Nevin Manimala

JMIR Mhealth Uhealth. 2024 Jul 12;12:e51216. doi: 10.2196/51216.

ABSTRACT

BACKGROUND: Wearable activity trackers have become key players in mobile health practice as they offer various behavior change techniques (BCTs) to help improve physical activity (PA). Typically, multiple BCTs are implemented simultaneously in a device, making it difficult to identify which BCTs specifically improve PA.

OBJECTIVE: We investigated the effects of BCTs implemented on a smartwatch, the Fitbit, to determine how each technique promoted PA.

METHODS: This study was a single-blind, pilot randomized controlled trial, in which 70 adults (n=44, 63% women; mean age 40.5, SD 12.56 years; closed user group) were allocated to 1 of 3 BCT conditions: self-monitoring (feedback on participants’ own steps), goal setting (providing daily step goals), and social comparison (displaying daily steps achieved by peers). Each intervention lasted for 4 weeks (fully automated), during which participants wore a Fitbit and responded to day-to-day questionnaires regarding motivation. At pre- and postintervention time points (in-person sessions), levels and readiness for PA as well as different aspects of motivation were assessed.

RESULTS: Participants showed excellent adherence (mean valid-wear time of Fitbit=26.43/28 days, 94%), and no dropout was recorded. No significant changes were found in self-reported total PA (dz<0.28, P=.40 for the self-monitoring group, P=.58 for the goal setting group, and P=.19 for the social comparison group). Fitbit-assessed step count during the intervention period was slightly higher in the goal setting and social comparison groups than in the self-monitoring group, although the effects did not reach statistical significance (P=.052 and P=.06). However, more than half (27/46, 59%) of the participants in the precontemplation stage reported progress to a higher stage across the 3 conditions. Additionally, significant increases were detected for several aspects of motivation (ie, integrated and external regulation), and significant group differences were identified for the day-to-day changes in external regulation; that is, the self-monitoring group showed a significantly larger increase in the sense of pressure and tension (as part of external regulation) than the goal setting group (P=.04).

CONCLUSIONS: Fitbit-implemented BCTs promote readiness and motivation for PA, although their effects on PA levels are marginal. The BCT-specific effects were unclear, but preliminary evidence showed that self-monitoring alone may be perceived demanding. Combining self-monitoring with another BCT (or goal setting, at least) may be important for enhancing continuous engagement in PA.

TRIAL REGISTRATION: Open Science Framework; https://osf.io/87qnb/?view_only=f7b72d48bb5044eca4b8ce729f6b403b.

PMID:38996332 | DOI:10.2196/51216

J Med Internet Res. 2024 Jul 12;26:e51506. doi: 10.2196/51506.

ABSTRACT

BACKGROUND: Hospitalization in psychiatric wards is a necessary step for many individuals experiencing severe mental health issues. However, being hospitalized can also be a stressful and unsettling experience. It is crucial to understand and address the various needs of hospitalized individuals with psychiatric disorders to promote their overall well-being and support their recovery.

OBJECTIVE: Our objectives were to identify and describe individual needs related to mental hospitals through peer-to-peer interactions on Polish web-based forums among individuals with depression and anxiety disorders and to assess whether these needs were addressed by peers.

METHODS: We conducted a search of web-based forums focused on depression and anxiety and selected samples of 160 and 176 posts, respectively, until we reached saturation. A mixed methods analysis that included an in-depth content analysis, the Pearson χ² test, and φ coefficient was used to evaluate the posts.

RESULTS: The most frequently identified needs were the same for depression and anxiety forums and involved informational (105/160, 65.6% and 169/393, 43%, respectively), social life (17/160, 10.6% and 90/393, 22.9%, respectively), and emotional (9/160, 5.6% and 66/393, 16.8%, respectively) needs. The results show that there is no difference in the expression of needs between the analyzed forums. The needs were directly (42/47, 89% vs 98/110, 89.1% of times for depression and anxiety, respectively) and not fully (27/47, 57% vs 86/110, 78.2% of times for depression and anxiety, respectively) addressed by forum users. In quantitative analysis, we found that depression-related forums had more posts about the need for informational support and rectification, the expression of anger, and seeking professional support. By contrast, anxiety-related forums had more posts about the need for emotional support; social life; and information concerning medications, hope, and motivation. The most common co-occurrence of expressed needs was between sharing own experience and the need for professional support, with a strong positive association. The qualitative analysis showed that users join web-based communities to discuss their fears and questions about psychiatric hospitals. The posts revealed 4 mental and emotional representations of psychiatric hospitals: the hospital as an unknown place, the ambivalence of presumptions and needs, the negative representation of psychiatric hospitals, and the people associated with psychiatric hospitals. The tone of the posts was mostly negative, with discussions revolving around negative stereotypes; traumatic experiences; and beliefs that increased anxiety, shock, and fright and deterred users from hospitalization.

