Category: Nevin Manimala

J Safety Res. 2024 Jun;89:288-298. doi: 10.1016/j.jsr.2024.04.002. Epub 2024 May 1.

ABSTRACT

INTRODUCTION: The occupational road-accident risk on public roads and the work conditions for professional driving is still an important issue in occupational health despite lower road-accident rates. This study presents the evolution over time of the work-related constraints for these employees based on the Sumer surveys carried out in 2003, 2010 and 2017.

METHOD: Data from the 2010 and 2017 surveys were restricted to match the scope of the 2003 survey in order to enable prevalence data to be compared in equivalent populations. The main variable of interest was “driving (car, truck, bus, and other vehicles) on public thoroughfares” for work (during the last week of work: yes/no). Work time characteristics, work rhythm, autonomy and scope for initiative, collective work group, standards and evaluations variables were completed by the occupational health physicians. A self-administered questionnaire was also provided to employees and contained the Job Content Questionnaire, which assesses decision latitude, social support and psychological demands, the reward scale of Siegrist questionnaire, the hostile behaviour with inspired questions for Leymann, sick leave and work accidents during the past 12 months and job satisfaction. Finally, prevention in the workplace was also completed by the occupational health physicians.

RESULTS: About 25% of employees in France were exposed to work-related driving in 2017, which was stable in comparison with 2003 and 2010. However, the population was older and there were more females, more often from the clerical staff/middle manager category and working in companies with fewer than 10 employees. Employees exposed to work-related driving were also more frequently exposed to sustained work schedules and physical constraints, but less exposed to psychosocial risks.

CONCLUSIONS: The percentage of employees exposed to occupational road accident risk, i.e., exposure to work-related driving, remained stable at about 25% in 2017 compared with previous surveys. These employees were also more frequently exposed to sustained work schedules and physical constraints, but less exposed to psychosocial risks.

PRACTICAL APPLICATIONS: Prevention campaigns on work-related road accident risk should be provided to all employees in all companies since all jobs can be concerned.

PMID:38858052 | DOI:10.1016/j.jsr.2024.04.002

Int J Epidemiol. 2024 Apr 11;53(3):dyae080. doi: 10.1093/ije/dyae080.

ABSTRACT

BACKGROUND: The Baby-Friendly Hospital Initiative (BFHI) is associated with improved breastfeeding outcomes in many high-income countries including the UK and the USA, but its effectiveness has never been evaluated in France. We investigated the impact of the BFHI on breastfeeding rates in French maternity units in 2010, 2016 and 2021 to assess if the BFHI aids to reduce inequalities in breastfeeding.

METHODS: We examined breastfeeding in maternity units (exclusive, mixed and any breastfeeding) in mothers of singleton full-term newborns using the 2010 (n = 13 075), 2016 (n = 10 919) and 2021 (n = 10 209) French National Perinatal Surveys. We used mixed-effect hierarchical multinomial regression models adjusting for neonatal, maternal, maternity unit and French administrative department characteristics, and tested certain interactions.

RESULTS: The adjusted rate of exclusive breastfeeding was higher by +5.8 (3.4-8.1) points among mothers delivering in BFHI-accredited maternity units compared with those delivering in non-accredited units. When compared with average-weight newborns, this difference was sharper for infants with low birthweight: +14.9 (10.0-19.9) points when their birthweight was 2500 g. Mixed breastfeeding was lower by -1.7 points (-3.2-0) in BFHI-accredited hospitals, with no notable difference according to the neonatal or maternal characteristics.

CONCLUSION: Mothers delivering in BFHI-accredited maternity units had higher exclusive breastfeeding rates and lower mixed breastfeeding rates than those delivering in non-accredited maternity units. The positive impact of the BFHI was stronger among low-birthweight neonates, who are less often breastfed, helping reduce the gap for this vulnerable group while favouring mothers with higher education levels.

PMID:38857529 | DOI:10.1093/ije/dyae080

JMIR Form Res. 2024 Jun 10;8:e54207. doi: 10.2196/54207.

ABSTRACT

BACKGROUND: The geographical environments within which individuals conduct their daily activities may influence health behaviors, yet little is known about individual-level geographic mobility and specific, linked behaviors in rural low- and middle-income settings.

OBJECTIVE: Nested in a 3-month ecological momentary assessment intervention pilot trial, this study aims to leverage mobile health app user GPS data to examine activity space through individual spatial mobility and locations of reported health behaviors in relation to their homes.

