Tag: pubmed

PLoS One. 2021 Nov 17;16(11):e0260104. doi: 10.1371/journal.pone.0260104. eCollection 2021.

ABSTRACT

INTRODUCTION: In Ethiopia the pharmacy service has had several gaps among these were low patient satisfaction, and poor availability of essential pharmaceuticals. In addition, previous studies showed variation in magnitude of client satisfaction, and there is no previous study in the study area. Therefore, the aim of the study was to determine client satisfaction with outpatient pharmacy service and associated factors among adult clients at Dubti General Hospital in Afar, Ethiopia.

METHODS: A hospital based cross sectional study design was employed from February 1 to March 30, 2020 at Dubti General Hospital. Participants were selected by systematic random sampling method. Bivariate and multivariate binary logistic regression was computed to assess statistical association between the outcome variable, and independent variables. AOR with 95% CI were used to show statistical Significance at P <0.05.

RESULTS: The overall satisfaction towards outpatient pharmacy service was 165(40.5%). Regarding associated factors, service payment insured through their workplace was positively associated with satisfaction (AOR = 3.178, 95% CI: 1.294-7.80) where as availability of some medications (AOR = 0.393, 95% CI: 0.208-0.741), unfair medication cost (AOR = 0.613, 95% CI: 0.607-0.910), and lack of organized pharmacy work flow (AOR = 0.105, 95% CI: 0.049-0.221) were negatively associated with clients’ satisfaction.

CONCLUSION: The clients’ satisfaction in this study is low that warrants immediate corrective measures. Corrective measures should be taken based on identified gaps such as improving drug availability, pharmacy work flow, and cost of medications.

PMID:34788317 | DOI:10.1371/journal.pone.0260104

PLoS Comput Biol. 2021 Nov 17;17(11):e1009601. doi: 10.1371/journal.pcbi.1009601. Online ahead of print.

ABSTRACT

Because local field potentials (LFPs) arise from multiple sources in different spatial locations, they do not easily reveal coordinated activity across neural populations on a trial-to-trial basis. As we show here, however, once disparate source signals are decoupled, their trial-to-trial fluctuations become more accessible, and cross-population correlations become more apparent. To decouple sources we introduce a general framework for estimation of current source densities (CSDs). In this framework, the set of LFPs result from noise being added to the transform of the CSD by a biophysical forward model, while the CSD is considered to be the sum of a zero-mean, stationary, spatiotemporal Gaussian process, having fast and slow components, and a mean function, which is the sum of multiple time-varying functions distributed across space, each varying across trials. We derived biophysical forward models relevant to the data we analyzed. In simulation studies this approach improved identification of source signals compared to existing CSD estimation methods. Using data recorded from primate auditory cortex, we analyzed trial-to-trial fluctuations in both steady-state and task-evoked signals. We found cortical layer-specific phase coupling between two probes and showed that the same analysis applied directly to LFPs did not recover these patterns. We also found task-evoked CSDs to be correlated across probes, at specific cortical depths. Using data from Neuropixels probes in mouse visual areas, we again found evidence for depth-specific phase coupling of primary visual cortex and lateromedial area based on the CSDs.

PMID:34788286 | DOI:10.1371/journal.pcbi.1009601

PLoS One. 2021 Nov 17;16(11):e0256382. doi: 10.1371/journal.pone.0256382. eCollection 2021.

