Tag: pubmed

PLoS One. 2021 Nov 11;16(11):e0259680. doi: 10.1371/journal.pone.0259680. eCollection 2021.

ABSTRACT

Cities and towns have often developed infrastructure that enabled a variety of socio-economic interactions. Street networks within these urban settings provide key access to resources, neighborhoods, and cultural facilities. Studies on settlement scaling have also demonstrated that a variety of urban infrastructure and resources indicate clear population scaling relationships in both modern and ancient settings. This article presents an approach that investigates past street network centrality and its relationship to population scaling in urban contexts. Centrality results are compared statistically among different urban settings, which are categorized as orthogonal (i.e., planned) or self-organizing (i.e., organic) urban settings, with places having both characteristics classified as hybrid. Results demonstrate that street nodes have a power law relationship to urban area, where the number of nodes increases and node density decreases in a sub-linear manner for larger sites. Most median centrality values decrease in a negative sub-linear manner as sites are larger, with organic and hybrid urban sites’ centrality being generally less and diminishing more rapidly than orthogonal settings. Diminishing centrality shows comparability to modern urban systems, where larger urban districts may restrict overall interaction due to increasing transport costs over wider areas. Centrality results indicate that scaling results have multiples of approximately ⅙ or ⅓ that are comparable to other urban and road infrastructure, suggesting a potential relationship between different infrastructure features and population in urban centers. The results have implications for archaeological settlements where urban street plans are incomplete or undetermined, as it allows forecasts to be made on past urban sites’ street network centrality. Additionally, a tool to enable analysis of street networks and centrality is provided as part of the contribution.

PMID:34762716 | DOI:10.1371/journal.pone.0259680

PLoS One. 2021 Nov 11;16(11):e0259855. doi: 10.1371/journal.pone.0259855. eCollection 2021.

ABSTRACT

BACKGROUND: Multiple sclerosis (MS) is the most common autoimmune inflammatory disease of the central nervous system in Europe, often causing severe physical, cognitive and emotional impairments. Currently, it is unclear whether the healthcare provisions of people with MS (PwMS) are in line with the recommendations for treatment based on guidelines or patients’ needs. The main objectives of the study are as follows: (a) to investigate how well PwMS are treated; and (b) to develop a needs-oriented, patient-centred care model.

METHODS: This mixed-methods study focuses on adult PwMS living in Lower Saxony, a federal state in Germany. The qualitative study comprises focus groups with PwMS, physicians and people involved in the healthcare process as well as a future workshop. The quantitative study comprises a cross-sectional online survey and addresses the patient-relevant outcomes and needs, as previously determined by literature searches and focus groups. It will be administered to all PwMS who are insured by the statutory health insurance company involved in the project (n~7,000). The survey data will be linked to the longitudinal secondary data from the statutory health insurance company and data from the German MS registry where available. The linked and single data sources will be statistically analysed.

DISCUSSION: By comprehensively comparing the current healthcare provisions with the needs and requirements of PwMS, the strengths and weaknesses of the overall healthcare process and provision of assistive devices can be identified. The barriers and facilitators of the health service providers and their impact on daily life will be explored (qualitative analyses). Reliable recommendations for improvements will be given based on a study population drawn from the largest statutory health insurance company in Lower Saxony (quantitative analyses). However, the inherent advantages and limitations of the qualitative and quantitative research approaches need to be considered.

TRIAL REGISTRATION: The study is registered at German Clinical Trials Register DRKS00021741.

PMID:34762697 | DOI:10.1371/journal.pone.0259855

PLoS One. 2021 Nov 11;16(11):e0259908. doi: 10.1371/journal.pone.0259908. eCollection 2021.

ABSTRACT

INTRODUCTION: The incidence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infections in the Belgian community is mainly estimated based on test results of patients with coronavirus disease (COVID-19)-like symptoms. The aim of this study was to investigate the evolution of the SARS-CoV-2 reverse transcriptase polymerase chain reaction (RT-PCR) positivity ratio and distribution of viral loads within a cohort of asymptomatic patients screened prior hospitalization or surgery, stratified by age category.

