Category: Nevin Manimala

Rev Sci Instrum. 2023 Jun 1;94(6):065101. doi: 10.1063/5.0137984.

ABSTRACT

Although bilirubin meters are still continuously widely used to screen neonatal jaundice worldwide, they still need a metrological calibration method to evaluate the measurement accuracy of these kinds of devices. In this article, the author describes a new calibration method for evaluation of the bilirubinometers measurements and evaluates the results with one of the most common statistical metrological techniques to establish and evaluate the calibration method; the techniques are x̄ and R control charts. The method mainly depends on establishing a correlation between two units, the bilirubin unit (mg/dl) and one of the metrological standard SI units, the irradiance (W/cm2), experimentally to achieve the calibration method. The study results showed that the estimated correlation coefficient of irradiance response to the bilirubinometer under test was around 0.80, which is a primary indication that the method is a considerably valid technique. In addition, the calibration method was evaluated by the statistical parameters x̄ and R control charts, and the results concluded that the variability calibration process is stable, controlled, and hence could be promisingly utilized to evaluate various bilirubinometers with satisfied accuracy and precision in measurements.

PMID:37862474 | DOI:10.1063/5.0137984

J Forensic Nurs. 2023 Oct 20. doi: 10.1097/JFN.0000000000000451. Online ahead of print.

ABSTRACT

This study investigates the impact of a professional development training series among a multidisciplinary team (MDT) during establishment of a trauma-informed sexual assault response and prevention program at a midsized university in the southeastern United States. MDT members included forensic nurses, advocates, counselors, law enforcement officers, and relevant faculty and staff. After completion of a baseline survey assessing attitudes toward trauma-informed care and perceptions of the team climate within the MDT, team members engaged in a trauma-informed care (TIC) professional development training series consisting of (a) 4-hour-long didactic lectures with incorporated group discussion and (2) one 2-hour in-situ simulation-based training exercise. MDT members subsequently completed 3-month and long-term follow-up surveys to assess the immediate and enduring impacts of the training series.The TIC training series significantly increased MDT members’ perceptions of participative safety, task orientation, and support for innovation within the group at the 3-month assessment. No long-term differences were found, likely because of a small sample size and low statistical power.Intensive TIC MDT professional development at the beginning of a campus-wide sexual assault prevention and response initiative enhances psychological safety within the group, evidenced by increased perceptions of participative safety and support for innovation, and builds team cohesiveness around a shared set of tasks. Within the present MDT, the professional development training series also appeared to facilitate adoption of a shared set of values for accomplishing the team’s goal of preventing and responding to sexual assault on campus. Recommendations for MDTs with similar goals are discussed.

PMID:37862460 | DOI:10.1097/JFN.0000000000000451

PLoS One. 2023 Oct 20;18(10):e0283133. doi: 10.1371/journal.pone.0283133. eCollection 2023.

ABSTRACT

This study is an attempt to investigate climate-induced increases in morbidity rates of food poisoning cases. Monthly food poisoning cases, average monthly meteorological data, and population data from 2004 to 2014 were obtained from the Malaysian Ministry of Health, Malaysian Meteorological Department, and Department of Statistics Malaysia, respectively. Poisson generalised linear models were developed to assess the association between climatic parameters and the number of reported food poisoning cases. The findings revealed that the food poisoning incidence in Malaysia during the 11 years study period was 561 cases per 100 000 population for the whole country. Among the cases, females and the ethnic Malays most frequently experienced food poisoning with incidence rates of 313 cases per 100,000 and 438 cases per 100,000 population over the period of 11 years, respectively. Most of the cases occurred within the active age of 13 to 35 years old. Temperature gave a significant impact on the incidence of food poisoning cases in Selangor (95% CI: 1.033-1.479; p = 0.020), Melaka (95% CI: 1.046-2.080; p = 0.027), Kelantan (95% CI: 1.129-1.958; p = 0.005), and Sabah (95% CI: 1.127-2.690; p = 0.012) while rainfall was a protective factor in Terengganu (95% CI: 0.996-0.999; p = 0.034) at lag 0 month. For a 1.0°C increase in temperature, the excess risk of food poisoning in each state can increase up to 74.1%, whereas for every 50 mm increase in rainfall, the risk of getting food poisoning decreased by almost 10%. The study concludes that climate does affect the distribution of food poisoning cases in Selangor, Melaka, Kelantan, Sabah, and Terengganu. Food poisoning cases in other states are not directly associated with temperature but related to monthly trends and seasonality.

