Tag: pubmed

PLoS One. 2021 Dec 16;16(12):e0261437. doi: 10.1371/journal.pone.0261437. eCollection 2021.

ABSTRACT

BACKGROUND AND OBJECTIVES: At present, the focus of the fighting against COVID-19 in China is shifting to strictly prevent the entrance of cases from abroad and disease transmission. Therefore, it is extremely urgent to better understand the clinical features of imported cases from overseas countries, which is conductive to formulate the corresponding countermeasures. This study aimed to describe the clinical features of COVID-19 cases imported from Russia through the Suifenhe port, in order to identify baseline and clinical data associated with disease progression and present corresponding countermeasures.

METHODS: All COVID-19 cases imported from Russia through the Suifenhe port were included in this retrospective study. According to the “Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (seventh edition)”, imported COVID-19 cases were divided into asymptomatic infection, mild, moderate, severe, and critical groups. Baseline and clinical data, including age, gender, comorbidities, disease severity, symptoms at onset, body temperature, white blood cell (WBC) count, lymphocyte (LYMPH) count, lymphocyte percentage (LYM%), C-reactive protein (CRP), oxygenation index (OI), and the use therapeutic modalities were obtained on admission, and then compared between groups.

RESULTS: A total of 375 COVID-19 cases imported from Russia through Suifenhe port were included, of whom the asymptomatic infection, mild, moderate, severe, and critical groups accounted for 4.0%, 13.9%, 75.5%, 5.3%, and 1.3%, respectively. The majority of the imported COVID-19 cases were men (61.9%) with a median age of 38.72 years who had no comorbidity (87.7%). Nearly one-third of them (33.1%) were asymptomatic at onset, and common initial symptoms included fever (36.5%), cough (36.0%), pharyngeal discomfort (12.3%), expectoration (8.0%), and chest tightness (5.3%). In total, 180 (48%) and 4 (1.1%) enrolled imported cases received nasal tube oxygen inhalation therapy and high-flow oxygen absorption, respectively; the remaining patients did not undergo oxygen therapy. The values of age, body temperature, WBC, LYMPH, LYM%, CRP, and OI were 38.72 ± 10.50, 35.10 ± 7.92, 5.59 ± 1.97, 1.67 ± 0.68, 31.05 ± 10.22, 8.00 ± 14.75, and 389.03 ± 74.07, respectively. Gender, age, LYMPH, LYM%, symptoms at onset, cough, fever, other rare symptoms, and oxygen therapy showed significant differences between groups (P = 0.036, < 0.001, < 0.001, < 0.001, < 0.001, < 0.001, < 0.001, = 0.045, < 0.001, respectively).

CONCLUSIONS: Compared with domestic confirmed patients, COVID-19 patients who arrived at China from Russia through the Suifenhe port had significantly different clinical features, and the differences in gender, age, LYMPH, LYM%, symptoms at onset, cough, fever, other rare symptoms, and oxygen therapy between groups were statistically significant. Therefore, detailed and comprehensive countermeasures were developed to manage and prevent another outbreak based on these clinical features.

PMID:34914808 | DOI:10.1371/journal.pone.0261437

PLoS One. 2021 Dec 16;16(12):e0261300. doi: 10.1371/journal.pone.0261300. eCollection 2021.

ABSTRACT

BACKGROUND: Heart failure (HF) imposes a substantial burden on patients and healthcare systems. Hospital-to-home transitional care, involving time-limited interventions delivered predominantly by nurses, was introduced to lighten this burden. This study aimed to examine the effectiveness and dose-response of nurse-led transitional care interventions (TCIs) on healthcare utilization among patients with HF.

METHODS: Health-related databases were systematically searched for articles published from January 2000 to June 2020. We included randomized controlled trials (RCTs) that compared nurse-led TCIs with usual care for adults hospitalized with HF and reported the following healthcare utilization outcomes: all-cause readmissions, HF-specific readmissions, emergency department visits, or length of hospital stay. Random-effects meta-analysis, meta-regression analysis, and dose-response analysis were performed to estimate the treatment effects and explain the heterogeneity.

