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Nevin Manimala Statistics

Clinimetric Evaluation of the Experienced Communication in Dementia Questionnaire (ECD)

Gerontologist. 2021 Dec 28:gnab187. doi: 10.1093/geront/gnab187. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Tools to measure self-perceived communication between persons with early-stage dementia and their caregivers are lacking. Therefore, we developed a questionnaire for Experienced Communication in Dementia (ECD) with a patient version (ECD-P) and a caregiver version (ECD-C), that contains items on (1) caregiver competence, (2) social communication, (3) communication difficulties, and (4) experienced emotions. This article describes the feasibility and clinimetric evaluation of this instrument.

RESEARCH DESIGN AND METHODS: A prospective observational cohort study was conducted with 57 dyads (community-dwelling person with dementia and primary caregiver). ECD-P, ECD-C, and measures on quality of life, caregiver burden, cognitive functioning, physical functioning, and functional independence were administered. After two weeks, the dyads filled out the ECD again. Feasibility (completion time and missing values per item), internal consistency (Cronbach’s α), test-retest reliability (intraclass correlation coefficients (ICCs)) and construct validity (hypotheses testing with Spearman’s r) were evaluated.

RESULTS: Mean completion time was ten minutes per questionnaire. ICCs for test-retest reliability ranged from 0.67 to 0.78, except for ECD-P2 (ICC = 0.31). Internal consistency ranged from α = 0.75 to 0.82 for ECD-P1 and all parts of ECD-C, except for ECD-P2 (α = 0.66). Correlation coefficients for convergent validity ranged from r = 0.31 to 0.69 and correlation coefficients for divergent validity were r < 0.20 and statistically insignificant.

DISCUSSION AND IMPLICATIONS: Pending future research, the ECD, except part ECD-P2, seems to be a promising tool to measure experienced communication between persons with early-stage dementia and their caregivers.

PMID:34962993 | DOI:10.1093/geront/gnab187

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Nevin Manimala Statistics

Global emergence and dissemination of Neisseria gonorrhoeae ST-9363 isolates with reduced susceptibility to azithromycin

Genome Biol Evol. 2021 Dec 28:evab287. doi: 10.1093/gbe/evab287. Online ahead of print.

ABSTRACT

Neisseria gonorrhoeae multi-locus sequence type (ST) 9363 core-genogroup isolates have been associated with reduced azithromycin susceptibility (AZMrs) and show evidence of clonal expansion in the U.S. Here we analyze a global collection of ST-9363 core-genogroup genomes to shed light on the emergence and dissemination of this strain. The global population structure of ST-9363 core-genogroup falls into three lineages: Basal, European, and North American; with 32 clades within all lineages. Although, ST-9363 core-genogroup is inferred to have originated from Asia in the mid-19th century; we estimate the three modern lineages emerged from Europe in the late 1970s to early 1980s. The European lineage appears to have emerged and expanded from around 1986 to 1998, spreading into North America and Oceania in the mid-2000s with multiple introductions, along with multiple secondary reintroductions into Europe. Our results suggest two separate acquisition events of mosaic mtrR and mtrR promoter alleles: first during 2009-2011 and again during the 2012-2013 time, facilitating the clonal expansion of this core-genogroup with AZMrs in the U.S. By tracking phylodynamic evolutionary trajectories of clades that share distinct demography as well as population-based genomic statistics, we demonstrate how recombination and selective pressures in the mtrCDE efflux operon granted a fitness advantage to establish ST-9363 as a successful gonococcal lineage in the U.S. and elsewhere. Although it is difficult to pinpoint the exact timing and emergence of this young core-genogroup, it remains critically important to continue monitoring it, as it could acquire additional resistance markers.

PMID:34962987 | DOI:10.1093/gbe/evab287

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Nevin Manimala Statistics

Husbands’ participation in birth preparedness and complication readiness plan in Kucha district, Gamo Zone, Southern Ethiopia

PLoS One. 2021 Dec 28;16(12):e0261936. doi: 10.1371/journal.pone.0261936. eCollection 2021.

