Nevin Manimala

JMIR Form Res. 2023 Jan 24. doi: 10.2196/36608. Online ahead of print.

ABSTRACT

BACKGROUND: Access to data is crucial for decision-making; this fact has become more evident during the pandemic. Data collected using mobile applications can positively influence diagnosis and treatment, the supply chain, and staffing resources of healthcare facilities. Developers and healthcare professionals have worked to create applications that can track a person’s COVID status. For example, these applications can monitor positive COVID test results and vaccination status. Regrettably, people may be concerned about sharing their data with government or private sector organizations developing applications. Understanding user perceptions is essential; without substantial user adoption and the use of mobile tracing apps, the benefits cannot be achieved.

OBJECTIVE: This study aims to assess the factors that positively and negatively affect the use of COVID-tracing apps by examining individuals’ perceptions about sharing data on mobile applications, such as testing regularity, infection, and immunization status.

METHODS: The hypothesized research model was tested using a cross-sectional survey instrument. The survey contained five reflective constructs and four control variables selected after reviewing the literature and interviewing healthcare professionals. A digital copy of the survey was created using Qualtrics. After receiving approval from Institutional Board Review (IRB). Data was collected from 367 participants through Amazon Mechanical Turk (MTurk). The inclusion criteria for participants to complete the anonymized survey included those of any gender who were 18 years and older. We then analyzed the theoretical model using structural equation modeling (SEM).

RESULTS: After analyzing the quality of responses, n=325 participants, 66.46% were male (n=216), and 33.53% were female (n=109). Of the participants in the final dataset, 72.61% were employed. The results of the structural equation modeling showed that perceived vulnerability (β = 0.688, p < .001), Self-efficacy (β = 0.292, p < .001), and an individual’s prior infection with COVID (β = 0.194, p < .05) have statistically significant positive impacts on the intention to use mobile tracing apps. Privacy concerns (β = -0.360, p < .001), risk aversion (β = -0.150, p < .1), and a family members prior infection with COVID (β = – 0.139, p < .05) have statistically significant negative influences on a person’s intention to use mobile tracing apps.

CONCLUSIONS: This study illustrates that various user perceptions affect whether individuals utilize COVID-tracing applications technology. By working collaboratively on legislation and the messaging provided to potential users before releasing an application, developers, healthcare professionals, and policymakers can improve the use of tracking apps. Healthcare professionals need to emphasize disease vulnerability to motivate people to utilize mobile tracing apps which can help reduce the spread of viruses and diseases. In addition, more work is needed at the policy-making level to protect the privacy of users which in return can increase user engagement.

PMID:36735838 | DOI:10.2196/36608

Plast Reconstr Surg. 2023 Feb 2. doi: 10.1097/PRS.0000000000010280. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate whether neurosensory recovery of the inferior alveolar nerve (IAN) is influenced by its location following sagittal split osteotomy (SSO) in patients undergoing large mandibular movements.

METHODS: This was a prospective, split-mouth study of skeletally mature patients undergoing BSSO. Patients were included as study subjects if they underwent BSSO for mandibular advancement > 10 mm and, following the splits, the IAN was freely entering the distal segment (IANDI) on one side and within the proximal segment (IANPR) on the other. Descriptive, bivariate, and Kaplan-Meier statistics were computed.

RESULTS: The study sample included 13 subjects (8 female, mean age 18.7 ± 1.8 years) undergoing 26 SSOs. Eleven subjects underwent bimaxillary surgery; 10 had simultaneous genioplasty. The mean mandibular movement was 12.2 ± 1.4 mm and was not significantly different between sides (p = 0.43). All subjects achieved FSR bilaterally within 1 year of surgery. There was no difference in the median times to FSR based upon the location of the IAN (IANDI = 105 days vs IANPR = 126 days, p = 0.57).

CONCLUSION: In SSO for mandibular advancement with movements > 10 mm, leaving the IAN within the proximal segment may not impact time to FSR.

