Tag: pubmed

PLoS Med. 2022 May 6;19(5):e1003983. doi: 10.1371/journal.pmed.1003983. eCollection 2022 May.

ABSTRACT

BACKGROUND: Current benzodiazepine (BZD) prescription guidelines recommend short-term use to minimize the risk of dependence, cognitive impairment, and falls and fractures. However, many clinicians overprescribe BZDs and chronic use by patients is common. There is limited evidence on the effectiveness of interventions delivered by general practitioners (GPs) on reducing prescriptions and long-term use of BZDs. We aimed to evaluate the effectiveness of a multicomponent intervention for GPs that seeks to reduce BZD prescriptions and the prevalence of long-term users.

METHODS AND FINDINGS: We conducted a multicenter two-arm, cluster randomized controlled trial in 3 health districts in Spain (primary health centers [PHCs] in Balearic Islands, Catalonia, and Valencian Community) from September 2016 to May 2018. The 81 PHCs were randomly allocated to the intervention group (n = 41; 372 GPs) or the control group (n = 40; 377 GPs). GPs were not blinded to the allocation; however, pharmacists, researchers, and trial statisticians were blinded to the allocation arm. The intervention consisted of a workshop about the appropriate prescribing of BZDs and tapering-off long-term BZD use using a tailored stepped dose reduction with monthly BZD prescription feedback and access to a support web page. The primary outcome, based on 700 GPs (351 in the control group and 349 in the intervention group), compared changes in BZD prescriptions in defined daily doses (DDDs) per 1,000 inhabitants per day after 12 months. The 2 secondary outcomes were the proportion of long-term users (≥6 months) and the proportion of long-term users over age 65 years. Intention-to-treat (ITT) analysis was used to assess all clinical outcomes. Forty-nine GPs (21 intervention group and 28 control group) were lost to follow-up. However, all GPs were included in the ITT analysis. After 12 months, there were a statistically significant decline in total BZD prescription in the intervention group compared to the control group (mean difference: -3.24 DDDs per 1,000 inhabitants per day, 95% confidence interval (CI): -4.96, -1.53, p < 0.001). The intervention group also had a smaller number of long-term users. The adjusted absolute difference overall was -0.36 (95% CI: -0.55, -0.16, p > 0.001), and the adjusted absolute difference in long-term users over age 65 years was -0.87 (95% CI: -1.44, -0.30, p = 0.003). A key limitation of this clustered design clinical trial is the imbalance of some baseline characteristics. The control groups have a higher rate of baseline BZD prescription, and more GPs in the intervention group were women, GPs with a doctorate degree, and trainers of GP residents.

CONCLUSIONS: A multicomponent intervention that targeted GPs and included educational meeting, feedback about BZD prescriptions, and a support web page led to a statistically significant reduction of BZD prescriptions and fewer long-term users. Although the effect size was small, the high prevalence of BZD use in the general population suggests that large-scale implementation of this intervention could have positive effects on the health of many patients.

TRIAL REGISTRATION: ISRCTN ISRCTN28272199.

PMID:35522626 | DOI:10.1371/journal.pmed.1003983

PLoS One. 2022 May 6;17(5):e0268185. doi: 10.1371/journal.pone.0268185. eCollection 2022.

ABSTRACT

BACKGROUND: Although Nigeria has made some progress in malaria control, there are variations across States. We investigated the factors associated with utilisation of long-lasting insecticide-treated net (LLIN) and parasitaemia among under-five children in 13 States with high malaria burden.

METHOD: Data from the 2015 Nigeria Malaria Indicator Survey and 2018 Demographic and Health Survey were obtained and analysed. The 2015 and 2018 data were compared to identify States with increase or reduction in parasitaemia. Analysis was done for all the 13 study States; four States with increased parasitaemia and nine States with reduction. Random-effects logit models were fitted to identify independent predictors of LLIN utilisation and parasitaemia.

RESULTS: LLIN was used by 53.4% of 2844 children, while parasitaemia prevalence was 26.4% in 2018. Grandchildren (AOR = 5.35, CI: 1.09-26.19) were more likely to use LLIN while other relatives (AOR = 0.33, CI: 0.11-0.94) were less likely compared to children of household-heads. LLIN use was more common in children whose mother opined that only weak children could die from malaria (AOR = 1.83, CI: 1.10-3.10). Children whose mothers obtained net from antenatal or immunisation clinics (AOR = 5.30, CI: 2.32-12.14) and campaigns (AOR = 1.77, CI: 1.03-3.04) were also more likely to use LLIN. In contrast, LLIN utilisation was less likely among children in female-headed households (AOR = 0.51, CI: 0.27-0.99) and those in poor-quality houses (AOR = 0.25, CI: 0.09-0.72). Children aged 24-59 months compared to 0-11 months (AOR = 1.78, CI: 1.28-2.48), those in whom fever was reported (AOR = 1.31, CI: 1.06-1.63) and children of uneducated women (AOR = 1.89, CI: 1.32-2.70) were more likely to have parasitaemia. The likelihood of parasitaemia was higher among children from poor households compared to the rich (AOR = 2.06, CI: 1.24-3.42). The odds of parasitaemia were 98% higher among rural children (AOR = 1.98, CI: 1.37-2.87).

