Nevin Manimala

BMC Public Health. 2022 Dec 29;22(1):2453. doi: 10.1186/s12889-022-14657-w.

ABSTRACT

BACKGROUND: Public health dashboards have been used in the past to communicate and guide local responses to outbreaks, epidemics, and a host of various health conditions. During the first year of the COVID-19 pandemic, dashboards proliferated but the availability and quality differed across the world. This study aimed to evaluate the quality, access, and end-user experience of one such dashboard in the Western Cape province, South Africa.

METHODS: We analysed retrospective aggregate data on viewership over time for the first year since launch of the dashboard (30 April 2020 – 29 April 2021) and conducted a cross-sectional survey targeting adult users of the dashboard at one year post the initial launch. The self-administered, anonymous questionnaire with a total of 13 questions was made available via an online digital survey tool for a 2-week period (6 May 2021 – 21 May 2021).

RESULTS: After significant communication by senior provincial political leaders, adequate media coverage and two waves of COVID-19 the Western Cape public COVID-19 dashboard attracted a total of 2,248,456 views during its first year. The majority of these views came from Africa/South Africa with higher median daily views during COVID-19 wave periods. A total of 794 participants responded to the survey questionnaire. Reported devices used to access the dashboard differed statistically between occupational status groups with students tending toward using mobile devices whilst employed and retired participants tending toward using desktop computers/laptops. Frequency of use increases with increasing age with 65.1% of those > 70 years old viewing it daily. Overall, 76.4% of respondents reported that the dashboard influenced their personal planning and behaviour. High Likert score ratings were given for clarity, ease of use and overall end-user experience, with no differences seen across the various age groups surveyed.

CONCLUSION: The study demonstrated that both the availability of data and an understanding of end-user need is critical when developing and delivering public health tools that may ultimately garner public trust and influence individual behaviour.

PMID:36581823 | DOI:10.1186/s12889-022-14657-w

BMC Bioinformatics. 2022 Dec 29;23(1):564. doi: 10.1186/s12859-022-05119-6.

ABSTRACT

BACKGROUND: Identifying drug-target interactions (DTIs) plays a key role in drug development. Traditional wet experiments to identify DTIs are expensive and time consuming. Effective computational methods to predict DTIs are useful to narrow the searching scope of potential drugs and speed up the process of drug discovery. There are a variety of non-negativity matrix factorization based methods to predict DTIs, but the convergence of the algorithms used in the matrix factorization are often overlooked and the results can be further improved.

RESULTS: In order to predict DTIs more accurately and quickly, we propose an alternating direction algorithm to solve graph regularized non-negative matrix factorization with prior knowledge consistency constraint (ADA-GRMFC). Based on known DTIs, drug chemical structures and target sequences, ADA-GRMFC at first constructs a DTI matrix, a drug similarity matrix and a target similarity matrix. Then DTI prediction is modeled as the non-negative factorization of the DTI matrix with graph dual regularization terms and a prior knowledge consistency constraint. The graph dual regularization terms are used to integrate the information from the drug similarity matrix and the target similarity matrix, and the prior knowledge consistency constraint is used to ensure the matrix decomposition result should be consistent with the prior knowledge of known DTIs. Finally, an alternating direction algorithm is used to solve the matrix factorization. Furthermore, we prove that the algorithm can converge to a stationary point. Extensive experimental results of 10-fold cross-validation show that ADA-GRMFC has better performance than other state-of-the-art methods. In the case study, ADA-GRMFC is also used to predict the targets interacting with the drug olanzapine, and all of the 10 highest-scoring targets have been accurately predicted. In predicting drug interactions with target estrogen receptors alpha, 17 of the 20 highest-scoring drugs have been validated.

PMID:36581822 | DOI:10.1186/s12859-022-05119-6

Proc Natl Acad Sci U S A. 2023 Jan 3;120(1):e2214423119. doi: 10.1073/pnas.2214423119. Epub 2022 Dec 29.

