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PloS One 2024This cross-sectional study aims to describe doubts regarding the diagnosis and treatment of syphilis in pregnancy among primary care professionals in a telehealth...
This cross-sectional study aims to describe doubts regarding the diagnosis and treatment of syphilis in pregnancy among primary care professionals in a telehealth service. All teleconsultations (TCs) offered through TelessaúdeRS-UFRGS to primary health care (PHC) services in the state of Rio Grande do Sul between 2018 and 2021 involving syphilis in pregnancy were included. A total of 356 (TCs) were analyzed. The main doubts about syphilis during pregnancy raised by primary care professionals were related to the need for retreatment (35%), diagnostic definition (23%) and initial treatment (16%). In addition, 95% of TCs were suitable for diagnosing and treating syphilis based on the 2020 Brazilian Ministry of Health guideline. This study suggests that TCs can identify failures in the diagnosis and treatment of public health problems and support decision making in PHC involving syphilis in pregnancy.
Topics: Humans; Female; Pregnancy; Syphilis; Telemedicine; Primary Health Care; Cross-Sectional Studies; Adult; Pregnancy Complications, Infectious; Brazil; Health Personnel
PubMed: 38941327
DOI: 10.1371/journal.pone.0306192 -
PloS One 2024This study develops a "Skill Talent Ecological Evaluation Model" across cultivation, potential energy, kinetic energy, innovation, and service and support ecologies....
This study develops a "Skill Talent Ecological Evaluation Model" across cultivation, potential energy, kinetic energy, innovation, and service and support ecologies. AHP-entropy determines indicator weights, Hopfield neural network assesses talent ecology levels, and the PVAR model analyzes digital transformation effects. Findings reveal: Cultivation ecology rates A, potential ecology rates B+, kinetic ecology rates B-, service and support ecology rates B-, and innovation ecology rates C. Digital transformation spurs skill demand, impacting talent and economic contributions. Kinetic ecology sees increased demand, potentially impacting traditional industries positively. Innovation ecology necessitates continuous skill learning. Service and support ecology witnesses growth in digital entrepreneurship, requiring policy incentives and incubation center support.
Topics: Neural Networks, Computer; China; Ecosystem; Humans; Ecology; Aptitude; Models, Theoretical
PubMed: 38941320
DOI: 10.1371/journal.pone.0302909 -
PloS One 2024Many have argued that discrimination against pit bulls is rooted in the breed's association with Black owners and culture. We theoretically and empirically interrogate...
Many have argued that discrimination against pit bulls is rooted in the breed's association with Black owners and culture. We theoretically and empirically interrogate that argument in a variety of ways and uncover striking similarities between the racialization of pit bulls and other racialized issues (e.g., poverty and crime) in public opinion and policy implementation. After detailing the reasons to expect pit bulls to be racialized as Black despite dog ownership in the U.S. generally being raced as white, the article shows: (1) Most Americans associate pit bulls with Black people. (2) Anti-Black attitudes, in general, are significant, independent, predictors of both anti-pit views and of preferring other breeds over them; (3) stereotypes of Black men as violent, in particular, are significant, independent, predictors of both anti-pit views and of preferring other breeds over them. (4) Implicit racialization through a national survey experiment further eroded support for legalizing pits, with the treatment effect significantly conditioned by respondent's race. And (5) state-level racial prejudice is a significant negative predictor of enacting legislation to preempt breed-specific bans. We conclude with our findings' broader insights into the nature of U.S. racial politics. Michael Tesler, [email protected], corresponding author, is Professor of Political Science at UC Irvine; Mary McThomas, [email protected], is Associate Professor of Political Science at UC Irvine. An earlier version of this paper was presented at the American Political Science Association's annual meeting. We thank Maneesh Arora, Rachel Bernhard, Nathan Chan, Louis Pickett, David Sears, DeSipio, Adam Duberstein, Jane Junn, Claire Kim, Jessica Manforti, J. Scott Matthews, Justin.
Topics: Animals; Dogs; Humans; Racism; Politics; Male; United States; Black or African American; Public Opinion; Female; Attitude
PubMed: 38941314
DOI: 10.1371/journal.pone.0305959 -
PloS One 2024The Brazilian Legal Amazon is an extensive territory in which different factors influence the dynamics of forest fires. Currently, the Brazilian government has two tools...
