Nevin Manimala

Sci Rep. 2023 Dec 18;13(1):22470. doi: 10.1038/s41598-023-48860-5.

ABSTRACT

A drop in physical activity and a deterioration in the capacity to undertake daily life activities are both connected with ageing and have negative effects on physical and mental health. An Elderly and Visually Impaired Human Activity Monitoring (EV-HAM) system that keeps tabs on a person’s routine and steps in if a change in behaviour or a crisis might greatly help an elderly person or a visually impaired. These individuals may find greater freedom with the help of an EVHAM system. As the backbone of human-centric applications like actively supported living and in-home monitoring for the elderly and visually impaired, an EVHAM system is essential. Big data-driven product design is flourishing in this age of 5G and the IoT. Recent advancements in processing power and software architectures have also contributed to the emergence and development of artificial intelligence (AI). In this context, the digital twin has emerged as a state-of-the-art technology that bridges the gap between the real and virtual worlds by evaluating data from several sensors using artificial intelligence algorithms. Although promising findings have been reported by Wi-Fi-based human activity identification techniques so far, their effectiveness is vulnerable to environmental variations. Using the environment-independent fingerprints generated from the Wi-Fi channel state information (CSI), we introduce Wi-Sense. This human activity identification system employs a Deep Hybrid convolutional neural network (DHCNN). The proposed system begins by collecting the CSI with a regular Wi-Fi Network Interface Controller. Wi-Sense uses the CSI ratio technique to lessen the effect of noise and the phase offset. The t- Distributed Stochastic Neighbor Embedding (t-SNE) is used to eliminate unnecessary data further. The data dimension is decreased, and the negative effects on the environment are eliminated in this process. The resulting spectrogram of the processed data exposes the activity’s micro-Doppler fingerprints as a function of both time and location. These spectrograms are put to use in the training of a DHCNN. Based on our findings, EVHAM can accurately identify these actions 99% of the time.

PMID:38110422 | DOI:10.1038/s41598-023-48860-5

Sci Data. 2023 Dec 18;10(1):909. doi: 10.1038/s41597-023-02814-8.

ABSTRACT

Retrieval-based Clinical Decision Support (ReCDS) can aid clinical workflow by providing relevant literature and similar patients for a given patient. However, the development of ReCDS systems has been severely obstructed by the lack of diverse patient collections and publicly available large-scale patient-level annotation datasets. In this paper, we collect a novel dataset of patient summaries and relations called PMC-Patients to benchmark two ReCDS tasks: Patient-to-Article Retrieval (ReCDS-PAR) and Patient-to-Patient Retrieval (ReCDS-PPR). Specifically, we extract patient summaries from PubMed Central articles using simple heuristics and utilize the PubMed citation graph to define patient-article relevance and patient-patient similarity. PMC-Patients contains 167k patient summaries with 3.1 M patient-article relevance annotations and 293k patient-patient similarity annotations, which is the largest-scale resource for ReCDS and also one of the largest patient collections. Human evaluation and analysis show that PMC-Patients is a diverse dataset with high-quality annotations. We also implement and evaluate several ReCDS systems on the PMC-Patients benchmarks to show its challenges and conduct several case studies to show the clinical utility of PMC-Patients.

PMID:38110415 | DOI:10.1038/s41597-023-02814-8

Nat Commun. 2023 Dec 18;14(1):7870. doi: 10.1038/s41467-023-43493-8.

ABSTRACT

Flood exposure has been linked to shifts in population sizes and composition. Traditionally, these changes have been observed at a local level providing insight to local dynamics but not general trends, or at a coarse resolution that does not capture localized shifts. Using historic flood data between 2000-2023 across the Contiguous United States (CONUS), we identify the relationships between flood exposure and population change. We demonstrate that observed declines in population are statistically associated with higher levels of historic flood exposure, which may be subsequently coupled with future population projections. Several locations have already begun to see population responses to observed flood exposure and are forecasted to have decreased future growth rates as a result. Finally, we find that exposure to high frequency flooding (5 and 20-year return periods) results in 2-7% lower growth rates than baseline projections. This is exacerbated in areas with relatively high exposure to frequent flooding where growth is expected to decline over the next 30 years.