NO ABSTRACT

PMID:36580595 | DOI:10.1073/pnas.2214423119

Proc Natl Acad Sci U S A. 2023 Jan 3;120(1):e2214972120. doi: 10.1073/pnas.2214972120. Epub 2022 Dec 29.

ABSTRACT

Regression learning is one of the long-standing problems in statistics, machine learning, and deep learning (DL). We show that writing this problem as a probabilistic expectation over (unknown) feature probabilities – thus increasing the number of unknown parameters and seemingly making the problem more complex-actually leads to its simplification, and allows incorporating the physical principle of entropy maximization. It helps decompose a very general setting of this learning problem (including discretization, feature selection, and learning multiple piece-wise linear regressions) into an iterative sequence of simple substeps, which are either analytically solvable or cheaply computable through an efficient second-order numerical solver with a sublinear cost scaling. This leads to the computationally cheap and robust non-DL second-order Sparse Probabilistic Approximation for Regression Task Analysis (SPARTAn) algorithm, that can be efficiently applied to problems with millions of feature dimensions on a commodity laptop, when the state-of-the-art learning tools would require supercomputers. SPARTAn is compared to a range of commonly used regression learning tools on synthetic problems and on the prediction of the El Niño Southern Oscillation, the dominant interannual mode of tropical climate variability. The obtained SPARTAn learners provide more predictive, sparse, and physically explainable data descriptions, clearly discerning the important role of ocean temperature variability at the thermocline in the equatorial Pacific. SPARTAn provides an easily interpretable description of the timescales by which these thermocline temperature features evolve and eventually express at the surface, thereby enabling enhanced predictability of the key drivers of the interannual climate.

PMID:36580592 | DOI:10.1073/pnas.2214972120

J Craniofac Surg. 2022 Dec 26. doi: 10.1097/SCS.0000000000009147. Online ahead of print.

ABSTRACT

The Temporomandibular Joint Dysfunction Syndrome (TJDS) is a group of pathologies that affect the temporomandibular joint, mastication muscles, and attached structures, 1 of the leading causes of orofacial pain. Arthroscopy is a technique used as a method of treatment for TJSD. This was a retrospective cohort study, and data were collected from the medical records of patients with TJDS. The diagnosis of TJDS was established based on computed tomography and nuclear magnetic resonance imaging tests, and clinical examination. All patients, who underwent arthroscopy, were operated on by the same surgeon in 2020. The variables analyzed in this study were: maximum mouth opening, laterality, and protrusion of patients undergoing arthroscopy at time intervals of 30, 90 days, and 6 months after surgery. Data from anamnesis of the medical records and findings on clinical examination were used to verify whether there was any correlation with good postoperative evolution. Afterward, these data were compared and submitted to statistical analysis (Wilcoxon (nonparametric and paired) and Mann-Whitney (nonparametric, unpaired) tests) to verify the degree of correlation between them. It could be concluded that in this sample, arthroscopy reduced the degree of pain in patients, increased mouth opening amplitude, and did not influence laterality and protrusion. The use of previous medication was correlated with a slight decrease in postoperative pain; patients who had undergone previous orthodontic treatment showed better results regarding maximum mouth opening without pain; patients who had previously felt pain on professional palpation had greater maximum mouth opening with and without pain after arthroscopy, and patients with noise at professional auscultation had greater maximum mouth opening without pain. Further studies should be conducted, with larger samples, associated with complementary exams (computed tomography and nuclear magnetic resonance) before and after arthroscopy.

PMID:36580580 | DOI:10.1097/SCS.0000000000009147

Phytother Res. 2022 Dec 29. doi: 10.1002/ptr.7585. Online ahead of print.