ABSTRACT

Curtailment of turbine operations during low wind conditions has become an operational minimization tactic to reduce bat mortality at terrestrial wind energy facilities. Site-specific studies have demonstrated that bat activity is higher during lower wind speeds and that operational curtailment can effectively reduce fatalities. However, the exact nature of the relationship between curtailment cut-in speed and bat fatality reduction remains unclear. To evaluate the efficacy of differing curtailment regimes in reducing bat fatalities, we examined data from turbine curtailment experiments in the United States and Canada in a meta-analysis framework. We used multiple statistical models to explore possible linear and non-linear relationships between turbine cut-in speed and bat fatality. Because the overall sample size for this meta-analysis was small (n = 36 control-treatment studies from 17 wind farms), we conducted a power analysis to assess the number of control-treatment curtailment studies needed to understand the relationship between fatality reduction and change in cut-in speed. We also identified the characteristics of individual curtailment field studies that may influence their power to detect fatality reductions, and in turn, contribute to future meta-analyses. We found strong evidence that implementing turbine curtailment reduces fatality rates of bats at wind farms; the estimated fatality ratio across all studies was 0.37 (p < 0.001), or a 63% decrease in fatalities. However, the nature of the relationship between the magnitude of treatment and reduction in fatalities was more difficult to assess. Models that represented the response ratio as a continuous variable (e.g., with a linear relationship between the change in cut-in speed and fatalities) and a categorical variable (to allow for possible non-linearity in this relationship) both had substantial support when compared using AICc. The linear model represented the best fit, likely due to model simplicity, but the non-linear model was the most likely without accounting for parsimony and suggested fatality rates decreased when the difference in curtailment cut-in speeds was 2m/s or larger. The power analyses showed that the power to detect effects in the meta-analysis was low if fatality reductions were less than 50%, which suggests that smaller increases in cut-in speed (i.e., between different treatment categories) may not be easily detectable with the current dataset. While curtailment is an effective operational mitigation measure overall, additional well-designed curtailment studies are needed to determine precisely whether higher cut-in speeds can further reduce bat fatalities.

PMID:34788295 | DOI:10.1371/journal.pone.0256382

PLoS Negl Trop Dis. 2021 Nov 17;15(11):e0009083. doi: 10.1371/journal.pntd.0009083. Online ahead of print.

ABSTRACT

BACKGROUND: Schistosomiasis remains a global-health problem with over 90% of its burden concentrated in Africa. Field studies reflect the complex ways in which socio-cultural and socio-economic variables, affect the distribution of Schistosoma infections across different populations. This review set out to systematically investigate and quantify the differences in Schistosoma infection burdens between males and females in Africa for two of the most prevalent Schistosoma species-Schistosoma mansoni and Schistosoma haematobium.

METHODOLOGY: We searched (from inception to 11th March 2020) Embase, MEDLINE, PubMed, and Web of Science for relevant studies on schistosomiasis. We included studies that report S. mansoni and/or S. haematobium prevalence and/or intensity data distributed between males and females. We conducted meta-analyses on the male to female (M:F) prevalence of infection ratios. Subgroup analyses were performed according to study baseline prevalence, sample size and the lower and upper age limit of study participants. We also present a descriptive analysis of differential risk and intensity of infection across males and females. Evidence for differences in the prevalence of schistosomiasis infection between males and females is presented, stratified by Schistosoma species.

RESULT: We identified 128 relevant studies, with over 200,000 participants across 23 countries. Of all the reported differences in the prevalence of infection between males and females, only 41% and 34% were statistically significant for S. mansoni and S. haematobium, respectively. Similar proportions of studies (27% and 34% for for S. haematobium and S. mansoni, respectively) of the reported differences in intensity of infection between males and females were statistically significant. The meta-analyses summarized a higher prevalence of infection in males; pooled random-effects weighted M:F prevalence of infection ratios were 1.20 (95% CI 1.11-1.29) for S. haematobium and 1.15 (95% CI 1.08-1.22) for S. mansoni. However, females are underrespresented in some of the studies. Additionally, there was significant heterogeneity across studies (Higgins I2 statistic (p-values < 0.001, I2values>95%)). Results of the subgroup analysis showed that the baseline prevalence influenced the M:F prevalence ratios for S. haematobium and S. mansoni, with higher M:F prevalence of infection ratios in settings with a lower baseline prevalence of infection. Across the studies, we identified four major risk factors associated with infection rates: occupational and recreational water contact, knowledge, socio-economic factors and demographic factors. The effect of these risk factors on the burden of infection in males and females varied across studies.