PMID:38110409 | DOI:10.1038/s41467-023-43493-8

Nat Commun. 2023 Dec 18;14(1):8006. doi: 10.1038/s41467-023-43730-0.

ABSTRACT

Developing synchronous bilateral Wilms tumor suggests an underlying (epi)genetic predisposition. Here, we evaluate this predisposition in 68 patients using whole exome or genome sequencing (n = 85 tumors from 61 patients with matched germline blood DNA), RNA-seq (n = 99 tumors), and DNA methylation analysis (n = 61 peripheral blood, n = 29 non-diseased kidney, n = 99 tumors). We determine the predominant events for bilateral Wilms tumor predisposition: 1)pre-zygotic germline genetic variants readily detectable in blood DNA [WT1 (14.8%), NYNRIN (6.6%), TRIM28 (5%), and BRCA-related genes (5%)] or 2)post-zygotic epigenetic hypermethylation at 11p15.5 H19/ICR1 that may require analysis of multiple tissue types for diagnosis. Of 99 total tumor specimens, 16 (16.1%) have 11p15.5 normal retention of imprinting, 25 (25.2%) have 11p15.5 copy neutral loss of heterozygosity, and 58 (58.6%) have 11p15.5 H19/ICR1 epigenetic hypermethylation (loss of imprinting). Here, we ascertain the epigenetic and genetic modes of bilateral Wilms tumor predisposition.

PMID:38110397 | DOI:10.1038/s41467-023-43730-0

Nat Commun. 2023 Dec 18;14(1):8411. doi: 10.1038/s41467-023-44087-0.

ABSTRACT

Individual differences in cognition during childhood are associated with important social, physical, and mental health outcomes in adolescence and adulthood. Given that cortical surface arealization during development reflects the brain’s functional prioritization, quantifying variation in the topography of functional brain networks across the developing cortex may provide insight regarding individual differences in cognition. We test this idea by defining personalized functional networks (PFNs) that account for interindividual heterogeneity in functional brain network topography in 9-10 year olds from the Adolescent Brain Cognitive Development℠ Study. Across matched discovery (n = 3525) and replication (n = 3447) samples, the total cortical representation of fronto-parietal PFNs positively correlates with general cognition. Cross-validated ridge regressions trained on PFN topography predict cognition in unseen data across domains, with prediction accuracy increasing along the cortex’s sensorimotor-association organizational axis. These results establish that functional network topography heterogeneity is associated with individual differences in cognition before the critical transition into adolescence.

PMID:38110396 | DOI:10.1038/s41467-023-44087-0

BMJ Open. 2023 Dec 18;13(12):e076114. doi: 10.1136/bmjopen-2023-076114.

ABSTRACT

INTRODUCTION: Metabolic disturbances are of major health concerns in the world. In addition to their high prevalence, these disorders have substantial roles in developing other physical and mental diseases. Diet could have a considerable influence on managing the progression of these conditions and their consequent health-related effects. The aim of the ‘Diet in relation to Metabolic, sleep and psychological health Status’ Project is to explore the association of nutrition with metabolic, sleep and mental health, considering potential mediators including brain-derived neurotrophic factor (BDNF) and adropin.

METHODS AND ANALYSIS: This cross-sectional study will be conducted on adults (20-65 years) working in schools of Isfahan, Iran. A multistage cluster random sampling method will be used to select participants. Anthropometric, body composition and biochemical values including fasting blood glucose, lipid profile, 25-hydroxy vitamin D, insulin, BDNF, adropin, malondialdehyde, superoxide dismutase, glutathione peroxidase, uric acid, creatinine and C reactive protein will be measured for each participant. National Cholesterol Education Program and Adult Treatment Panel III will be considered to define metabolic syndrome. Diet will be assessed through a validated Food Frequency Questionnaire. Furthermore, sleep status, mental health, quality of life, physical activity and demographic status of individuals will be assessed by validated questionnaires. The collected data will be analysed using appropriate statistical methods.