PMID:37862373 | DOI:10.1371/journal.pone.0283133

PLoS One. 2023 Oct 20;18(10):e0293095. doi: 10.1371/journal.pone.0293095. eCollection 2023.

ABSTRACT

This study aimed to explore the differences in playing style and technical performance according to the ranking level in Spanish football teams. The sample comprised 38 professional teams that competed in LaLiga from 2008/09 to 2020/21, with a total of 4940 matches. The teams were grouped by their final ranking position: Champion (1st); Champions League (2nd-4th); Europa League (5th-6th); middle teams (7th-17th); and relegated teams (18th-20th). Linear mixed models were used to examine the effects of the team ranking on variables related to playing style and technical performance. The F2 statistic was calculated as effect size (ES). Regarding the style of play, the Champion teams initiated offensive sequences from a more advanced field position than the remaining ranking groups with a descending effect as the ranking position decreased (p < 0.001; ES = medium). The sequence duration and passes per sequence showed a decreasing effect across ranking groups (both p < 0.001; ES = small). In contrast, the direct speed showed an increasing effect as the ranking position decreased (p < 0.001; ES = small). A decreasing effect was observed in the number of sequences ending in the final third as the ranking position decreased (p < 0.001; ES = large) while no effect was found for the sequences ending in a shot. There was a reduction effect in ball possession, passing accuracy, through balls and crosses as the teams’ ranking decreased (all p < 0.001; ES = small-to-large). In summary, higher-ranked teams had an advanced starting position, longer offensive sequences, slower progression speed, more ball possession, higher passing accuracy, and more crosses and through balls than lower-ranked teams. Football coaches should consider that adopting a playing style focused on regaining the ball possession in advanced field zones and using long passing sequences can be an effective tactical strategy to improve the teams’ ranking during the season.

PMID:37862370 | DOI:10.1371/journal.pone.0293095

Adv Neonatal Care. 2023 Oct 19. doi: 10.1097/ANC.0000000000001115. Online ahead of print.

ABSTRACT

BACKGROUND: Nursing assessment of milk flow regulation and associated apnea, bradycardia, and desaturation (ABD events) contribute to considerations for the discharge of newborns from the acute care setting. Research regarding infant feeding-related (FR) events (sucking and swallowing difficulties) and ABD events in moderate to late-preterm and full-term infants is lacking.

PURPOSE: This study observes the impact of FR and ABD events during feeding on hospital length of stay (LOS) and healthcare utilization (cost) in moderate-to-late preterm newborns, as well as full-term infants.

METHODS: In a retrospective study, bottle-fed infants admitted to the level II specialty care nursery of an academic community hospital in Southern California were observed for FR and ABD events. Statistical analyses were used to determine the impact of FR events on adjusted LOS, to evaluate the interaction between FR event status and adjusted LOS on total hospital charges, and to assess the statistical independence between FR events and diagnostic-related group severity.

RESULTS: The full sample of patient records included 308 infants born between 32- and 44-week gestational age between April 1, 2018, and October 31, 2022. LOS was twice as long in infants who had FR events. Total median charges were higher in the group with FR events at $160,165 versus $64,380 with non-FR events.

IMPLICATIONS FOR PRACTICE AND RESEARCH: Increased knowledge in the epidemiology and nursing care of infants experiencing milk flow regulation and associated ABD events is critical for informing practices and guidelines related to the prevention of related morbidities.

PMID:37862366 | DOI:10.1097/ANC.0000000000001115

PLoS One. 2023 Oct 20;18(10):e0292754. doi: 10.1371/journal.pone.0292754. eCollection 2023.

ABSTRACT

BACKGROUND: The burden of drowning among occupational boaters in low and middle-income countries is highest globally. In Uganda, over 95% of people who drowned from boating-related activities were not wearing lifejackets at the time of the incident. We implemented and evaluated a peer-led training program to improve lifejacket wear among occupational boaters on Lake Albert, Uganda.

METHODS: We conducted a two-arm cluster randomized controlled trial in which fourteen landing sites were randomized to the intervention and non-intervention arm with a 1:1 allocation ratio. In the intervention arm, a six-month peer-to-peer training program on lifejacket wear was implemented while the non-intervention arm continued to receive the routine Marine Police sensitizations on drowning prevention through its community policing program. The effect of the intervention was assessed on self-reported and observed lifejacket wear using a test of differences in proportions of wear following the intention to treat principle. The effect of contamination was assessed using mixed effect modified Poisson regression following the As Treated analysis principle at 95% CI. Results are reported according to the CONSORT statement-extension for cluster randomized trials.