RESULTS: Twenty-five RCTs including 8422 patients with HF were included. Nurse-led TCIs for patients with HF resulted in a mean 9% (RR = 0.91; 95% CI = 0.82 to 0.99; p = 0.04; I2 = 46%) and 29% (RR = 0.71; 95% CI = 0.60 to 0.84; p < 0.0001; I2 = 0%) reduction in all-cause and HF-specific readmission risks respectively compared to usual care. The interventions were also effective in shortening the length of hospital stay (MD = -2.37; 95% CI = -3.16 to -1.58; p < 0.0001; I2 = 14%). However, no significant reduction was found for emergency department visits (RR = 0.96; 95% CI = 0.84 to 1.10; p = 0.58; I2 = 0%). The effect of meta-regression coefficients on all-cause and HF-specific readmissions was not statistically significant for any prespecified trial-level characteristic. Dose-response analysis revealed that the HF-specific readmission risk decreased in a dose-dependent manner with the complexity and intensity of nurse-led TCIs.

CONCLUSIONS: Nurse-led TCIs were effective in decreasing all-cause and HF-specific readmission risks, as well as in reducing the length of hospital stay; however, the interventions were not effective in reducing the frequency of emergency department visits.

PMID:34914810 | DOI:10.1371/journal.pone.0261300

PLoS One. 2021 Dec 16;16(12):e0261301. doi: 10.1371/journal.pone.0261301. eCollection 2021.

ABSTRACT

Infant and young child feeding is a key area to improve child survival and promote healthy growth and development. Nepal government has developed and implemented different programs to improve infant and young child feeding practice. However, the practice remains poor and is a major cause of malnutrition in Nepal. This study aims to identify infant and young child feeding practices and its associated factors among mothers of children aged less than two years in western hilly region of Nepal. A descriptive cross-sectional study was carried out among 360 mothers of under two years’ children in Syangja district. A semi structural questionnaire was used. Data was entered in EpiData and analyzed using IBM SPSS version 21. Descriptive statistics were used to report the feeding practices and other independent variables. Bivariate and multivariate logistic regression model was used to establish the factors associated with infant and young child feeding practices. The prevalence of breastfeeding, timely initiation of breastfeeding, exclusive breastfeeding, timely initiation of complementary feeding, minimum dietary diversity, minimum meal frequency and minimum acceptable diet (MAD) were 95.6%, 69.2%, 47.6%, 53.3%, 61.5%, 67.3% and 49.9% respectively. Normal delivery (AOR 6.1, 95% CI 1.2-31.3) and higher maternal autonomy (AOR 5.2, 95% CI 1.8-14.6) were significantly associated with exclusive breastfeeding. Similarly, crop production and food security (AOR 3.8, 95% CI 1.9-7.7), maternal knowledge on MAD (AOR 2.5, 95% CI 1.0-6.2) and maternal autonomy (AOR 4.2, 95% CI 2.1-8.4) were significantly associated with minimum acceptable diet. Factors such as maternal education, maternal health services utilization, maternal knowledge, and maternal autonomy were associated with infant and young child feeding practices, which warrants further attention to these factors to reduce malnutrition.

PMID:34914802 | DOI:10.1371/journal.pone.0261301

PLoS One. 2021 Dec 16;16(12):e0261373. doi: 10.1371/journal.pone.0261373. eCollection 2021.