PMID:36735814 | DOI:10.1097/PRS.0000000000010280

Dermatol Surg. 2023 Feb 2. doi: 10.1097/DSS.0000000000003697. Online ahead of print.

ABSTRACT

BACKGROUND: Treating infraorbital dark circles is one of the commonest aesthetic demands worldwide. Autologous fat transfer is commonly used to treat dark circles by filling the grooves, without effect on skin quality. Platelet-rich plasma has been reported to improve skin quality. Autologous fat can be emulsified and filtered to produce nanofat, which is then injected superficially in the dark circles to improve skin quality and discoloration.

OBJECTIVE: To compare the efficacy of platelet-rich plasma versus combined fat transfer and nanofat in treating infraorbital dark circles.

MATERIALS AND METHODS: 30 patients with infraorbital dark circles of combined etiological factors were randomized into 2 equal groups: Group A treated with platelet-rich plasma and Group B treated with autologous fat transfer with emulsified fat injection.

RESULTS: Excellent and moderate responses were observed in 3 (20%) and 2 (13%) patients in group A versus 7 (46.7%) and 4 (27%) in group B, respectively. Nonresponders were 8 (53.3%) in group A and only 1 patient (6.7%) in group B. The difference was statistically significant regarding improvement (p = .048) and patient satisfaction (p = .032).

CONCLUSION: Autologous fat transfer with nanofat is significantly superior to platelet-rich plasma in improvement and satisfaction.

PMID:36735798 | DOI:10.1097/DSS.0000000000003697

PLoS Comput Biol. 2023 Feb 3;19(2):e1010811. doi: 10.1371/journal.pcbi.1010811. Online ahead of print.

ABSTRACT

A topic of growing interest in computational neuroscience is the discovery of fundamental principles underlying global dynamics and the self-organization of the brain. In particular, the notion that the brain operates near criticality has gained considerable support, and recent work has shown that the dynamics of different brain states may be modeled by pairwise maximum entropy Ising models at various distances from a phase transition, i.e., from criticality. Here we aim to characterize two brain states (psychedelics-induced and placebo) as captured by functional magnetic resonance imaging (fMRI), with features derived from the Ising spin model formalism (system temperature, critical point, susceptibility) and from algorithmic complexity. We hypothesized, along the lines of the entropic brain hypothesis, that psychedelics drive brain dynamics into a more disordered state at a higher Ising temperature and increased complexity. We analyze resting state blood-oxygen-level-dependent (BOLD) fMRI data collected in an earlier study from fifteen subjects in a control condition (placebo) and during ingestion of lysergic acid diethylamide (LSD). Working with the automated anatomical labeling (AAL) brain parcellation, we first create “archetype” Ising models representative of the entire dataset (global) and of the data in each condition. Remarkably, we find that such archetypes exhibit a strong correlation with an average structural connectome template obtained from dMRI (r = 0.6). We compare the archetypes from the two conditions and find that the Ising connectivity in the LSD condition is lower than the placebo one, especially in homotopic links (interhemispheric connectivity), reflecting a significant decrease of homotopic functional connectivity in the LSD condition. The global archetype is then personalized for each individual and condition by adjusting the system temperature. The resulting temperatures are all near but above the critical point of the model in the paramagnetic (disordered) phase. The individualized Ising temperatures are higher in the LSD condition than the placebo condition (p = 9 × 10-5). Next, we estimate the Lempel-Ziv-Welch (LZW) complexity of the binarized BOLD data and the synthetic data generated with the individualized model using the Metropolis algorithm for each participant and condition. The LZW complexity computed from experimental data reveals a weak statistical relationship with condition (p = 0.04 one-tailed Wilcoxon test) and none with Ising temperature (r(13) = 0.13, p = 0.65), presumably because of the limited length of the BOLD time series. Similarly, we explore complexity using the block decomposition method (BDM), a more advanced method for estimating algorithmic complexity. The BDM complexity of the experimental data displays a significant correlation with Ising temperature (r(13) = 0.56, p = 0.03) and a weak but significant correlation with condition (p = 0.04, one-tailed Wilcoxon test). This study suggests that the effects of LSD increase the complexity of brain dynamics by loosening interhemispheric connectivity-especially homotopic links. In agreement with earlier work using the Ising formalism with BOLD data, we find the brain state in the placebo condition is already above the critical point, with LSD resulting in a shift further away from criticality into a more disordered state.

