Tag: pubmed

Int J Health Plann Manage. 2022 Mar 26. doi: 10.1002/hpm.3465. Online ahead of print.

ABSTRACT

BACKGROUND: Maternal and child health is an important component of the Sustainable Development Goals. Pakistan has one of the worst maternal and neonatal health outcomes in the world. This is despite significant health system investments across the country.

AIMS: The objectives of this study are twofold. First, the study estimates the technical efficiency of the public healthcare facilities in Pakistan, defined as the number of obstetric deliveries compared to the number of medical specialists, nurses, and other health and non-health staff members. Second, the study evaluates the relationship between efficiency and quality of care; the latter is measured in terms of maternal and neonatal mortality.

MATERIALS & METHODS: The data were taken from the Pakistan Health Facility Assessment Survey. Efficiency score was calculated for 843 public healthcare facilities, using Stochastic Frontier Analysis. We then used two-stage residual inclusion approach with bootstrapping to evaluate the relationship between efficiency and quality.

RESULTS AND DISCUSSION: The average efficiency score was 0.48 (range: 0-1) and none of the public healthcare facilities were on the frontier, implying that efficiency gains can be made across the board. The relationship between efficiency and quality is found to be positive and statistically significant, that is, more efficient healthcare facilities also had lower rates of maternal and neonatal mortality.

CONCLUSION: We conclude that more efficient public healthcare facilities also had lower mortality rates, probably due to better infrastructure and health system financing.

PMID:35340046 | DOI:10.1002/hpm.3465

Clin Exp Dermatol. 2022 Mar 26. doi: 10.1111/ced.15194. Online ahead of print.

ABSTRACT

BACKGROUND: The term topical steroid withdrawal (TSW) describes an adverse effect that generally occurs with inappropriate prolonged use of high-potency topical corticosteroids (TCS). The presence of user-generated content relating to TSW on social media has not been well-defined to date.

OBJECTIVE: We aimed to explore content relating to topical steroid withdrawal on social media.

METHODS: Using a data analytics platform, we retrospectively analysed the hashtag #topicalsteroidwithdrawal on social media over a 5 year period, from the 8th of February 2016 until the 8th of February 2021. We assessed: interactions, performance, shares, likes, mentions, language and country of origin using descriptive statistics.

RESULTS: Across all social media platforms there was a 274% increase in mentions of the hashtag #topicalsteroidwithdrawal in the year 2020(7992) compared with the year 2016(2138). Top associated hashtags included #TSW, #eczema, and #topicalsteroidaddiction. On Instagram, we found a 288% increase in number of mentions and a 592% increase in performance of #topicalsteroidwithdrawal in 2020(618,354) when compared to 2016(89,390).

CONCLUSION: Our results confirm an increase in the presence of user-generated content relating to TSW on social media and also highlight its extent. Large numbers of patients are exposed to this content which could influence their engagement with TCS.

PMID:35340034 | DOI:10.1111/ced.15194

Evolution. 2022 Mar 27. doi: 10.1111/evo.14486. Online ahead of print.

ABSTRACT

Log-linear models are widely used for assessing determinants of fitness in empirical studies, for example, in determining how reproductive output depends on trait values or environmental conditions. Similarly, theoretical works of fitness and natural selection employ log-linear models, often with a negative quadratic term, generating Gaussian fitness functions. However, in the specific application of regression-based analysis of natural selection, such models are rarely employed. Rather, OLS regression is the predominant means of assessing the form of natural selection. OLS regressions allow specific evolutionary quantitative parameters, selection gradients, to be estimated, and benefit from the fact that the associated statistical models are easily applied. We examine whether selection gradients can be directly expressed in terms of the coefficients of models using exponential fitness functions with linear or quadratic arguments. Such models can be easily fitted with generalised linear models (GLMs). The expressions we obtain coincide with those for Gaussian functions, but relax the major constraint that the (log) fitness function is concave (downwardly curved). Additionally these results lead to univariate and multivariate analyses of both linear and quadratic selection that potentially incorporate pragmatic and interpretable models of fitness functions, where the parameters can be related analytically to selection gradients, and that can be operationalised using widely-available statistical tools. This article is protected by copyright. All rights reserved.

