Tag: statistics

Eur J Neurol. 2021 Jun 3. doi: 10.1111/ene.14956. Online ahead of print.

ABSTRACT

BACKGROUND: Several modifiable lifestyle factors have been associated with the onset and health outcomes of multiple sclerosis (MS), including clinically significant fatigue. A combined lifestyle score approach represents one method of assessing their relationship with clinical outcomes.

OBJECTIVES: To examine the association of two lifestyle scores with clinically significant fatigue and change thereof over 2.5 years’ follow-up using inverse probability treatment weighting (IPTW).

METHODS: We used data on sociodemographic, lifestyle and clinical characteristics surveyed from an international cohort of people with MS at baseline and 2.5-year follow-up. Fatigue was defined by Fatigue Severity Scale (FSS>5), healthy lifestyle by the Healthy Lifestyle Index Score (HLIS) and the Smoking, Nutrition, Alcohol, Physical Activity (SNAP) score. Analyses were by IPTW accounting for age, sex, MS type, disability, treated comorbidity number, immunomodulatory medication use, prescription antifatigue medication use, and ongoing relapse symptoms.

RESULTS: 1,268 participants completed the FSS at both timepoints, approximately 62% had fatigue. Using doubly robust IPTW, high (>11/20) HLIS (OR=0.90, 95% CI: 0.81-0.98) and high (>3/5) SNAP (OR=0.82, 95% CI: 0.73-0.90) were each associated with lower risk of fatigue at follow-up. Evaluating change in fatigue, higher SNAP score was associated with lower risk of fatigue (OR=0.89, 95% CI: 0.80-0.97) but that for HLIS did not reach statistical significance (OR=0.93, 95% CI: 0.85-1.01).

CONCLUSION: These results suggest a robust role for key lifestyle factors in preventing clinically significant fatigue and may represent a place for lifestyle modification in improving clinical outcomes in MS.

PMID:34081818 | DOI:10.1111/ene.14956

Chem Biodivers. 2021 Jun 3. doi: 10.1002/cbdv.202100241. Online ahead of print.

ABSTRACT

Artemisia fragrans is commonly used as a folk medicine as antispasmodic, anti-pyretic, anti-inflammatory, and abortifacient agents. The villagers use its pungent odor to repel rodents, mites, and pests, as well as its essential oil and smoke after burning to treat lung infections after uprooting the plant. Herein, we extracted the essential oils (EOs) of different parts of the plant and analyzed their chemical compositions and antibacterial activities. The chemical analysis led to the identification of 73, 59, and 57 compounds in the EOs of the stem, leaf, and flower, respectively. All of the EOs exhibited antibacterial activities against both G+ and G- bacteria. The EOs of the leaf and flower were more effective against tested bacteria, except B. anthracis and P. aeruginosa, compared to that of the stem. The binary combination of the EOs (stem and flower) or (stem and leaf) showed a synergistic effect. Statistical analysis indicated EOs of leaf and flower are more potent than that of the stem. These findings suggest the application of leaf and flower of the plant, which not only can prevent its uprooting but also ensure better therapeutic function.

PMID:34081830 | DOI:10.1002/cbdv.202100241

Transpl Int. 2021 Jun 3. doi: 10.1111/tri.13932. Online ahead of print.

ABSTRACT

BACKGROUND: Hypomagnesemia is common in kidney transplant recipients (KTRs). We sought to explore the relationship between Mg and outcomes in KTRs, which may be associated with mortality and thus, may be a potential intervention target to improve outcomes.

METHODS: We followed KTRs performed between 01/2000 and 6/2016 at a large US transplant center from 6 months post-transplant to graft failure, death, or loss to follow-up. Using Mg as a time-dependent variable, associations between Mg and outcomes any time after 6-months post-transplant were evaluated.

RESULTS: 3,680 KTRs with 50,413 Mg measurements met inclusion criteria. 657 deaths occurred over a median follow-up of 5.1 years. Compared to Mg of 1.5-1.8 mg/dL, both lower (HR 1.17, 95% Confidence interval (CI): 1.07-1.28) and higher (HR 1.16, 95% CI: 1.09-1.23) Mg levels were associated with greater risk of mortality. Similar U-shaped associations were observed for Mg and cardiovascular disease-related mortality (HR for Mg ≤1.5 mg/dL: 1.31; CI: 1.03-1.68) and infection-related mortality (HR for Mg ≤1.5 mg/dL: 1.28; CI: 1.09-1.51), although relationships for Mg >1.8 mg/dL were not statistically significant.