PMID:36735751 | DOI:10.1371/journal.pcbi.1010811

PLoS One. 2023 Feb 3;18(2):e0281454. doi: 10.1371/journal.pone.0281454. eCollection 2023.

ABSTRACT

OBJECTIVES: The paper has two objectives. The first one examines whether informing women about the benefits and adverse effects of breast cancer screening could have an effect on three variables: their knowledge, the importance women attach to the future consequences of their current decisions (time perspective), and the degree to which women are worried about developing breast cancer (worry). The second one examines whether these three variables affect their intention to participate in the screening, either directly or indirectly through their feeling of regret if they do not attend the screening (anticipated regret); through their values and the support they receive in making their decisions (decisional conflict); and, through the perceived acceptability and benefits of the screening programme (attitude).

METHODS: Partial least squares-structural equation modelling (PLS-SEM) is used to analyse both objectives and to differentiate between direct, indirect, and moderating effects, due to the incorporation in the model of the three mediating variables (anticipated regret, decisional conflict, and attitude) and a moderating variable (educational level).

RESULTS: Information affects knowledge (objective variable), but not the behavioural variables (time perspective and worry). On the other hand, the level of knowledge has no direct or indirect effect on intention, but behavioural variables do affect it through the mediating variables.

CONCLUSIONS: The variables of the planned behaviour theory are relevant to understand women’s decisions and to be able to take appropriate health policy measures. Doing so, the processes of personalised screening would improve, or there would be the incorporation of shared decision-making in this context; these being demands associated with the most recent goals achieved in health programmes in many countries.

PMID:36735750 | DOI:10.1371/journal.pone.0281454

PLoS One. 2023 Feb 3;18(2):e0268912. doi: 10.1371/journal.pone.0268912. eCollection 2023.

ABSTRACT

OBJECTIVE: This study was carried out to identify the frequency and types of injuries in adult ice hockey, in order to better understand injury patterns and identify potential areas for injury prevention.

METHODS: We conducted a retrospective database review of acute injuries reported in ice hockey in patients presenting to a Level-1 adult Emergency Centre in Switzerland. Patients between January 1, 2013 and December 31, 2019 and over 16 years of age were identified in our computerised patient database. Each consultation was reviewed to derive information on demographics, playing level and the features of the injury, including location, type, mechanism and consequences. Different age groups were compared, as were amateur and professional players. A statistical analysis was performed.

RESULTS: A total of 230 patients were identified. The most common diagnoses were fracture (28.3%), contusion/abrasion (23.9%), laceration (12.6%) and concussion (10.4%). The most commonly affected body parts were the face (31.3%), the shoulder/clavicle (13.0%) and the head (12.2%). Most lesions were caused by player-player contact (37.4%), contact with the puck (24.3%) and falls (10.9%). In comparison to the younger cohorts, patients >36 years of age more frequently suffered injuries caused by falls, (p < 0.001) and were less frequently injured by player-player contact (p = 0.01813). In amateur players, significantly more injuries were caused by stick contact (OR 0, 95% CI (0.00-0.83), p = 0.02) and surgery was more rarely performed (OR 2.35, 95% CI 0.98-5.46, p = 0.04).

CONCLUSIONS: Injuries continue to play a major role in ice hockey, especially in the face and due to player-player contact. Future investigations should focus on player-player contact and possible effective preventive measures. Players must be encouraged to employ face protection and to wear a mouth guard at all times.

PMID:36735749 | DOI:10.1371/journal.pone.0268912

PLoS One. 2023 Feb 3;18(2):e0272160. doi: 10.1371/journal.pone.0272160. eCollection 2023.