METHODS: Pilot trial participants were recruited from the Rakai Community Cohort Study-an ongoing population-based cohort study in rural south-central Uganda. Participants used a smartphone app that logged their GPS coordinates every 1-2 hours for approximately 90 days. They also reported specific health behaviors (alcohol use, cigarette smoking, and having condomless sex with a non-long-term partner) via the app that were both location and time stamped. In this substudy, we characterized participant mobility using 3 measures: average distance (kilometers) traveled per week, number of unique locations visited (deduplicated points within 25 m of one another), and the percentage of GPS points recorded away from home. The latter measure was calculated using home buffer regions of 100 m, 400 m, and 800 m. We also evaluated the number of unique locations visited for each specific health behavior, and whether those locations were within or outside the home buffer regions. Sociodemographic information, mobility measures, and locations of health behaviors were summarized across the sample using descriptive statistics.

RESULTS: Of the 46 participants with complete GPS data, 24 (52%) participants were men, 30 (65%) participants were younger than 35 years, and 33 (72%) participants were in the top 2 socioeconomic status quartiles. On median, participants traveled 303 (IQR 152-585) km per week. Over the study period, participants on median recorded 1292 (IQR 963-2137) GPS points-76% (IQR 58%-86%) of which were outside their 400-m home buffer regions. Of the participants reporting drinking alcohol, cigarette smoking, and engaging in condomless sex, respectively, 19 (83%), 8 (89%), and 12 (86%) reported that behavior at least once outside their 400-m home neighborhood and across a median of 3.0 (IQR 1.5-5.5), 3.0 (IQR 1.0-3.0), and 3.5 (IQR 1.0-7.0) unique locations, respectively.

CONCLUSIONS: Among residents in rural Uganda, an ecological momentary assessment app successfully captured high mobility and health-related behaviors across multiple locations. Our findings suggest that future mobile health interventions in similar settings can benefit from integrating spatial data collection using the GPS technology in mobile phones. Leveraging such individual-level GPS data can inform place-based strategies within these interventions for promoting healthy behavior change.

PMID:38857493 | DOI:10.2196/54207

Int J Adolesc Med Health. 2024 Jun 12. doi: 10.1515/ijamh-2024-0056. Online ahead of print.

ABSTRACT

OBJECTIVES: Adolescent cases suffering from obesity tend to increase in middle-income countries. This study focused on the relationship between adolescent obesity and parents body mass index (BMI) and the variables of satisfaction, diet implementation and sports promotion.

METHODS: This cross-sectional study was conducted among adolescents living in the Mediterranean region (n=522, evaluated n=488). Anthropometric measurements were taken by expert researchers and data were collected using face-to-face survey technique.

RESULTS: The average BMI of the adolescents and parents’ was found to be above normal values. In adolescents, there was a positive and very good correlation with maternal BMI (r=0.711, p<0.01), a positive and moderate correlation with paternal BMI (r=0.512, p<0.01); In girl adolescents, it was positively and very well with maternal BMI (r=0.731, p<0.01), positively and moderately with father BMI (r=0.549, p<0.01); In boy adolescents, a positive and good correlation was found with maternal BMI (r=0.698, p<0.01), and a positive and moderate correlation with paternal BMI (r=0.459, p<0.01). In the analyzes comparing those who thought obesity threatened them (group 1) and those who did not think it threatened them (group 2), there was a statistically significant difference between the groups in terms of BMI distribution, satisfaction with body weight, diet program implementation, diet recommendation by the family and sports encouragement (p<0, 05).

CONCLUSIONS: In a cross-sectional perspective paternal obesity is also significant in adolescents and the correlation with maternal obesity is relatively more effective. Also includes evidence of individual efforts and parental contribution in adolescents who see obesity as a threat.

PMID:38857484 | DOI:10.1515/ijamh-2024-0056

Neurology. 2024 Jul 9;103(1):e209541. doi: 10.1212/WNL.0000000000209541. Epub 2024 Jun 10.

ABSTRACT

BACKGROUND AND OBJECTIVES: Aicardi Goutières syndrome (AGS) is type I interferonopathy characterized by severe neurologic impairment. Although many children with AGS demonstrate motor and expressive language deficits, the magnitude of receptive language impairment is uncharacterized. We sought to characterize cognitive function in AGS-affected children using assessment tools with reduced dependence on motor abilities and compare cognitive testing outcomes with overall severity and parental assessment of adaptive behavior.

METHODS: We performed a cross-sectional study. Children were recruited as part of the Myelin Disorders Biorepository Project at the Children’s Hospital of Philadelphia. We included individuals with a confirmed diagnosis of AGS. We administered the Leiter International Performance Scale, third edition (Leiter-3), and the Vineland Adaptive Behavior Scale, third edition (VABS-3), in the context of research encounters. Motor skills were categorized by AGS Severity Scale mobility levels. Descriptive statistics and Spearman’s rank correlation were used to compare assessments. Mann-Whitney and Kruskal-Wallis tests with correction with Dunn’s multiple comparison test were used to compare test performance between mobility groups.