ABSTRACT

BACKGROUND: Birth-preparedness and complication-readiness (BPCR) is the process of planning for normal birth and anticipating the actions needed in case of an emergency. The involvement of husband during pregnancy helps a mother to make timely decisions to avoid delays. Identifying the level of husband involvement in Birth-preparedness and complication-readiness is very important, as husband is the major decision maker in household and health service related issue. However, there is no sufficient data in the Kucha district, which describes the level of husband involvement in Birth-preparedness and complication-readiness. Therefore, this study assessed the level of husband involvement in birth preparedness and complication readiness in Kucha District, Gamo Zone, Ethiopia.

METHODS: Community-based cross-sectional study was conducted on 421 husbands whose wife gave birth within the last 12 months at Kucha District using simple random sampling technique. Data was collected using a pretested interviewer-administered questionnaire by trained data collectors. Binary and multivariable logistic regression with odds ratios along with the 95% confidence interval analysis were employed to find factors associated with the level of husband involvement. A p-value <0.05 with 95% confidence level used to decide statistical significance.

RESULTS: Data were collected from 421 study participants. One hundred twenty-seven (30.2%) were involved in birth preparedness and complication readiness plan. Participants who had at least secondary school education AOR = 3.1, CI (1.84-5.23), had at least four antenatal care visits AOR = 4.91, CI (2.36-10.2), and live more than five km from the health care facility AOR = 2.35, CI = 1.40-3.96) were involved in birth preparedness and complication readiness plan.

CONCLUSION: Husbands’ involvement in birth preparedness and complication readiness was low. Husband’s higher educational level, high frequency of antenatal care, and long distance to the health facility were significantly associated with husbands’ involvement in Birth-preparedness and complication-readiness plan. Therefore, advocating for higher frequency of antenatal care and improving educational level are important to increase husbands’ involvement in birth preparedness and complication readiness plan.

PMID:34962971 | DOI:10.1371/journal.pone.0261936

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Nevin Manimala Statistics

Altered fecal microbiota, IgA, and fermentative end-products in adult dogs fed prebiotics and a nonviable Lactobacillus acidophilus

J Anim Sci. 2021 Dec 1;99(12):skab347. doi: 10.1093/jas/skab347.

ABSTRACT

A study investigating the use of a nonviable Lactobacillus acidophilus (NVL: Culbac; TransAgra, Storm Lake, IA) and a mixed prebiotic (MP) blend (beet pulp, fructooligosaccharide (FOS), mannanoligosaccharide (MOS), inulin, and kelp) was done to evaluate changes in fecal microbiota, fermentative end products, and gut immune health in healthy female and male adult Beagle dogs (n = 24; 5.74 ± 2.18 yr; 9.30 ± 1.32 kg). The study protocol was first approved by the facility’s Institutional Animal Care and Use Committee (Summit Ridge Farms; Susquehanna, PA) and followed throughout. Each of four test diets (control, NVL, MP, and MP + NVL [formulated to crude protein 25%, crude fat 14%, crude fiber 10% as-fed]) was fed once daily to maintain body weight for 21 d in a randomized-crossover design (four treatment periods and four washout periods). Fecal samples were collected on days 0 and 21 only for immunoglobulin A (IgA) and microbiota evaluation (16S rRNA V4 region and qPCR for Escherichia coli and Bifidobacterium), and fecal fermentative end-products and fecal pH were assessed only on day 21. Over the test periods, apparent total tract nutrient digestibility and stool quality were assessed. Data were analyzed by ANOVA (SAS v9.4, Cary, NC) or Kruskal-Wallis for between-diet effects, and paired t-test or Wilcoxon for time effects. Statistical significance was set at P ≤ 0.05. Apparent total tract nutrient digestibility revealed feeding MP-containing diets resulted in lower (P < 0.05) crude protein and fat digestibility vs. control and NVL diets. When dogs were fed MP, they had lower (P < 0.05) fecal pH compared with control and NVL diets, whereas fecal pH was lower in (P < 0.05) MP + NVL- vs. NVL-fed dogs. Fecal E. coli was (P < 0.05) lower at day 21 vs. day 0 when dogs were fed MP. Fecal Fusobacterium spp. was lower (P < 0.05) in both MP diets vs. control. Fecal Lactobacillus spp. increased (P < 0.05) from baseline with MP. Both diets with MP elicited greater (P < 0.05) fecal acetate and propionate concentration vs. control diet. At day 21, fecal IgA was greater (P < 0.05) in MP and MP + NVL compared with NVL diet. Only when dogs were fed MP did they have increased (P < 0.05) fecal IgA from day 21 vs. day 0. The MP + NVL diet decreased (P < 0.05) fecal isovalerate, isobutyrate, phenol, and indole vs. control. Overall, the MP elicited the most changes on microbiota, fermentative end-products, and IgA. Further investigation into NVL’s gut health benefits is warranted.