MATERIALS/METHODS: We retrospectively studied data on SARS-CoV-2 real-time RT-PCR detection in respiratory tract samples of asymptomatic patients screened pre-hospitalization or pre-surgery in nine Belgian hospitals located in Flanders over a 12-month period (1 April 2020-31 March 2021).

RESULTS: In total, 255925 SARS-CoV-2 RT-PCR test results and 2421 positive results for which a viral load was reported, were included in this study. An unweighted overall SARS-CoV-2 real-time RT-PCR positivity ratio of 1.27% was observed with strong spatiotemporal differences. SARS-CoV-2 circulated predominantly in 80+ year old individuals across all time periods except between the first and second COVID-19 wave and in 20-30 year old individuals before the second COVID-19 wave. In contrast to the first wave, a significantly higher positivity ratio was observed for the 20-40 age group in addition to the 80+ age group compared to the other age groups during the second wave. The median viral load follows a similar temporal evolution as the positivity rate with an increase ahead of the second wave and highest viral loads observed for 80+ year old individuals.

CONCLUSION: There was a high SARS-CoV-2 circulation among asymptomatic patients with a predominance and highest viral loads observed in the elderly. Moreover, ahead of the second COVID-19 wave an increase in median viral load was noted with the highest overall positivity ratio observed in 20-30 year old individuals, indicating they could have been the hidden drivers of this wave.

PMID:34762704 | DOI:10.1371/journal.pone.0259908

PLoS One. 2021 Nov 11;16(11):e0259854. doi: 10.1371/journal.pone.0259854. eCollection 2021.

ABSTRACT

In this study, 90 (51 males, 39 females) tennis players performed single-leg quiet stance and single-leg landing tasks. For the static standing task, center-of pressure (CoP) velocities, amplitudes, frequency and area were calculated. For the landing tasks, time to stabilization as well as dynamic postural stability index were considered. The analysis of differences between the legs was done based on two methods for a priori determination of leg preference, one based on the preference of kicking a ball and one based on the preference for single-leg jumping. An additional analysis was done based on the leg dominance (determined post hoc), based on the observed performance of the tasks. In case of the classification based on kicking a ball, there was a statistically significantly lower CoP anterior-posterior velocity and anterior-posterior amplitude in static balance task (p ≤ 0.017; 0.17 ≤ d ≤ 0.28) for the preferred leg. The CoP frequency was higher in the preferred leg for both directions (p ≤ 0.002; 0.10 ≤ d ≤ 0.22). For the landing task, CoP medial-lateral time to stabilization was statistically significantly shorter for the preferred leg (0.28 ± 0.38 s) compared to the non-preferred leg (0.47 ± 0.60 s) (p = 0.012; d = 0.38). There were no differences between the legs for the landing task. Moreover, there were no differences between the legs when we used the preference based on jumping for either of the tasks (d ≤ 0.14). The differences between legs in terms of observed dominance were larger than the differences based on the preference, which stresses the need for clear distinction of limb preference and limb dominance in research and practice. Regarding the effect of leg preference, small differences in static balance may exist between the legs (when the preference is based on kicking a ball).

PMID:34762690 | DOI:10.1371/journal.pone.0259854

PLoS One. 2021 Nov 11;16(11):e0259572. doi: 10.1371/journal.pone.0259572. eCollection 2021.

ABSTRACT

The objective of this study was to calculate the extent and decay of linkage disequilibrium (LD) in 96 crossbred Vrindavani cattle genotyped with Bovine SNP50K Bead Chip. After filtering, 43,821 SNPs were retained for final analysis, across 2500.3 Mb of autosome. A significant percentage of SNPs was having minor allele frequency of less than 0.20. The extent of LD between autosomal SNPs up to 10 Mb apart across the genome was measured using r2 statistic. The mean r2 value was 0.43, if pairwise distance of marker was less than10 kb and it decreased further to 0.21 for 25-50 kb markers distance. Further, the effect of minor allele frequency and sample size on LD estimate was investigated. The LD value decreased with the increase in inter-marker distance, and increased with the increase of minor allelic frequency. The estimated inbreeding coefficient and effective population size were 0.04, and 46 for present generation, which indicated small and unstable population of Vrindavani cattle. These findings suggested that a denser or breed specific SNP panel would be required to cover all genome of Vrindavani cattle for genome wide association studies (GWAS).