PMID:35340021 | DOI:10.1111/evo.14486

Gait Posture. 2022 Mar 21;94:166-172. doi: 10.1016/j.gaitpost.2022.03.012. Online ahead of print.

ABSTRACT

BACKGROUND: Limited attention has been paid to age- or body size-related changes in the ground reaction forces (GRF) during walking despite their strong associations with lower limb injuries and pathology.

RESEARCH QUESTION: Do the features of GRF during walking associate with age or body size?

METHODS: Fifty-four participants were subdivided into four groups according to their age and body size: overweight old (n = 12), non-overweight old (n = 13), overweight young (n = 13), and non-overweight young (n = 16). Participants were asked to walk at their self-selected speeds on level ground with force plates embedded in the center of walkway. Functional principal component analysis (FPCA) was performed to extract major modes of variation and functional principal component scores (FPCs) in three-dimensional GRFs. Analysis of variance models were employed to investigate the effect of age, body size, or their interactions on the FPCs of each component of the GRF, with the adjustment to gait speed.

RESULTS: Significant age and body size effects were observed in FPC1 across all three-dimensional GRF. Both overweight and older groups showed greater braking force after heel-strike and greater propulsive forces during pre-swing when compared to the non-overweight and younger groups, respectively. The overweight old group displayed greater medial forces during mid-stance and the overweight young group showed prominently larger medial forces during pre-swing, while non-overweight old showed a tendency of flatter medial-lateral GRF waveforms during the entire stance phase. FPC2 revealed that only body size had an effect on three-dimensional GRF with the highest FPC2 scores in the overweight old group.

SIGNIFICANCE: Three-dimensional GRF during walking could be altered by the body size and age, which were more pronounced in the overweight and older group. The more dynamic GRF pattern with greater and/or lower peaks could be contributing factors to the increased joint load and injury rates observed in overweight aged individuals.

PMID:35339964 | DOI:10.1016/j.gaitpost.2022.03.012

Med Image Anal. 2022 Mar 17;78:102422. doi: 10.1016/j.media.2022.102422. Online ahead of print.

ABSTRACT

Multiphase CT scanning of the liver is performed for several clinical applications; however, radiation exposure from CT scanning poses a nontrivial cancer risk to the patients. The radiation dose may be reduced by determining the scan range of the subsequent scans by the location of the target of interest in the first scan phase. The purpose of this study is to present and assess an automatic method for determining the scan range for multiphase CT scans. Our strategy is to first apply a CNN-based method for detecting the liver in 2D slices, and to use a liver range search algorithm for detecting the liver range in the scout volume. The target liver scan range for subsequent scans can be obtained by adding safety margins achieved from Gaussian liver motion models to the scan range determined from the scout. Experiments were performed on 657 multiphase CT volumes obtained from multiple hospitals. The experiment shows that the proposed liver detection method can detect the liver in 223 out of a total of 224 3D volumes on average within one second, with mean intersection of union, wall distance and centroid distance of 85.5%, 5.7 mm and 9.7 mm, respectively. In addition, the performance of the proposed liver detection method is comparable to the best of the state-of-the-art 3D liver detectors in the liver detection accuracy while it requires less processing time. Furthermore, we apply the liver scan range generation method on the liver CT images acquired from radiofrequency ablation and Y-90 transarterial radioembolization (selective internal radiation therapy) interventions of 46 patients from two hospitals. The result shows that the automatic scan range generation can significantly reduce the effective radiation dose by an average of 14.5% (2.56 mSv) compared to manual performance by the radiographer from Y-90 transarterial radioembolization, while no statistically significant difference in performance was found with the CT images from intra RFA intervention (p = 0.81). Finally, three radiologists assess both the original and the range-reduced images for evaluating the effect of the range reduction method on their clinical decisions. We conclude that the automatic liver scan range generation method is able to reduce excess radiation compared to the manual performance with a high accuracy and without penalizing the clinical decision.