RESULTS: Cognitive and adaptive behavior performance was captured in 57 children. The mean age at encounters was 8.51 (SD 5.15) years. The median (IQR) Leiter-3 score was 51 (interquartile range [IQR] 60), with administration failure in 20 of 57 (35%) individuals. On the VABS-3, the Motor Domain (median 29, IQR 36.25) was more impacted than the Communication (median 50, IQR 52), Daily Living Skills (median 52, IQR 31), and Socialization (median 54, IQR 40) Domains (p < 0.0001). The AGS Scale correlated with VABS-3 (r = 0.86, p < 0.0001) and Leiter-3 (r = 0.87, p < 0.0001). There was correlation between VABS-3 Domains and Leiter-3 (r-range 0.83-0.97). Gross motor and fine motor categories, respectively, correlated with VABS-3 (H = 39.37, p < 0.0001; U = 63, p < 0.0001) and Leiter-3 (H = 40.43, p < 0.0001; U = 66, p < 0.0001). Within each gross motor and fine motor category of the AGS Scale, a subset of children scored within normal IQ range.

DISCUSSION: Parental assessment of function by the VABS-3 correlated with directly assessed performance measures. Our data underscore the potential value of VABS-3 and Leiter-3 as tools to assess psychometric function in AGS. With a deeper understanding of our patients’ abilities, we can better guide clinicians and families to provide appropriate support and personalized interventions to empower children with leukodystrophies to maximize their communication and educational potential.

PMID:38857477 | DOI:10.1212/WNL.0000000000209541

JCO Clin Cancer Inform. 2024 Jun;8:e2300091. doi: 10.1200/CCI.23.00091.

ABSTRACT

PURPOSE: Data on lines of therapy (LOTs) for cancer treatment are important for clinical oncology research, but LOTs are not explicitly recorded in electronic health records (EHRs). We present an efficient approach for clinical data abstraction and a flexible algorithm to derive LOTs from EHR-based medication data on patients with glioblastoma multiforme (GBM).

METHODS: Nonclinicians were trained to abstract the diagnosis of GBM from EHRs, and their accuracy was compared with abstraction performed by clinicians. The resulting data were used to build a cohort of patients with confirmed GBM diagnosis. An algorithm was developed to derive LOTs using structured medication data, accounting for the addition and discontinuation of therapies and drug class. Descriptive statistics were calculated and time-to-next-treatment (TTNT) analysis was performed using the Kaplan-Meier method.

RESULTS: Treating clinicians as the gold standard, nonclinicians abstracted GBM diagnosis with a sensitivity of 0.98, specificity 1.00, positive predictive value 1.00, and negative predictive value 0.90, suggesting that nonclinician abstraction of GBM diagnosis was comparable with clinician abstraction. Of 693 patients with a confirmed diagnosis of GBM, 246 patients contained structured information about the types of medications received. Of them, 165 (67.1%) received a first-line therapy (1L) of temozolomide, and the median TTNT from the start of 1L was 179 days.

CONCLUSION: We described a workflow for extracting diagnosis of GBM and LOT from EHR data that combines nonclinician abstraction with algorithmic processing, demonstrating comparable accuracy with clinician abstraction and highlighting the potential for scalable and efficient EHR-based oncology research.

PMID:38857465 | DOI:10.1200/CCI.23.00091

J Am Med Inform Assoc. 2024 Jun 10:ocae129. doi: 10.1093/jamia/ocae129. Online ahead of print.

ABSTRACT

OBJECTIVES: Precise literature recommendation and summarization are crucial for biomedical professionals. While the latest iteration of generative pretrained transformer (GPT) incorporates 2 distinct modes-real-time search and pretrained model utilization-it encounters challenges in dealing with these tasks. Specifically, the real-time search can pinpoint some relevant articles but occasionally provides fabricated papers, whereas the pretrained model excels in generating well-structured summaries but struggles to cite specific sources. In response, this study introduces RefAI, an innovative retrieval-augmented generative tool designed to synergize the strengths of large language models (LLMs) while overcoming their limitations.

MATERIALS AND METHODS: RefAI utilized PubMed for systematic literature retrieval, employed a novel multivariable algorithm for article recommendation, and leveraged GPT-4 turbo for summarization. Ten queries under 2 prevalent topics (“cancer immunotherapy and target therapy” and “LLMs in medicine”) were chosen as use cases and 3 established counterparts (ChatGPT-4, ScholarAI, and Gemini) as our baselines. The evaluation was conducted by 10 domain experts through standard statistical analyses for performance comparison.

RESULTS: The overall performance of RefAI surpassed that of the baselines across 5 evaluated dimensions-relevance and quality for literature recommendation, accuracy, comprehensiveness, and reference integration for summarization, with the majority exhibiting statistically significant improvements (P-values <.05).

