial financial and logistic challenges, and ethical restrictions in children, moreover, allows partitioning in more fine-grained age groups. Prothrombin Time/INR measurements performed in patients aged birth-18 years between January 2013 and December 2020, were retrieved from laboratory management system of the Aga Khan Hospital. Reference intervals were computed using an indirect KOSMIC algorithm. The KOSMIC package function on the assumption that the non-pathologic samples follow a Gaussian distribution (after Box-Cox transformation of the data), following an elaborate statistical process to isolate distribution of physiological samples from mixed dataset. A total of 56,712 and 52,245 values were retrieved for PT and INR respectively. After the exclusion of patients with multiple specimens obtained during the study period, RIs were calculated for 37,356 (PT) and 37,192 (INR) children with stratification into 9 age groups. A comparison of 2.5th and 97.5th percentile results with those of established RIs from SickKids Handbook of Pediatric Thrombosis and Hemostasis demonstrated good agreement in between different age groups. This study supports data mining as an alternate approach for establishing PT/INR RIs, specifically in resource-limited settings. The results obtained are specific to studied population and instrument/reagent used. The study also allows understanding of fluctuations in coagulation pathways with increasing age and hence better clinical decision-making based on PT and INR results.

PMID:36302050 | DOI:10.1371/journal.pone.0276884

PLoS One. 2022 Oct 27;17(10):e0275029. doi: 10.1371/journal.pone.0275029. eCollection 2022.

ABSTRACT

BACKGROUND: Endoscopic ultrasound-guided biliary drainage (EUS-BD) was associated with better clinical success and a lower rate of adverse events (AEs) than fluoroscopy-guided percutaneous transhepatic biliary drainage (PTBD) in recent single center studies with mainly retrospective design and small case numbers (< 50). The aim of this prospective European multicenter study is to compare both drainage procedures using ultrasound-guidance and primary metal stent implantation in patients with malignant distal bile duct obstruction (PUMa Trial).

METHODS: The study is designed as a non-randomized, controlled, parallel group, non-inferiority trial. Each of the 16 study centers performs the procedure with the best local expertise (PTBD or EUS-BD). In PTBD, bile duct access is performed by ultrasound guidance. EUS-BD is performed as an endoscopic ultrasound (EUS)-guided hepaticogastrostomy (EUS-HGS), EUS-guided choledochoduodenostomy (EUS-CDS) or EUS-guided antegrade stenting (EUS-AGS). Insertion of a metal stent is intended in both procedures in the first session. Primary end point is technical success. Secondary end points are clinical success, duration pf procedure, AEs graded by severity, length of hospital stay, re-intervention rate and survival within 6 months. The target case number is 212 patients (12 calculated dropouts included).

DISCUSSION: This study might help to clarify whether PTBD is non-inferior to EUS-BD concerning technical success, and whether one of both interventions is superior in terms of efficacy and safety in one or more secondary endpoints. Randomization is not provided as both procedures are rarely used after failed endoscopic biliary drainage and study centers usually prefer one of both procedures that they can perform best.

TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT03546049 (22.05.2018).

PMID:36302047 | DOI:10.1371/journal.pone.0275029

PLoS Comput Biol. 2022 Oct 27;18(10):e1010559. doi: 10.1371/journal.pcbi.1010559. Online ahead of print.

ABSTRACT

Machine learning is increasingly introduced into medical fields, yet there is limited evidence for its benefit over more commonly used statistical methods in epidemiological studies. We introduce an unsupervised machine learning framework for longitudinal features and evaluate it using sexual behaviour data from the last 20 years from over 3’700 participants in the Swiss HIV Cohort Study (SHCS). We use hierarchical clustering to find subgroups of men who have sex with men in the SHCS with similar sexual behaviour up to May 2017, and apply regression to test whether these clusters enhance predictions of sexual behaviour or sexually transmitted diseases (STIs) after May 2017 beyond what can be predicted with conventional parameters. We find that behavioural clusters enhance model performance according to likelihood ratio test, Akaike information criterion and area under the receiver operator characteristic curve for all outcomes studied, and according to Bayesian information criterion for five out of ten outcomes, with particularly good performance for predicting future sexual behaviour and recurrent STIs. We thus assess a methodology that can be used as an alternative means for creating exposure categories from longitudinal data in epidemiological models, and can contribute to the understanding of time-varying risk factors.

PMID:36302041 | DOI:10.1371/journal.pcbi.1010559

PLoS One. 2022 Oct 27;17(10):e0276388. doi: 10.1371/journal.pone.0276388. eCollection 2022.

