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Nevin Manimala Statistics

Human papillomavirus (HPV) vaccination intent and its associated factors: a study of ethnically diverse married women aged 27 to 45 in Malaysia, a Southeast Asian country

Hum Vaccin Immunother. 2022 Jun 17:2076525. doi: 10.1080/21645515.2022.2076525. Online ahead of print.

ABSTRACT

INTRODUCTION: This study aimed to investigate HPV vaccination intention among adult married women aged 27 to 45 years and its associated factors, and their spouse/partner’s influence on HPV vaccination decision-making.

METHODS: This is a cross-sectional, questionnaire-based study. Study participants were recruited through simple random sampling of patients attending obstetrics and gynecology outpatient clinics in a university teaching hospital.Participants were selected based on a computer-generated list of a random list of patients attending the clinic.

RESULTS: A total of 794 complete responses were received (response rate 88.2%). The mean age of the respondents was 32.2 years with a standard deviation (SD) of ±3.9 years.The vast majority (85.3%) would communicate with their spouse/partner with regard to HPV vaccination decision-making. Nearly 30% (over half were of the Malay ethnic group) perceived their spouse/partner would not consent to their HPV vaccination. Over half (54.9%) reported joint decision-making, and 9.1% (the majority of whom were Malay) reported that HPV vaccination was dependent on their spouse/partner’s decision. Intention to vaccinate against HPV was high (74.5%). Factors influencing HPV vaccination intention were spouse/partner’s consent to HPV vaccination (odds ratio [OR] = 4.51; 95% confidence interval [CI], 3.08-6.62), being a postgraduate student (OR = 4.55 ; 95% CI, 2.13-9.72 vs. unemployed/housewife), average household income MYR2000-4000 (OR = 2.09 ; 95%CI, 1.16-3.78 vs. below MYR2000), and an HPV-related knowledge score of 9-20 (OR = 1.60 ; 95% CI, 1.10-2.32 vs. score 0-8).

CONCLUSION: Findings highlight the importance of culture-centered interventions to enhance male partner’s awareness and support for the HPV vaccination of married women.

PMID:35714272 | DOI:10.1080/21645515.2022.2076525

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The Evaluation of Correlation Between Serum PTH and Dentoskeletal Changes in Panoramic Imaging of Hemodialysis Patients

Iran J Kidney Dis. 2022 May;16(3):203-208.

ABSTRACT

INTRODUCTION: This study aimed to investigate the relationship between serum levels of PTH and dental and bone changes in the panoramic view of hemodialysis patients.

METHODS: Out of 236 patients with end-stage kidney disease (ESKD) who were hospitalized in two hemodialysis centers, 68 ones were selected and concerning their PTH serum levels, they were assigned to case group (PTH > 300 pg/mL) and control group (150 < PTH < 300 pg/mL). Patients in both groups had undergone dialysis for at least 6 months. After intraoral and extraoral examinations, panoramic radiography was performed for patients who hadn’t taken any panoramic radiograph within 6 months prior to our study. All radiographs were evaluated for DMFT (decayed, missing and filled teeth) index, bone resorption, periodontal ligament (PDL), lamina dura, mandibular cortical thickness, bone granular pattern, pulp and periapical lesion and giant cell (brown) tumor. The results were analyzed by Chi square statistical tests. Significant level (P value) of test was considered less than .05.

RESULTS: Among the eight variables, there was only a significant statistical difference between the case and control groups in the granular bone pattern and inferior mandibular cortex thickness.

CONCLUSION: High levels of PTH in hemodialysis patients with secondary hyperparathyroidism can significantly change the trabecular alveolar bone pattern to a granular bone pattern. It also dramatically decreases the thickness of the inferior mandibular cortex. The findings of this study could influence the dental treatment plans for ESKD patients and help in early diagnosis of osteoporosis in patients on dialysis with secondary hyperparathyroidism. DOI: 10.52547/ijkd.6817.

PMID:35714215

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Nevin Manimala Statistics

Auryon Laser in Treating Symptomatic Infrainguinal Arterial Disease: 1-Year Outcome

J Invasive Cardiol. 2022 Jun 17:JIC20220617-2. Online ahead of print.

