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The individual reports below - including each headline - were generated automatically by our machine-reading software from an RSS feed of recent PLoS papers on 20 March 2021.
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Tuberculous meningitis (TBM) has been a leading cause of death in modern humans.
A team led by Olga Spekker of the University of Szeged described tracking down the White Plague. From a total of 427 skeletons assessed in the Terry Collection, 216 displayed abnormally pronounced digital impressions on the endocranial surface. TBM is characterized by diffuse granulomatous inflammation of the leptomeninges with strong predilection for the basal areas of the brain. The generated sensitivity and specificity estimate values for APDIs were 65.81% and 67.88%. A comprehensive macromorphological study regarding APDIs on pre-antibiotic era skeletons of known cause of death from documented collections is still needed. The vast majority of individuals from the TB group were recorded to have died of pulmonary TB. More than two-thirds of them exhibited at least one out of the four examined endocranial alteration types probably related to TBM.
234 skeletons with tuberculosis were involved in the study. The researchers’ conclusions appear to support what was previously known about this field: “The vast majority of individuals from the TB group were recorded to have died of pulmonary TB. More than two-thirds of them exhibited at least one of the four examined endocranial alteration types probably related to TBM. About one-third of them displayed GIs that can be considered as specific signs of the disease,” Spekker suggested. Discussing potential shortcomings, “It should be noted that our research project has two major methodological limitations. Even if an individual from the Terry Collection died of TB, it cannot be excluded that there was a coinciding NTB medical condition that could also result in the formation of APDIs on the inner skull surface,” they observe.
A systematic review and meta-analyses of literature published between 2010 and 2019 on the implementation of integrated disease surveillance and response in the African region.
A group from the Affiliations School of Health Systems and Public Health (SHSPH) led by Arthur Ng’etich (2021) reported on a systematic review on improving implementation of the revitalised integrated disease surveillance and response system in the African region. Surveillance assessment studies were based in 13 countries in the World Health Organization-AFRO region. Three out of the twenty studies mentioned diseases targeted for elimination and eradication. Recommendations to improve IDSR system implementation extracted from the included studies were summarised. Public health surveillance involves continuous collection, analysis and interpretation of health data. Identifying recommendations derived from studies assessing the performance of IDSR system functions is key to focusing decision makers on the critical policy priority areas. The review illustrated that implementation of key recommendations based on health workers’ perspectives will prioritise use of scarce healthcare resources.
There were 30 assessment studies included in the study. The researchers claim their results substantiate what was previously known about this subject: “Effective disease surveillance is difficult to achieve in a health system with inadequate infrastructure and a limited health workforce. Unavailability of reporting forms and guidelines unavailability has an impact on health workers reporting performance and impedes their ability to conduct outbreak investigations,” Ng’etich claimed. Discussing possible improvements, “Minimal routine data analysis especially at the lower level facilities has been attributed to limited knowledge and skills among health workers to undertake analysis of surveillance data. Lack of simplified guidelines has been suggested as suggested by some authors,” they concede. They advocate that variations in reporting completeness across health system levels in northern Ghana and Cameroon were to be mitigated through undertaking further research investigations to address the root causes and enhancing human resource capacity respectively.
Perception of mesopredators as beautiful increases the likelihood of sheep farmers tolerating them, according to an ethnographic study in the South African Karoo.
Marine Drouilly et al. (2021) reported in ‘Beauty or beast?’ that mesocarnivores present particular attributes such as small size and both behavioral and ecological flexibility, which are important traits for persisting in anthropogenic landscapes. They explored the perceptions and attitudes of small-livestock farmers towards different wildlife species common on farms. Jackal and caracal are regarded as the most serious predators of livestock in the Karoo. Farmers who described jackal/caracal as beautiful were more likely to be tolerant of them. They hypothesized that the percentage of lamb losses farmers attributed to jackal and/or caracal on their farm would be significantly associated with tolerance of them. They showed that farmer-mesopredator negative interactions over the same resources was the predominant narrative in the study area and mostly fostered negative emotions.
19 farmers were included in the analysis. The findings appear to confirm previous studies in this area: “Other answers were coded zero and represented a lack of tolerance. Our definition of tolerance is consistent with that of Kansky: “The ability and willingness of an individual to absorb the extra potential or actual costs of living with wildlife”,” Drouilly said.
The impact of identity concealment and passing on the lives of non-binary transgender people in the United States.
In ‘Interactions between blending and identity concealment’, Sana Flynn and Nathan Smith (2021) noted that according to the United States Transgender Survey, around one-third of transgender people identify as a gender identity outside of the traditional man/woman binary. This study contributes to the literature on non-binary transgender people by examining identity concealment and blending. Study results demonstrated that participants who did not blend reported more instances of victimization. Non-binary people may face victimization or distress from any choice regarding gender identity expression. Not blending may be one way to express a non-binary identity in social contexts, resulting in less distress.
