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Nevin Manimala Statistics

Management of dental emergencies amongst Australian general medical practitioners – A case-vignette study

Aust Dent J. 2021 Sep 30. doi: 10.1111/adj.12878. Online ahead of print.

ABSTRACT

BACKGROUND: In Australia, because of inequity in dental service accessibility and affordability, patients can see general medical practitioners (GPs) for acute dental conditions.

METHODS: This cross-sectional study consisted of surveys distributed to the board registered GPs practising in Australia. The main outcome measures included statistical analysis of GPs managing different dental emergency scenarios and their confidence and expectations in managing dental emergencies.

RESULTS: A total of 425 GPs participated in the study. The sample primarily consisted of GPs practising in metropolitan clinics (n=315). Most participants reported that they would refer to the dentist for mobilised tooth (n=402). There was a negative correlation between GPs with 5-29 years of experience and traumatised tooth management (P<0.05). GPs aged between 40-49 years were more inclined to treat patients with mobilised teeth [Multivariate (MV): 0.42(0.09-0.74)]. However, GPs with 0-5 years of experience were less likely to manage patients with dental abscess [MV: -0.52(-0.80 – – 0.24)].

CONCLUSION: Most GPs refer dental emergencies to dentists. GP management of dental emergencies is predominantly palliative. Therefore, opportunities for collaborative practice models amongst GPs and dentists may be needed to bridge the gap in the regional and remote locations.

PMID:34591999 | DOI:10.1111/adj.12878

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Nevin Manimala Statistics

Diagnosis of osteoarticular tuberculosis by immuno-PCR assay based on mycobacterial antigen 85 complex detection

Lett Appl Microbiol. 2021 Sep 30. doi: 10.1111/lam.13567. Online ahead of print.

ABSTRACT

Diagnosis of osteoarticular tuberculosis (OATB) exhibits serious challenges owing to paucibacillary nature of specimens and localization of disease at sites that are difficult to access. We recently developed indirect immuno-PCR (I-PCR) and real-time I-PCR (RT-I-PCR) assays for the detection of mycobacterial antigen 85 complex (Ag85) in OATB patients. Detection limits for the purified Ag85 protein were found to be 1 fg ml-1 and 41 fg ml-1 by I-PCR and RT-I-PCR, respectively, which were at least 105 -fold lower than respective ELISA. While spiking synovial fluids of non-TB control subjects with the purified Ag85 protein, LODs of 100 fg ml-1 and 120 fg ml-1 were obtained by I-PCR and RT-I-PCR, respectively, thus demonstrating the sample matrix effect. Sensitivities of 87.5% and 70.5% were observed in bodily fluids of confirmed (n=8) and clinically suspected (n=51) OATB cases, respectively by I-PCR, with a specificity of 93.9% (n=33). Markedly, the sensitivities obtained by I-PCR/RT-I-PCR were significantly higher (p<0.05-0.01) than ELISA and GeneXpert assay (n=30). However, no substantial difference in sensitivity was observed between the I-PCR and RT-I-PCR assays. After further improving the accuracy of I-PCR, this test may lead to development of an attractive diagnostic kit.

PMID:34592012 | DOI:10.1111/lam.13567

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Nevin Manimala Statistics

Air pollution exposure in relation to guard duty at Tidworth Camp: A cross-sectional study

PLoS One. 2021 Sep 30;16(9):e0258070. doi: 10.1371/journal.pone.0258070. eCollection 2021.

ABSTRACT

BACKGROUND: Air pollution is the largest environmental health risk in the United Kingdom, and an issue of concern amongst outdoor workers. Road transport is a major source producing the largest amount of nitrogen dioxide (NO2) and ozone (O3) (as a secondary pollutant). Hundreds of vehicles enter and exit the Tidworth Camp’s main gate daily, potentially producing these pollutants. However, the air pollution exposure experienced by personnel on guard duty is unknown. This study aimed to determine and compare background NO2 and O3 levels experienced by personnel on guard duty.

METHODS: Cross-sectional data was collected using a static sampling technic on randomly selected days of the week. Data analysis was done using IBM-SPSS-26 and a p-value of <0.05 was considered statistically significant.