ABSTRACT

There is a growing interest in the considerable health benefits of Gymnema Sylvestre (GS) supplementation, as some studies have reported that it may improve cardiometabolic risk factors. However, the widespread impact of GS supplementation on the parameters mentioned above is not fully resolved. Consequently, this study aimed to examine the effects of GS supplementation on lipid profile, glycemic control, blood pressure, and anthropometric indices in adults. Eligible randomized controlled trials (RCT), published up to November 2021, were identified through PubMed, Scopus, and ISI Web of Science databases. Six studies were included and analyzed using a random-effects model to calculate weighted mean differences (WMDs) with 95% confidence intervals (CI). All studies were conducted in adults that used a GC supplement (>1 week) and assessed our selected cardiovascular risk factors. Outcomes revealed that GS supplementation significantly decreased triglyceride (p < .001), total cholesterol (p < .001), low-density lipoprotein (p < .001), fasting blood sugar (p < .001), and diastolic blood pressure (p = .003). Some limitations, including notable heterogeneity, low quality of studies, and lack of diversity among research participants, should be considered when interpreting our results. Our outcomes suggest that GS supplementation may improve cardiovascular risk factors. Future large-high-quality RCTs with longer duration and various populations are needed to firmly establish the clinical efficacy of the plant.

PMID:36580574 | DOI:10.1002/ptr.7585

J Laparoendosc Adv Surg Tech A. 2022 Dec 29. doi: 10.1089/lap.2022.0514. Online ahead of print.

ABSTRACT

Purpose: The aim of this study is to investigate the effect of bladder neck plication during transperitoneal robot-assisted radical prostatectomy (tRARP) on orgasm-related incontinence (climacturia) and the relationship between International Index of Erectile Function 5 (IIEF-5) scores and climacturia. Materials and Methods: We evaluated 118 patients who underwent nerve-sparing tRARP in our clinic and survived the first postoperative year. Patients were divided into two groups: those who underwent bladder neck plication (Group 1, n = 58) and those who did not (Group 2, n = 60). Our study investigated whether there is a difference between the groups in terms of climacturia or if there is a relationship between IIEF-5 scores and climacturia. Results: Of the patients in Group 1, 10.3% had incontinence and 13.8% had climacturia. Of the patients in Group 2 who did not have bladder neck plication, 10% had incontinence and 15% had climacturia. There was no difference between the groups in terms of climacturia (P > .825). Three patients (5.2%) in Group 1 and four patients (6.6%) in Group 2 requested treatment. There was no statistically significant correlation between IIEF-5 scores and climacturia in both groups (Group 1, P > .208; and Group 2, P > .508). Conclusions: In our study, the frequency of climacturia in patients who underwent bladder neck plication during tRARP was consistent with the literature and did not show a statistically significant difference from patients who did not undergo bladder neck plication. It has been observed that bladder neck plication, which has no effect on long-term continence, does not contribute to prevention of climacturia. No correlation was found between IIEF-5 scores and climacturia.

PMID:36580546 | DOI:10.1089/lap.2022.0514

J Palliat Med. 2022 Dec 29. doi: 10.1089/jpm.2022.0360. Online ahead of print.

ABSTRACT

Background: Potentially burdensome transitions at the end of life (e.g., repeated hospitalizations toward the end of life and/or health care transitions in the last three days of life) are common among residential care/assisted living (RC/AL) residents, and are associated with lower quality of end-of-life care reported by bereaved family members. We examined the association between state RC/AL regulations relevant to end-of-life care delivery and the likelihood of residents experiencing potentially burdensome transitions. Methods: Retrospective cohort study combining RC/AL registries of states’ regulations with Medicare claims data for residents in large RC/ALs (i.e., 25+ beds) in the United States on the 120th day before death (N = 129,153), 2017-2019. Independent variables were state RC/AL regulations relevant to end-of-life care, including third-party services, staffing, and medication management. Analyses included: (1) separate logistic regression models for each RC/AL regulation, adjusting for sociodemographic covariates; (2) separate logistic regression models with a Medicare fee-for-service (FFS) subgroup to control for comorbidities, and (3) multivariable regression analysis, including all regulations in both the overall sample and the Medicare FFS subgroup. Results: We found a lack of associations between potentially burdensome transitions and regulations regarding third-party services and staffing. There were small associations found between regulations related to medication management (i.e., requiring regular medication reviews, permitting direct care workers for injections, requiring/not requiring licensed nursing staff for injections) and potentially burdensome transitions. Conclusions: In this cross-sectional study, the associations of RC/AL regulations with potentially burdensome transitions were either small or not statistically significant, calling for more studies to explain the wide variation observed in end-of-life outcomes among RC/AL residents.