The study involved 9769 participants. The findings appear to support earlier work in this field: “This study offers a first glance at the relationships among these variables in an understudied population. It confirms the negative correlation between blending and victimization seen in prior studies of binary transgender people,” Flynn suggested. Discussing potential shortcomings, “The United States Transgender Survey had the sample bias typical of online surveys, skewed towards White participants with internet access. Extensive recruitment efforts focused on reaching other demographics, particularly people of Color, mitigated the situation somewhat. The sample still was largely White and thus is likely not representative of the larger population of non-binary persons,” they observe. They recommend that the construct of blending is potentially more complex than can be understood using a dichotomous variable. Blending as gender assigned at birth could potentially be experienced as more erasing for some. Future research should address the nuances of blending as a man or woman in relation to non-binary people’s gender. Data and code to reproduce the analyses can be found at: http://www.ustranssurvey.org/data-requests.
A study of care partners of people with Parkinson’s disease and their experiences of managing psychosis.
Sneha Mantri and colleagues (2021) studied the experience of care partners of patients with Parkinson’s disease psychosis. Psychosis is common in advanced Parkinson’s disease, with a cumulative prevalence of over 80%. Care partners provide a large amount of unpaid care for loved ones with PD psychosis, leading to higher indirect costs and higher cumulative income loss over time. Understanding these difficulties would be valuable to design strategies to improve caregiver-physician communication. This qualitative analysis uncovers important aspects of the care partner experience, including challenges in navigating the medical system and communicating with professionals. Care partners reported relying on informal networks for knowledge and anticipatory guidance.
There were 193 respondents included in the analysis. The results appear to support what was previously known about this topic: “A qualitative interview captures the severity of care partner burden in a richer way than a Likert-scale questionnaire. For instance, the extended quotation from care partner 3’s interview mirrors what Arthur Frank, a medical sociologist, terms the chaos narrative,” Mantri suggested. The authors say that “The number of interviews was relatively small, favoring depth of analysis over breadth. All the care partners were female and highly educated. Their experiences may not necessarily reflect challenges faced by care partners of other sociodemographic groups.”
Cardiovascular diseases and diabetes are the leading causes of non-communicable diseases (NCD) deaths in the Iganga-Mayuge health and demographic surveillance site in Eastern Uganda.
In an assessment of non-communicable disease mortality among adults in Eastern Uganda, Natukwatsa and colleagues (2021) reported that age-adjusted mortality rates were calculated using direct method, with the average population across the seven years of the study (2010 to 2016) as the standard. Cardiovascular diseases accounted for the largest proportion of NCD deaths in each year. Women had substantially higher cardiovascular disease mortality rates compared to men. The present analysis is based on cause-of-death data generated through verbal autopsies conducted in Iganga-Mayuge Health and Demographic Surveillance Site in Eastern Uganda.
65 villages were included in the study. Discussing potential shortcomings, “We only examined data for seven years within a relatively modest population, thus we were unable to establish clear patterns or trends due to lack of statistical power. Despite these limitations, our study provides much needed assessment of sub-national NCD mortality in Uganda,” they say.
About 1100 women from tribal communities in the southern Indian state of Karnataka have been screened for cervical infections, infections and reactive changes in the cervix.
A research team from the Department of Science and Technology led by Supriti Ghosh (2021) studied cervical cytology and associated factors among tribal women of Karnataka, India. 1140 married women from the tribal population were screened for cervical premalignant/ malignant lesions, microbial infections and symptoms suggestive of gynaecological morbidities. Of the 1140 women screened, 12.4% showed cervical microbial infections, 23.6% were reported to have reactive changes, and 0.2% had epithelial cell abnormalities in the cervix. These infections were found to be 1.65 times (95% CI: 1.11, 2.47) higher among participants with low socio-economic status. Cervical microbial infections were found to be associated with younger age group, low socio-economic status and younger age at sexual debut. This study strengthens the existing evidence by presenting the information on prevalence and the factors associated with cervical cytology among the tribal population.
Discussing potential shortcomings, “This could be a limitation of the study, i.e., the data cannot be extrapolated to other populations from different resource setting. Further, due to the cross-sectional nature of the research, we cannot comment on the causative effect of the associated factors on cervical cytology,” they admit. They suggest that this study reports the baseline prevalence of symptoms suggestive of gynaecological morbidities, cervical lesions, microbial infections and inflammation among women from a vulnerable community in this region. The data can be used for designing future studies and implementation of population-based interventions.