CONCLUSIONS: Mg exhibits a U-shaped association with mortality in KTRs, with levels between 1.5-1.8 mg/dL associated with the lowest risk.

PMID:34081803 | DOI:10.1111/tri.13932

Eur J Neurol. 2021 Jun 3. doi: 10.1111/ene.14957. Online ahead of print.

ABSTRACT

INTRODUCTION: Amyotrophic lateral sclerosis (ALS) is a devastating neurodegenerative disease that causes progressive degeneration of neurons in motor and non-motor brain regions, affecting multiple cognitive domains such as memory. We performed a functional magnetic resonance imaging (fMRI) study to explore working memory function in ALS.

METHODS: To contribute to the growing research field that employs structural and functional neuroimaging to investigate the effect of ALS on different working memory components, we explored the localization and intensity of alterations in neural activity using fMRI. Being the first study to specifically address verbal working memory via fMRI in the context of ALS, we employed the verbal n-back task with 0-back and 2-back conditions.

RESULTS: Despite ALS patients showing unimpaired accuracies (p = 0.724) and reaction times (p = 0.0785), there was significantly increased brain activity of frontotemporal and parietal regions in the 2-back minus 0-back contrast in patients compared to controls (using nonparametric statistics with 5000 permutations and a T-threshold of 2.5).

DISCUSSION: Increased brain activity of frontotemporal and parietal regions during working memory performance was largely associated with better neuropsychological function within the ALS group, suggesting a compensatory effect during working memory execution. This study therefore adds to the current knowledge on neural correlates of working memory in ALS and contributes to a more nuanced understanding of hyperactivity during cognitive processes in fMRI studies of ALS.

PMID:34081813 | DOI:10.1111/ene.14957

PLoS One. 2021 Jun 3;16(6):e0252703. doi: 10.1371/journal.pone.0252703. eCollection 2021.

ABSTRACT

INTRODUCTION: Mauritius introduced Acute respiratory infection (ARI) syndromic surveillance in 2007. The Moving Epidemic Method (MEM) and the World Health Organization Average Curve Method (WHO ACM) have been used widely in several countries to establish thresholds to determine the seasonality of acute respiratory infections. This study aimed to evaluate the appropriateness of these tools for ARI syndromic surveillance in Mauritius, where two or more waves are observed.

METHOD: The proportion of attendance due to acute respiratory infections was identified as the transmissibility indicator to describe seasonality using the Moving Epidemic Method and the WHO Average Curve Method. The proportion was obtained from weekly outpatient data between 2012 and 2018 collected from the sentinel acute respiratory infections surveillance. A cross-validation analysis was carried out. The resulting indicators of the goodness of fit model were used to assess the robustness of the seasonal/epidemic threshold of both the Moving Epidemic Method and WHO Average Curve Method. Additionally, a comparative analysis examined the integrity of the thresholds without the year 2017.

RESULT: The cross-validation analysis demonstrated no statistically significant differences between the means scores of the indicators when comparing the two waves/seasons curves of WHO ACM and MEM. The only exception being that the Wilcoxon sign rank test strongly supported that the specificity mean score of the two waves/seasons curve for WHO ACM outweighed that of its corresponding wave model for the MEM (P = 0.002). The comparative analysis with 2017 data showed the value of the epidemic threshold remained the same regardless of the methods and the number of seasonal waves.

CONCLUSION: The two waves models of the Moving Epidemic Method and WHO Average Curve Method could be deployed for acute respiratory infection syndromic surveillance in Mauritius, considering that two or more activity peaks are observed in a season.

PMID:34081752 | DOI:10.1371/journal.pone.0252703

PLoS One. 2021 Jun 3;16(6):e0252491. doi: 10.1371/journal.pone.0252491. eCollection 2021.

ABSTRACT

BACKGROUND: There is no consensus on the best timing for prophylactic oxytocin administration during cesarean section (CS) to prevent post-partum hemorrhage (PPH).

OBJECTIVES: Assess the effects of administrating prophylactic oxytocin at different times during CS.

METHODS: We searched nine databases to identify relevant randomized controlled trials (RCT). We pooled results and calculated average risk ratios (RR), mean differences (MD), and 95% confidence intervals (CI). We used GRADE to assess the overall evidence certainty.

