Tag: nevin manimala

Am J Speech Lang Pathol. 2024 Mar 19:1-12. doi: 10.1044/2024_AJSLP-23-00332. Online ahead of print.

ABSTRACT

PURPOSE: Socioeconomically disadvantaged areas are more resource poor, impacting adherence to swallowing care recommendations. Neighborhood-level disadvantage metrics, such as the Area Deprivation Index (ADI), allow for examination of social determinants of health (SDOH) in a precise region. We examined ADI in a cohort of persons living with dementia (PLWD) to determine representation of those residing in areas of socioeconomic disadvantage (high ADI), distribution of swallowing care provided, and frequency of SDOH-related counseling or resource linking prior to discharge.

METHOD: A retrospective chart abstraction was performed for all inpatients with a diagnosis of dementia (N = 204) seen by the Swallow Service at a large academic hospital in 2014. State ADI Deciles 1 (least) to 10 (most socioeconomic disadvantage) and decile groups (1-3, 4-7, and 8-10) were compared with the surrounding county. Frequency of videofluoroscopic swallowing evaluations (VFSEs) based on ADI deciles was recorded. To determine whether SDOH-related counseling or resource linking occurred for those in high ADI (8-10) neighborhoods, speech-language pathology notes, and discharge summaries were reviewed. Descriptive statistics, independent samples t tests, and one-way analysis of variance were calculated.

RESULTS: ADI was significantly higher in this cohort (M = 3.84, SD = 2.58) than in the surrounding county (M = 2.79, SD = 1.88, p = .000). There was no significant difference in utilization of swallowing services across decile groups (p = .88). Although the majority (85%) in high ADI areas was recommended diet modifications or alternative nutrition likely requiring extra resources, there was no documentation indicating that additional SDOH resource linking or counseling was provided.

CONCLUSIONS: These findings raise important questions about the role and responsibility of speech-language pathologists in tailoring swallowing services to challenges posed by the lived environment, particularly in socioeconomically disadvantaged areas. This underscores the need for further research to understand and address gaps in postdischarge support for PLWD in high-ADI regions and advocate for more equitable provision of swallowing care.

PMID:38502719 | DOI:10.1044/2024_AJSLP-23-00332

Scand J Pain. 2024 Mar 19;24(1). doi: 10.1515/sjpain-2023-0113. eCollection 2024 Jan 1.

ABSTRACT

OBJECTIVES: Perceived pain is a multi-factorial subjective variable, commonly measured by numeric rating scales, verbal descriptive scales (VDS), or by a position on an analogue line (VAS). A major question is whether an individual’s VAS and VDS pain assessments, on the same occasion, could be comparable. The aim was to compare continuous and discretized VAS pain data with verbal descriptive pain datasets from the Oswestry Disability Index (ODI) and the European Quality of Life Scale (EQ-5D) in paired pain datasets.

METHODS: The measurement level of data from any type of scale assessments is ordinal, having rank-invariant properties only. Non-parametric statistical methods were used. Two ways of discretizing the VAS-line to VAS-intervals to fit the number of the comparing VDS-categories were used: the commonly used (equidistant VAS,VDS)-pairs and the (unbiased VAS,VDS)-pairs of pain data. The comparability of the (VAS,VDS)-pairs of data of perceived pain was studied by the bivariate ranking approach. Hence, each pair will be regarded as ordered, disordered, or tied with respect to the other pairs of data. The percentage agreement, PA, the measures of disorder, D, and of order consistency, MA, were calculated. Total interchangeability requires PA = 1 and MA = 1.

RESULTS: The wide range of overlapping of (VAS,VDS)-pairs indicated that the continuous VAS data were not comparable to any of the VDS pain datasets. The percentage of agreement, PA; in the (equidistant VAS,ODI) and (equidistant VAS, EQ-5D) pairs were 38 and 49%, and the order consistency, MA, was 0.70 and 0.80, respectively. Corresponding results for the (unbiased VAS,VDS)-pairs of pain data were PA: 54 and 100%, and MA: 0.77 and 1.0.

CONCLUSION: Our results confirmed that perceived pain is the individual’s subjective experience, and possible scale-interchangeability is only study-specific. The pain experience is not possible to be measured univocally, but is possible for the individual to rate on a scale.