RESULTS: The background concentration of NO2 and O3 pollutants were within recommended limits. There was no significant difference between mean morning and afternoon exposure levels for both pollutants. However, NO2 and O3 levels were significantly higher during weekdays compared to weekends (M = -0.022, SD = 0.007, t(6) = -8.672, p <0.0001 and M = -0.016, SD = 0.008, t(6) = -5.040, p = 0.002 respectively). Both pollutants showed no significant differences in exposure levels when only weekdays were compared. NO2 levels showed a weak positive correlation during weekdays (r = 0.04) and a strong positive correlation during weekends (r = 0.96). O3 levels had a positive correlation on both weekdays and weekends; however, levels on Monday showed a negative correlation (r = -0.55). Linear regression analysis showed that outside temperature was a significant predictor of O3 levels (p = 0.026).

CONCLUSION: Personnel on guard duty experienced higher pollution levels during weekdays compared to weekends; however, air pollution levels for both pollutants were within recommended limits. Further studies are recommended over hotter months using a personal sampling technic to measure personal air pollution exposure levels in order to minimise any health and safety risks.

PMID:34591936 | DOI:10.1371/journal.pone.0258070

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Nevin Manimala Statistics

Efficacy of Ustekinumab in Crohn’s Disease With and Without Concurrent Autoimmune Skin Disease

Inflamm Bowel Dis. 2021 Sep 30:izab201. doi: 10.1093/ibd/izab201. Online ahead of print.

ABSTRACT

BACKGROUND: Approximately 33% of Crohn’s disease (CD) patients have associated autoimmune skin disease. The pathophysiology of the latter frequently involves interleukin-12/interleukin-23 signaling pathways that may also impact gut inflammation. Ustekinumab is an anti-IL-12/23 FDA-approved biologic for psoriasis and inflammatory bowel disease. However, its relative efficacy has never been studied in CD with autoimmune skin disease (CD-ASD) vs CD without autoimmune skin disease (CD-none).

METHODS: This is a retrospective, single-center, case-control study comparing markers of disease activity between CD-ASD and CD-none. Biomarkers (fecal calprotectin [FCP], C-reactive protein [CRP]) prior to drug initiation and after at least 5 months of standard IBD dose ustekinumab therapy were extracted from the medical record. In addition, 2 blinded observers performed 5-point Likert scoring before and after endoscopic, pathologic, and imaging reports.

RESULTS: In all, 395 CD patients received ustekinumab therapy (79 CD-ASD, 316 CD-none). Patients were similar in age; gender; ethnicity; CD severity, phenotype, and duration; tobacco, immunomodulator, and steroid use. Ustekinumab had greater efficacy in CD-ASD when evaluated by FCP (P = .0337) and CRP (P = .078). The CD-ASD group also showed better outcomes in Likert scores of endoscopy (P = .016), histopathology (P = .074), and imaging (P = .094). In all Likert parameters, CD-ASD had more patients with complete resolution of moderate/severe disease (P < .05). Additional subanalyses for surgeries, ulcers, abscesses, fistulas, and colitis were conducted, with colitis reaching statistical significance (P = .0011).

CONCLUSIONS: Concurrent autoimmune skin disease in CD is associated with greater ustekinumab effectiveness in controlling intestinal inflammation.

PMID:34591972 | DOI:10.1093/ibd/izab201

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Nevin Manimala Statistics

Prevalence of common mental disorder and associated factors among mothers of under five year children at Arbaminch Town, South Ethiopia, 2019

PLoS One. 2021 Sep 30;16(9):e0257973. doi: 10.1371/journal.pone.0257973. eCollection 2021.

ABSTRACT

BACKGROUND: Common mental disorders are the major public healthproblem that affects mothers with young children. Although there were a number of studies done on maternal mental health problems, they were largely focused on perinatal period. However, there is scarcity of information on the magnitude and correlates of these mental health problems beyond perinatal period and due concern is not given mainly in LMICs including our country.

OBJECTIVE: To assess the prevalence and factors associated with common mental disorderamong mothers of under-five year children at Arbaminch town, South Ethiopia, 2019.