RESULTS: We screened 13,389 references and included four trials. We found no statistically significant differences between oxytocin given before versus after fetal delivery on PPH (RR 0.60, 95%CI 0.15-2.47; 1 RCT, N = 300) or nausea/vomiting (RR 1.21, 95%CI 0.69-2.13; 1 RCT, N = 300). There was a significant reduction in the need for additional uterotonics when oxytocin was given immediately before uterine incision versus after fetal delivery (RR 0.37, 95%CI 0.18-0.73; I2 = 0%; 2 RCTs; N = 301). Oxytocin given before fetal delivery significantly reduced intra-operative blood loss (MD -146.77mL, 95%CI -168.10 to -125.43; I2 = 0%; 3 RCTs, N = 601) but did not change the incidence of blood transfusion (RR 0.50, 95%CI 0.13-1.95; I2 = 0%; 2 RCTs, N = 301) or hysterectomy (RR 3.00; 95%CI 0.12-72.77; I2 = 0%; 2 RCTs, N = 301). One trial (N = 100) compared prophylactic oxytocin before versus after placental separation and found no significant differences on PPH, additional uterotonics, or nausea/vomiting.

CONCLUSIONS: In women having pre-labor CS, there is limited evidence indicating no significant differences between prophylactic oxytocin given before versus after fetal delivery on PPH, nausea/vomiting, blood transfusion, or hysterectomy. Earlier oxytocin administration may reduce the volume of blood loss and need for additional uterotonics. There is very limited evidence suggesting no significant differences between prophylactic oxytocin given before versus after placental separation on PPH, need for additional uterotonic, or nausea/vomiting. The overall certainty of the evidence was mostly low or very low due to imprecision. Protocol: CRD42020186797.

PMID:34081734 | DOI:10.1371/journal.pone.0252491

PLoS One. 2021 Jun 3;16(6):e0252728. doi: 10.1371/journal.pone.0252728. eCollection 2021.

ABSTRACT

Female sex workers are highly mobile, which may influence their risk of experiencing physical and sexual violence. However, there remains a paucity of research, particularly longitudinal, from Sub-Saharan Africa exploring mobility and gender-based violence among female sex workers. To address this gap, this study examined the longitudinal relationship between work-related mobility and recent experience of physical or sexual gender-based violence from a client or partner among female sex workers in Iringa, Tanzania. A secondary data analysis was conducted using baseline and 18-month follow-up data from Project Shikamana, a community empowerment-based combination HIV prevention intervention. Responses from 387 female sex workers aged 18 years and older participating in both baseline and follow-up were analyzed. Unadjusted and adjusted Poisson regression models with robust variance estimations, accounting for clustering of female sex workers’ responses over time, were fit. Final models adjusted for socio-demographic characteristics and aspects of participants’ living situations and work environments. Recent physical or sexual violence from a client or partner was common (baseline: 40%; follow-up: 29%). Twenty-six percent of female sex workers at baseline, and 11% at follow-up, had recently traveled outside of Iringa for sex work. In the final adjusted longitudinal model, female sex workers recently mobile for sex work had a 25% increased risk of any recent experience of physical or sexual gender-based violence when compared with their non-mobile counterparts (adjusted incidence rate ratio: 1.25; 95% CI: 1.03-1.53; p<0.05). Interventions must identify ways-such as mobile support services, linkages and referrals to health and other social services while traveling, or the use of mobile or digital technology-to address mobile female sex workers’ unique needs while traveling. Future quantitative and qualitative research is needed to understand the context of female sex workers’ mobility and how and why mobility influences risk environments and experiences of gender-based violence.

PMID:34081739 | DOI:10.1371/journal.pone.0252728

PLoS One. 2021 Jun 3;16(6):e0252639. doi: 10.1371/journal.pone.0252639. eCollection 2021.

ABSTRACT

INTRODUCTION: Vitamin A deficiency is a major public health problem in poor societies. Dietary consumption of foods rich in vitamin A was low in Ethiopia. This study aimed to assess the spatial distribution and spatial determinants of dietary consumption of foods rich in vitamin A among children aged 6-23 months in Ethiopia.

METHODS: Ethiopian 2016 demographic and health survey dataset using a total of 3055 children were used to conduct this study. The data were cleaned and weighed by STATA version 14.1 software and Microsoft Excel. Children who consumed foods rich in vitamin A (Egg, Meat, Vegetables, Green leafy vegetables, Fruits, Organ meat, and Fish) at least one food item in the last 24 hours were declared as good consumption. The Bernoulli model was fitted using Kuldorff’s SaTScan version 9.6 software. ArcGIS version 10.7 software was used to visualize spatial distributions for poor consumption of foods rich in vitamin A. Geographical weighted regression analysis was employed using MGWR version 2.0 software. A P-value of less than 0.05 was used to declare statistically significant predictors spatially.