CONCLUSIONS: We find evidence of differences in prevalence of infection between males and females which may reflect differences in gender norms and water contact activities, suggesting that policy changes at the regional level may help ameliorate gender-related disparities in schistosomiasis infection burden. Collecting, robustly analysing, and reporting, sex-disaggregated epidemiological data, is currently lacking, but would be highly informative for planning effective treatment programmes and establishing those most at risk of schistosomiasis infections.

PMID:34788280 | DOI:10.1371/journal.pntd.0009083

PLoS Comput Biol. 2021 Nov 17;17(11):e1009160. doi: 10.1371/journal.pcbi.1009160. eCollection 2021 Nov.

ABSTRACT

Gene expression analysis is becoming increasingly utilized in neuro-immunology research, and there is a growing need for non-programming scientists to be able to analyze their own genomic data. MGEnrichment is a web application developed both to disseminate to the community our curated database of microglia-relevant gene lists, and to allow non-programming scientists to easily conduct statistical enrichment analysis on their gene expression data. Users can upload their own gene IDs to assess the relevance of their expression data against gene lists from other studies. We include example datasets of differentially expressed genes (DEGs) from human postmortem brain samples from Autism Spectrum Disorder (ASD) and matched controls. We demonstrate how MGEnrichment can be used to expand the interpretations of these DEG lists in terms of regulation of microglial gene expression and provide novel insights into how ASD DEGs may be implicated specifically in microglial development, microbiome responses and relationships to other neuropsychiatric disorders. This tool will be particularly useful for those working in microglia, autism spectrum disorders, and neuro-immune activation research. MGEnrichment is available at https://ciernialab.shinyapps.io/MGEnrichmentApp/ and further online documentation and datasets can be found at https://github.com/ciernialab/MGEnrichmentApp. The app is released under the GNU GPLv3 open source license.

PMID:34788279 | DOI:10.1371/journal.pcbi.1009160

Am J Emerg Med. 2021 Oct 30;51:290-295. doi: 10.1016/j.ajem.2021.10.034. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the short-term mortality of adult patients presenting to the emergency department (ED) with altered mental status (AMS) as compared to other common chief complaints.

METHODS: Observational cohort study of adult patients (age ≥ 40) who presented to an academic ED over a 1-year period with five pre-specified complaints at ED triage: AMS, generalized weakness, chest pain, abdominal pain, and headache. Primary outcomes included 7 and 30-day mortality. Hazard ratios (HR) were calculated with 95% confidence intervals (CI) using Cox proportional hazards models adjusted for age, acuity level, and comorbidities.

RESULTS: A total of 9850 ED visits were included for analysis from which 101 (1.0%) and 295 (3.0%) died within 7 and 30 days, respectively. Among 683 AMS visits, the 7-day mortality rate was 3.2%. Mortality was lower for all other chief complaints, including generalized weakness (17/1170, 1.5%), abdominal pain (32/3609, 0.9%), chest pain (26/3548, 0.7%), and headache (4/840, 0.5%). After adjusting for key confounders, patients presenting with AMS had a significantly higher risk of death within 7 days of ED arrival than patients presenting with chest pain (HR 3.72, 95% CI 2.05 to 6.76, p < .001). Similarly, we found that patients presenting with AMS had a significantly higher risk of dying within 30 days compared to patients with chest pain (HR 3.65, 95% CI 2.49 to 5.37, p < .001), and headache (HR 2.09, 95% CI 1.09 to 4.01, p = .026). Differences were not statistically significant for comparisons with abdominal pain and generalized weakness, but confidence intervals were wide.

CONCLUSION: Patients presenting with AMS have worse short-term prognosis than patients presenting to the ED with chest pain or headache. AMS may indicate an underlying brain dysfunction (delirium), which is associated with adverse outcomes and increased mortality.