RESULTS: Self-reported lifejacket wear increased markedly from 30.8% to 65.1% in the intervention arm compared to the non-intervention arm which rose from 29.9% to 43.2%. Observed wear increased from 1.0% to 26.8% in the intervention arm and from 0.6% to 8.8% in the non-intervention arm. The test of differences in proportions of self-reported lifejacket wear (65.1%- 43.2% = 21.9%, p-value <0.001) and observed wear (26.8%- 8.8% = 18%, p-value <0.001) showed statistically significant differences between the intervention and non-intervention arm. Self-reported lifejacket wear was higher among boaters who received peer training than those who did not (Adj. PR 1.78, 95% CI 1.38-2.30).

CONCLUSION: This study demonstrated that peer-led training significantly improves lifejacket wear among occupational boaters. The government of Uganda through the relevant ministries, and the Landing Site Management Committees should embrace and scale up peer-led training programs on lifejacket wear to reduce drowning deaths.

PMID:37862363 | DOI:10.1371/journal.pone.0292754

PLoS Genet. 2023 Oct 20;19(10):e1010983. doi: 10.1371/journal.pgen.1010983. Online ahead of print.

ABSTRACT

In high-throughput spatial transcriptomics (ST) studies, it is of great interest to identify the genes whose level of expression in a tissue covaries with the spatial location of cells/spots. Such genes, also known as spatially variable genes (SVGs), can be crucial to the biological understanding of both structural and functional characteristics of complex tissues. Existing methods for detecting SVGs either suffer from huge computational demand or significantly lack statistical power. We propose a non-parametric method termed SMASH that achieves a balance between the above two problems. We compare SMASH with other existing methods in varying simulation scenarios demonstrating its superior statistical power and robustness. We apply the method to four ST datasets from different platforms uncovering interesting biological insights.

PMID:37862362 | DOI:10.1371/journal.pgen.1010983

J Am Acad Orthop Surg. 2023 Oct 19. doi: 10.5435/JAAOS-D-21-00249. Online ahead of print.

ABSTRACT

BACKGROUND: Pavlik harness treatment is the standard of care for developmental dysplasia of the hip in infants younger than 6 months. The effect of Pavlik harness treatment on the achievement of motor milestones has not previously been reported.

METHODS: In this prospective cohort study, 35 patients were prospectively enrolled to participate and received questionnaires with sequential clinical visits monitoring treatment of their developmental dysplasia of the hip. One-sample Student t-tests assessed differences in milestone attainment age, and the Benjamini-Hochberg procedure was conducted to decrease the false discovery rate. Post hoc power analyses of each test were conducted. The age of achievement of eight early motor milestones were recorded and compared with a previously published cohort of healthy infants.

RESULTS: Infants treated with a Pavlik harness achieved four early motor milestones markedly later than the reported age of achievement in a historical control group. These milestones included “roll supine” (5.3 vs. 4.5 months; P = 0.039), “roll prone” (5.7 vs. 5.0 months; P = 0.039), “sit” (6.4 vs. 5.2 months; P < 0.001), and “crawl on stomach” (7.7 vs. 6.6 months; P = 0.039). However, there was no difference in time to achievement of later motor milestones of “crawl on knees,” “pull to stand,” and “independent walking.”

CONCLUSION: Several early motor milestones were achieved at a statistically significantly later time than historical control subjects not treated in a Pavlik harness. Despite statistical significance, the small delays in early motor milestones were not thought to be clinically significant. No differences were observed in the later motor milestones, including knee crawling, standing, and independent walking. Clinicians and parents may be reassured by these findings.

LEVEL OF EVIDENCE: Therapeutic Level II-prospective study.

PMID:37862341 | DOI:10.5435/JAAOS-D-21-00249

J Med Internet Res. 2023 Oct 20;25:e46552. doi: 10.2196/46552.

ABSTRACT

BACKGROUND: Elicitation of patients’ preferences is an integral part of shared decision-making, the recommended approach for prostate cancer decision-making. Existing decision aids for this population often do not specifically focus on patients’ preferences. Healium is a brief interactive web-based decision aid that aims to elicit patients’ treatment preferences and is designed for a low health literate population.

OBJECTIVE: This study used a randomized controlled trial to evaluate whether Healium, designed to target preference elicitation, is as efficacious as Healing Choices, a comprehensive education and decision tool, in improving outcomes for decision-making and emotional quality of life.