CONCLUSIONS: Our study demonstrates that web-based forums can provide a platform for individuals with depression and anxiety disorders to express a wide range of needs. Most needs were addressed by peers but not sufficiently. Mental health professionals can benefit from these findings by gaining insights into the unique needs and concerns of their patients, thus allowing for more effective treatment and support.

PMID:38996331 | DOI:10.2196/51506

Phys Rev Lett. 2024 Jun 28;132(26):260402. doi: 10.1103/PhysRevLett.132.260402.

ABSTRACT

The state of an open quantum system undergoing an adiabatic process evolves by following the instantaneous stationary state of its time-dependent generator. This observation allows one to characterize, for a generic adiabatic evolution, the average dynamics of the open system. However, information about fluctuations of dynamical observables, such as the number of photons emitted or the time-integrated stochastic entropy production in single experimental runs, requires controlling the whole spectrum of the generator and not only the stationary state. Here, we show how such information can be obtained in adiabatic open quantum dynamics by exploiting tools from large deviation theory. We prove an adiabatic theorem for deformed generators, which allows us to encode, in a biased quantum state, the full counting statistics of generic time-integrated dynamical observables. We further compute the probability associated with an arbitrary “rare” time history of the observable and derive a dynamics which realizes it in its typical behavior. Our results provide a way to characterize and engineer adiabatic open quantum dynamics and to control their fluctuations.

PMID:38996317 | DOI:10.1103/PhysRevLett.132.260402

Phys Rev Lett. 2024 Jun 28;132(26):268001. doi: 10.1103/PhysRevLett.132.268001.

ABSTRACT

We identify the thermodynamic conditions necessary to observe indefinite growth in homogeneous open chemical reaction networks (CRNs) satisfying mass action kinetics. We also characterize the thermodynamic efficiency of growth by considering the fraction of the chemical work supplied from the surroundings that is converted into CRN free energy. We find that indefinite growth cannot arise in CRNs chemostatted by fixing the concentration of some species at constant values, or in continuous-flow stirred tank reactors. Indefinite growth requires a constant net influx from the surroundings of at least one species. In this case, unimolecular CRNs always generate equilibrium linear growth, i.e., a continuous linear accumulation of species with equilibrium concentrations and efficiency one. Multimolecular CRNs are necessary to generate nonequilibrium growth, i.e., the continuous accumulation of species with nonequilibrium concentrations. Pseudounimolecular CRNs-a subclass of multimolecular CRNs-always generate asymptotic linear growth with zero efficiency. Our findings demonstrate the importance of the CRN topology and the chemostatting procedure in determining the dynamics and thermodynamics of growth.

PMID:38996287 | DOI:10.1103/PhysRevLett.132.268001

Phys Rev Lett. 2024 Jun 21;132(25):252301. doi: 10.1103/PhysRevLett.132.252301.

ABSTRACT

In ultrarelativistic heavy-ion collisions, a plasma of deconfined quarks and gluons is formed within 1 fm/c of the nuclei’s impact. The complex dynamics of the collision before ≈1 fm/c is often described with parametric models, which affect the predictivity of calculations. In this work, we perform a systematic analysis of LHC measurements from Pb-Pb collisions, by combining an ab initio model of the early stage of the collisions with a hydrodynamic model of the plasma. We obtain state-of-the-art constraints on the shear and bulk viscosity of quark-gluon plasma. We mitigate the additional cost of the ab initio initial conditions by combining Bayesian model averaging with transfer learning, allowing us to account for important theoretical uncertainties in the hydrodynamics-to-hadron transition. We show that, despite the apparent strong constraints on the shear viscosity, metrics that balance the model’s predictivity with its degree of agreement with data do not prefer a temperature-dependent specific shear viscosity over a constant value. We validate the model by comparing with discriminating observables not used in the calibration, finding excellent agreement.

PMID:38996233 | DOI:10.1103/PhysRevLett.132.252301

Phys Rev Lett. 2024 Jun 21;132(25):250205. doi: 10.1103/PhysRevLett.132.250205.