METHODS: A community based cross-sectional study was conducted in May and June 2019 at Arbaminch town. A systematic random sampling technique was used to select 776 participants. The Self-Reporting Questionnaire (SRQ-20) was used to assess common mental disorder (CMD). Data was coded and entered in EPIDATA3.1 and analyzed using SPSS version 25. Bivariable and multivariable logistic regression were used to identify factors associated to common mental disorder. P-values less than 0.05 were considered statistically significant and strength of the association was presented by adjusted odds ratio with 95% confidence interval.

RESULT: The prevalence of common mental disorder among mothers with children aged below five years was 36.6% with (95% CI, 33.2, 39.9). Being single/divorced/widowed [AOR = 3.64, 95% CI:(1.47, 8.99), chronic medical illness [AOR = 3.25, 95% CI:(2.10, 5.04)], exposure to two/more stressful events [AOR = 1.62, 95% CI:(1.11, 2.36)], poor social support [AOR = 2.59, 95% CI:(1.62, 4.14)], mothers living with cigarette smoker husband [AOR = 2.03, 95% CI:(1.19, 3.47)], and mothers physically abused by their spouse [AOR = 2.36, 95% CI:(1.49, 3.74)] were factors associated with common mental disorder.

CONCLUSION AND RECOMMENDATION: The prevalence of common mental disorder was high among mothers with children aged below five years compared to the general population. Being single/divorced/widowed, chronic medicalillness, exposure to two/more stressful events, poor social support, mothers living with cigarette smoker husbandand physically abuse by their spouse were factors associated with common mental disorder. Early detection and management of these maternal mental health problems is vital for mothers’ wellbeing as well as growth and development of children.

PMID:34591914 | DOI:10.1371/journal.pone.0257973

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Nevin Manimala Statistics

Local topology and bifurcation hot-spots in proteins with SARS-CoV-2 spike protein as an example

PLoS One. 2021 Sep 30;16(9):e0257886. doi: 10.1371/journal.pone.0257886. eCollection 2021.

ABSTRACT

Novel topological methods are introduced to protein research. The aim is to identify hot-spot sites where a bifurcation can alter the local topology of the protein backbone. Since the shape of a protein is intimately related to its biological function, a substitution that causes a bifurcation should have an enhanced capacity to change the protein’s function. The methodology applies to any protein but it is developed with the SARS-CoV-2 spike protein as a timely example. First, topological criteria are introduced to identify and classify potential bifurcation hot-spot sites along the protein backbone. Then, the expected outcome of asubstitution, if it occurs, is estimated for a general class of hot-spots, using a comparative analysis of the surrounding backbone segments. The analysis combines the statistics of structurally commensurate amino acid fragments in the Protein Data Bank with general stereochemical considerations. It is observed that the notorious D614G substitution of the spike protein is a good example of a bifurcation hot-spot. A number of topologically similar examples are then analyzed in detail, some of them are even better candidates for a bifurcation hot-spot than D614G. The local topology of the more recently observed N501Y substitution is also inspected, and it is found that this site is proximal to a different kind of local topology changing bifurcation.

PMID:34591922 | DOI:10.1371/journal.pone.0257886

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Disparities in menstrual hygiene management between urban and rural schoolgirls in Northeast, Ethiopia

PLoS One. 2021 Sep 30;16(9):e0257853. doi: 10.1371/journal.pone.0257853. eCollection 2021.

ABSTRACT

INTRODUCTION: Even though menstruation is a normal biological process, adolescents are facing managing their menstruation when they are at school. It causes girls to miss their class on average three days every month. Studies in some countries showed that the magnitude of menstrual hygiene management problems is higher in rural adolescent girls, but little is known in the Ethiopia context. The objective of this study was to assess and compare menstrual hygiene management practices among rural and urban schoolgirls, Northeast, Ethiopia.

METHODS: An institution-based comparative cross-sectional study was employed among 1078 schoolgirls (539 urban and 539 rural) from February to March 2020. The participants were selected using a multi-stage sampling technique. A structured self-administrative questionnaire and observational checklist were used for data collection. Bivariate and multivariable logistic regression analysis with a 95% confidence interval was employed. A P- value less than 0.05 was used to declare statistical significance.