PMID:35339951 | DOI:10.1016/j.media.2022.102422

Health Place. 2022 Mar 24;75:102778. doi: 10.1016/j.healthplace.2022.102778. Online ahead of print.

ABSTRACT

There has been a generally negative view of the impact of urbanization on a rising burden of non-communicable diseases including cardiovascular disease. However, the evidence on the relationship between urbanization and cardiovascular health has remained inconclusive. A comprehensive picture of the relationship is lacking, given an implicit assumption that the longitudinal association between changes in cardiovascular health and an increasingly urbanized environment is similar between less and more urbanized communities, men and women. We used the longitudinal data on adults (18-64 years) from the China Health and Nutrition Survey (1991-2015) and employed within-between random-effects models to disaggregates the longitudinal and cross-sectional associations between urbanization and systolic/diastolic blood pressure (SBP/DBP) and examined heterogeneities in the longitudinal association by average urbanization level and gender. We found that the positive longitudinal association of urbanization with SBP/DBP was stronger in less urbanized than more urbanized communities. The cross-sectional association between urbanization and SBP was negative and significant, although the cross-sectional association between urbanization and DBP was of no statistical significance. Moreover, the positive longitudinal association between urbanization and DBP was stronger among men than women, although the gender heterogeneity in the longitudinal association of urbanization with SBP was not significant.

PMID:35339955 | DOI:10.1016/j.healthplace.2022.102778

Poult Sci. 2022 Feb 22;101(5):101798. doi: 10.1016/j.psj.2022.101798. Online ahead of print.

ABSTRACT

Dermanyssus gallinae is an obligatory ectoparasite of birds which feeds on blood and significantly compromise the well-being of commercially raised laying hens. In this study, the mortality rates and responses of D. gallinae to 2 acaricides with a physical mode of action (Dergall and Mite Max) and 2 acaricides with a chemical mode of action (Milben Ex and Bio PK) were evaluated in tree dilutions (S1-3) and compared at 8-time intervals after application. The evaluation involved a novel method that simulates real-world conditions in a commercial poultry farm. Tested products have shown high efficacy (84.3-100%) against D. gallinae in the producer recommended solution (S1). Acaricides with a physical mechanism of action were as effective as chemical agents in eradicating poultry red mites. The compared preparations differed only in the onset of action which was longer in acaricides with a physical mode of action (1-6 h for chemical 24 h for physical in S1). An increase in the concentration of the active ingredient did not significantly speed up the onset of action of the evaluated preparations. However, the efficacy of Dergall and Bio PK decreased when the applied dose was halved, to 12% and 0% respectively. A decrease in the dose Mite Max led to a somewhat smaller, but not statistically significant decrease in mite mortality rates (74%). The proposed method for evaluating acaricide efficacy can be helpful in selecting the most effective preparations and the optimal concentration of the working solution to be applied in commercial layer farms, thus reducing the costs associated with the eradication of D. gallinae. The developed method enables a reliable evaluation of acaricides with both a physical and chemical mode of action, and it supports observations of the parasites’ responses to the applied treatment.

PMID:35339937 | DOI:10.1016/j.psj.2022.101798

Int J Food Microbiol. 2022 Mar 17;370:109635. doi: 10.1016/j.ijfoodmicro.2022.109635. Online ahead of print.