PMID:38502712 | DOI:10.1515/sjpain-2023-0113

PLoS One. 2024 Mar 19;19(3):e0298526. doi: 10.1371/journal.pone.0298526. eCollection 2024.

ABSTRACT

BACKGROUND: Orthodontic systematic reviews (SRs) use different methods to pool the individual studies in a meta-analysis when indicated. However, the number of studies included in orthodontic meta-analyses is relatively small. This study aimed to evaluate the direction of estimate changes of orthodontic meta-analyses (MAs) using different between-study variance methods considering the level of heterogeneity when few trials were pooled.

METHODS: Search and study selection: Systematic reviews (SRs) published over the last three years, from the 1st of January 2020 to the 31st of December 2022, in six main orthodontic journals with at least one MA pooling five or lesser primary studies were identified. Data collection and analysis: Data were extracted from each eligible MA, which was replicated in a random effect model using DerSimonian and Laird (DL), Paule-Mandel (PM), Restricted maximum-likelihood (REML), Hartung Knapp and Sidik Jonkman (HKSJ) methods. The results were reported using median and interquartile range (IQR) for continuous data and frequencies for categorical data and analyzed using non-parametric tests. The Boruta algorithm was used to assess the significant predictors for the significant change in the confidence interval between the different methods compared to the DL method, which was only feasible using the HKSJ method.

RESULTS: 146 MAs were included, most applying the random effect model (n = 111; 76%) and pooling continuous data using mean difference (n = 121; 83%). The median number of studies was three (range 2, 4), and the overall statistical heterogeneity (I2 ranged from 0 to 99% with a median of 68%). Close to 60% of the significant findings became non-significant when HKSJ was applied compared to the DL method and when the heterogeneity was present I2>0%. On the other hand, 30.43% of the non-significant meta-analyses using the DL method became significant when HKSJ was used when the heterogeneity was absent I2 = 0%.

CONCLUSION: Orthodontic MAs with few studies can produce different results based on the between-study variance method and the statistical heterogeneity level. Compared to DL, HKSJ method is overconservative when I2 is greater than 0% and may result in false positive findings when the heterogeneity is absent.

PMID:38502662 | DOI:10.1371/journal.pone.0298526

PLoS One. 2024 Mar 19;19(3):e0300677. doi: 10.1371/journal.pone.0300677. eCollection 2024.

ABSTRACT

This study aims to integrate research in the field of aerobics and mental health through the visualization analysis method of the CiteSpace map, to clarify the impact of aerobics on mental health and stress levels. Firstly, based on the literature method, pieces of literature related to aerobics and mental health are searched and collected. Secondly, the visualization analysis method of the CiteSpace map is employed to summarize and analyze the contents of the literature, involving statistical analysis of the annual number of publications, analysis of author characteristics, and analysis of publishing institution characteristics. In addition, keyword co-occurrence analysis and keyword cluster analysis are also conducted in related research fields. Among them, the Log-Likelihood Ratio is used in keyword cluster analysis. Finally, the results are analyzed using the visualization analysis method of the CiteSpace map and the statistics-based comprehensive results. The results demonstrate that in the recent 20 years, the average annual number of articles in related fields exceeds 190. The high-yield authors are distributed in economically developed areas, and the cooperation among authors is scattered. In the keyword clustering results, a total of 77 cluster labels are obtained. The Q value of the clustering module is 0.89, and the average clustering profile silhouette (S) value is 0.92, indicating that the clustering structure is significant and the results are reasonable. The aerobics cluster contains the most closely related keywords, covering mental health and stress levels. Data analysis based on existing studies reveals that aerobics has a significant impact on mental health and stress levels. Individuals participating in aerobics show obvious improvement in mental health inventory (MHI) scores (t(100) = 4.32, p<0.05). Individuals participating in aerobics present a remarkable reduction in the questionnaire evaluation of stress levels (t(100) = -3.91, p<0.05). This study’s results support aerobics’ positive effects on mental health and stress levels.

PMID:38502660 | DOI:10.1371/journal.pone.0300677

PLOS Glob Public Health. 2024 Mar 19;4(3):e0001756. doi: 10.1371/journal.pgph.0001756. eCollection 2024.