ABSTRACT

Effective conservation management strategies require accurate information on the movement patterns and behaviour of wild animals. To collect these data, researchers are increasingly turning to remote sensing technology such as radio-frequency identification (RFID). RFID technology is a powerful tool that has been widely implemented in ecological research to identify and monitor unique individuals, but it bears a substantial price tag, restricting this technology to generously-funded disciplines and projects. To overcome this price hurdle, we provide detailed step-by-step instructions to source the components for, and construct portable RFID loggers in house, at a fraction of the cost (~5%) of commercial RFID units. Here, we assess the performance of these RFID loggers in the field and describe their application in two studies of Australian mammal species; monitoring nest-box use in the Northern quolls (Dasyurus hallucatus) and observing the foraging habits of quenda (Isoodon fusciventer) at feeding stations. The RFID loggers performed well, identifying quenda in >80% of visits, and facilitating the collection of individual-level behavioural data including common metrics such as emergence time, latency to approach, and foraging effort. While the technology itself is not novel, by lowering the cost per unit, our loggers enabled greater sample sizes, increasing statistical power from 0.09 to 0.75 in the quoll study. Further, we outline and provide solutions to the limitations of this design. Our RFID loggers proved an innovative method for collecting accurate behavioural and movement data. With their ability to successfully identify individuals, the RFID loggers described here can act as an alternative or complementary tool to camera traps. These RFID loggers can also be applied in a wide variety of projects which range from monitoring animal welfare or demographic traits to studies of anti-predator responses and animal personality, making them a valuable addition to the modern ecologists’ toolkit.

PMID:36302036 | DOI:10.1371/journal.pone.0276388

PLoS One. 2022 Oct 27;17(10):e0276186. doi: 10.1371/journal.pone.0276186. eCollection 2022.

ABSTRACT

BACKGROUND: Water is essential for maintaining human life, health, and dignity. Untreated water consumption causes 1.8 million deaths annually, over 99.8% of which happen in developing nations and 90% of which include children. Point-of-use water treatment enables people without reliable access to safe drinking water to reduce contamination and minimize microbial risk levels. This Systematic Review and Meta-analysis was, therefore, used to identify, select, and critically appraise relevant evidence about water treatment practices and their associated factors among Ethiopian households.

METHODS: PubMed, Science Direct, Web of Science, Scopus, Embase, Google Scholar, ProQuest, and other databases were searched for studies published before May 5, 2022. The final synthesis included twelve investigations. Microsoft Excel was used to extract the data, and STATA 16 was used for the analysis. The Joanna Briggs Institute’s Critical assessment checklist for prevalence studies was used to evaluate the quality of the included studies. Egger’s test and funnel plot were used to assess publication bias. I2 statistics were calculated to check for study heterogeneity. The DerSimonian and Laird random-effects model was used to analyze the pooled effect size, odds ratios, and 95% confidence intervals across studies. Analysis of subgroups was done by publication year and geographic region.

RESULTS: Of the 550 identified articles, 12 studies were eligible for analysis (n = 4849 participants). The pooled prevalence estimate of point-of-use water treatment practice among Ethiopian homes was 36.07% (95% CI: 21.94-50.19, I2 = 99.5%). Receiving training from Community health workers (OR, 1.7; 95% CI: 1.33-2.08), female headship (OR, 2.52; 95% CI: 1.60-3.44), and household wealth (OR, 1.6; 95% CI: 1.19-2.16) were significantly associated with point-of-use water treatment practice.

CONCLUSION: Despite the absence of safely managed water sources, very few homes routinely treated their drinking water. Adoption of water treatment practices necessitates ongoing communication and assistance from health extension personnel. Moreover, program planners must be aware of the many user categories that households may fall under to guarantee that ongoing training messages and treatment products reach every home.

PMID:36301990 | DOI:10.1371/journal.pone.0276186

PLoS One. 2022 Oct 27;17(10):e0276653. doi: 10.1371/journal.pone.0276653. eCollection 2022.

ABSTRACT

INTRODUCTION: After African Americans, Latinx are the second largest population affected by Sickle Cell Disease (SCD) in the U.S. However, research has largely ignored how this devastating rare blood disorder specifically affects Latinx nationwide.

METHODS: This study compared demographics, genotypes, primary insurance, and health care utilization among Latinx and non-Latinx Californians living with SCD, using data from the California SCD Data Collection Program (2016-2018) and newborn screening cases 2000-2017.

RESULTS: Stemming from 6,837 SCD patients, 501(7%) were Latinx. Latinx with SCD (Lx-SCD) were statistically significantly younger than non-Latinx (NLx-SCD) counterparts. Within both groups, females predominated, with 70% being insured by Medicaid. Mean Emergency Department encounters were statistically significantly lower among Lx-SCD adults.