RESULTS: Overall, the magnitude of good menstrual hygiene practice was 52.9% (95%CI: 50.3%-56.5%), which was 65.9% (95% CI: 62.8%-70.7%) among urban and 39.9% (95% CI: 36.2%-44.6%) among rural schoolgirls. Among urban schoolgirls, the odds of good menstrual hygiene management practice was higher for girls aged below 18 years (AOR = 1.58, 95%CI: 1.05-2.39), learned about menstrual hygiene at school (AOR = 1.89, 95%CI: 1.21-2.97), heard about menstrual hygiene before menarche (AOR = 4.98, 95%CI: 2.71-9.13), and discussed menstrual hygiene with parents (AOR = 2.56, 95%CI: 1.25-5.27). Whereas, the odds of good menstrual hygiene management practice was higher among those who were knowledgeable on menstrual hygiene (AOR = 5.47, 95%CI: 3.68-8.12), those who learned about menstrual hygiene at school (AOR = 1.75, 95%CI: 1.13-2.70), and girls who heard about menstrual hygiene before menarche (AOR = 3.34, 95%CI: 1.44-7.76) in rural schoolgirls.

CONCLUSIONS: Though the overall menstrual hygiene practice was low, it was relatively better among urban schoolgirls. This calls for more effort to solve these problems and achieve sustainable development goals. Therefore, education and awareness creation on menstrual hygiene for schoolgirls, even before menarche at both settings should be strengthened. Encouraging parent-adolescent discussion on menstrual hygiene would have paramount importance, particularly to urban schoolgirls.

PMID:34591900 | DOI:10.1371/journal.pone.0257853

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Nevin Manimala Statistics

Geographical variation in demand, utilization, and outcomes of hospital services for COVID-19 in Brazil: A descriptive serial cross-sectional study

PLoS One. 2021 Sep 30;16(9):e0257643. doi: 10.1371/journal.pone.0257643. eCollection 2021.

ABSTRACT

OBJECTIVE: To analyze the geographical variation in the provision of health services, namely in demand, patterns of utilization, and effectiveness in the Brazilian Health Regions in four different periods of the COVID-19 pandemic, from February 2020 to March 2021.

METHODS: Descriptive serial cross-sectional study based on secondary data on COVID-19 hospitalizations from SIVEP-Gripe, a public and open-access database of Severe Acute Respiratory Illness records collected by the Brazilian Ministry of Health, and COVID-19 case notification data from Brasil.io, a repository of public data. Fifty-six epidemiological weeks were split into four periods. The following variables were considered for each Brazilian Health Region, per period: number of hospitalizations, hospitalizations per 100,000 inhabitants, hospitalizations per 100 new cases notified in the Health Region, percentage of hospitalizations with ICU use, percentages of hospitalizations with invasive and non-invasive ventilatory support, percentage of hospitalizations resulting in death and percentage of hospitalizations with ICU use resulting in death. Descriptive statistics of the variables were obtained across all 450 Health Regions in Brazil over the four defined pandemic periods. Maps were generated to capture the spatiotemporal variation and trends during the first year of the COVID-19 pandemic in Brazil.

RESULTS: There was great variation in how COVID-19 hospitalizations grew and spread among Health Regions, with higher numbers between June and August 2020, and, especially, from mid-December 2020 to March 2021. The variation pattern in the proportion of ICU use in the hospitalizations across the Health Regions was broad, with no intensive care provision in large areas in the North, Northeast, and Midwest. The proportions of hospitalizations and hospitalizations with ICU use resulting in deaths were remarkably high, reaching medians of 34.0% and 62.0% across Health Regions, respectively.

CONCLUSION: The Heath Regions in Brazil are highly diverse, showing broad disparities in the capacity to respond to the demands imposed by COVID-19, services provided, use and outcomes.