ETHICS AND DISSEMINATION: The study protocol was approved by the local Ethics Committee of Isfahan University of Medical Sciences. All participants will provide written informed consent. Dissemination will be through conference presentations and publications in peer-reviewed journals.

PMID:38110391 | DOI:10.1136/bmjopen-2023-076114

BMJ Open. 2023 Dec 18;13(12):e075723. doi: 10.1136/bmjopen-2023-075723.

ABSTRACT

OBJECTIVE: In developing countries, malnutrition is a noteworthy concern related to the well-being of people, and this study aimed to determine the factors that affect malnutrition among children below 5 years in Ghana.

DESIGN: The study used a secondary data source, specifically the Ghanaian Multiple Indicator Cluster Survey Six (MICS 6), which was conducted by the Ghana Statistical Service in 2017-2018. The MICS data are hierarchical, as children are categorised within households, and households are further grouped within a higher cluster, violating the independence assumption that must be addressed in the analyses. This study used a Bayesian multilevel ordinal logistic regression to model, identify and analyse the factors linked to child malnutrition in Ghana.

SETTING: The setting of the study was the household level across the previous 10 administrative regions in Ghana.

PARTICIPANTS: Data for 8875 children under 5 years were used for the study. The data were gathered from households in all 10 administrative regions of Ghana using a sampling procedure consisting of stratification and random selection to ensure national representation.

RESULTS: The results showed that the Northern Region of Ghana had the highest occurrence rate of severe and moderate malnutrition, and factors such as the count of children’s books or picture books, whether the child experienced fever in the last 2 weeks, age and sex of the child, and the child’s household wealth index quintile were strongly linked to malnutrition among Ghanaian children.

CONCLUSION: These findings underscore the intricate interplay of factors contributing to child nutrition in Ghana and suggest that addressing malnutrition necessitates a comprehensive approach that considers factors such as access to healthcare and reading materials, household wealth, and other social and environmental factors.

PMID:38110390 | DOI:10.1136/bmjopen-2023-075723

BMJ Open. 2023 Dec 18;13(12):e070237. doi: 10.1136/bmjopen-2022-070237.

ABSTRACT

OBJECTIVES: Compared with ST-segment elevation myocardial infarction (STEMI) patients, non-STEMI (NSTEMI) patients have more comorbidities and extensive coronary artery disease. Contemporary comparative data on the long-term prognosis of stable post-myocardial infarction subtypes are needed.

DESIGN: Long-Term rIsk, clinical manaGement and healthcare Resource utilisation of stable coronary artery dISease (TIGRIS) was a multinational, observational and longitudinal cohort study.

SETTING: Patients were enrolled from 350 centres, with >95% coming from cardiology practices across 24 countries, from 19 June 2013 to 31 March 2017.

PARTICIPANTS: This study enrolled 8277 stable patients 1-3 years after myocardial infarction with ≥1 additional risk factor.

OUTCOME MEASURES: Over a 2 year follow-up, cardiovascular events and deaths and self-reported health using the EuroQol 5-dimension questionnaire score were recorded. Relative risk of clinical events and health resource utilisation in STEMI and NSTEMI patients were compared using multivariable Poisson regression models, adjusting for prognostically relevant patient factors.

RESULTS: Of 7752 patients with known myocardial infarction type, 46% had NSTEMI; NSTEMI patients were older with more comorbidities than STEMI patients. NSTEMI patients had significantly poorer self-reported health and lower prevalence of dual antiplatelet therapy at hospital discharge and at enrolment 1-3 years later. NSTEMI patients had a higher incidence of combined myocardial infarction, stroke and cardiovascular death (5.6% vs 3.9%, p<0.001) and higher all-cause mortality (4.2% vs 2.6%, p<0.001) compared with STEMI patients. Risks were attenuated after adjusting for other patient characteristics. Health resource utilisation was higher in NSTEMI patients, although STEMI patients had more cardiologist visits.

CONCLUSIONS: Post-NSTEMI chronic coronary syndrome patients had a less favourable risk factor profile, poorer self-reported health and more adverse cardiovascular events during long-term follow-up than individuals post STEMI. Efforts are needed to recognise the risks of stable patients after NSTEMI and optimise secondary prevention and care.