PMID:34962977 | DOI:10.1093/jas/skab347

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Nevin Manimala Statistics

The spread of agriculture in Iberia through Approximate Bayesian Computation and Neolithic projectile tools

PLoS One. 2021 Dec 28;16(12):e0261813. doi: 10.1371/journal.pone.0261813. eCollection 2021.

ABSTRACT

In the present article we use geometric microliths (a specific type of arrowhead) and Approximate Bayesian Computation (ABC) in order to evaluate possible origin points and expansion routes for the Neolithic in the Iberian Peninsula. In order to do so, we divide the Iberian Peninsula in four areas (Ebro river, Catalan shores, Xúquer river and Guadalquivir river) and we sample the geometric microliths existing in the sites with the oldest radiocarbon dates for each zone. On this data, we perform a partial Mantel test with three matrices: geographic distance matrix, cultural distance matrix and chronological distance matrix. After this is done, we simulate a series of partial Mantel tests where we alter the chronological matrix by using an expansion model with randomised origin points, and using the distribution of the observed partial Mantel test’s results as a summary statistic within an Approximate Bayesian Computation-Sequential Monte-Carlo (ABC-SMC) algorithm framework. Our results point clearly to a Neolithic expansion route following the Northern Mediterranean, whilst the Southern Mediterranean route could also find support and should be further discussed. The most probable origin points focus on the Xúquer river area.

PMID:34962962 | DOI:10.1371/journal.pone.0261813

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Nevin Manimala Statistics

Improving sexually transmitted infection screening, testing, and treatment among people with HIV: A mixed method needs assessment to inform a multi-site, multi-level intervention and evaluation plan

PLoS One. 2021 Dec 28;16(12):e0261824. doi: 10.1371/journal.pone.0261824. eCollection 2021.

ABSTRACT

Bacterial sexually transmitted infections (STIs) continue to be a worsening public health concern in the United States (US). Though the national incidence of HIV infection has decreased over recent years, that of chlamydia, gonorrhea, and syphilis have not. Despite national recommendations on prevention, screening, and treatment of these STIs, these practices have not been standardized. Nine Health Resources and Services Administration Ryan White HIV/AIDS Program funded clinics across 3 US jurisdictions (Florida, Louisiana, and Washington, DC), were selected as clinical demonstration sites to be evaluated in this mixed method needs assessment to inform a multi-site, multi-level intervention to evaluate evidence-based interventions to improve STI screening and testing of bacterial STIs among people with or at risk for HIV. These 3 US jurisdictions were selected due to having higher than national average incidence rates of HIV and bacterial STIs. Descriptive statistics and deductive analysis were used to assess quantitative and qualitative needs assessment data. Results indicate the following needs across participating sites: inconsistent and irregular comprehensive sexual behavior history taking within and among sites, limited routine bacterial STI testing (once/year and if symptomatic) not in accordance with CDC recommendations, limited extragenital site gonorrhea/chlamydia testing, limited annual training on STI-related topics including LGBTQ health and adolescent/young adult sexual health, and limited efforts for making high-STI incidence individuals feel welcome in the clinic (primarily LGBTQ individuals and adolescents/young adults). These findings were used to identify interventions to be used to increase routine screenings and testing for bacterial STIs.

PMID:34962965 | DOI:10.1371/journal.pone.0261824

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Nevin Manimala Statistics

Mathematical modeling of the hematocrit influence on cerebral blood flow in preterm infants

PLoS One. 2021 Dec 28;16(12):e0261819. doi: 10.1371/journal.pone.0261819. eCollection 2021.

