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Nationwide, the prevalence of the hepatitis C virus (HCV) has risen in recent years. At least 90% of infected persons must be treated to achieve global elimination targets. The current study aimed to explore barriers to, and facilitators of, direct-acting antiviral (DAA) HCV treatment uptake amongst pregnant and early-parenting women undergoing comprehensive substance use treatment. Twenty participants with documented HCV antibody positivity were recruited from two substance use treatment centers in central Kentucky. Semi-structured interviews were conducted to explore knowledge about HCV, previous experiences, and intentions to seek care. Themes were extracted using an inductive analytical approach. Most participants were aware of the dangers posed by HCV infection. However, there was a high degree of misinformation about transmission mechanisms and treatment eligibility requirements. Low priority for HCV treatment also surfaced as a barrier to treatment uptake. Participants reported being unable to seek care due to time and resource limitations in the presence of a highly demanding treatment process. Findings from the current study suggest that more work is needed to eliminate residual barriers that limit access to HCV treatment among pregnant and early-parenting women in treatment for substance use disorder. [ABSTRACT FROM AUTHOR]

Nutrients are substances that are used by living organisms in the growth and survival of organisms. On the basis of this background, the aim of this study was to assess the concentration of nutrients (macro and micronutrients) and chlorophyll in the Menjer lake and to examine the relationship between nutrient concentration and algal biomass to identify the determinants of algal development in tropical lakes (Menjer Lake Wonosobo, Indonesia). The research was conducted using a survey method at Menjer Lake Wonosobo. Observations and sampling were carried out 3 times with intervals of 1 month at 7 locations in the photic zone. The concentrations of macronutrients and micronutrients in the Menjer Lake were spatially even in all locations and the temporally slightly increased concentrations were relatively the same during the measurement period. The Cu, NO2, Si, and Na macronutrients are the determining factors for algal blooming in Menjer Lake Wonosobo. The effect of Cu, NO2 and Si concentrations was inversely related to the algal abundance, while the Ca, Na and Mo concentrations were in line with the abundance of algae. [ABSTRACT FROM AUTHOR]

In this paper, we propose a flexible cure rate model including a frailty term, which was obtained by incorporating a random effect in the risk function of latent competing causes. The number of competing causes of the event of interest follows a negative binomial distribution, and the frailty variable follows a power variance function distribution, which includes other frailty models such as gamma, positive stable, and inverse Gaussian frailty models as special cases. The proposed model takes into account the presence of covariates and right-censored data, which are suitable for populations with a long-term survivors. Besides, it allows quantification of the degree of unobserved heterogeneity induced by unobservable risk factors, which is important to explain the lifetime. Once the posterior density function is not expressed in the closed form, Markov chain Monte Carlo algorithms are performed for the estimation procedure. Simulation studies were considered in order to evaluate the proposed model performance, and its practical relevance was illustrated in a real medical dataset from a population-based study of incident cases of melanoma diagnosed in the state of São Paulo, Brazil. [ABSTRACT FROM AUTHOR]

The use of phytoplankton as an indicator of water pollution is a promising tool for assessment of water quality. The purpose of this study was to determine whether diversity indices, including the species richness and diversity of phytoplankton, could be used for reliable assessment of water quality in the Wadaslintang Reservoir in Indonesia. Surveys were conducted monthly at eight sites, from July 2019 to October 2019. Phytoplankton was collected during the day at 10:00 until approximately 15:00 in the euphotic zone. The parameters investigated were species richness and the abundance of phytoplankton, as well as water quality parameters listed in Government Regulation Number 82 of 2001. The level of pollution was represented biologically by the Shannon–Wiener diversity index and physicochemically by the STORET (storage and retrieval of water quality data) index. Moreover, the two indices were compared to determine whether a particular diversity index was more effective for assessment of this reservoir. The results showed that during the dry season, 22 taxa of phytoplankton were present, belonging to Cyanophyta, Chlorophyta, Chrysophyta, and Euglenophyta. During the wet season, 29 taxa were found, belonging to Cyanophyta, Chlorophyta, and Chrysophyta. Based on the Shannon-Wiener index and STORET index, water quality was better during the wet season than during the dry season. The results of water quality assessment using both indices were consistent, but the diversity index was a more sensitive indicator of pollution levels. Therefore, the Shannon–Wiener index is a useful tool for assessment of water quality in the Wadaslintang Reservoir. [ABSTRACT FROM AUTHOR]