ABSTRACT

BACKGROUND: The Auryon 355-nm laser atherectomy system (AngioDynamics, Inc) showed a low rate of target-lesion revascularization (TLR) at 6-month follow-up in the EX-PAD-03 investigational device exemption study and the Auryon single-center experience (SCE) in treating infrainguinal arteries. In this study, we present the 1-year outcomes of the Auryon SCE study on TLR in all comers at a single center.

METHODS: The Auryon SCE was a retrospective study that evaluated the outcomes of all comers treated with the Auryon laser for infrainguinal arterial disease. There was no TLR seen at 6-month follow-up. We present the TLR rate at 1 year in the same cohort of patients. TLR rates were obtained from medical record review of patients enrolled in the study who had completed office visit follow-up at 1 year. Secondary endpoints included unplanned major amputation and total mortality. Kaplan-Meier survival analysis was performed to estimate the freedom from TLR rate following index procedure. Statistical differences were analyzed for ankle-brachial index (ABI) between baseline and 1 year.

RESULTS: A total of 56 patients (65 procedures, 70 lesions) were enrolled. The mean age was 70.9 ± 10 years, with 66.1% males, 48.2% diabetics, and 25% demonstrating limb ischemia. Of the 70 lesions, 31.4% had severe calcification, 38.6% were chronic total occlusions, and 48.6% were de novo disease (in-stent restenosis, 29.6%). Stenting was performed in 24/70 lesions (34.3%), with 11/70 (15.7%) bailout procedures. Embolic filters were used in 26/65 procedures (40%). The majority of treated lesions were femoropopliteal (90.0%); of all procedures, 29.2% had 2 or more prior interventions. Drug-coated balloon usage was 47.1% Lutonix (BD/Bard), 27.1% In.Pact (Boston Scientific), and 1.4% both in all lesions treated. Distal embolization occurred in 1/65 procedures (1.5%). At 1 year, mortality occurred in 3/56 patients (5.4%). Of 65 limbs treated, 2 (3.1%) had major amputation at 1 year. The probability of freedom from TLR was 83.7%.

CONCLUSION: In a realworld cohort of patient with complex disease, the Auryon laser had excellent freedom from TLR at 1 year.

PMID:35714224

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Profilometric, volumetric, and esthetic analysis of guided bone regeneration with L-shaped collagenated bone substitute and connective tissue graft in the maxillary esthetic zone: A case series with 1-year observational study

Clin Implant Dent Relat Res. 2022 Jun 17. doi: 10.1111/cid.13116. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to evaluate 1-year stability and maintenance of peri-implant soft and hard tissues after guided bone regeneration (GBR) with L-shaped collagenated bone substitute and subepithelial connective tissue graft (CTG) in the maxillary anterior region using profilometric, volumetric, and esthetic analyses.

METHODS: Fourteen peri-implant defects were grafted with L-shaped collagenated bone substitute, and 5 months after implant placement with GBR, reentry surgery in combination with CTG was performed in all participants. CBCT scans and STL files were acquired at baseline (after implant surgery, T1), reentry surgery (T2), and 1-year follow-up (T3). The profilometric and volumetric changes of the peri-implant tissues were measured, and the pink esthetic score (PES) was assessed at T3.

RESULTS: One year after GBR and CTG at the buccal aspect of the maxillary esthetic zone, the mean thickness of the hard tissue (HT) decreased (HT0: -0.87 ± 0.67 mm, HT1: -0.74 ± 0.75 mm, HT2: -0.92 ± 0.48 mm, 45-HT: -0.87 ± 0.73 mm) and the corresponding thickness of the soft tissue (ST) increased (ST0: 0.96 ± 1.06 mm, ST1: 0.85 ± 0.95 mm, ST2: 0.38 ± 0.82 mm, 45-ST: 0.12 ± 0.62 mm), and as a result, there was no statistically significant difference in the total tissue thickness between T1 and T3 (p < 0.05). The mean volumetric changes of the peri-implant tissues increased after 1-year of implant surgery (T1-T2: 1.52 ± 0.83 mm, T2-T3: -0.88 ± 1.04 mm, T1-T3: 0.64 ± 0.90 mm), and a statistically significant difference was shown in all compared time periods (p < 0.05). The mean PES score was 8.07 ± 1.54 at T3 (range, 6-10).

CONCLUSION: Within the limitations of this 1-year follow-up study, GBR with an L-shaped collagenated bone substitute and subepithelial CTG in the maxillary esthetic zone was beneficial for stable and maintainable peri-implant hard and soft tissues.