PMID:34785485 | DOI:10.1016/j.ajem.2021.10.034

J Stroke Cerebrovasc Dis. 2021 Nov 13;31(1):106167. doi: 10.1016/j.jstrokecerebrovasdis.2021.106167. Online ahead of print.

ABSTRACT

PURPOSE: Patients with polycythemia, either primary or secondary, are at elevated risk for thrombotic complications, including stroke. We aimed to investigate the clinical and radiological characteristics of cerebrovascular disease (CVD) in polycythemia, and describe other neurologic manifestations.

METHODOLOGY: We conducted a cross-sectional study of patients diagnosed with polycythemia between 2014 and 2019 at a tertiary care center and collected relevant medical data with a special focus on cerebrovascular disease and neurologic manifestations. We performed descriptive and inferential analyses. We have also described and analyzed the available neuroimaging features.

RESULTS: We analyzed data from 56 patients. 20 patients (35.7%) had ischemic stroke. The incidence of CVD was higher in those with primary polycythemia (43%) than in those with secondary polycythemia (8%). The most common subtype of stroke was large vessel disease, and the most common arterial territory was the anterior circulation. There was no statistically significant difference in the hematocrit level between those with or without CVD. Neuroimaging revealed multiple large vessel intracranial stenoses on MR Angiography, and hyperdense vessels on plain CT. Other neurologic manifestations included headache, seizures, dizziness, visual symptoms and papilledema, and these were significantly more common in primary polycythemia.

CONCLUSIONS: CVD is common in patients with polycythemia. The most common type observed was large vessel occlusion, predominantly in the anterior circulation. In stroke patients, multiple vessel stenosis and hyperdense vessels may be clues to polycythemia.

PMID:34785446 | DOI:10.1016/j.jstrokecerebrovasdis.2021.106167

Am J Emerg Med. 2021 Oct 30;51:285-289. doi: 10.1016/j.ajem.2021.10.050. Online ahead of print.

ABSTRACT

OBJECTIVES: Ultrasound (US) is an essential component of emergency department patient care. US machines have become smaller and more affordable. Handheld ultrasound (HUS) machines are even more portable and easy to use at the patient’s bedside. However, miniaturization may come with consequences. The ability to accurately interpret ultrasound on a smaller screen is unknown. This pilot study aims to assess how screen size affects the ability of emergency medicine clinicians to accurately interpret US videos.

METHODS: This pilot study enrolled a prospective convenience sample of emergency medicine physicians. Participants completed a survey and were randomized to interpret US videos starting with either a phone-sized screen or a laptop-sized screen, switching to the other device at the halfway point. 50 unique US videos depicting right upper quadrant (RUQ) views of the Focused Assessment with Sonography in Trauma (FAST) examination were chosen for inclusion in the study. There were 25 US videos per device. All of the images were previously obtained on a cart-based machine (Mindray M9) and preselected by the study authors. Participants answered “Yes” or “No” in response to whether they identified free fluid. The time that each participant took to interpret each video was also recorded. Following the assessment, participants completed a post-interpretation survey. The goal of the pilot was to determine the accuracy of image interpretation on a small screen as compared to a laptop-sized screen. Statistical analyses were performed using MATLAB (The MathWorks, Inc., Natick, MA). Nonparametric statistical tests were utilized to compare subgroups, with a Wilcoxon signed rank test used for paired data and a Wilcoxon rank sum test for unpaired data.

RESULTS: 52 emergency medicine physicians were enrolled in the study. The median accuracy of US interpretation for phone versus laptop image screen was 88.0% and 87.6% (p = 0.67). The mean time to interpret with phone versus laptop screen was 293 and 290 s (p = 0.66).

CONCLUSIONS: The study found no statistically significant difference in the accuracy of US interpretation nor time spent interpreting when the pre-selected RUQ videos generated on a cart-based ultrasound machine were reviewed on a phone-sized versus a laptop-sized screen. This pilot study suggests that the accuracy of US interpretation may not be dependent upon the size of the screen utilized.