ABSTRACT

Research increasingly involves cross-cultural work with non-English-speaking populations, necessitating translation and cultural validation of research tools. This paper describes the process of translating and criterion validation of the Client Diagnostic Questionnaire (CDQ) for use in a multisite study in Kenya and Uganda. The English CDQ was translated into Swahili, Dholuo (Kenya) and Runyankole/Rukiga (Uganda) by expert translators. The translated documents underwent face validation by a bilingual committee, who resolved unclear statements, agreed on final translations and reviewed back translations to English. A diagnostic interview by a mental health specialist was used for criterion validation, and Kappa statistics assessed the strength of agreement between non-specialist scores and mental health professionals’ diagnoses. Achieving semantic equivalence between translations was a challenge. Validation analysis was done with 30 participants at each site (median age 32.3 years (IQR = (26.5, 36.3)); 58 (64.4%) female). The sensitivity was 86.7%, specificity 64.4%, positive predictive value 70.9% and negative predictive value 82.9%. Diagnostic accuracy by the non-specialist was 75.6%. Agreement was substantial for major depressive episode and positive alcohol (past 6 months) and alcohol abuse (past 30 days). Agreement was moderate for other depressive disorders, panic disorder and psychosis screen; fair for generalized anxiety, drug abuse (past 6 months) and Post Traumatic Stress Disorder (PTSD); and poor for drug abuse (past 30 days). Variability of agreement between sites was seen for drug use (past 6 months) and PTSD. Our study successfully adapted the CDQ for use among people living with HIV in East Africa. We established that trained non-specialists can use the CDQ to screen for common mental health and substance use disorders with reasonable accuracy. Its use has the potential to increase case identification, improve linkage to mental healthcare, and improve outcomes. We recommend further studies to establish the psychometric properties of the translated tool.

PMID:38502647 | DOI:10.1371/journal.pgph.0001756

IEEE J Biomed Health Inform. 2024 Mar 19;PP. doi: 10.1109/JBHI.2024.3379194. Online ahead of print.

ABSTRACT

Epilepsy, a chronic neuropsychiatric brain disorder characterized with recurrent seizures, is closely associated with abnormal neural communications within the brain. Despite that the phase-amplitude coupling (PAC) has been suggested to offer a new way to observe neural interactions during epilepsy, however, few studies pay attention to alterations of the epileptic functional brain network based on PAC, especially on the β-γ PAC. Therefore, we use scalp electroencephalography (EEG) data of epileptic patients and the β-γ PAC modulation index (MI) to construct functional brain networks to examine variations of neural interactions during different epileptic phases. Statistically, the findings show that between-channel MI values in the post-ictal period significantly increase compared to that in the pre-ictal period, and the between-channel MI value has a close association with the information of phase and amplitude provided by the channels. Importantly, in both the phase-amplitude and amplitude-phase functional brain networks, the average node degree is remarkably higher in the post-ictal period than that in the pre-ictal period, whereas the characteristic path length in the ictal and post-ictal periods is significantly lower than that in the pre-ictal period. Besides, the average betweenness centrality in the post-ictal period is remarkably higher than that in the ictal period. Interestingly, the positive correlations between within-channel MI values and between-channel MI values can be observed during the pre-ictal, ictal and post-ictal periods. These findings suggest that the β-γ PAC-based functional brain network may provide a novel perspective to understanding alterations of neural interactions during the epileptic evolution, and may contribute to effectively controlling the spread of epileptic seizures.

PMID:38502614 | DOI:10.1109/JBHI.2024.3379194

IEEE Trans Haptics. 2024 Mar 19;PP. doi: 10.1109/TOH.2024.3375295. Online ahead of print.

ABSTRACT

This paper proposed linear and non-linear models for predicting human-exoskeleton coupling forces to enhance the studies of human-exoskeleton coupling dynamics. Then the parameters of these models were identified with a newly designed platform and the help of ten adult male and ten adult female volunteers (Age: 23.65 ±4.03 years, Height: 165.60 ±8.32 mm, Weight: 62.35 ±14.09 kg). Comparing the coupling force error predicted by the models with experimental measurements, one obtained a more accurate and robust prediction of the coupling forces with the non-linear model. Moreover, statistical analysis of the experimental data was performed to reveal the correlation between the coupling parameters and coupling positions and looseness. Finally, backpropagation (BP) neural network and Gaussian Process Regression (GPR) were used to predict the human-exoskeleton coupling parameters. The significance of each input parameter to the human-exoskeleton coupling parameters was assessed by analyzing the sensitivity of GPR performance to its inputs. The novelty and contribution are the establishment of the non-linear coupling model, the design of the coupling experimental platform and a regression model which provides a possibility to obtain human-exoskeleton without experimental measurement and identification. Based on this work, one can optimize control algorithm and design comfortable human-exoskeleton interaction.