The Brazilian Legal Amazon is an extensive territory in which different factors influence the dynamics of forest fires. Currently, the Brazilian government has two tools in the public domain and free of charge, PRODES and BDQueimadas, to monitor and make decisions to combat deforestation and forest fires. This work aimed to evaluate and correlate the forest fire alerts and deforestation in the Amazon Forest in the state of Pará. The analyses were based on carrying out a diagnosis of forest fires and deforestation; the behavior of forest fires and deforestation over the last twenty years; the statistical relationship between deforestation and forest fires and their spatialization. This work identified that Pará is the state in the Legal Amazon with the highest occurrence of forest fires and deforestation. Deforestation in the four-year period Jan/2003-Dec/2006 showed a higher rate compared to the four-year periods Jan/2011-Dec/2018. A high correlation was found between forest fire alerts and increases in deforestation. There is a spatial relationship between cities with greater increases in deforestation and high numbers of fire alerts. In relation to the occurrence of forest fires and deforestation, the south of the state was the most critical region and the north had lower rates.
Topics: Brazil; Conservation of Natural Resources; Forests; Wildfires; Fires
PubMed: 38941313
DOI: 10.1371/journal.pone.0306238 -
PloS One 2024The global rise in diabetes, particularly in India, poses a significant public health challenge, with factors such as limited awareness, financial strain, and cultural...
BACKGROUND
The global rise in diabetes, particularly in India, poses a significant public health challenge, with factors such as limited awareness, financial strain, and cultural considerations hindering its effective management. Although lifestyle changes have shown promising results, their consistent implementation and maintenance continue to pose challenges. Most studies have focused primarily on dietary modifications, overlooking other essential aspects of lifestyle intervention. The DiRemI study aims to address these gaps by evaluating the efficacy of a comprehensive one-year program that combines diet, exercise, psychological support, and medical management to achieve weight loss, diabetes remission, and improved glycemic control among patients with type 2 diabetes (T2D) in India, while also considering the unique needs of the Indian population.
METHODS
The DiRemI study is a prospective, open-label, matched-group trial aimed at assessing the impact of a one-year online integrated intensive lifestyle intervention (ILI) comprising dietary modifications, physical activity, psychological support, and medical management on weight loss and remission in adult T2D patients (aged 30-70 years), with a body mass index (BMI) between 25 and 35 kg/m2, and disease duration of <15 years. ILI will be compared with routine medical care (RMC). Participants will be recruited from three clinics: one providing ILI and two others providing RMC. The co-primary outcome will be weight loss and remission at 12 months, with a follow-up at 18 months. The proposed sample size is 360 participants (180 each in intervention and control group).
DISCUSSION
The DiRemI study represents the first large-scale remission study in India to show the effectiveness of an integrated approach in the remission and management of T2D and its complications. The findings of this study hold the potential to report evidence-based strategies for managing T2D both in India and globally, thus alleviating the substantial burden of diabetes on public health systems.
TRIAL REGISTRATION
Clinical Trials Registry, India (Registered Number: CTRI/2023/06/053885).
Topics: Humans; Diabetes Mellitus, Type 2; India; Prospective Studies; Middle Aged; Adult; Female; Male; Aged; Weight Loss; Exercise; Life Style; Remission Induction; Body Mass Index
PubMed: 38941311
DOI: 10.1371/journal.pone.0306394 -
PloS One 2024The COmprehensive Score for Financial Toxicity (COST) has proven to be a reliable tool for quantifying the impact of financial toxicity (FT) in patients with cancer in...
INTRODUCTION
The COmprehensive Score for Financial Toxicity (COST) has proven to be a reliable tool for quantifying the impact of financial toxicity (FT) in patients with cancer in clinical and public health settings. However, the COST has not yet been validated in Vietnam. Therefore, we aimed to evaluate its reliability and validity among Vietnamese patients with cancer.
METHODS
A cross-sectional study was conducted in a sample of 300 patients with cancer aged 27-95 years (mean: 58.5±11.2) in a tertiary hospital. The COST was translated into Vietnamese and English and adjusted to suit the local culture. Reliability was evaluated using Cronbach's alpha and McDonald's omega coefficients. The construct and convergent validities were also assessed.
RESULTS
The COST demonstrated good internal consistency and reliability (Cronbach's alpha = 0.913; McDonald's omega = 0.915). The exploratory factor analysis revealed two factors that explained 64.9% of the variance. The adjusted fit indices indicated a good fit of the model (χ2 (39) = 67.78, p = 0.003; standardized root mean squared residual = 0.042; Tucker-Lewis index = 0.971; comparative fit index = 0.979; root mean square error of approximation = 0.061, 90% confidence interval = 0.035-0084). Higher COST scores were significantly correlated with higher health-related quality of life (EQ-5D-5L utility score: r = 0.21, p = 0.002; EQ VAS: r = 0.28, p < 0.001). Multivariate quantile regression analysis revealed that female sex, rural residence, and unstable job/unemployment were associated with lower COST scores. There was no statistically significant difference in other factors, including clinical factors (types of cancer, staging, and treatment modalities).