RESULTS: Overall, 62% (95% CI: 60.56-64.00) of children aged 6-23 months had poor consumption of foods rich in vitamin A in Ethiopia. Poor consumption of foods rich in vitamin A highly clustered in Afar, eastern Tigray, southeast Amhara, and the eastern Somali region of Ethiopia. Spatial scan statistics identified 142 primary spatial clusters located in Afar, the eastern part of Tigray, most of Amhara and some part of the Oromia Regional State of Ethiopia. Children living in the primary cluster were 46% more likely vulnerable to poor consumption of foods rich in vitamin A than those living outside the window (RR = 1.46, LLR = 83.78, P < 0.001). Poor wealth status of the household, rural residence and living tropical area of Ethiopia were spatially significant predictors.

CONCLUSION: Overall, the consumption of foods rich in vitamin A was low and spatially non-random in Ethiopia. Poor wealth status of the household, rural residence and living tropical area were spatially significant predictors for the consumption of foods rich in vitamin A in Ethiopia. Policymakers and health planners should intervene in nutrition intervention at the identified hot spot areas to reduce the poor consumption of foods rich in vitamin A among children aged 6-23 months.

PMID:34081718 | DOI:10.1371/journal.pone.0252639

PLoS One. 2021 Jun 3;16(6):e0252106. doi: 10.1371/journal.pone.0252106. eCollection 2021.

ABSTRACT

BACKGROUND: Sub-Saharan Africa (SSA) carries the highest burden of maternal mortality, yet, the accurate maternal mortality ratios (MMR) are uncertain in most SSA countries. Measuring maternal mortality is challenging in this region, where civil registration and vital statistics (CRVS) systems are weak or non-existent. We describe a protocol designed to explore the use of CRVS to monitor maternal mortality in Zimbabwe-an SSA country.

METHODS: In this study, we will collect deliveries and maternal death data from CRVS (government death registration records) and health facilities for 2007-2008 and 2018-2019 to compare MMRs and causes of death. We will code the causes of death using classifications in the maternal mortality version of the 10th revision to the international classification of diseases. We will compare the proportions of maternal deaths attributed to different causes between the two study periods. We will also analyse missingness and misclassification of maternal deaths in CRVS to assess the validity of their use to measure maternal mortality in Zimbabwe.

DISCUSSION: This study will determine changes in MMR and causes of maternal mortality in Zimbabwe over a decade. It will show whether HIV, which was at its peak in 2007-2008, remains a significant cause of maternal deaths in Zimbabwe. The study will recommend measures to improve the quality of CRVS data for future use to monitor maternal mortality in Zimbabwe and other SSA countries of similar characteristics.

PMID:34081727 | DOI:10.1371/journal.pone.0252106

PLoS One. 2021 Jun 3;16(6):e0252563. doi: 10.1371/journal.pone.0252563. eCollection 2021.

ABSTRACT

The present study examines the phenomenon of compensative and compulsive buying among online shoppers. Firstly, the obtained empirical data make it possible to estimate the prevalence of compensative and compulsive buying among the general population of Poles aged 15 years old and over, with the sample split into users and non-users of the e-commerce market offer. Secondly, the conducted analysis shows to what extent the prevalence of compulsive and compensative buying is differentiated by the frequency of online shopping, by the extent of the expenditures on online shopping compared with offline shopping, by attitudes towards online shopping, and by sociodemographic conditions (gender, age, monthly net income of household). The findings come from a survey conducted in 2019 based on a nationwide statistically representative sample of 1,000 Poles aged 15 years old and over. Drawing on this survey based on the German Compulsive Buying Indicator (GCBI), the prevalence of compulsive buying is observed at about 3% and compensative buying at about 12%. Dividing the general population into online and offline shoppers, one can see serious differences between both target groups; the share of compulsive and compensative buyers in the segment of online shoppers amounts to 3.6% and 16.9%, while among non-online shoppers- 3.3% and 10.1%. The strongest susceptibility to compulsive buying is characteristic of female online shoppers having very positive attitudes towards online shopping and doing online shopping very frequently.

PMID:34081731 | DOI:10.1371/journal.pone.0252563