ABSTRACT

BACKGROUND: Celiac disease (CD) is now viewed as a systemic disease with multifaceted clinical manifestations. Among the extra-intestinal features, neurological and neuropsychiatric symptoms are still a diagnostic challenge, since they can precede or follow the diagnosis of CD. In particular, it is well known that some adults with CD may complain of cognitive symptoms, that improve when the gluten-free diet (GFD) is started, although they may re-appear after incidental gluten intake. Among the neurophysiological techniques, motor evoked potentials (MEPs) to transcranial magnetic stimulation (TMS) can non-invasively probe in vivo the excitation state of cortical areas and cortico-spinal conductivity, being also able to unveil preclinical impairment in several neurological and psychiatric disorders, as well as in some systemic diseases affecting the central nervous system (CNS), such as CD. We previously demonstrated an intracortical disinhibition and hyperfacilitation of MEP responses to TMS in newly diagnosed patients. However, no data are available on the central cholinergic functioning indexed by specific TMS measures, such as the short-latency afferent inhibition (SAI), which might represent the neurophysiological correlate of cognitive changes in CD patients, also at the preclinical level.

METHODS: Cognitive and depressive symptoms were screened by means of the Montreal Cognitive Assessment (MoCA) and the 17-item Hamilton Depression Rating Scale (HDRS), respectively, in 15 consecutive de novo CD patients and 15 healthy controls. All patients were on normal diet at the time of the enrolment. Brain computed tomography (CT) was performed in all patients. SAI, recorded at two interstimulus intervals (2 and 8 ms), was assessed as the percentage amplitude ratio between the conditioned and the unconditioned MEP response. Resting motor threshold, MEP amplitude and latency, and central motor conduction time were also measured.

RESULTS: The two groups were comparable for age, sex, anthropometric features, and educational level. Brain CT ruled out intracranial calcifications and clear radiological abnormalities in all patients. Scores at MoCA and HDRS were significantly worse in patients than in controls. The comparison of TMS data between the two groups revealed no statistically significant difference for all measures, including SAI at both interstimulus intervals.

CONCLUSIONS: Central cholinergic functioning explored by the SAI of the motor cortex resulted to be not affected in these de novo CD patients compared to age-matched healthy controls. Although the statistically significant difference in MoCA, an overt cognitive impairment was not clinically evident in CD patients. Coherently, to date, no study based on TMS or other diagnostic techniques has shown any involvement of the central acetylcholine or the cholinergic fibers within the CNS in CD. This finding might add support to the vascular inflammation hypothesis underlying the so-called “gluten encephalopathy”, which seems to be due to an aetiology different from that of the cholinergic dysfunction. Longitudinal studies correlating clinical, TMS, and neuroimaging data, both before and after GFD, are needed.

PMID:34914787 | DOI:10.1371/journal.pone.0261373

PLoS One. 2021 Dec 16;16(12):e0261278. doi: 10.1371/journal.pone.0261278. eCollection 2021.

ABSTRACT

As part of a wider reform to scaffold quantitative and research skills throughout the biology major, we introduced course-based undergraduate research experiences (CURE) in sections of a large-enrollment introductory biology laboratory course in a mid-level, public, minority-serving institution. This initiative was undertaken as part of the in the National Science Foundation / Council for Undergraduate Research Transformations Project. Student teams performed two or three experiments, depending on semester. They designed, implemented, analyzed, revised and iterated, wrote scientific paper-style reports, and gave oral presentations. We tested the impact of CURE on student proficiency in experimental design and statistical reasoning, and student research confidence and attitudes over two semesters. We found that students in the CURE sections met the reformed learning objectives for experimental design and statistical reasoning. CURE students also showed higher levels of experimental design proficiency, research self-efficacy, and more expert-like scientific mindsets compared to students in a matched cohort with the traditional design. While students in both groups described labs as a positive experience in end-of-semester reflections, the CURE group showed a high level of engagement with the research process. Students in CURE sections identified components of the research process that were difficult, while also reporting enjoying and valuing research. This study demonstrates improved learning, confidence, and attitudes toward research in a challenging CURE laboratory course where students had significant autonomy combined with appropriate support at a diverse public university.

PMID:34914796 | DOI:10.1371/journal.pone.0261278

PLoS One. 2021 Dec 16;16(12):e0261271. doi: 10.1371/journal.pone.0261271. eCollection 2021.