PMID:35714206 | DOI:10.1111/cid.13116

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Towards developing a beef meat export oriented policy in Tanzania: -Exploring the factors that influence beef meat exports

PLoS One. 2022 Jun 17;17(6):e0270146. doi: 10.1371/journal.pone.0270146. eCollection 2022.

ABSTRACT

The purpose of this study was to investigate the factors that influence beef meat exports in Tanzania, with a particular focus on the years 1985 to 2020, in enhancing the development of beef meat export-oriented policy in Tanzania, thereby enhancing beef exports in Tanzania. A time-series panel dataset was analyzed using both descriptive statistics and ordinary least squares (OLS) linear regression analyses models. As per the descriptive analyses, beef meat exports reached the highest pick of 4,300 tons per year in 1990, whereas from 1991 to date, beef meat exportation in Tanzania has been in declining trends despite an increase in beef meat output and trade openness from 162,500 to 486,736 tons and 7.6 to 98.7%, respectively. Nevertheless, while the prospect of Tanzanian beef meat exports appears bright and promising, the industry will continue to encounter trade barriers and must stay competitive to produce enough volume and quality beef meat to meet the needs of its existing and expanding markets. This is because, Tanzanian beef meat competes for market share with beef meat from other countries in the global markets, where customers pay a premium for lines of beef meat that meet quality standards while discarding those that do not. This indicates that the quantity of beef meat produced has no relevance to its world market share, but its quality standards do. Furthermore, the econometric results revealed that the coefficients of the terms of trade, Tanzania GDP per capita, global beef meat consumption, trade openness, and beef meat outputs were found to be significantly positive (P < 0.05) influencing beef meat exports in Tanzania, whereas the trading partners’ GDP per capita and exchange rate were not. The findings have varying implications as to what factors need to be addressed to further improve beef meat exports. From the farmer’s perspective, better access to adequate funds as a result of increased income benefit from export will assist in improving beef cattle productivity and quality to compete effectively in the global markets. From the government’s perspective, because trade openness promotes economic growth through export benefits, the Tanzania government and policymakers need to establish balanced policies to strengthen bilateral trade relationships to generate more opportunities in global markets.

PMID:35714166 | DOI:10.1371/journal.pone.0270146

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Nevin Manimala Statistics

Socioeconomic disparities associated with symptomatic Zika virus infections in pregnancy and congenital microcephaly: A spatiotemporal analysis from Goiânia, Brazil (2016 to 2020)

PLoS Negl Trop Dis. 2022 Jun 17;16(6):e0010457. doi: 10.1371/journal.pntd.0010457. Online ahead of print.

ABSTRACT

The Zika virus (ZIKV) epidemic, which was followed by an unprecedented outbreak of congenital microcephaly, emerged in Brazil unevenly, with apparent pockets of susceptibility. The present study aimed to detect high-risk areas for ZIKV infection and microcephaly in Goiania, a large city of 1.5 million inhabitants in Central-West Brazil. Using geocoded surveillance data from the Brazilian Information System for Notifiable Diseases (SINAN) and from the Public Health Event Registry (RESP-microcefalia), we analyzed the spatiotemporal distribution and socioeconomic indicators of laboratory confirmed (RT-PCR and/or anti-ZIKV IgM ELISA) symptomatic ZIKV infections among pregnant women and clinically confirmed microcephaly in neonates, from 2016 to 2020. We investigated temporal patterns by estimating the risk of symptomatic maternal ZIKV infections and microcephaly per 1000 live births per month. We examined the spatial distribution of maternal ZIKV infections and microcephaly cases across the 63 subdistricts of Goiania by manually plotting the geographical coordinates. We used spatial scan statistics estimated by discrete Poisson models to detect high clusters of maternal ZIKV infection and microcephaly and compared the distributions by socioeconomic indicators measured at the subdistrict level. In total, 382 lab-confirmed cases of maternal ZIKV infections, and 31 cases of microcephaly were registered in the city of Goiania. More than 90% of maternal cases were reported between 2016 and 2017. The highest incidence of ZIKV cases among pregnant women occurred between February and April 2016. A similar pattern was observed in the following year, although with a lower number of cases, indicating seasonality for ZIKV infection, during the local rainy season. Most congenital microcephaly cases occurred with a time-lag of 6 to 7 months after the peak of maternal ZIKV infection. The highest estimated incidence of maternal ZIKV infections and microcephaly were 39.3 and 2.5 cases per 1000 livebirths, respectively. Districts with better socioeconomic indicators and with higher proportions of self-identified white inhabitants were associated with lower risks of maternal ZIKV infection. Overall, the findings indicate heterogeneity in the spatiotemporal patterns of maternal ZIKV infections and microcephaly, which were correlated with seasonality and included a high-risk geographic cluster. Our findings identified geographically and socio-economically underprivileged groups that would benefit from targeted interventions to reduce exposure to vector-borne infections.