ABSTRACT

Premature birth is one of the most important factors increasing the risk for brain damage in newborns. Development of an intraventricular hemorrhage in the immature brain is often triggered by fluctuations of cerebral blood flow (CBF). Therefore, monitoring of CBF becomes an important task in clinical care of preterm infants. Mathematical modeling of CBF can be a complementary tool in addition to diagnostic tools in clinical practice and research. The purpose of the present study is an enhancement of the previously developed mathematical model for CBF by a detailed description of apparent blood viscosity and vessel resistance, accounting for inhomogeneous hematocrit distribution in multiscale blood vessel architectures. The enhanced model is applied to our medical database retrospectively collected from the 254 preterm infants with a gestational age of 23-30 weeks. It is shown that by including clinically measured hematocrit in the mathematical model, apparent blood viscosity, vessel resistance, and hence the CBF are strongly affected. Thus, a statistically significant decrease in hematocrit values observed in the group of preterm infants with intraventricular hemorrhage resulted in a statistically significant increase in calculated CBF values.

PMID:34962951 | DOI:10.1371/journal.pone.0261819

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Nevin Manimala Statistics

Analysis of the spatial differentiation and scale effects of the three-dimensional architectural landscape in Xi’an, China

PLoS One. 2021 Dec 28;16(12):e0261846. doi: 10.1371/journal.pone.0261846. eCollection 2021.

ABSTRACT

Three-dimensional landscape patterns are an effective means to study the relationship between landscape pattern evolution and eco-environmental effects. This paper selects six districts in Xi’an as the study area to examine the spatial distribution characteristics of the three-dimensional architectural landscape in the city’s main urban area using three-dimensional information on the buildings in 2020 with the support of GIS. In this study, two new architectural landscape indices-landscape height variable coefficient and building rugosity index-were employed in landscape pattern analysis, whilst a system of rigorous and comprehensive three-dimensional architectural landscape metrics was established using principal component analysis. A mathematical model of weighted change of landscape metrics based on the objective weighting method was applied to carry out scale analysis of the landscape patterns. Spatial statistical analysis and spatial autocorrelation analysis were conducted to comprehensively study the differentiation of three-dimensional architectural landscape spatial patterns. The results show that the characteristic scale of the three-dimensional landscape pattern in Xi’an’s main urban area is around 8 km. Moreover, the three-dimensional landscape of the buildings in this area is spatially positively correlated, exhibiting a high degree of spatial autocorrelation whilst only showing small spatial differences. The layout of the architectural landscape pattern is disorderly and chaotic within the second ring, whilst the clustering of patch types occurs near the third ring. Moreover, the building density in the Beilin, Lianhu, and Xincheng districts is large, the building height types are rich, and the roughness of the underlying surface is high, such that these are key areas to be improved through urban renewal. The height, volume, density, morphological heterogeneity, and vertical roughness of the architectural landscape vary amongst functional areas within the study area. This paper is the first to apply the study of spatial heterogeneity of three-dimensional landscape patterns to Xi’an. It does so in order to provide a quantitative basis for urban landscape ecological design for urban renewal and the rational planning of built-up areas, which will promote the sustainable development of the city’s urban environment.

PMID:34962958 | DOI:10.1371/journal.pone.0261846

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Nevin Manimala Statistics

Colchicine use in patients with COVID-19: A systematic review and meta-analysis

PLoS One. 2021 Dec 28;16(12):e0261358. doi: 10.1371/journal.pone.0261358. eCollection 2021.

ABSTRACT

INTRODUCTION: Colchicine may inhibit inflammasome signaling and reduce proinflammatory cytokines, a purported mechanism of COVID-19 pneumonia. The aim of this systematic review and meta-analysis is to report on the state of the current literature on the use of colchicine in COVID-19 and to investigate the reported clinical outcomes in COVID-19 patients by colchicine usage.

METHODS: The literature was searched from January 2019 through January 28, 2021. References were screened to identify studies that reported the effect of colchicine usage on COVID-19 outcomes including mortality, intensive care unit (ICU) admissions, or mechanical ventilation. Studies were meta-analyzed for mortality by the subgroup of trial design (RCT vs observational) and ICU status. Studies reporting an risk ratio (RR), odds ratio (OR) and hazard ratio (HR) were analyzed separately.