TRIAL REGISTRATION NUMBER: NCT01866904.

PMID:38110389 | DOI:10.1136/bmjopen-2022-070237

BMJ Open. 2023 Dec 18;13(12):e076735. doi: 10.1136/bmjopen-2023-076735.

ABSTRACT

OBJECTIVE: To characterise surgical site infections (SSIs) after open surgery in the UK’s National Health Service.

DESIGN: Retrospective cohort analysis of electronic records of patients from Clinical Practice Research Datalink, linked with Hospital Episode Statistics’ secondary care datasets.

SETTING: Clinical practice in the community and secondary care.

PARTICIPANTS: Cohort of 50 000 adult patients who underwent open surgery between 2017 and 2022.

OUTCOME MEASURES: Incidence of SSI, clinical outcomes, patterns of care and costs of wound management.

RESULTS: 11% (5281/50 000) of patients developed an SSI a mean of 18.4±14.7 days after their surgical procedure, of which 15% (806/5281) were inpatients and 85% (4475/5281) were in the community after hospital discharge. The incidence of SSI varied according to anatomical site of surgery. The incidence also varied according to a patient’s risk and whether they underwent an emergency procedure. SSI onset reduced the 6 months healing rate by a mean of 3 percentage points and increased time to wound healing by a mean of 15 days per wound. SSIs were predominantly managed in the community by practice and district nurses and 16% (850/5281) of all patients were readmitted into hospital. The total health service cost of surgical wound management following SSI onset was a mean of £3537 per wound ranging from £2542 for a low-risk patient who underwent an elective procedure to £4855 for a high-risk patient who underwent an emergency procedure.

CONCLUSIONS: This study provides important insights into several aspects of SSI management in clinical practice in the UK that have been difficult to ascertain from surveillance data. Surgeons are unlikely to be fully aware of the true incidence of SSI and how they are managed once patients are discharged from hospital. Current SSI surveillance services appear to be under-reporting the actual incidence.

PMID:38110388 | DOI:10.1136/bmjopen-2023-076735

BMJ Open. 2023 Dec 18;13(12):e079874. doi: 10.1136/bmjopen-2023-079874.

ABSTRACT

OBJECTIVES: This study aims to investigate the incidence of and factors associated with irritable bowel syndrome (IBS) among resident physicians in standardised training at eight traditional Chinese medicine (TCM) hospitals in China.

DESIGN: A cross-sectional survey was administered to resident physicians in their first to third years of standardised training at eight TCM hospitals.

PARTICIPANTS AND SETTING: A total of 514 resident physicians in standardised training were included.

MEASURES: The questionnaire consisted of two sections, namely: section A collected basic information, and section B included the four-item Perceived Stress Scale (PSS-4), the Patient Health Questionnaire-4 (PHQ-4), the Pittsburgh Sleep Quality Index (PSQI) and the Rome IV criteria for IBS. Univariate and multivariate logistic regression models were constructed to assess the associations of age, sex, body mass index, stress, depression, anxiety, sleep quality and IBS.

RESULTS: Of the included resident doctors, 77.2% were female, 20.4% were obese or underweight and 8.6% had symptoms consistent with a diagnosis of IBS. There were no statistically significant differences in lifestyle factors (night shift work, overtime work or working efficiency during the COVID-19 pandemic) between patients with IBS and participants without IBS (hereafter, non-IBS participants) (p=0.429, p=0.572 or p=0.464, respectively). Notably, compared with non-IBS participants, patients with IBS had significantly higher mean scores on the PSS-4 and PHQ-4 (p=0.028 and p=0.012, respectively); however, there was not a significant difference in PSQI scores between these two groups (p=0.079). Depression symptoms were significantly associated with IBS (unadjusted OR 0.498, 95% CI 0.265 to 0.935, p=0.030).

CONCLUSION: These findings suggest that IBS is common among resident physicians in standardised training. Future studies should investigate emotional distress, especially stress and depression, in the development of prevention or treatment of IBS.

PMID:38110383 | DOI:10.1136/bmjopen-2023-079874