PMID:34762692 | DOI:10.1371/journal.pone.0259572

PLoS One. 2021 Nov 11;16(11):e0259780. doi: 10.1371/journal.pone.0259780. eCollection 2021.

ABSTRACT

Amazonia and the Northeast region of Brazil exhibit the highest levels of climate vulnerability in the country. While Amazonia is characterized by an extremely hot and humid climate and hosts the world largest rainforest, the Northeast is home to sharp climatic contrasts, ranging from rainy areas along the coast to semiarid regions that are often affected by droughts. Both regions are subject to extremely high temperatures and are susceptible to many tropical diseases. This study develops a multidimensional Extreme Climate Vulnerability Index (ECVI) for Brazilian Amazonia and the Northeast region based on the Alkire-Foster method. Vulnerability is defined by three components, encompassing exposure (proxied by seven climate extreme indicators), susceptibility (proxied by sociodemographic indicators), and adaptive capacity (proxied by sanitation conditions, urbanization rate, and healthcare provision). In addition to the estimated vulnerability levels and intensity, we break down the ECVI by indicators, dimensions, and regions, in order to explore how the incidence levels of climate-sensitive infectious and parasitic diseases correlate with regional vulnerability. We use the Grade of Membership method to reclassify the mesoregions into homoclimatic zones based on extreme climatic events, so climate and population/health data can be analyzed at comparable resolutions. We find two homoclimatic zones: Extreme Rain (ER) and Extreme Drought and High Temperature (ED-HT). Vulnerability is higher in the ED-HT areas than in the ER. The contribution of each dimension to overall vulnerability levels varies by homoclimatic zone. In the ER zone, adaptive capacity (39%) prevails as the main driver of vulnerability among the three dimensions, in contrast with the approximately even dimensional contribution in the ED-HT. When we compare areas by disease incidence levels, exposure emerges as the most influential dimension. Our results suggest that climate can exacerbate existing infrastructure deficiencies and socioeconomic conditions that are correlated with tropical disease incidence in impoverished areas.

PMID:34762688 | DOI:10.1371/journal.pone.0259780

PLoS One. 2021 Nov 11;16(11):e0259803. doi: 10.1371/journal.pone.0259803. eCollection 2021.

ABSTRACT

Racial/ethnic disparities are among the top-selective underlying determinants associated with the disproportional impact of the COVID-19 pandemic on human mobility and health outcomes. This study jointly examined county-level racial/ethnic differences in compliance with stay-at-home orders and COVID-19 health outcomes during 2020, leveraging two-year geo-tracking data of mobile devices across ~4.4 million point-of-interests (POIs) in the contiguous United States. Through a set of structural equation modeling, this study quantified how racial/ethnic differences in following stay-at-home orders could mediate COVID-19 health outcomes, controlling for state effects, socioeconomics, demographics, occupation, and partisanship. Results showed that counties with higher Asian populations decreased most in their travel, both in terms of reducing their overall POIs’ visiting and increasing their staying home percentage. Moreover, counties with higher White populations experienced the lowest infection rate, while counties with higher African American populations presented the highest case-fatality ratio. Additionally, control variables, particularly partisanship, median household income, percentage of elders, and urbanization, significantly accounted for the county differences in human mobility and COVID-19 health outcomes. Mediation analyses further revealed that human mobility only statistically influenced infection rate but not case-fatality ratio, and such mediation effects varied substantially among racial/ethnic compositions. Last, robustness check of racial gradient at census block group level documented consistent associations but greater magnitude. Taken together, these findings suggest that US residents’ responses to COVID-19 are subject to an entrenched and consequential racial/ethnic divide.

PMID:34762685 | DOI:10.1371/journal.pone.0259803

PLoS One. 2021 Nov 11;16(11):e0259577. doi: 10.1371/journal.pone.0259577. eCollection 2021.