ABSTRACT

Refrigeration systems are complex, non-linear, multi-modal, and multi-dimensional. However, traditional methods are based on a trial and error process to optimize these systems, and a global optimum operating point cannot be guaranteed. Therefore, this work aims to study a two-stage vapor compression refrigeration system (VCRS) through a novel and robust hybrid multi-objective grey wolf optimizer (HMOGWO) algorithm. The system is modeled using response surface methods (RSM) to investigate the impacts of design variables on the set responses. Firstly, the interaction between the system components and their cycle behavior is analyzed by building four surrogate models using RSM. The model fit statistics indicate that they are statistically significant and agree with the design data. Three conflicting scenarios in bi-objective optimization are built focusing on the overall system following the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) and Linear Programming Technique for Multidimensional Analysis of Preference (LINMAP) decision-making methods. The optimal solutions indicate that for the first to third scenarios, the exergetic efficiency (EE) and capital expenditure (CAPEX) are optimized by 33.4% and 7.5%, and the EE and operational expenditure (OPEX) are improved by 27.4% and 19.0%. The EE and global warming potential (GWP) are also optimized by 27.2% and 19.1%, where the proposed HMOGWO outperforms the MOGWO and NSGA-II. Finally, the K-means clustering technique is applied for Pareto characterization. Based on the research outcomes, the combined RSM and HMOGWO techniques have proved an excellent solution to simulate and optimize two-stage VCRS.

PMID:36735732 | DOI:10.1371/journal.pone.0272160

PLoS One. 2023 Feb 3;18(2):e0281284. doi: 10.1371/journal.pone.0281284. eCollection 2023.

ABSTRACT

INTRODUCTION: Retinopathy of prematurity (ROP) is a serious eye disease in preterm infants. Generally, the progression of this disease can be detected by screening infants regularly. In case of progression, treatment can be instituted to stop the progression. In Indonesia, however, not all infants are screened because the number of pediatric ophthalmologists trained to screen for ROP and provide treatment is limited. Therefore, other methods are required to identify infants at risk of developing severe ROP.

OBJECTIVE: To assess a scoring model’s internal and external validity to predict ROP progression in Indonesia.

METHOD: To develop a scoring model and determine its internal validity, we used data on 98 preterm infants with ROP who had undergone one or more serial eye examinations between 2009 and 2014. For external validation, we analyzed data on 62 infants diagnosed with ROP irrespective of the stage between 2017 and 2020. Patients stemmed from one neonatal unit and three eye clinics in Jakarta, Indonesia.

RESULTS: We identified the duration of oxygen supplementation, gestational age, socio-economic status, place of birth, and oxygen saturation monitor setting as risk factors for developing ROP. We developed two models-one based on the duration of supplemental oxygen and one on the setting of the oxygen saturation monitor. The ROP risk and probabilistic models obtained the same sensitivity and specificity for progression to Type 1 ROP. The agreement, determined with the Kappa statistic, between the ROP risk model’s suitability and the probabilistic model was excellent. The external validity of the ROP risk model showed 100% sensitivity, 73% specificity, 76% positive predictive value, 100% negative predictive value, positive LR +3.7, negative LR 0, 47% pre-test probability, and 77% post-test probability.

CONCLUSION: The ROP risk scoring model can help to predict which infants with first-stage ROP might show progression to severe ROP and may identify infants who require referral to a pediatric ophthalmologist for treatment.

PMID:36735727 | DOI:10.1371/journal.pone.0281284

Altern Ther Health Med. 2023 Feb 3:AT7794. Online ahead of print.

ABSTRACT

CONTEXT: With the rapidly aging population globally, osteoporosis (OP) has become a major public health problem, and fracture is a common complication of OP. Older adults, especially postmenopausal women, have a higher incidence of OP.

OBJECTIVE: The study intended to analyze the clinical information, epidemiological characteristics, treatments, and follow-up results of patients with osteoporotic fractures (OPFs) in adults over 65 years old, to provide data support for the prevention, treatment, and use of OPF focus groups in clinical practice.