RESULTS: Eight studies, reporting on 16,248 patients, were included in this review. The Recovery trial reported equivalent mortality between colchicine and non-colchicine users. Across the other studies, patients who received colchicine had a lower risk of mortality-HR of 0.25 (95% CI: 0.09, 0.66) and OR of 0.22 (95% CI: 0.09, 0.57). There was no statistical difference in risk of ICU admissions between patients with COVID-19 who received colchicine and those who did not-OR of 0.26 (95% CI: 0.06, 1.09).

CONCLUSION: Colchicine may reduce the risk of mortality in individuals with COVID-19. Further prospective investigation may further determine the efficacy of colchicine as treatment in COVID-19 patients in various care settings of the disease, including post-hospitalization and long-term care.

PMID:34962939 | DOI:10.1371/journal.pone.0261358

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Nevin Manimala Statistics

Clinical and radiological characteristics of acute pulmonary embolus in relation to 28-day and 6-month mortality

PLoS One. 2021 Dec 28;16(12):e0258843. doi: 10.1371/journal.pone.0258843. eCollection 2021.

ABSTRACT

BACKGROUND: Patients with acute pulmonary embolism (PE) exhibit a wide spectrum of clinical and laboratory features when presenting to hospital and pathophysiologic mechanisms differentiating low-risk and high-risk PE are poorly understood.

OBJECTIVES: To investigate the prognostic value of clinical, laboratory and radiological information that is available within routine tests undertaken for patients with acute PE.

METHODS: Electronic patient records (EPR) of patients who underwent Computed Tomography Pulmonary Angiogram (CTPA) scan for the investigation of acute PE during 6-month period (01.01.2016-30.06.2016) were examined. Data was gathered from EPR for patients that met inclusion criteria and all CTPA scans were re-evaluated. Biochemical thresholds of low-grade and high-grade inflammation, serum CRP >10mg/L and >150mg/L and serum albumin concentrations <35g/L and <25 g/L, were combined in the Glasgow Prognostic Score (GPS) and peri-operative Glasgow Prognostic Score (poGPS) respectively. Neutrophil Lymphocyte ratio (NLR) was also calculated. Pulmonary Embolus Severity Index score was calculated.

RESULTS: Of the total CTPA reports (n = 2129) examined, 245 patients were eligible for inclusion. Of these, 20 (8%) patients had died at 28-days and 43 (18%) at 6-months. Of the 197 non-cancer related presentations, 28-day and 6-month mortality were 3% and 8% respectively. Of the 48 cancer related presentations, 28-day and 6-month mortality were 29% and 58% respectively. On univariate analysis, age ≥65 years (p<0.01), PESI score ≥100(p = <0.001), NLR ≥3(p<0.001) and Coronary Artery Calcification (CAC) score ≥ 6 (p<0.001) were associated with higher 28-day and 6-month mortality. PESI score ≥100 (OR 5.2, 95% CI: 1.1, 24.2, P <0.05), poGPS ≥1 (OR 2.5, 95% CI: 1.2-5.0, P = 0.01) and NLR ≥3 (OR 3.7, 95% CI: 1.0-3.4, P <0.05) remained independently associated with 28-day mortality. On multivariate binary logistic regression analysis of factors associated with 6-month mortality, PESI score ≥100 (OR 6.2, 95% CI: 2.3-17.0, p<0.001) and coronary artery calcification score ≥6 (OR 2.3, 95% CI: 1.1-4.8, p = 0.030) remained independently associated with death at 6-months. When patients who had an underlying cancer diagnosis were excluded from the analysis only GPS≥1 remained independently associated with 6-month mortality (OR 5.0, 95% CI 1.2-22.0, p<0.05).

CONCLUSION: PESI score >100, poGPS≥1, NLR ≥3 and CAC score ≥6 were associated with 28-day and 6-month mortality. PESI score ≥100, poGPS≥1 and NLR ≥3 remained independently associated with 28-day mortality. PESI score ≥100 and CAC score ≥6 remained independently associated with 6-month mortality. When patients with underlying cancer were excluded from the analysis, GPS≥1 remained independently associated with 6-month mortality. The role of the systemic inflammatory response (SIR) in determining treatment and prognosis requires further study. Routine reporting of CAC scores in CTPA scans for acute PE may have a role in aiding clinical decision-making regarding treatment and prognosis.

PMID:34962922 | DOI:10.1371/journal.pone.0258843