ABSTRACT

Quantum nonlocality, pioneered in Bell’s seminal work and subsequently verified through a series of experiments, has drawn substantial attention due to its practical applications in various protocols. Evaluating and comparing the extent of nonlocality within distinct quantum correlations holds significant practical relevance. Within the resource theoretic framework this can be achieved by assessing the interconversion rate among different nonlocal correlations under free local operations and shared randomness. In this study we, however, present instances of quantum nonlocal correlations that are incomparable in the strongest sense. Specifically, when starting with an arbitrary many copies of one nonlocal correlation, it becomes impossible to obtain even a single copy of the other correlation, and this incomparability holds in both directions. Such incomparable quantum correlations can be obtained even in the simplest Bell scenario, which involves two parties, each having two dichotomic measurements setups. Notably, there exist an uncountable number of such incomparable correlations. Our result challenges the notion of a “unique gold coin,” often referred to as the “maximally resourceful state,” within the framework of the resource theory of quantum nonlocality. To this end, we provide examples of isotropic quantum correlations that cannot be distilled up to the Tsirelson point, and thus partially answer a long-standing open question in nonlocality distillation.

PMID:38996229 | DOI:10.1103/PhysRevLett.132.250205

J Am Acad Orthop Surg Glob Res Rev. 2024 Jul 10;8(7). doi: 10.5435/JAAOSGlobal-D-23-00278. eCollection 2024 Jul 1.

ABSTRACT

BACKGROUND: A recent database study found that 15.2% of clavicle fractures underwent surgical treatment. Recent evidence accentuates the role of smoking in predicting nonunion. The purpose of this study was to further elucidate the effect of smoking on the 30-day postoperative outcomes after surgical treatment of clavicle fractures.

METHODS: The authors queried the American College of Surgeons National Surgical Quality Improvement Program database for all patients who underwent open reduction and internal fixation of clavicle fracture between 2015 and 2020. Multivariate logistic regression, adjusted for notable patient demographics and comorbidities, was used to identify associations between current smoking status and postoperative complications.

RESULTS: In total, 6,132 patients were included in this study of whom 1,510 (24.6%) were current smokers and 4,622 (75.4%) were nonsmokers. Multivariate analysis found current smoking status to be significantly associated with higher rates of deep incisional surgical-site infection (OR, 7.87; 95% CI, 1.51 to 41.09; P = 0.014), revision surgery (OR, 2.74; 95% CI, 1.67 to 4.49; P < 0.001), and readmission (OR, 3.29; 95% CI, 1.84 to 5.89; P < 0.001).

CONCLUSION: Current smoking status is markedly associated with higher rates of deep incisional surgical-site infection, revision surgery, and readmission within 30 days after open reduction and internal fixation of clavicle fracture.

PMID:38996220 | DOI:10.5435/JAAOSGlobal-D-23-00278

J Am Acad Orthop Surg Glob Res Rev. 2024 Jul 10;8(7). doi: 10.5435/JAAOSGlobal-D-24-00119. eCollection 2024 Jul 1.

ABSTRACT

INTRODUCTION: The purpose of this systematic review and meta-analysis was to provide an update of the recent literature comparing clinical outcomes of surgically treated fibular fractures using intramedullary nailing (IMN) with open reduction and internal plate fixation (ORIF).

METHODS: A literature search reporting clinical outcomes after IMN or ORIF of the distal fibula was conducted on PubMed. Inclusion criteria consisted of original studies; studies focusing on clinical outcomes after IMN or IMN and ORIF published before May 11, 2022; studies with at least 5 patients; and studies reporting union rates, complication rates, and patient-reported outcomes such as American Orthopaedic Foot and Ankle Society (AOFAS) and Olerud-Molander scores.

RESULTS: Of 2,394 studies identified, a total of 29 studies (4 LOE-I, 2 LOE-II, 6 LOE-III, 17 LOE-IV) were included consisting of 1,850 IMN patients and 514 plate patients. The pooled mean age of IMN patients was 58 years (95% confidence interval [CI], 54 to 62, I2 = 42%) versus 57 years (95% CI, 53 to 62, I2 = 49%) in ORIF. Union rates for IMN patients revealed a 99% union rate (95% CI, 0.98 to 1.00, I2 = 20%) versus 97% union rate for ORIF patients (95% CI, 0.94 to 0.99, I2 = 0%). Studies that compared IMN with ORIF revealed no difference in union rates (risk ratio [RR] = 0.99, 95% CI, 0.96 to 1.02, I2 = 0%). IMN patients showed a 15% complication rate (95% CI, 0.09 to 0.23, I2 = 89%), whereas plate patients had a complication rate of 30% (95% CI, 0.18 to 0.46, I2 = 63%). When comparing studies with both treatments, IMN patients had a significantly lower risk of complications (RR = 0.49, 95% CI, 0.29 to 0.82, I2 = 50%). The IMN group trended toward a higher mean AOFAS and Olerud-Molander score than the plate group by 4.53 (95% CI, -14.58 to 23.65, I2 = 85%) and 3.54 (95% CI, -2.32 to 9.41, I2 = 76%) points, respectively.