ABSTRACT

BACKGROUND: Emergency department (ED) crowding is a frequent situation. To decrease this overload, patients without a life-threating condition are transferred to wards that offer ED support. This study aimed to evaluate if implementing a rapid response team (RRT) triggered by the modified early warning score (MEWS) in high-risk wards offering ED support is associated with decreased in-hospital mortality rate.

METHODS: A before-and-after cross-sectional study compared in-hospital mortality rates before and after implementation of an RRT triggered by the MEWS ≥4 in two wards of a tertiary hospital that offer ED support.

RESULTS: We included 6863 patients hospitalized in these wards before RRT implementation from July 2015 through June 2017 and 6944 patients hospitalized in these same wards after RRT implementation from July 2018 through June 2020. We observed a statistically significant decrease in the in-hospital mortality rate after intervention, 449 deaths/6944 hospitalizations [6.47% (95% confidence interval (CI) 5.91%- 7.07%)] compared to 534 deaths/6863 hospitalizations [7.78% (95% CI 7.17-8.44)] before intervention; with an absolute risk reduction of -1.31% (95% CI -2.20 –0.50).

CONCLUSION: RRT trigged by the MEWS≥4 in high-risk wards that offer ED support was found to be associated with a decreased in-hospital mortality rate. A further cluster-randomized trial should evaluate the impact of this intervention in this setting.

PMID:34762677 | DOI:10.1371/journal.pone.0259577

PLoS One. 2021 Nov 11;16(11):e0259793. doi: 10.1371/journal.pone.0259793. eCollection 2021.

ABSTRACT

With the development of economic integration, Beijing has become more closely connected with surrounding areas, which gradually formed the Beijing metropolitan area (BMA). The authors define the scope of BMA from two dimensions of space and time. BMA is determined to be the built-up area of Beijing and its surrounding 10 districts. Designed questionnaire survey the personal characteristics, family characteristics, and travel characteristics of residents from 10 districts in the surrounding BMA. The statistical analysis of questionnaires shows that the supply of public transportation is insufficient and cannot meet traffic demand. Further, the travel mode prediction model of Softmax regression machine learning algorithm for BMA (SRBM) is established. To further verify the prediction performance of the proposed model, the Multinomial Logit Model (MNL) and Support Vector Machine (SVM), model are introduced to compare the prediction accuracy. The results show that the constructed SRBM model exhibits high prediction accuracy, with an average accuracy of 88.35%, which is 2.83% and 18.11% higher than the SVM and MNL models, respectively. This article provides new ideas for the prediction of travel modes in the Beijing metropolitan area.

PMID:34762681 | DOI:10.1371/journal.pone.0259793

PLoS One. 2021 Nov 11;16(11):e0259139. doi: 10.1371/journal.pone.0259139. eCollection 2021.

ABSTRACT

An understanding of the types of shocks that disrupt and negatively impact urban household food security is of critical importance to develop relevant and targeted food security emergency preparedness policies and responses, a fact magnified by the current COVID-19 pandemic. This gap is addressed by the current study which draws from the Hungry Cities Partnership (HCP) city-wide household food insecurity survey of Nairobi city in Kenya. It uses both descriptive statistics and multilevel modelling using General Linear Mixed Models (GLMM) to examine the relationship between household food security and 16 different shocks experienced in the six months prior to the administration of the survey. The findings showed that only 29% of surveyed households were completely food secure. Of those experiencing some level of food insecurity, more experienced economic (55%) than sociopolitical (16%) and biophysical (10%) shocks. Economic shocks such as food price increases, loss of employment, and reduced income were all associated with increased food insecurity. Coupled with the lack of functioning social safety nets in Nairobi, households experiencing shocks and emergencies experience serious food insecurity and related health effects. In this context, the COVID-19 pandemic is likely to have a major negative economic impact on many vulnerable urban households. As such, there is need for new policies on urban food emergencies with a clear emergency preparedness plan for responding to major economic and other shocks that target the most vulnerable.

PMID:34762674 | DOI:10.1371/journal.pone.0259139