Objective: To determine if a structured care-by-parent (CBP) protocol is associated with a reduction in diagnosis of treatment-requiring Neonatal Opioid Withdrawal Syndrome (NOWS).Study design: We performed a pilot retrospective, case control study of pregnant women enrolled in a comprehensive prenatal care program for opioid-dependent patients during which they received buprenorphine for Medication Assisted Treatment (MAT) for Opioid Use Disorder (OUD). Patients who participated in the CBP program actively roomed-in with their infants even after maternal hospital discharge while infants continued to be monitored for development of treatment-requiring NOWS. The primary outcome was the rate of treatment-requiring NOWS in the CBP grouping.Results: Thirty-two (32) cases that were enrolled in the CBP model were compared with 32 matched controls that were not enrolled in this model. There was a significant reduction in the rate of treatment-requiring NOWS among cases compared to the controls (OR = 0.10; p = .001). Neonates undergoing CBP had a decreased length of stay and lower Finnegan scores compared to those who did not undergo CBPConclusion: Among infants born to mothers with OUD in pregnancy, CBP significantly reduces the rate of treatment-requiring NOWS. [ABSTRACT FROM AUTHOR]

A statistical approach that estimates soil ciliate diversity and distribution based on data from five continents is presented. The model might resolve the controversial issue on global species diversity of soil ciliates by enabling the achievement of a minimum regional diversity and global species diversity.

Objective: The objective of this study is to evaluate risk factors and propose a model for the prediction of insulin requirement during the treatment of early-diagnosed gestational diabetes mellitus (GDM). Research design and methods: Retrospective cohort analysis of all pregnant women who were diagnosed with GDM by abnormal fasting blood glucose at the first prenatal visit. According to the requirement for insulin therapy to achieve good glycemic control (insulin or diet group), women were compared regarding clinical and laboratory variables. The performance of these variables in predicting insulin need for GDM treatment was identified by a logistic regression model, and a nomogram was created based on the model to facilitate clinical interpretation. Results: In total, 408 women were included for analysis. Among them, 135 (33%) needed insulin therapy. In the logistic regression model, maternal age, prepregnancy body mass index, fasting blood glucose (FBG) value, prior GDM, and family history of diabetes were significant independent variables for the prediction of insulin need. Conclusions: The need for insulin therapy in women with early diagnosis of GDM can be predicted by a logistic regression model, which can be converted to a clinically usable nomogram that could help to properly address follow-up strategies for GDM treatment in regions where health resources are limited. [ABSTRACT FROM AUTHOR]

In this paper, we propose a defective model induced by a frailty term for modeling the proportion of cured. Unlike most of the cure rate models, defective models have advantage of modeling the cure rate without adding any extra parameter in model. The introduction of an unobserved heterogeneity among individuals has bring advantages for the estimated model. The influence of unobserved covariates is incorporated using a proportional hazard model. The frailty term assumed to follow a gamma distribution is introduced on the hazard rate to control the unobservable heterogeneity of the patients. We assume that the baseline distribution follows a Gompertz and inverse Gaussian defective distributions. Thus we propose and discuss two defective distributions: the defective gamma-Gompertz and gamma-inverse Gaussian regression models. Simulation studies are performed to verify the asymptotic properties of the maximum likelihood estimator. Lastly, in order to illustrate the proposed model, we present three applications in real data sets, in which one of them we are using for the first time, related to a study about breast cancer in the A.C.Camargo Cancer Center, São Paulo, Brazil. [ABSTRACT FROM AUTHOR]

Objective: To investigate the ultrasound (US) markers predictive of complex gastroschisis (CG), mortality, and morbidity in fetuses with gastroschisis.Materials and Methods: This was a retrospective cohort study of 186 pregnancies with isolated fetal gastroschisis. Eight US markers were analyzed. The predictions and associations of US markers with CG, mortality, and morbidity were assessed. Combinations of US markers predictive of CG were investigated.Results: Extra-abdominal bowel dilatation (EABD), intra-abdominal bowel dilatation (IABD), and polyhydramnios were predictive of CG. EABD between 25 and 28 weeks had a sensitivity of 64%, a specificity of 89%, a positive predictive value (PPV) of 56.2%, and negative predictive value (NPV) of 91.8%. The predictions of IABD were sensitivity = 26.7%, specificity = 96.7%, PPV = 61.5%, and NPV = 86.8%. The odds ratios for CG in the presence of 1 and 2 US markers, compared with the absence of a US marker, were 18.3 (95% CI, 3.83-87.64) and 73.3 (95% CI, 6.14-876), respectively.Conclusion: US markers predictive of CG were established. The combination of these markers increases the probability of CG. [ABSTRACT FROM AUTHOR]