PMID:35714146 | DOI:10.1371/journal.pntd.0010457

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Effect of methylprednisolone treatment on COVID-19: An inverse probability of treatment weighting analysis

PLoS One. 2022 Jun 17;17(6):e0266901. doi: 10.1371/journal.pone.0266901. eCollection 2022.

ABSTRACT

OBJECTIVES: While corticosteroids have been hypothesized to exert protective benefits in patients infected with SARS-CoV-2, data remain mixed. This study sought to investigate the outcomes of methylprednisone administration in an Italian cohort of hospitalized patients with confirmed SARS-CoV-2 infection.

METHODS: Patients with confirmatory testing for SARS-CoV-2 were retrospectively enrolled from a tertiary university hospital in Milan, Italy from March 1st to April 30th, 2020 and divided into two groups by administration of corticosteroids. Methylprednisolone was administered to patients not responding to pharmacological therapy and ventilatory support at 0.5-1mg/kg/day for 4 to 7 days. Inverse probability of treatment weighting (IPTW) was used to adjust for baseline differences between the steroid and non-steroid cohorts via inverse probability of treatment weight. Primary outcomes included acute respiratory failure (ARF), shock, and 30-day mortality among surviving patients.

RESULTS: Among 311 patients enrolled, 71 patients received steroids and 240 did not receive steroids. The mean age was 63.1 years, 35.4% were female, and hypertension, diabetes, heart disease, and chronic pulmonary disease were present in 3.5%, 1.3%, 14.8% and 12.2% respectively. Crude analysis revealed no statistically significant reduction in the incidence of 30-day mortality (36,6% vs 21,7%; OR, 2.09; 95% CI, 1.18-3.70; p = 0.011), shock (2.8% vs 4.6%; OR, 0.60; 95% CI = 0.13-2.79; p = 0.514) or ARF (12.7% vs 15%; OR, 0.82; 95% CI = 0.38-1.80; p = 0.625) between the steroid and non-steroid groups. After IPTW analysis, the steroid-group had lower incidence of shock (0.9% vs 4.1%; OR, 0.21; 95% CI,0.06-0.77; p = 0.010), ARF (6.6% vs 16.0%; OR, 0.37; 95% CI, 0.22-0.64; p<0.001) and 30-day mortality (20.3% vs 22.8%; OR 0.86; 95% CI, 0.59-1.26 p = 0.436); even though, for the latter no statistical significance was reached. Steroid use was also associated with increased length of hospital stay both in crude and IPTW analyses. Subgroup analysis revealed that patients with cardiovascular comorbidities or chronic lung diseases were more likely to be steroid responsive. No significant survival benefit was seen after steroid treatment.

CONCLUSIONS: Physicians should avoid routine methylprednisolone use in SARS-CoV-2 patients, since it does not reduce 30-day mortality. However, they must consider its use for severe patients with cardiovascular or respiratory comorbidities in order to reduce the incidence of either shock or acute respiratory failure.

PMID:35714141 | DOI:10.1371/journal.pone.0266901

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Measuring re-identification risk using a synthetic estimator to enable data sharing

PLoS One. 2022 Jun 17;17(6):e0269097. doi: 10.1371/journal.pone.0269097. eCollection 2022.

ABSTRACT

BACKGROUND: One common way to share health data for secondary analysis while meeting increasingly strict privacy regulations is to de-identify it. To demonstrate that the risk of re-identification is acceptably low, re-identification risk metrics are used. There is a dearth of good risk estimators modeling the attack scenario where an adversary selects a record from the microdata sample and attempts to match it with individuals in the population.