PMID:36580545 | DOI:10.1089/jpm.2022.0360

Med J (Ft Sam Houst Tex). 2023 Jan-Mar;(Per 23-1/2/3):97-102.

ABSTRACT

INTRODUCTION: Airway obstruction is the second leading cause of potentially survivable death on the battlefield. The Committee on Tactical Combat Casualty Care (CoTCCC) has evolving recommendations for the optimal supraglottic airway (SGA) device for inclusion to the medics’ aid bag.

METHODS: We convened an expert consensus panel consisting of a mix of 8 prehospital specialists, emergency medicine experts, and experienced combat medics, with the intent to offer recommendations for optimal SGA selection. Prior to meeting, we independently reviewed previously published studies conducted by our study team, conducted a virtual meeting, and summarized the findings to the panel. The studies included an analysis of end-user after action reviews, a market analysis, engineering testing, and prospective feedback from combat medics. The panel members then made recommendations regarding their top 3 choices of devices including the options of military custom design. Simple descriptive statistics were used to analyze panel recommendations.

RESULTS: The preponderance (7/8, 88%) of panel members recommended the gel-cuffed SGA, followed by the self-inflating-cuff SGA (5/8, 62%) and laryngeal tube SGA (5/8, 62%). Panel members expressed concerns primarily related to the (1) devices’ tolerance for the military environment, and (2) ability to effectively secure the gel-cuffed SGA and the self-inflating-cuff SGA during transport.

CONCLUSIONS: A preponderance of panel members selected the gel-cuff SGA with substantial feedback highlighting the need for military-specific customizations to support the combat environment needs.

PMID:36580532

Med J (Ft Sam Houst Tex). 2023 Jan-Mar;(Per 23-1/2/3):57-63.

ABSTRACT

BACKGROUND: Introduction: Military Role 1 practitioners have difficulty maintaining skill competency by working solely in military medical treatment facilities. Recognizing this, the Army Medical Department has renewed focus on physician specialty-specific Individual Critical Task Lists (ICTL) and is increasing the number of military-civilian partnerships, wherein small military treatment teams work full-time in civilian trauma centers. Yet, data to validate this approach is lacking. We hypothesize military Role 1 practitioners working full-time at a civilian Level 1 trauma center would attain similar resuscitation-specific procedural frequency to providers deployed to an active combat zone, and use the emergency medicine (EM) ICTL to compare select procedural frequency between a cohort of trauma patients from a civilian Level 1 trauma center and a cohort of combat casualties from the Department of Defense Trauma Registry (DODTR).

METHODS: We compared a selected subset of critically-injured, military-aged (18-35 years) trauma patients who were seen in a Level I Trauma Center emergency department (ED) between January 1, 2016 and December 31, 2017 and dispositioned directly either to the operating room, intensive care unit, or morgue to a selected cohort from the Department of Defense Trauma Registry (DODTR) who were seen in EDs in Iraq and Afghanistan between January 2007 and August 2016 using descriptive statistics. The primary outcome was the frequency of ICTL procedures performed, and the secondary outcome was injury severity.

RESULTS: We identified 843 civilian patients meeting inclusion criteria, of 1,719 military-aged patients captured by the trauma registry during the study. The selected cohort from the DODTR included 27,359 patients. Demographics were similar between the 2 groups, except the DODTR cohort included significantly more patients with blast trauma (55% versus 0.4%). We found similar ICTL procedural frequency (1 procedure for every 1.84 patients in the civilian cohort compared to one procedure/1.52 patients in the military cohort).

CONCLUSION: Role-1 ICTL trauma procedures were performed at similar frequencies between civilian patients seen at a Level 1 trauma center and combat casualties. With proper practice implementation, the opportunity exists for Role 1 practitioners to maintain their trauma resuscitation skills at civilian trauma centers.

PMID:36580525