CONCLUSIONS
The COST is reliable and valid, making it suitable for assessing FT severity in Vietnamese patients with cancer.
Topics: Humans; Middle Aged; Male; Female; Vietnam; Aged; Adult; Neoplasms; Cross-Sectional Studies; Aged, 80 and over; Reproducibility of Results; Surveys and Questionnaires; Cost of Illness; Southeast Asian People
PubMed: 38941304
DOI: 10.1371/journal.pone.0306339 -
PloS One 2024Data on COVID-19 vaccine effectiveness to support regional vaccine policy and practice are limited in Africa. Thus, this review aimed to evaluate the efficacy and...
BACKGROUND
Data on COVID-19 vaccine effectiveness to support regional vaccine policy and practice are limited in Africa. Thus, this review aimed to evaluate the efficacy and effectiveness of COVID-19 vaccines administered in Africa.
METHODS
We systematically searched peer-reviewed randomized controlled trials (RCTs), prospective and retrospective cohort studies, and case-control studies that reported on VE in Africa. We carried out a risk of bias assessment, and the findings of this review were synthesized and presented in a narrative form, including tables and figures. The synthesis was focused on COVID-19 VE against various levels of the disease condition and outcomes (infection, hospitalization or critical, and death), time points, and variants of concern.
RESULTS
A total of 13 studies, with a total sample size of 913,285 participants, were included in this review. The majority (8/13) of studies were from South Africa and 38.5% (5/13) were randomized clinical trials. The studies reported that a full dose of Pfizer-BioNTech vaccine had a VE of 100% against COVID-19 infection by Beta (B.1.351) and Delta variants and 96.7% against hospitalization by Delta variant. The Johnson and Johnson vaccine had VE ranging from 38.1%-62.0% against hospitalization and 51.9%- 86% against critical disease by Beta (B 1.351) variant. The Oxford-AstraZeneca vaccine had a VE of 89.4% against hospitalization by the Omicron variant but was not effective against the B.1.351 variant (10.4%). The Sinopharm vaccine had a VE of 67% against infection and 46% against hospitalization by Delta variant.
CONCLUSIONS
COVID-19 vaccines administered in Africa were effective in preventing infections, hospitalization, and death. These review findings underscore the need for concerted efforts of all stakeholders to enhance the access and availability of COVID-19 vaccines and reinforce public awareness to reach the high-risk, unvaccinated group of the African population.
Topics: Humans; COVID-19 Vaccines; COVID-19; SARS-CoV-2; Africa; Vaccine Efficacy; Hospitalization; Randomized Controlled Trials as Topic
PubMed: 38941303
DOI: 10.1371/journal.pone.0306309 -
PloS One 2024Based on 908 consumer questionnaire data from 15 urban areas in Shanghai, we use the binary logit model to empirically analyze the impact of traceability label trust on...
Based on 908 consumer questionnaire data from 15 urban areas in Shanghai, we use the binary logit model to empirically analyze the impact of traceability label trust on consumers' traceable pork purchase behavior and the moderating effect of food safety identification. After constructing the theoretical analysis framework, this paper verifies it from the two aspects of statistical analysis and econometric analysis and tests the robustness of the final results. The results show that: first, traceability label trust has a significant positive impact on consumers' traceability pork behavior. Second, food safety identification can significantly strengthen and promote this process. Third, consumers' purchasing behavior is significantly positively affected by traceable pork consumption scenarios and price labels, but the permanent elderly in the composition of family members significantly negative impact on it. Therefore, we put forward relevant policy suggestions, such as strengthening the knowledge popularization and publicity based on the advantageous commodity attributes of traceable pork, carrying out food safety knowledge popularization education, and enhancing consumers' risk perception and food safety identification ability.
Topics: Humans; Consumer Behavior; Food Safety; Male; Female; Food Labeling; Middle Aged; Adult; Trust; Surveys and Questionnaires; Animals; Swine; China; Young Adult; Aged
PubMed: 38941301
DOI: 10.1371/journal.pone.0306041 -
PloS One 2024Body mass index (BMI) is inversely proportional with adiponectin levels among adults, while insulin, C-reactive protein (CRP), interleukin 6 (IL-6), resistin and tumor...
BACKGROUND AND OBJECTIVES
Body mass index (BMI) is inversely proportional with adiponectin levels among adults, while insulin, C-reactive protein (CRP), interleukin 6 (IL-6), resistin and tumor necrosis factor-alpha (TNF-α) have been linked with elevated BMI. The role and relation of these biomarkers with BMI among a Hispanic pediatric population are less known. Thus, the objective of this study was to examine the association of inflammatory markers with the odds of overweight/obesity while controlling for several sociodemographic factors among a Hispanic youth population in Northeast Tennessee.