CONCLUSION: The key drivers of LLIN utilisation were source of net and socioeconomic characteristics. The latter was also a key factor associated with parasitaemia. These should be targeted as part of integrated malaria elimination efforts.

PMID:35522617 | DOI:10.1371/journal.pone.0268185

Evolution. 2022 May 6. doi: 10.1111/evo.14512. Online ahead of print.

ABSTRACT

Simulation-based and permutation-based inferential methods are commonplace in phylogenetic comparative methods, especially as evolutionary data have become more complex and parametric methods more limited for their analysis. Both approaches simulate many random outcomes from a null model to empirically generate sampling distributions of statistics. Although simulation-based and permutation-based methods seem commensurate in purpose, results from analysis of variance (ANOVA) based on the distributions of random -statistics produced by these methods can be quite different in practice. Differences could be from either the null model process that generates variation across many simulations or random permutations of the data, or different estimation methods for linear model coefficients and statistics. Unfortunately, because null model process and coefficient estimation are intrinsically linked in phylogenetic ANOVA methods, the precise reason for methodological differences has not been fully considered. Here we show that the null model processes of phylogenetic simulation and randomization of residuals in a permutation procedure (RRPP) are indeed commensurate, and that both also produce results consistent with parametric ANOVA, for cases where parametric ANOVA is possible. We also provide results that caution against using ordinary least-squares estimation along with phylogenetic simulation; a typical phylogenetic ANOVA implementation. This article is protected by copyright. All rights reserved.

PMID:35522593 | DOI:10.1111/evo.14512

Phys Rev Lett. 2022 Apr 22;128(16):162001. doi: 10.1103/PhysRevLett.128.162001.

ABSTRACT

Two narrow resonant states are observed in the Λ_{b}^{0}K^{-}π^{+} mass spectrum using a data sample of proton-proton collisions at a center-of-mass energy of 13 TeV, collected by the LHCb experiment and corresponding to an integrated luminosity of 6 fb^{-1}. The minimal quark content of the Λ_{b}^{0}K^{-}π^{+} system indicates that these are excited Ξ_{b}^{0} baryons. The masses of the Ξ_{b}(6327)^{0} and Ξ_{b}(6333)^{0} states are m[Ξ_{b}(6327)^{0}]=6327.28_{-0.21}^{+0.23}±0.12±0.24 and m[Ξ_{b}(6333)^{0}]=6332.69_{-0.18}^{+0.17}±0.03±0.22 MeV, respectively, with a mass splitting of Δm=5.41_{-0.27}^{+0.26}±0.12 MeV, where the uncertainties are statistical, systematic, and due to the Λ_{b}^{0} mass measurement. The measured natural widths of these states are consistent with zero, with upper limits of Γ[Ξ_{b}(6327)^{0}]<2.20(2.56) and Γ[Ξ_{b}(6333)^{0}]<1.60(1.92) MeV at a 90% (95%) credibility level. The significance of the two-peak hypothesis is larger than nine (five) Gaussian standard deviations compared to the no-peak (one-peak) hypothesis. The masses, widths, and resonant structure of the new states are in good agreement with the expectations for a doublet of 1D Ξ_{b}^{0} resonances.

PMID:35522517 | DOI:10.1103/PhysRevLett.128.162001

Phys Rev Lett. 2022 Apr 22;128(16):160601. doi: 10.1103/PhysRevLett.128.160601.

ABSTRACT

We analytically compute the full counting statistics of charge transfer in a classical automaton of interacting charged particles. Deriving a closed-form expression for the moment generating function with respect to a stationary equilibrium state, we employ asymptotic analysis to infer the structure of charge current fluctuations for a continuous range of timescales. The solution exhibits several unorthodox features. Most prominently, on the timescale of typical fluctuations the probability distribution of the integrated charge current in a stationary ensemble without bias is distinctly non-Gaussian despite diffusive behavior of dynamical charge susceptibility. While inducing a charge imbalance is enough to recover Gaussian fluctuations, we find that higher cumulants grow indefinitely in time with different exponents, implying singular scaled cumulants. We associate this phenomenon with the lack of a regularity condition on moment generating functions and the onset of a dynamical critical point. In effect, the scaled cumulant generating function does not, irrespectively of charge bias, represent a faithful generating function of the scaled cumulants, yet the associated Legendre dual yields the correct large-deviation rate function. Our findings hint at novel types of dynamical universality classes in deterministic many-body systems.