Antidepressants are widely prescribed in primary care clinics in low and middle-income countries, but adherence to treatment is low, according to a large study in India.
Aravind Pillai et al. (2021) studied antidepressant prescriptions and adherence in primary care in India. In low and middle-income countries, depressive disorders are the second leading cause of years lost due to disability. About 38% of screened positive patients who did not meet any diagnosis received an antidepressant prescription in usual care clinic. About 47% of patients adhered to antidepressant treatment for one month or more. Study was done among people who screened positive for common mental disorders in a large study of primary care clinics in Goa, India. About 47% of screened positive patients received a prescription for an antidepressant. Patients with moderate to severe depression were the most likely diagnostic group to receive an antidepressant prescription.
The research involved 1320 patients. The researchers’ conclusions may reinforce what was previously known about this field: “This study had access to the CIS-R based psychiatric diagnosis that was not available to the physician during the clinical consultation. Our findings are similar to reports from primary care in high income countries that antidepressants are widely prescribed following screening in primary care,” Pillai claimed. Discussing potential improvements, “About 11%, 13% and 15% of patients were lost to follow-up at two months, six months, and twelve months, respectively. This is the first study that focuses on antidepressant prescriptions following screening in primary care in a low or middle-income country,” they concede. Data and code are available from: http://www.sangath.in/data-archive.
The prevalence of psychiatric disorders among Norwegian 10-14-year-olds was 6.93% (95% CI 5.06-9.41), according to the Bergen Child Study.
Tormod Bøe et al. (2021) reported on prevalence of psychiatric disorders in Norwegian 10-14-year-olds. Mental health problems among children are a major public health concern and the leading cause of disability worldwide. The point prevalence of any psychiatric disorder was highest among the youngest participants, with anxiety disorders, ADHD and disruptive disorders being the most common diagnoses in this age group. According to the population weighted interval estimate 5.41% of participants met DSM-IV criteria for a psychiatric disorder. In the population-weighted analyses, the prevalence of any psychiatric disorder was estimated to be 6.93%. For conduct disorder, the upper interval estimate is about 1% lower than the lowest interval estimate reported by Polanczyk et al.
There were 2043 10-14-year-olds in the study. The findings appear to substantiate what was previously known about this subject: “The data for this study was gathered in 2006, and may therefore not reflect current prevalence rates in the population. Our results are consistent with studies of Norwegian children that have been conducted both earlier and later,” Bøe claimed. Discussing potential improvements, “Another limitation may be related to the lack of self-reported information from children. However, studies have not found additional informants to produce significantly different prevalence rates,” they admit. The researchers recommend that in line with previous studies from Scandinavia, the prevalence of psychiatric disorders was found to be relatively low in this sample of Norwegian children. Given the high worldwide prevalence and burden of disease of mental disorders, these findings raise important scientific questions for future research.
The use of evidence-based practice (EBP) among nurses in Ethiopia is low, according to a study conducted in Amhara Region Referral Hospitals.
In ‘Evidence-based practice utilization and associated factors among nurses working in Amhara Region Referral Hospitals, Ethiopia’, Zewdu Aynalem et al. (2021) noted that Evidence-Based Practice (EBP) is an approach to a clinical practice whereby clinicians integrate current best evidence with their clinical expertise to make decisions for a specific client. This study was conducted to determine EBP utilization and identify factors that affect it among nurses working in Amhara Region Referral Hospitals, Ethiopia. Nurses who had internet access and availability of evidence-based guideline at the work area were 65.5% and 82.7% more likely to have good EBP usage. The study revealed that evidence-based practice utilization among nurses is low. This study found out that training about EBP was significantly associated with the utilization of EBP.
684 respondents were included in the analysis. The researchers’ findings may back up previous work in this subject: “A large proportion of our respondents were in the younger age group, who might be active in information sharing. This finding was supported by results from Ethiopia, Malaysia, and the US. Nurses who knew about evidence-based practice concepts were more likely to utilize evidence based practice,” Aynalem suggested. Discussing possible improvements, “This study might encounter response bias as using a self-administered questionnaire was considered as a limitation of this study. It would have been worthy if role at the hospital and shifting type had been determined,” they admit.
An upside-down jellyfish, Cassiopea sp. andromeda, has been identified as a potential invasive species in the Mare Nostrum, off the coast of Italy.
Marta Mammone et al. (2021) report that jellyfish are among the most versatile marine invertebrates. Changes in light penetration were reproduced in laboratory experiments to assess the physiological plasticity of the photosynthetic machinery of Cassiopea jellyfish. The results suggest that the cell size and chlorophyll content of symbiotic Cladocopium undergo rapid changes with short-time environmental variations. To characterize the symbiont genotype associated with the jellyfish, they investigated the chloroplast subunit rDNA sequence.