ABSTRACT

Primary and secondary models were developed for quantitatively characterizing the survival of Listeria monocytogenes in soy-sauce based acidified Asian style products that do not undergo a thermal treatment. The objective of this study was to quantify the effect of food matrix properties on L. monocytogenes’ survival in soy sauce-based products. This quantification enables a product-specific estimation of 5-log reduction time to ensure a safe processing and management operation, to ultimately facilitate a science-based, safety-oriented product development process. A central composite design with four independent variables (pH, soy sauce, added NaCl and soluble solids) with five levels was used to plan the challenge studies on different formulations. To model microbial survival over time, different non-linear primary models were fit to the data obtained from challenge studies. The best-fit model was selected based on a series of statistical goodness-of-fit measures. Kinetic parameters estimated from the best-fit primary models were fit to response surface equations using second order polynomial regression. The best-fit primary model representative of the product formulations was a modified Weibull model. The natural logarithm of the scale parameter (δ, in h) was used as the response variable for the secondary model. This resulted in acceptable fitting compared to the observed values with R² values of 0.95 and RMSE of 0.7 h. External validity of model predictions was conducted by comparing them to 5-log reduction times observed in independent challenge tests using different product formulations. Results indicated an acceptable validation with R² = 0.81 and RMSE = 35 h. The present study provides quantitative tools specific for cold-fill-hold soy sauce-based products to enhance microbial safety management plans and product development.

PMID:35339915 | DOI:10.1016/j.ijfoodmicro.2022.109635

J Psychosom Res. 2022 Mar 22;157:110794. doi: 10.1016/j.jpsychores.2022.110794. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Despite the availability of successful treatment approaches for chronic tinnitus, it has proven difficult to predict who profits from treatment and it is still an open question if it is possible at all. We tried to overcome methodological shortcomings and to predict treatment outcome indicated by questionnaires measuring tinnitus distress.

METHODS: This is an observational, prospective cohort study. Lasso and post-selection inference methods were used to predict treatment outcome in patients suffering from chronic tinnitus (N = 747). Patients were treated for five consecutive days in an interdisciplinary setting according to guidelines.

RESULTS: Early change, i.e. a positive response after the screening day, as well as change due to treatment was predicted by several psychopathological variables, but also tinnitus-related factors. Female gender as an example was a predictor for change due to treatment. In general, therapy success both for early change and change due to treatment cannot be predicted satisfactorily as indicated by a high mean cross-validation error (for early change: 9.83, for change due to treatment: 14.40). Analyzing sub-groups separated by tinnitus severity to reduce heterogeneity did not improve the situation and for patients with high tinnitus severity no predictors at all could be reported (cross-validated error: 11.62 for the low quartile, 13.38 for the low-medium quartile, and 15.61 for the medium-high quartile).

CONCLUSION: Several psychopathological and tinnitus-related variables predicted early and long-term change. Nevertheless, also overcoming methodological shortcomings to predict treatment success did not lead to satisfactory results, but rather emphasizes the high heterogeneity of chronic tinnitus.

PMID:35339906 | DOI:10.1016/j.jpsychores.2022.110794

J Zoo Wildl Med. 2022 Mar;53(1):126-132. doi: 10.1638/2021-0052.

ABSTRACT

Effective management of articular injuries in avian species is a known and frequent challenge. Potential treatments include many domestic animal therapeutics, such as Adequan®, which is used widely in dogs and horses. However, clinical reports have described hemorrhagic diatheses in a variety of avian species treated with varying doses and administration frequency of Adequan. This study investigated the hypocoagulability associated with parenteral administration of Adequan in avian species. Following a pilot dosing study in domestic chickens (Gallus gallus), citrated plasma from Chilean flamingos (Phoenicopterus chilensis) (n = 42) was spiked with Adequan to represent three dosing regimens (1 mg/kg, 5 mg/kg, 10 mg/kg). The fibrinogen content of plasma samples was determined and thrombin-clotting times (TCTs) were compared for the untreated (control) and spiked flamingo samples. The TCT for control and 1-mg/kg spiked plasma were not significantly different; however, both 5 mg/kg and 10 mg/kg spiked samples demonstrated significantly prolonged TCT (P-value < 0.0001) indicating hypocoagulability. These results support that Adequan given parenterally at 1 mg/kg can be utilized safely in clinical case management as an adjunctive treatment for osteoarthritis in flamingos and potentially other avian species.

PMID:35339157 | DOI:10.1638/2021-0052