PMID:35522513 | DOI:10.1103/PhysRevLett.128.160601

J Environ Qual. 2022 May 6. doi: 10.1002/jeq2.20366. Online ahead of print.

ABSTRACT

Nitrate in subsurface tile drainage from Midwestern USA corn (Zea mays L.)-soybean [Glycine max (L.) Merr] systems is detrimental to water quality at local and national scales. The objective of this replicated plot study in Northwest Iowa, 2015-2020, was to investigate the influence of nitrogen (N) fertilizer timing on crop production and NO₃ load in subsurface (tile) drainage discharge. Four treatments applied to corn included fall anhydrous ammonia with a nitrification inhibitor (F), spring anhydrous ammonia (S), split-banded urea at planting and mid-vegetative growth (SS), and no N fertilizer (0N). Across crops and years, NO₃ -N concentration in subsurface drainage discharge was the same 11.7 mg L^-1 for F and S applied anhydrous ammonia (AA). Concentration was statistically lower with SS urea (10 mg L^-1 ) than F and S, and 0N was lower than SS at 8.3 mg L^-1 . Average annual NO₃ -N loads were not different between any treatments due to plot variability in drainage discharge. Corn responded to N application, with overall mean yield the same for F, S, and SS. There were no agronomic or water quality benefits for applying AA in the spring compared to fall, where the F included a nitrification inhibitor and was applied to cold soils. Split-applied urea had a small positive water quality impact but no crop yield enhancement. This study shows that there were improvements to NO₃ -N concentration in subsurface drainage discharge, but more nutrient reduction practices are needed than fertilizer N management alone to reduce nitrate load to surface water systems. This article is protected by copyright. All rights reserved.

PMID:35522457 | DOI:10.1002/jeq2.20366

JMIR Form Res. 2022 May 6;6(5):e34960. doi: 10.2196/34960.

ABSTRACT

BACKGROUND: Mobile health technologies can be useful for providing disease self-management information and support to people with inflammatory bowel disease (IBD).

OBJECTIVE: The aim of this study was to test a self-management SMS text messaging intervention for people with IBD. Our goal was to examine intervention feasibility, acceptability, and engagement and to preliminarily evaluate improvements in certain self-reported health outcomes among participants.

METHODS: We developed an SMS text messaging program called Text4IBD. The program sent daily support messages and resources about disease self-management over the course of a 2-week, single-group, pretest-posttest intervention to participants (N=114) diagnosed with IBD. We examined intervention feasibility, acceptability, and engagement through Text4IBD message topic recall and use of resources (ie, visiting supplemental websites recommended by the Text4IBD program). We also assessed pretest-posttest measures of IBD-related distress, self-efficacy, perceived support, use of coping strategies, and medication adherence. Analyses examined participants’ evaluations of the intervention and compared pretest-posttest changes in secondary outcomes using paired-samples statistics.

RESULTS: Approximately all participants who completed the intervention (n=105) were receptive to Text4IBD and viewed the program as feasible and acceptable. In addition, most participants (103/105, 98.1%) recalled at least one of the message topics sent by the program, and 79% (83/105) of them self-reported engaging with at least one of the external self-management resources recommended by the Text4IBD program. Pretest-posttest results showed reduced IBD-related distress (mean 3.33, SD 0.68 vs mean 2.86, SD 0.73; P<.001) and improvements in most other secondary outcomes.

CONCLUSIONS: Findings from this study highlight the value of SMS text messaging as a useful digital medium for providing support to people with IBD, particularly to those who may struggle with disease-related distress. Text4IBD was highly feasible and acceptable and may help people self-manage their IBD. Future studies should aim to evaluate this program in a randomized controlled trial in clinical settings.

PMID:35522471 | DOI:10.2196/34960

Br J Community Nurs. 2022 May 2;27(5):232-241. doi: 10.12968/bjcn.2022.27.5.232.