METHODS
Height, weight, demographic information, and blood samples were collected from 107 Hispanic children aged 2 to 10 years recruited at a large community health center in 2015-2016 in Northeast Tennessee. Data for this research were accessed and analyzed in 2022. Multivariable logistic regression was conducted to assess the relations between adiponectin, insulin, resistin, CRP, TNF-α, and IL-6, and overweight/obesity vs. having a healthy (normal) weight.
RESULTS
Adiponectin levels were significantly lower among overweight/obese Hispanic children (p = 0.0144) compared to healthy weight children. The odds of overweight/obesity decreased by 4% for every one-unit increase in serum adiponectin. Insulin levels were significantly higher among overweight/obese Hispanic children compared to healthy weight children (p = 0.0048). The odds of overweight/obesity increased by 7% for every one-unit increase in serum insulin. Resistin, IL-6, TNF-α, and CRP were not significantly associated with overweight/obesity in this population.
CONCLUSION
Adiponectin behaves similarly in Hispanic youth as it does in other pediatric populations, possibly making it a valuable marker when examining metabolic health status in this population.
Topics: Humans; Child; Body Mass Index; Male; Female; Hispanic or Latino; Child, Preschool; Biomarkers; Adiponectin; C-Reactive Protein; Interleukin-6; Resistin; Insulin; Tumor Necrosis Factor-alpha; Inflammation; Pediatric Obesity; Overweight; Tennessee
PubMed: 38941300
DOI: 10.1371/journal.pone.0289523 -
JMIR Research Protocols Jun 2024Artificial intelligence (AI) medical devices have the potential to transform existing clinical workflows and ultimately improve patient outcomes. AI medical devices have...
BACKGROUND
Artificial intelligence (AI) medical devices have the potential to transform existing clinical workflows and ultimately improve patient outcomes. AI medical devices have shown potential for a range of clinical tasks such as diagnostics, prognostics, and therapeutic decision-making such as drug dosing. There is, however, an urgent need to ensure that these technologies remain safe for all populations. Recent literature demonstrates the need for rigorous performance error analysis to identify issues such as algorithmic encoding of spurious correlations (eg, protected characteristics) or specific failure modes that may lead to patient harm. Guidelines for reporting on studies that evaluate AI medical devices require the mention of performance error analysis; however, there is still a lack of understanding around how performance errors should be analyzed in clinical studies, and what harms authors should aim to detect and report.
OBJECTIVE
This systematic review will assess the frequency and severity of AI errors and adverse events (AEs) in randomized controlled trials (RCTs) investigating AI medical devices as interventions in clinical settings. The review will also explore how performance errors are analyzed including whether the analysis includes the investigation of subgroup-level outcomes.
METHODS
This systematic review will identify and select RCTs assessing AI medical devices. Search strategies will be deployed in MEDLINE (Ovid), Embase (Ovid), Cochrane CENTRAL, and clinical trial registries to identify relevant papers. RCTs identified in bibliographic databases will be cross-referenced with clinical trial registries. The primary outcomes of interest are the frequency and severity of AI errors, patient harms, and reported AEs. Quality assessment of RCTs will be based on version 2 of the Cochrane risk-of-bias tool (RoB2). Data analysis will include a comparison of error rates and patient harms between study arms, and a meta-analysis of the rates of patient harm in control versus intervention arms will be conducted if appropriate.
RESULTS
The project was registered on PROSPERO in February 2023. Preliminary searches have been completed and the search strategy has been designed in consultation with an information specialist and methodologist. Title and abstract screening started in September 2023. Full-text screening is ongoing and data collection and analysis began in April 2024.
CONCLUSIONS
Evaluations of AI medical devices have shown promising results; however, reporting of studies has been variable. Detection, analysis, and reporting of performance errors and patient harms is vital to robustly assess the safety of AI medical devices in RCTs. Scoping searches have illustrated that the reporting of harms is variable, often with no mention of AEs. The findings of this systematic review will identify the frequency and severity of AI performance errors and patient harms and generate insights into how errors should be analyzed to account for both overall and subgroup performance.
TRIAL REGISTRATION
PROSPERO CRD42023387747; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=387747.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
PRR1-10.2196/51614.
Topics: Humans; Randomized Controlled Trials as Topic; Artificial Intelligence; Algorithms; Systematic Reviews as Topic; Patient Harm; Equipment and Supplies; Research Design
PubMed: 38941147
DOI: 10.2196/51614