DISCUSSION: RefAI demonstrated substantial improvements in literature recommendation and summarization over existing tools, addressing issues like fabricated papers, metadata inaccuracies, restricted recommendations, and poor reference integration.

CONCLUSION: By augmenting LLM with external resources and a novel ranking algorithm, RefAI is uniquely capable of recommending high-quality literature and generating well-structured summaries, holding the potential to meet the critical needs of biomedical professionals in navigating and synthesizing vast amounts of scientific literature.

PMID:38857454 | DOI:10.1093/jamia/ocae129

Bioinformatics. 2024 Jun 10:btae360. doi: 10.1093/bioinformatics/btae360. Online ahead of print.

ABSTRACT

MOTIVATION: The identification of cancer subtypes plays a crucial role in cancer research and treatment. With the rapid development of high-throughput sequencing technologies, there has been an exponential accumulation of cancer multi-omics data. Integrating multi-omics data has emerged as a cost-effective and efficient strategy for cancer subtyping. While current methods primarily rely on genomics data, protein expression data offers a closer representation of phenotype. Therefore, integrating protein expression data holds promise for enhancing subtyping accuracy. However, the scarcity of protein expression data compared to genomics data presents a challenge in its direct incorporation into existing methods. Moreover, striking a balance between omics-specific learning and cross-omics learning remains a prevalent challenge in current multi-omics integration methods.

RESULTS: We introduce Subtype-MGTP, a novel cancer subtyping framework based on the translation of Multiple Genomics To Proteomics. Subtype-MGTP comprises two modules: a translation module, which leverages available protein data to translate multi-type genomics data into predicted protein expression data, and an improved deep subspace clustering module, which integrates contrastive learning to cluster the predicted protein data, yielding refined subtyping results. Extensive experiments conducted on benchmark datasets demonstrate that Subtype-MGTP outperforms nine state-of-the-art cancer subtyping methods. The interpretability of clustering results is further supported by the clinical and survival analysis. Subtype-MGTP also exhibits strong robustness against varying rates of missing protein data and demonstrates distinct advantages in integrating multi-omics data with imbalanced multi-omics data.

AVAILABILITY AND IMPLEMENTATION: The code and results are available at https://github.com/kybinn/Subtype-MGTP.

PMID:38857453 | DOI:10.1093/bioinformatics/btae360

Plast Reconstr Surg. 2024 May 24. doi: 10.1097/PRS.0000000000011562. Online ahead of print.

ABSTRACT

BACKGROUND: Color match of a reconstructed breast with the surrounding area is of importance for the overall aesthetic result. The objective of our study was to quantify the degree of color match achieved with different autologous breast reconstructions and to analyze the changes in color over time by analyzing digital photographs.

METHODS: 193 patients that underwent a delayed autologous breast reconstruction (DIEP, PAP, LAP, LD) were included. Standardized pictures from 242 flaps at 3 months and 9-12 months postoperative were analyzed and the L*a*b* values and delta E2000 (dE) values were determined to qualify the color match. The Kruskal-Wallis and Wilcoxon rank-sum tests were used for statistical analysis.

RESULTS: Initially, DIEP flaps had a significant lower dE value compared to LD (p=0.012) and PAP flaps (p < 0.001) when compared with the natural breast. PAP flaps showed a significant decrease after 9-12 months (p=0.003). Perception of color match was in all flaps comparable. Compared to the cleavage, at late follow-up, DIEP flaps had a significant higher dE value compared to LD (p=0.017) and PAP flaps (p < 0.001). PAP flaps presented a significant decrease of dE after 9-12 months (p =0.031). Abdominal skin presented no better skin color match in patients with PAP, LD, and LAP flaps.

CONCLUSIONS: All analyzed flaps have a comparable color match with the surrounding tissue as well as with the contralateral breast about one year after surgery. The color of PAP flaps changes more, which leads to an improvement at a later follow-up.

PMID:38857415 | DOI:10.1097/PRS.0000000000011562

Proc Natl Acad Sci U S A. 2024 Jun 18;121(25):e2401326121. doi: 10.1073/pnas.2401326121. Epub 2024 Jun 10.

ABSTRACT

When wires are cut, the tool produces striations on the cut surface; as in other forms of forensic analysis, these striation marks are used to connect the evidence to the source that created them. Here, we argue that the practice of comparing two wire cut surfaces introduces complexities not present in better-investigated forensic examination of toolmarks such as those observed on bullets, as wire comparisons inherently require multiple distinct comparisons, increasing the expected false discovery rate. We call attention to the multiple comparison problem in wire examination and relate it to other situations in forensics that involve multiple comparisons, such as database searches.

PMID:38857394 | DOI:10.1073/pnas.2401326121