ABSTRACT

This systematic review and meta-analysis estimates the prevalence of common comorbid health disorders in adults with rheumatoid arthritis (RA). A multi-database search strategy was undertaken. Screening, data extraction and quality assessment were carried out by two independent reviewers. A meta-analysis and meta-regression were used to generate a pooled prevalence estimate and identify relevant moderators. After study selection, 33 studies (74633 participants) were included in the meta-analysis. Some 31 studies were judged to be of low risk of bias, and two studies were judged to be at moderate risk of bias. The three most common comorbidities in RA were anxiety disorders (62.1%, 95% Cl: 43.6%; 80.6%), hypertension (37.7%, 95% Cl: 29.2%; 46.2%) and depression (32.1%, 95% Cl: 21.6%; 42.7%). There was substantial statistically significant heterogeneity for all comorbidities (I2 ≥77%). Meta-regression identified that the covariate of mean age (unit increase) had a statistically significant effect on the prevalence of hypertension (+2.3%, 95% Cl: 0.4%; 4.2%), depression (-0.5%, 95% Cl: -0.6%; -0.4%) and cancer (0.5%, 95% Cl: 0.2%; 0.8%) in adults with RA. A country’s income was identified to have a statistically significant effect on the prevalence of depression, with low-to moderate-income countries having 40% (95% Cl: 14.0%; 66.6%) higher prevalence than high-income countries. No studies consider health inequalities. It is concluded that comorbidities are prevalent among people with RA, particularly those associated with mental health and circulatory conditions. Provision of health services should reflect the importance of such multimorbidity and the consequences for quality and length of life.

PMID:35522453 | DOI:10.12968/bjcn.2022.27.5.232

Environ Sci Pollut Res Int. 2022 May 6. doi: 10.1007/s11356-022-20379-8. Online ahead of print.

ABSTRACT

INTRODUCTION: Recent studies demonstrated that living in areas with high ambient air pollution may have adverse effects on pregnancy outcomes, but few studies have investigated its association with spontaneous abortion. Further investigation is needed to explore the acute effect and lag effect of air pollutants exposure on spontaneous abortion.

OBJECTIVE: To investigate the acute effect and lag effect between exposure to ambient air pollutants and spontaneous abortion.

METHODS: Research data of spontaneous abortion were collected from the Chongqing Health Center for Women and Children (CQHCWC) in China. The daily ambient air pollution exposure measurements were estimated for each woman using inverse distance weighting from monitoring stations. A time-stratified, case-crossover design combined with distributed lag linear models was applied to assess the associations between spontaneous pregnancy loss and exposure to each of the air pollutants over lags 0-7 days, adjusted for temperature and relative humidity.

RESULTS: A total of 1399 women who experienced spontaneous pregnancy loss events from November 1, 2016, to September 30, 2019, were selected for this study. Maternal exposure to particulate matter 2.5 (PM_2.5), particle matter 10 (PM₁₀) nitrogen dioxide (NO₂), and sulfur dioxide (SO₂) exhibited a significant association with spontaneous abortion. For every 20 μg/m³ increase in PM_2.5, PM₁₀, NO₂, and SO₂, the RRs were 1.18 (95% CI: 1.06, 1.34), 1.12 (95% CI, 1.04-1.20), 1.15 (95% CI: 1.02, 1.30), and 1.92 (95% CI: 1.18, 3.11) on lag day 3, lag day 3, lag day 0, and lag day 3, respectively. In two-pollutant model combined with PM_2.5 and PM₁₀, a statistically significant increase in spontaneous abortion incidence of 18.0% (RR = 1.18, 95% CI: 1.06, 1.32) was found for a 20 μg/m³ increase in PM_2.5 exposure, and 11.2% (RR = 1.11, 95% CI: 1.03, 1.20) for a 20 μg/m³ increase in PM₁₀ exposure on lag day 3, similar to single-pollutant model analysis.

CONCLUSION: Maternal exposure to high levels of PM_2.5, PM₁₀, NO₂, and SO₂ during pregnancy may increase the risk of spontaneous abortion for acute effects and lag effects. Further research to explore sensitive exposure time windows is needed.

PMID:35522417 | DOI:10.1007/s11356-022-20379-8

Environ Sci Pollut Res Int. 2022 May 6. doi: 10.1007/s11356-022-20196-z. Online ahead of print.

ABSTRACT

Coronavirus (COVID-19) is a highly contagious virus (SARS-CoV-2) that has caused a global pandemic since January 2020. Scientists around the world are doing extensive research to control this disease. They are working tirelessly to find out the origin and causes of the disease. Several studies and experiments mentioned that there are some meteorological parameters which are highly correlated with COVID-19 transmission. In this work, we studied the effects of 11 meteorological parameters on the transmission of COVID-19 in Bangladesh. We first applied statistical analysis and observed that there is no significant effect of these parameters. Therefore, we proposed a novel technique to analyze the insight effects of these parameters by using a combination of Random Forest, CART, and Lasso feature selection techniques. We observed that 4 parameters are highly influential for COVID-19 where [Formula: see text] and Cloud have positive association whereas WS and AQ have negative impact. Among them, Cloud has the highest positive impact which is 0.063 and WS has the highest negative association which is [Formula: see text]. Moreover, we have validated our performance using DLNM technique. The result of this investigation can be used to develop an alert system that will assist the policymakers to know the characteristics of COVID-19 against meteorological parameters and can impose different policies based on the weather conditions.

PMID:35522407 | DOI:10.1007/s11356-022-20196-z