METHODS: Patients diagnosed with localized prostate cancer who had not yet made a treatment decision were randomly assigned to the brief Healium intervention or Healing Choices, a decision aid previously developed by our group that serves as a virtual information center on prostate cancer diagnosis and treatment. Assessments were completed at baseline, 6 weeks, and 3 months post baseline, and included decisional outcomes (decisional conflict, satisfaction with decision, and preparation for decision-making), and emotional quality of life (anxiety/tension and depression), along with demographics, comorbidities, and health literacy.

RESULTS: A total of 327 individuals consented to participate in the study (171 were randomized to the Healium intervention arm and 156 were randomized to Healing Choices). The majority of the sample was non-Hispanic (272/282, 96%), White (239/314, 76%), married (251/320, 78.4%), and was on average 62.4 (SD 6.9) years old. Within both arms, there was a significant decrease in decisional conflict from baseline to 6 weeks postbaseline (Healium, P≤.001; Healing Choices, P≤.001), and a significant increase in satisfaction with one’s decision from 6 weeks to 3 months (Healium, P=.04; Healing Choices, P=.01). Within both arms, anxiety/tension (Healium, P=.23; Healing Choices, P=.27) and depression (Healium, P=.001; Healing Choices, P≤.001) decreased from baseline to 6 weeks, but only in the case of depression was the decrease statistically significant.

CONCLUSIONS: Healium, our brief decision aid focusing on treatment preference elicitation, is as successful in reducing decisional conflict as our previously tested comprehensive decision aid, Healing Choices, and has the added benefit of brevity, making it the ideal tool for integration into the physician consultation and electronic medical record.

TRIAL REGISTRATION: ClinicalTrials.gov NCT05800483; https://clinicaltrials.gov/study/NCT05800483.

PMID:37862103 | DOI:10.2196/46552

J Med Internet Res. 2023 Oct 20;25:e48093. doi: 10.2196/48093.

ABSTRACT

BACKGROUND: With the global rise in Alzheimer disease (AD), early screening for mild cognitive impairment (MCI), which is a preclinical stage of AD, is of paramount importance. Although biomarkers such as cerebrospinal fluid amyloid level and magnetic resonance imaging have been studied, they have limitations, such as high cost and invasiveness. Digital markers to assess cognitive impairment by analyzing behavioral data collected from digital devices in daily life can be a new alternative. In this context, we developed a “virtual kiosk test” for early screening of MCI by analyzing behavioral data collected when using a kiosk in a virtual environment.

OBJECTIVE: We aimed to investigate key behavioral features collected from a virtual kiosk test that could distinguish patients with MCI from healthy controls with high statistical significance. Also, we focused on developing a machine learning model capable of early screening of MCI based on these behavioral features.

METHODS: A total of 51 participants comprising 20 healthy controls and 31 patients with MCI were recruited by 2 neurologists from a university hospital. The participants performed a virtual kiosk test-developed by our group-where we recorded various behavioral data such as hand and eye movements. Based on these time series data, we computed the following 4 behavioral features: hand movement speed, proportion of fixation duration, time to completion, and the number of errors. To compare these behavioral features between healthy controls and patients with MCI, independent-samples 2-tailed t tests were used. Additionally, we used these behavioral features to train and validate a machine learning model for early screening of patients with MCI from healthy controls.

RESULTS: In the virtual kiosk test, all 4 behavioral features showed statistically significant differences between patients with MCI and healthy controls. Compared with healthy controls, patients with MCI had slower hand movement speed (t₄₉=3.45; P=.004), lower proportion of fixation duration (t₄₉=2.69; P=.04), longer time to completion (t₄₉=-3.44; P=.004), and a greater number of errors (t₄₉=-3.77; P=.001). All 4 features were then used to train a support vector machine to distinguish between healthy controls and patients with MCI. Our machine learning model achieved 93.3% accuracy, 100% sensitivity, 83.3% specificity, 90% precision, and 94.7% F₁-score.

CONCLUSIONS: Our research preliminarily suggests that analyzing hand and eye movements in the virtual kiosk test holds potential as a digital marker for early screening of MCI. In contrast to conventional biomarkers, this digital marker in virtual reality is advantageous as it can collect ecologically valid data at an affordable cost and in a short period (5-15 minutes), making it a suitable means for early screening of MCI. We call for further studies to confirm the reliability and validity of this approach.

PMID:37862101 | DOI:10.2196/48093