DISCUSSION: Lx-SCD differ in age, genotype, and Emergency Department utilization, when compared to NLx-SCD counterparts in California. Latinx are now the largest racial and/or ethnic group in the US, and their presence in SCD population is expected to grow. Therefore, their specific demographic, genotypic, and health care utilization characteristics merit attention to inform policies and programs that will improve their health.

PMID:36301979 | DOI:10.1371/journal.pone.0276653

PLoS One. 2022 Oct 27;17(10):e0276851. doi: 10.1371/journal.pone.0276851. eCollection 2022.

ABSTRACT

During the COVID-19 pandemic, infection protection/control education has become increasingly important for not only healthcare professionals but also students undertaking medical, nursing, physical therapy, occupational therapy, and other related courses. A review of the literature on infection control education reveals that the target participants often comprise healthcare workers, and very few studies of infection control education focus on students. We have developed a protocol for the systematic review of the literature on simulation-based infection prevention/control education for students undertaking medical, nursing, rehabilitation, and other related courses. The protocol for the systematic review and meta-analysis has been drafted in alignment with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Systematic literature search will be performed for the period between 1990 (January) and 2022 (September) using the CENTRAL, MEDLINE, and Scopus databases. We will qualitatively and quantitatively examine the effects of simulation-based infection education for students in this systematic review and meta-analysis. Two investigators will independently search the databases according to the defined search strategy. The full-text of the selected articles will be screened independently keeping in mind the inclusion criteria by a pair of reviewers. Descriptive data will be extracted from each study regarding: study design, methods, participants, and outcomes. A meta-analysis will be performed if the quantitative data is suitable. Heterogeneity will be assessed using the standard χ2. Odds ratio for categorical data and weighted mean differences for continuous data and their 95% confidence intervals will be calculated and used for analysis. Where statistical pooling is not possible, the findings of the quantitative papers will be presented in narrative form. The qualitative aspect will employ narrative (descriptive) synthesis. Our review will make a valuable contribution to the domain of simulation-based infection prevention/control for students enrolled in medical and/or related courses.

PMID:36301969 | DOI:10.1371/journal.pone.0276851

PLoS One. 2022 Oct 27;17(10):e0275342. doi: 10.1371/journal.pone.0275342. eCollection 2022.

ABSTRACT

The entomopathogenic nematode, Heterorhabditis indica, is a popular biocontrol agent of high commercial significance. It possesses tremendous genetic architecture to survive desiccation stress by undergoing anhydrobiosis to increase its lifespan-an attribute exploited in the formulation technology. The comparative transcriptome of unstressed and anhydrobiotic H. indica revealed several previously concealed metabolic events crucial for adapting towards the moisture stress. During the induction of anhydrobiosis in the infective juveniles (IJ), 1584 transcripts were upregulated and 340 downregulated. As a strategy towards anhydrobiotic survival, the IJ showed activation of several genes critical to antioxidant defense, detoxification pathways, signal transduction, unfolded protein response and molecular chaperones and ubiquitin-proteasome system. Differential expression of several genes involved in gluconeogenesis – β-oxidation of fatty acids, glyoxylate pathway; glyceroneogenesis; fatty acid biosynthesis; amino-acid metabolism – shikimate pathway, sachharopine pathway, kyneurine pathway, lysine biosynthesis; one-carbon metabolism-polyamine pathway, transsulfuration pathway, folate cycle, methionine cycle, nucleotide biosynthesis; mevalonate pathway; and glyceraldehyde-3-phosphate dehydrogenase were also observed. We report the role of shikimate pathway, sachharopine pathway and glyceroneogenesis in anhydrobiotes, and seven classes of repeat proteins, specifically in H. indica for the first time. These results provide insights into anhydrobiotic survival strategies which can be utilized to strengthen the development of novel formulations with enhanced and sustained shelf-life.

PMID:36301967 | DOI:10.1371/journal.pone.0275342

PLoS One. 2022 Oct 27;17(10):e0276856. doi: 10.1371/journal.pone.0276856. eCollection 2022.

ABSTRACT

BACKGROUND: Community-based Health Insurance (CBHI) is a voluntary prepayment mechanism that guarantees the provision of basic healthcare services without financial barriers to underserved segments of the population in developing countries. The Government of Ethiopia launched the CBHI program to protect the community from high out-of-pocket health expenditure and improve health service utilization a decade ago. However, to improve the quality of healthcare services delivery in health facilities and cover the changing costs of healthcare, the government should revise the contribution of the CBHI scheme. Therefore, we determined the willingness to pay for a CBHI scheme and associated factors among rural households of Lemu and Bilbilo district, South Central Ethiopia.