PMID:34785484 | DOI:10.1016/j.ajem.2021.10.050

Neural Netw. 2021 Nov 8;145:300-307. doi: 10.1016/j.neunet.2021.10.026. Online ahead of print.

ABSTRACT

Clipping on learning rates in Adam leads to an effective stochastic algorithm-AdaBound. In spite of its effectiveness in practice, convergence analysis of AdaBound has not been fully explored, especially for non-convex optimization. To this end, we address the convergence of the last individual output of AdaBound for non-convex stochastic optimization problems, which is called individual convergence. We prove that, with the iteration of the AdaBound, the cost function converges to a finite value and the corresponding gradient converges to zero. The novelty of this proof is that the convergence conditions on the bound functions and momentum factors are much more relaxed than the existing results, especially when we remove the monotonicity and convergence of the bound functions, and only keep their boundedness. The momentum factors can be fixed to be constant, without the restriction of monotonically decreasing. This provides a new perspective on understanding the bound functions and momentum factors of AdaBound. At last, numerical experiments are provided to corroborate our theory and show that the convergence of AdaBound extends to more general bound functions.

PMID:34785445 | DOI:10.1016/j.neunet.2021.10.026

Epilepsy Behav. 2021 Nov 13;125:108399. doi: 10.1016/j.yebeh.2021.108399. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate Sexual Function Scores in women of childbearing age with epilepsy.

METHOD: Cross-sectional study and comparison of two groups, one with and the other without epilepsy. The instruments used were: semi-structured socioeconomic, demographic and clinical questionnaire; Beck Anxiety and Depression Inventories; Word Health Organization Quality of Life (WHOQOL-brief); Female Sexual Function Index (FSFI); and Female Genital Self Image Scale (FGSIS). Statistical analysis was performed using Fisher’s Exact Test, Chi-Square, Mann-Whitney, and Spearman’s Correlation, considering p < 0.05 as a measure of significance.

RESULTS: 110 women were included (55 with epilepsy and 55 without epilepsy) with a mean age of 32 years. Both groups had sexual dysfunction (with epilepsy: 19.28 vs. without epilepsy: 21.05; p = 0.416). There was no significant difference between groups in the analysis of self-image of the genitalia, Quality of Life, or Anxiety. However, there was a statistical difference in Depression Symptoms (with epilepsy: 11.44 vs. without epilepsy:13.82, p = 0.038). When evaluating the influence of epilepsy on sexual function score, women who used enzyme-inducing drugs had worse scores in desire domain (5.21 vs. 6.65; p = 0.020) and lubrication domain (9.48 vs. 12.95; p = 0.047) when compared to women who used non-enzyme-inducing drugs, respectively. In the correlation of Sexual Function with Anxiety, Depression, Quality of Life, and Self-Image of the genitalia, it was observed that when Depression levels increase, desire is impaired [-0.273(p = 0.043)]. In Quality of Life, the psychological [0.311(p = 0.021)] and environmental [0.268(p = 0.048)] domains positively influenced desire. The social relationships domain improved desire [0.504(p = 0.000)], excitement [0.461(p = 0.000)], lubrication [0.342(p = 0.011)], orgasm [0.425(p = 0.001)], satisfaction [0.449(p = 0.001)], and decreased pain [0.402(p = 0.002)]. Consequently, these influence appeared to improve sexual function [0.521(p = 0.000)].

CONCLUSION: Women of childbearing age with epilepsy have sexual dysfunction. The presence of signs of depression and the use of enzyme-inducing drugs must be carefully analyzed, as they can worsen the sexual function score. Health professionals need to be aware that sexual dysfunction must be investigated because this issue influences the quality of life of these women.

PMID:34785412 | DOI:10.1016/j.yebeh.2021.108399