OBJECTIVES: Develop an accurate risk estimator for the sample-to-population attack.

METHODS: A type of estimator based on creating a synthetic variant of a population dataset was developed to estimate the re-identification risk for an adversary performing a sample-to-population attack. The accuracy of the estimator was evaluated through a simulation on four different datasets in terms of estimation error. Two estimators were considered, a Gaussian copula and a d-vine copula. They were compared against three other estimators proposed in the literature.

RESULTS: Taking the average of the two copula estimates consistently had a median error below 0.05 across all sampling fractions and true risk values. This was significantly more accurate than existing methods. A sensitivity analysis of the estimator accuracy based on variation in input parameter accuracy provides further application guidance. The estimator was then used to assess re-identification risk and de-identify a large Ontario COVID-19 behavioral survey dataset.

CONCLUSIONS: The average of two copula estimators consistently provides the most accurate re-identification risk estimate and can serve as a good basis for managing privacy risks when data are de-identified and shared.

PMID:35714132 | DOI:10.1371/journal.pone.0269097

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Monitoring occurrence of SARS-CoV-2 in school populations: A wastewater-based approach

PLoS One. 2022 Jun 17;17(6):e0270168. doi: 10.1371/journal.pone.0270168. eCollection 2022.

ABSTRACT

Clinical testing of children in schools is challenging, with economic implications limiting its frequent use as a monitoring tool of the risks assumed by children and staff during the COVID-19 pandemic. Here, a wastewater-based epidemiology approach has been used to monitor 16 schools (10 primary, 5 secondary and 1 post-16 and further education) in England. A total of 296 samples over 9 weeks have been analysed for N1 and E genes using qPCR methods. Of the samples returned, 47.3% were positive for one or both genes with a detection frequency in line with the respective local community. WBE offers a low cost, non-invasive approach for supplementing clinical testing and can provide longitudinal insights that are impractical with traditional clinical testing.

PMID:35714109 | DOI:10.1371/journal.pone.0270168

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Knowledge about hypertension and associated factors among patients with hypertension in public health facilities of Gondar city, Northwest Ethiopia: Ordinal logistic regression analysis

PLoS One. 2022 Jun 17;17(6):e0270030. doi: 10.1371/journal.pone.0270030. eCollection 2022.

ABSTRACT

BACKGROUND: Hypertension is a disease that imposes risks of diseases on multi-system. Failure to control hypertension leads patients to end up with unavoidable complications, including death. Noncompliance to treatment is the main factor to develop such devastating complications whereas knowledge of patients about their disease is a key factor for better compliance. Thus, the purpose of this study is to assess the level of knowledge about hypertension and associated factors among hypertensive patients in public health facilities of Gondar city.

METHODS: Facility-based cross-sectional study was conducted between March and April 2019 in Gondar town. A systematic sampling technique was applied to select a total of 389 patients. A structured interview questionnaire was used to gather the data. The data were analyzed using STATA version 14. Ordinal logistic regression analysis was performed at P < 0.05 with a 95% confidence interval to identify statistically significant variables.

RESULTS: A total of 385 respondents participated giving a response rate of 98.9%. The majority (55.3%) of the patients had a low level of, 17.9% had a moderate level of knowledge whereas 26.8% had a high level of knowledge about hypertension. Those working in government organizations had 5.5 times higher odds of having a high level of knowledge than other groups (AOR = 5.5; 95%CI = 1.21, 25). Patients who received longer than four years of treatment showed twice larger odds of knowledge than those with below two years of treatment (AOR = 2; 95%CI = 1.29, 3.22) Moreover, patients residing proximate to the hospital increases the odds of having a higher level of knowledge by 1.64 times versus patients living far away from the hospital (AOR = 1.64, 95% CI = 1.07-2.63).

CONCLUSIONS: This finding revealed that knowledge about hypertension and risk factors among patients with hypertension was low. Employment in governmental organizations, longer duration of treatment, and residential proximity to hospitals/ health centers were statistically significant predictors of the participants’ knowledge about hypertension. Therefore, it is important to give health education to patients working in non-governmental organizations and self-employed individuals about diseases and risk factors. In addition, emphasis should be given to patients receiving less than two years of treatment and coming from remote areas to improve their knowledge of the disease.

PMID:35714113 | DOI:10.1371/journal.pone.0270030