METHODS: We conducted a community-based cross-sectional study design to assess willingness to pay for the CBHI scheme and its associated factors among households in Lemu and Bilbilo districts, South Central Ethiopia. We used a double bounded contingent valuation method to elicit households’ willingness to pay for the CBHI scheme. Data were coded, cleaned, entered into Statistical Package for Social Science (SPSS) version 25, and exported to STATA 16 for analysis. A logistic regression analysis was conducted to determine the presence of statistically significant associations between the willingness to pay for the CBHI scheme and independent variables at a p-value <0.05 and Adjusted odds ratio (AOR) values with 95% CI. Finally, we checked the fitness of the model using Hosmer and Lemeshow’s goodness-of-fit test.

RESULTS: Of the 476 study participants, 82.9% (95% CI: 79.2%, 86.01%) were willing to pay for the CBHI scheme and only 62% of them can afford the average amount of 358.32ETB ($7.68) per household per annum. Primary education (AOR = 3.17; 95% CI: 1.74-5.80), secondary and above education (AOR = 4.13; 95% CI: 1.86-9.18), large family size (AOR = 2.75; 95% CI: 1.26-5.97), monthly income of 500-1000ETB (AOR = 3.75; 95% CI: 1.97-7.13) and distance to public health facilities (AOR = 2.14, 95% CI: 1.04-4.39 were significantly associated with willingness to pay for the CBHI scheme.

CONCLUSION: In this study, around 83% of respondents were willing to pay for the CBHI and meet the government expectation for 2020. The study also revealed that educational status, family size, monthly income, and distance from the health facilities were significant factors associated with WTP for the CBHI scheme. In addition, we found that a large number of the respondents couldn’t afford the average amount of money that the participants were willing to pay for the CBHI scheme. So, the government should consider the economic status of the communities while revising the CBHI scheme premium not to miss those who cannot afford the contribution.

PMID:36301951 | DOI:10.1371/journal.pone.0276856

PLoS One. 2022 Oct 27;17(10):e0276682. doi: 10.1371/journal.pone.0276682. eCollection 2022.

ABSTRACT

BACKGROUND: Home birth preference is the need of pregnant women to give birth at their home with the help of traditional (unskilled) birth attendants. Homebirth with unskilled birth attendants during childbirth is the main leading indicator for maternal and newborn death. In Ethiopia, numbers of women prefer homebirth which is assisted by unskilled personal. However, there is no information regarding the problem in the Arba Minch zuria woreda. Therefore, it is important to identify prevalence of preference of homebirth and associated factors.

OBJECTIVES: This study aimed to assess the preference of home birth and associated factors among pregnant women in Arba Minch health and demographic surveillance site.

METHOD AND MATERIALS: A community-based cross-sectional study was conducted among pregnant women in Arba Minch health and demographic surveillance site, from May 1 to June 1, 2021. Using simple random sampling technique, 416 study samples were selected. Data were collected by interviewer-administered questionnaire. Data were coded and entered into Epi-Data version 4.4.2.1 computer software and exported to Statistical Package for Social Sciences software version 25 for analysis. Bi-variable binary logistic regression for the selection of potential candidate variables at p-value < 0.25 for multivariable analysis and multivariable binary logistic regression to identify the association between homebirth preference and independent variables were carried out. The level of statistical significance was declared at a p-value < 0.05.

RESULT: In this study, in Arba Minch demographic health surveillance site, the prevalence of preference of pregnant women to give birth at their home was 24% [95%CI: (19.9%-28.2%)] The factors significantly associated with the preference of home birth were husband involvement in decision making [AOR: 0.14 (0.05-0.38)], no access of road for transportation [AOR: 2.4 (1.2-5.18)], not heard about the benefit of institutional birth [AOR: 5.3 (2.3-12.2)], poor knowledge about danger signs [AOR: 3 (1.16-7.6)], negative attitude toward services [AOR: 3.1 (1.19-8.02)], and high fear to give birth at institution [AOR: 5.12 (2.4-10.91)].

CONCLUSIONS: In Arba Minch demographic health surveillance site, the prevalence of preference of pregnant women to give birth at their home was 24%. Husband involvement in decision making, no access of road for transportation, not heard about the benefit of institutional birth, poor knowledge about danger signs, negative attitude toward services, and high fear to give birth at health institutions were factors significantly associated with the preference of home birth.

PMID:36301942 | DOI:10.1371/journal.pone.0276682