ABSTRACT

This study aimed to validate the recently developed Occupational Depression Inventory (ODI) in South Africa. A total of 327 employees (60% female) participated in the study. Bifactor exploratory structural equation modeling analysis indicated that the ODI can be considered essentially unidimensional. The ODI displayed strong scalability (e.g., scale-level H = 0.657). No monotonicity violation was detected. The reliability of the instrument, as indexed by Cronbach’s alpha, McDonald’s omega-total, Guttman’s λ2, and the Molenaar-Sijtsma statistic, was highly satisfactory. Measurement invariance was observed across age groups, sexes, and ethnicities, as well as between our sample and the ODI’s original validation sample. As expected, the ODI showed both a degree of convergent validity and a degree of discriminant validity vis-à-vis a measure of “cause-neutral” depressive symptoms. Moreover, the ODI manifested substantial associations, in the anticipated directions, with measures of work engagement, job satisfaction, and life satisfaction. Overall, the ODI exhibited excellent structural and psychometric properties within the South African context. Consistent with previous research, this study suggests that occupational health specialists can confidently rely on the ODI to investigate job-related distress.

PMID:34914772 | DOI:10.1371/journal.pone.0261271

PLoS One. 2021 Dec 16;16(12):e0261237. doi: 10.1371/journal.pone.0261237. eCollection 2021.

ABSTRACT

Malnutrition continues to be a primary concern for researchers and policymakers in India. There is limited scientific research on the effect of agriculture on child nutrition in the country using a large representative sample. To the best of our knowledge, no study has examined the spatial clustering of child malnutrition and its linkage with agricultural production at the district-level in the country. The present study aims to examine agricultural production’s role in improving the nutritional status of Indian children through child feeding practices. The nutritional indicators of children from the National Family Health Survey-4 (2015-16) and the agricultural production data for all the 640 districts of India obtained from the District-Wise Crop Production Statistics (2015-16), published by the Ministry of Agriculture, Government of India were used for the analysis. The statistical analysis was undertaken in STATA (version 14.1). ArcMap (version 10.3), and GeoDa (version 1.8) were used for the spatial analysis. The study found a higher prevalence of malnutrition among children who had not received Minimum Meal Frequency (MMF), Minimum Dietary Diversity (MDD), and Minimum Acceptable Diet (MAD). Further, child feeding practices- MMF, MDD, and MAD- were positively associated with high yield rates of spices and cereals. The yield rate of cash crops, on the contrary, harmed child feeding practices. Production of pulses had a significant positive effect on MDD and MAD. Districts with high cereal yield rates ensured that children receive MMF and MAD. There is a significant spatial association between child feeding practices and malnutrition across Indian districts. The study suggests that adopting nutrient-sensitive agriculture may be the best approach to improving children’s nutritional status.

PMID:34914784 | DOI:10.1371/journal.pone.0261237

PLoS One. 2021 Dec 16;16(12):e0260849. doi: 10.1371/journal.pone.0260849. eCollection 2021.

ABSTRACT

In his pioneering research, G. K. Zipf formulated a couple of statistical laws on the relationship between the frequency of a word with its number of meanings: the law of meaning distribution, relating the frequency of a word and its frequency rank, and the meaning-frequency law, relating the frequency of a word with its number of meanings. Although these laws were formulated more than half a century ago, they have been only investigated in a few languages. Here we present the first study of these laws in Catalan. We verify these laws in Catalan via the relationship among their exponents and that of the rank-frequency law. We present a new protocol for the analysis of these Zipfian laws that can be extended to other languages. We report the first evidence of two marked regimes for these laws in written language and speech, paralleling the two regimes in Zipf’s rank-frequency law in large multi-author corpora discovered in early 2000s. Finally, the implications of these two regimes will be discussed.

PMID:34914766 | DOI:10.1371/journal.pone.0260849

PLoS One. 2021 Dec 16;16(12):e0261356. doi: 10.1371/journal.pone.0261356. eCollection 2021.