CONCLUSION: Current literature reveals near equivalence in union rates and a markedly lower risk of complications when comparing IMN with plate fixation. While IMN patients had higher AOFAS and Olerud-Molander scores, these differences were not statistically significant. Notably, subgroup analyses indicated that rates of symptomatic implant and removal of implant were comparable between IMN and ORIF, which may indicate that wound-related complications were reduced in the minimally invasive IMN technique. While the high cost of IMN implants remains a barrier to their widespread adoption, the long-term benefits of reducing complications, specifically associated with wound complications in high-risk populations, may greatly improve quality of care for patients with distal fibula fractures. Additional research and cost-effectiveness analyses are warranted to fully assess the long-term benefits and economic feasibility of using IMN fixation for distal fibula fractures.

LEVEL OF EVIDENCE: Therapeutic Level IV.

PMID:38996216 | DOI:10.5435/JAAOSGlobal-D-24-00119

JCO Clin Cancer Inform. 2024 Jul;8:e2300192. doi: 10.1200/CCI.23.00192.

ABSTRACT

PURPOSE: Patients with epithelial ovarian cancer (EOC) have an elevated risk for venous thromboembolism (VTE). To assess the risk of VTE, models were developed by statistical or machine learning algorithms. However, few models have accommodated deep learning (DL) algorithms in realistic clinical settings. We aimed to develop a predictive DL model, exploiting rich information from electronic health records (EHRs), including dynamic clinical features and the presence of competing risks.

METHODS: We extracted EHRs of 1,268 patients diagnosed with EOC from January 2007 through December 2017 at the National Cancer Center, Korea. DL survival networks using fully connected layers, temporal attention, and recurrent neural networks were adopted and compared with multi-perceptron-based classification models. Prediction accuracy was independently validated in the data set of 423 patients newly diagnosed with EOC from January 2018 to December 2019. Personalized risk plots displaying the individual interval risk were developed.

RESULTS: DL-based survival networks achieved a superior area under the receiver operating characteristic curve (AUROC) between 0.95 and 0.98 while the AUROC of classification models was between 0.85 and 0.90. As clinical information benefits the prediction accuracy, the proposed dynamic survival network outperformed other survival networks for the test and validation data set with the highest time-dependent concordance index (0.974, 0.975) and lowest Brier score (0.051, 0.049) at 6 months after a cancer diagnosis. Our visualization showed that the interval risk fluctuating along with the changes in longitudinal clinical features.

CONCLUSION: Adaption of dynamic patient clinical features and accounting for competing risks from EHRs into the DL algorithms demonstrated VTE risk prediction with high accuracy. Our results show that this novel dynamic survival network can provide personalized risk prediction with the potential to assist risk-based clinical intervention to prevent VTE among patients with EOC.

PMID:38996199 | DOI:10.1200/CCI.23.00192

Egypt J Immunol. 2024 Jul;31(3):81-94.

ABSTRACT

Inflammatory bowel disease is a chronic immune-mediated disorder with a relapsing and remitting course. It leads to disabling gastrointestinal symptoms, low quality of life, and a significant burden for healthcare utilization and associated costs. Therefore, non-invasive biomarkers are needed for early diagnosis and follow up to avoid the complications of invasive diagnostic procedures. Calgranulin C is a calcium binding protein with proinflammatory properties. The aim of this study was to evaluate the role of serum calgranulin C as a non-invasive biomarker for diagnosis and prediction of activity in comparison to different biomarkers and endoscopic activity scores in inflammatory bowel disease. The study included 80 inflammatory bowel disease patients (50 Ulcerative colitis and 30 Chron’s patients) and 20 normal controls. Complete blood picture, C-reactive protein, erythrocyte sedimentation rate, fecal calprotectin and serum calgranulin C were measured. Colonoscopies with histopathological examination were done and different activity scoring systems assessed. Among ulcerative colitis group, serum calgranulin C was statistically significantly higher in comparison to control group [723.640±529.055 ng/ml versus 80.850±24.416 ng/ml]. Depending on the American college of gastroenterology ulcerative colitis activity index, fecal calprotectin and serum calgranulin C were statistically significantly higher among moderate to severe ulcerative colitis than those with mild activity and those in remission (p < 0.001, for both). Regarding Crohn’s disease group, serum calgranulin C was statistically significantly higher in comparison to control group [759.233±797.963 ng/ml versus 80.850±24.416 ng/mL]. Depending on Crohn’s disease activity index, both serum calgranulin C and fecal calprotectin were statistically significantly higher among active disease than those in remission (p < 0.001, for both). In conclusion, serum calgranulin C could be used as a non-invasive marker to predict activity and severity and to ensure remission among inflammatory bowel disease patients.

PMID:38995671