PMID:34591896 | DOI:10.1371/journal.pone.0257643

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Having a latrine facility is not a guarantee for eliminating open defecation owing to socio-demographic and environmental factors: The case of Machakel district in Ethiopia

PLoS One. 2021 Sep 30;16(9):e0257813. doi: 10.1371/journal.pone.0257813. eCollection 2021.

ABSTRACT

BACKGROUND: Open defecation practice problem is rampant in most rural areas of developing countries, including Ethiopia. To combat this problem, the Ethiopian government implemented different sanitation interventions including Community-Led Total Sanitation and Hygiene (CLTSH). The CLTSH approach is mainly aimed to eradicate open defecation practice through mobilizing the community to construct a latrine facility and utilize it. Although this intervention has significantly improved households’ access to a latrine facility, its impact on bringing behavioral change such as avoiding open defecation is not well studied.

OBJECTIVE: Our study aimed to assess the prevalence of open defecation among households having their latrine and its determinant factors in rural settings in Northwest Ethiopia.

METHODS: A community-based cross-sectional study was conducted in Machakal district from September 1 to 30, 2019. A total of 472 household heads who had a latrine facility and systematically selected from six rural Kebeles of the district, were involved in the study. The data were collected using a structured questionnaire and observational checklist tools through face-to-face interviews and observation methods. Bivariate and multivariable logistic regression models were run to identify the factors that influence open defecation practice. During the multivariable analysis, statistical significance was declared at the p-value of <0.05 with 95% CI.

RESULTS: The prevalence of open defecation practice among household heads who had latrine facility was 27.8% (95% CI, [23.1-32.8]). Female gender (AOR = 2.94, 95% CI [1.13-7.68]), not attending of formal education (AOR = 3.10, CI 95% [1.34-7.13]), having >5 family members (AOR = 1.72, CI 95% [1.05-2.80]), presence of under-five child (AOR = 3.64 CI 95% [2.14-6.21]), preferring leaf as anal cleaning material (AOR = 3.18, CI 95% [1.67-6.08]), having unclean latrine (AOR = 2.15, CI 95% [1.34-3.44]), and having latrine that needs maintenance (AOR = 2.50 CI 95% [1.52-4.11]) variables were associated with open defecation practice.

CONCLUSIONS: Among the total respondents, finding more than a quarter of open defecators is concerning for a district that achieved greatly in terms of latrine coverage. This indicates the above-mentioned factors contributed to influence household heads to defecate openly despite having latrines. Therefore, the government and partners need to focus on designing strategies that effectively address determinant factors of open defecation.

PMID:34591873 | DOI:10.1371/journal.pone.0257813

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Gender-based comparison of factors affecting regular exercise of patients with Non-Insulin Dependent Diabetes Mellitus (NIDDM) based on the 7th Korea National Health and Nutrition Examination Survey (KNHANES)

PLoS One. 2021 Sep 30;16(9):e0257822. doi: 10.1371/journal.pone.0257822. eCollection 2021.

ABSTRACT

OBJECTIVE: This study aimed to determine the gender factors that influence regular exercise in patients with non-insulin-dependent diabetes mellitus (NIDDM) in Korea.

METHODS: A total of 1,432 patients with NIDDM were recruited using raw data from the Korea National Health and Nutrition Survey conducted between 2016 and 2018. SAS 9.4 was adopted for data analyses, and the distributional difference was measured with multinomial logistic regression and Rao-Scott x2 statistics to identify the factors that influence the regular physical activities of patients. that the analysis only provides associations.

RESULTS: Based on general characteristics, health behaviors, and conditions, patients with NIDDM in Korea were less physically active. In addition, patients with higher educational attainment, higher income, and higher subjective health conditions had a higher odds ratio for regular exercise. Meanwhile, the ratio was lower for smokers and those stressed up.

CONCLUSION: A professional guide for the initial phase of training and consistent management is required to increase the involvement of patients with NIDDM in regular exercise. Therefore, it is important to maintain their motivation to continue exercising. Rather than providing a universal guideline, it is more important to provide customized programs and management plans which reflect factors that influence their engagement in physical activities, such as individual physical strength, stress level, alcohol consumption, and arthritis.

PMID:34591887 | DOI:10.1371/journal.pone.0257822