DESIGN: The research team performed a retrospective analysis using electronic medical records and related imaging data of patients.

SETTING: The study took place at Hebei General Hospital in Hebei, China.

PARTICIPANTS: Participants were 387 patients over 65 years old with osteoporotic fractures who had been admitted to the hospital between July 2012 and July 2018.

OUTCOME MEASURES: The research team recorded participants’ ages, genders, fracture causes, and fracture sites. The team performed a follow-up analysis on refractures, treatment with anti-osteoporotic drugs, exercise, and survival status within the 3 years after surgery.

RESULTS: The study’s male-to-female ratio was 1:3.1, and the rate of osteoporotic fracture for females was significantly higher than that of males. The mean age of participants with fractures was 75.6 ± 8.5 years, and most fractures occurred in participants 78 to 85 years old. Of the 387 participants, 169 participants had hip fractures (43.67%); 98 had vertebral compression fractures (25.32%); 51 had distal radius and ulna fractures (13.18%); 42 had proximal humerus fractures (10.85%); and 27 had other fractures (6.98%). The number of women with fractures at each site was greater than the number of men, but the differences weren’t statistically significant (P > .05). The main causes of injury were falls (71.58%), and the main place of the occurrence of injury was at home (65.6%). Of the 387 participants, 346 had surgical treatment (89.41%), and the effective rate of surgical treatment was 99.42%. Three years after surgery, the research team followed up with 235 participants, for a follow-up rate of 60.72%. Within the 3 years of the follow-up period, 61 participants had refractures (25.63%), 29 received treatment with regular anti-osteoporotic drugs (12.34%), 36 exercised twice or more a week (15.32%), and 32 had died for various reasons (13.62%).

CONCLUSIONS: The study preliminarily described the epidemiological characteristics of 387 osteoporotic fractures in adults over 65 years old. More women had fractures than men; the hip was the most common fracture site, and falls were the main cause of injury. Most of the fractures occurred in the place of residence, and the refracture rate was 25.96% at three years after surgery.

PMID:36735718

PLoS One. 2023 Feb 3;18(2):e0274060. doi: 10.1371/journal.pone.0274060. eCollection 2023.

ABSTRACT

OBJECTIVES: To evaluate the association between plasma metabolites, biochemical analytes, diagnostic imaging findings, and the histologic diagnosis of hepatic lipidosis in bearded dragons. To assess the effects of gemfibrozil therapy on hepatic lipid accumulation and associated diagnostic tests.

ANIMALS: Fourteen bearded dragons (Pogona vitticeps) with varying severity of hepatic lipid accumulation (with and without hepatic lipidosis) were included.

PROCEDURES: Animals underwent coelomic ultrasound, computed tomography (CT) scans, and coelioscopic hepatic biopsies. Clinical pathology tests included lipidologic tests, hepatic biomarkers, and mass spectrometry-based metabolomics. Animals were medicated with gemfibrozil 6mg/kg orally once a day for 2 months in a randomized blinded clinical trial prior to repeating previous diagnostic testing.

RESULTS: Hounsfield units on CT were negatively associated with increased hepatic vacuolation, while ultrasound and gross evaluation of the liver were not reliable. Beta-hydroxybutyric-acid (BHBA) concentrations were significantly associated with hepatic lipidosis. Metabolomics and lipidomics data found BHBA and succinic acid to be potential biomarkers for diagnosing hepatic lipidosis in bearded dragons. Succinic acid concentrations were significantly lower in the gemfibrozil treatment group. There was a tendency for improvement in the biomarkers and reduced hepatic fat in bearded dragons with hepatic lipidosis when treated with gemfibrozil, though the improvement was not statistically significant.

CONCLUSIONS: These findings provide information on the antemortem assessment of hepatic lipidosis in bearded dragons and paves the way for further research in diagnosis and treatment of this disease.

PMID:36735707 | DOI:10.1371/journal.pone.0274060