ABSTRACT

INTRODUCTION: Manhiça District, in Southern Mozambique harbors high HIV prevalence and a long history of migration. To optimize HIV care, we sought to assess how caregiver’s mobility impacts children living with HIV (CLHIV)´s continuation in HIV care and to explore the strategies used by caregivers to maintain their CLHIV on antiretroviral treatment (ART).

METHODS: A clinic-based cross-sectional survey conducted at the Manhiça District Hospital between December-2017 and February-2018. We enrolled CLHIV with a self-identified migrant caregiver (moved outside of Manhiça District ≤12 months prior to survey) and non-migrant caregiver, matched by the child age and sex. Survey data were linked to CLHIV clinical records from the HIV care and treatment program.

RESULTS: Among the 975 CLHIV screened, 285 (29.2%) were excluded due to absence of an adult at the appointment. A total of 232 CLHIV-caregiver pairs were included. Of the 41 (35%) CLHIV migrating with their caregivers, 38 (92.6%) had access to ART at the destination because either the caregivers travelled with it 24 (63%) or it was sent by a family member 14 (36%). Among the 76 (65%) CLHIV who did not migrate with their caregivers, for the purpose of pharmacy visits, 39% were cared by their grandfather/grandmother, 28% by an aunt/uncle and 16% by an adult brother/sister. CLHIV of migrant caregivers had a non-statistically significant increase in the number of previous reported sickness episodes (OR = 1.38, 95%CI: 0.79-2.42; p = 0.257), ART interruptions (OR = 1.73; 95%CI: 0.82-3.63; p = 0.142) and lost-to-follow-up episodes (OR = 1.53; 95%CI: 0.80-2.94; p = 0.193).

CONCLUSIONS: Nearly one third of the children attend their HIV care appointments unaccompanied by an adult. The caregiver mobility was not found to significantly affect child’s retention on ART. Migrant caregivers adopted strategies such as the transportation of ART to the mobility destination to avoid impact of mobility on the child’s HIV care. However this may have implications on ART stability and effectiveness that should be investigated in rural areas.

PMID:34914769 | DOI:10.1371/journal.pone.0261356

PLoS One. 2021 Dec 16;16(12):e0261405. doi: 10.1371/journal.pone.0261405. eCollection 2021.

ABSTRACT

INTRODUCTION: Therapeutic communities (TCs) are mutual aid based residential programs for the treatment of substance abuse and criminal behavior. While it is expected that residents will provide feedback to peers, there has been no social network study of the hierarchy through which feedback flows.

METHODS: Data for this study was drawn from clinical records of peer corrections exchanged between TC residents in six units kept over periods of less than two to over eight years. Four of the units served men while two served women. Hierarchy position was measured using eigenvector centrality, on the assumption that residents who were more central in the network of corrections were lower in the hierarchy. It was hypothesized that residents would rise in the hierarchy over time. This was tested using Wilcoxon paired samples tests comparing the mean and maximum eigenvector centrality for time in treatment with those in the last month of treatment. It was also hypothesized that residents who rose higher in the hierarchy were more likely to graduate, the outcome of primary interest. Logistic regression was used to test hierarchy position as a predictor of graduation, controlling for age, race, risk of recidivism as measured by the Level of Services Inventory-Revised (LSI-R) and days spent in the program.

RESULTS: Residents averaged a statistically significantly lower eigenvector centrality in the last month in all units, indicating a rise in the hierarchy over time. Residents with lower maximum and average eigenvector centrality both over the length of treatment and in the last month of treatment were more likely to graduate in four of the six units, those with lower maximum and average eigenvector centrality in the last month but not over the length of treatment were more likely to graduate in one of the six units, while eigenvector centrality did not predict graduation in one unit. However, this last unit was much smaller than the others, which may have influenced the results.

CONCLUSION: These results suggest that TC residents move through a social network hierarchy and that movement through the hierarchy predicts successful graduation.

PMID:34914758 | DOI:10.1371/journal.pone.0261405