Commonly known as the upside-down benthic jellyfish, Cassiopea includes a group of 10 species native of tropical and sub-tropical, shallow-water environments. The majority of jellyfish taxa associated with Symbiodiniaceae dinoflagellates. The conclusions may substantiate previous studies in this field: “Photosynthesis to respiration ratio can be used as proxy for autotrophic contribution. Our findings are in accordance with those observed in C. and Andromeda and in other zooxanthellate jellyfish such as Linuche and Mastigias,” Mammone said.
The visual perception of freshness is an important factor in the purchase of fruits and vegetables, but it is difficult to train machine learning models to identify freshness levels.
Kento Koyama et al. (2021) reported in ‘Predicting sensory evaluation of spinach freshness using machine learning model and digital images’ that correlation analysis between the color and local features obtained from the spinach image and the sensory evaluation score showed a positive correlation for a minimum value of gray, g, v, and L*. The prediction accuracy of this method was over 70%, which is similar to the accuracy of individual panel evaluation. Predicting the results of the visual evaluation of freshness by humans using machine learning methods and smartphone images is cost effective, rapid, and reproducible at any time or place. Spinach leaf images were taken, and a sensory evaluation was conducted by non-trained panels to obtain data for the machine-based evaluation model. The lower the class number, the higher the accuracy in both the machine learning model and panel evaluation.
16 subjects were involved in the study. The researchers’ findings may challenge prior research in the field: “ORB was chosen as our algorithm to extract key points in images. Unlike SIFT, ORB is free from licensing restrictions and has a fast computation.” Discussing possible shortcomings, “Our model is limited by the target of the non-trained panels. The panelists used in the presented study had the same age ranges and were from the same country. The results of the freshness evaluation could change depending on the age and country of origin of the panelists, and other factors. Multiple targets of consumers will need to be investigated in the future,” they acknowledge. Data and code are available from: https://github.com/kento-koyama/Predicting-sensory-evaluation-of-spinach-freshness-using-machine-learning-model-and-digital-images.
An animal-assisted, school-based humane education programme promotes a humane attitude and enhances social–emotional competence for children in Hong Kong.
Joe Ngai et al. (2021) describe the findings of a mixed-methods evaluation research study on the Competence in Active Resilience for Kids (CARing Kids) humane education with animal-assisted SEL implemented in primary schools in Hong Kong. The CARing Kids programme incorporates an animal assisted education component in six sessions that aim to provide experiential learning on humane attitude. The school teachers read the script to instruct the participants to complete the questionnaire, and they read each item of the questionnaire in class to ensure the participants understood the meaning of the items.
There were 110 primary three students involved in the analysis. The results appear to support earlier work in this area: “The pilot experience provides insight into how the presence of animals impacts the development of empathy and social–emotional competence in the school setting in Hong Kong. The current results echo previous literature on animal assisted education in the education setting,” Ngai claimed. However, “CARing Kids aims to compensate for the shortcomings of the current education system. Traditional humane education is not a priority for primary schools in Hong Kong. We believe that humane education in childhood is a foundation for developing the One Health mindset,” observe the researchers. They advocate that this study revealed positive development of SEL competence among participants. How individual- and systematic-level factors such as school support, teaching styles, and community factors could interplay and impact the effectiveness of animal-assisted education will be explored in a future study.
Sarcopenia is an increased risk factor for metabolic syndrome, but there is also a dose-response relationship between sarcopenia and skeletal muscle mass.
A team from the Affiliations Department of Internal Medicine led by Su Kim (2021) described association between sarcopenia level and metabolic syndrome. Sarcopenia by bioelectrical impedance analysis (BIA) is independently associated with MetS and has a dose-response relationship. After adjustment for age, sex, obesity, hypertension, diabetes mellitus, dyslipidemia, smoking, alcohol intake, and C-reactive protein, sarcopenia remained significantly associated with MetS. Risk of MetS decreased by 25% per 1Q increment in ASM% (P < 0.001). Skeletal muscle mass and VFA were measured using the BIA method (Inbody 720). The study showed that skeletal muscle mass measured by BIA was positively correlated.
The research involved 13620 participants. The conclusions may support earlier work in this field: “The association between sarcopenia and MetS seemed more prominent in participants with low visceral fat or in non-obese participants. These findings are consistent with those of previous studies,” Kim said. The investigators concede that “In the current study, the data of HOMA-IR results were available only in a small sample size. We failed to analyze the association between sarcopenia and MetS adjusted for insulin resistance.” The authors recommend that future studies that assess causal relationship between sarcopenia and MetS are needed. BIA can be used as an easy, useful, and important guide to identify participants with the risk of MetS.