PMID:38502610 | DOI:10.1109/TOH.2024.3375295

PLoS One. 2024 Mar 19;19(3):e0292980. doi: 10.1371/journal.pone.0292980. eCollection 2024.

ABSTRACT

Explainable Artificial Intelligence (XAI) is becoming a disruptive trend in healthcare, allowing for transparency and interpretability of autonomous decision-making. In this study, we present an innovative application of a rule-based classification model to identify the main causes of chronic cough-related quality of life (QoL) impairment in a cohort of asthmatic patients. The proposed approach first involves the design of a suitable symptoms questionnaire and the subsequent analyses via XAI. Specifically, feature ranking, derived from statistically validated decision rules, helped in automatically identifying the main factors influencing an impaired QoL: pharynx/larynx and upper airways when asthma is under control, and asthma itself and digestive trait when asthma is not controlled. Moreover, the obtained if-then rules identified specific thresholds on the symptoms associated to the impaired QoL. These results, by finding priorities among symptoms, may prove helpful in supporting physicians in the choice of the most adequate diagnostic/therapeutic plan.

PMID:38502606 | DOI:10.1371/journal.pone.0292980

AIDS Care. 2024 Mar 19:1-10. doi: 10.1080/09540121.2024.2307383. Online ahead of print.

ABSTRACT

Social network strategy (SNS) testing uses network connections to refer individuals at high risk to HIV testing services (HTS). In Tanzania, SNS testing is offered in communities and health facilities. In communities, SNS testing targets key and vulnerable populations (KVP), while in health facilities it complements index testing by reaching unelicited index contacts. Routine data were used to assess performance and trends over time in PEPFAR-supported sites between October 2021 and March 2023. Key indicators included SNS social contacts tested, and new HIV-positives individuals identified. Descriptive and statistical analysis were conducted. Univariable and multivariable analysis were applied, and variables with P-values <0.2 at univariable analysis were considered for multivariable analysis. Overall, 121,739 SNS contacts were tested, and 7731 (6.4%) previously undiagnosed individuals living with HIV were identified. Tested contacts and identified HIV-positives were mostly aged ≥15 years (>99.7%) and females (80.6% of tests, 79.4% of HIV-positives). Most SNS contacts were tested (78,363; 64.7%) and diagnosed (6376; 82.5%) in communities. SNS tests and HIV-positives grew 11.5 and 6.1-fold respectively, from October-December 2021 to January-March 2023, with majority of clients reached in communities vs. facilities (78,763 vs. 42,976). These results indicate that SNS testing is a promising HIV case-finding approach in Tanzania.

PMID:38502602 | DOI:10.1080/09540121.2024.2307383

Eur J Phys Rehabil Med. 2024 Mar 19. doi: 10.23736/S1973-9087.24.08234-0. Online ahead of print.

ABSTRACT

BACKGROUND: A high rate of hospitalized patients for COVID-19 had dysphagia, frequently underdiagnosed, and not treated, inducing a prolonged dysphagia with protracted recovery. Specific treatments and protocols have not been well described yet.

AIM: Given the potential benefits of respiratory muscle training (IEMT) and neuromuscular stimulation (NMES) in dysphagia treatment, this study aimed to assess the feasibility of the protocol used for treating dysphagia in patients who experienced prolonged hospitalization for COVID-19.

DESIGN: Observational, descriptive, prospective study.

SETTING: Department of Physical Medicine and Rehabilitation of a tertiary University hospital.

POPULATION: Fifty-eight COVID-19 patients were admitted for intensive rehabilitation (March 2020 to October 2021) were prospectively studied.

METHODS: Dysphagia was diagnosed using videofluoroscopy and treated with a 3-week protocol adapted from neuromuscular stimulation (NMES) in a motor threshold and inspiratory/expiratory muscle strength training (IEMST), five sets of five repetitions three times daily for 3 weeks. Feasibility was assessed with adherence, outcomes achieved, and occurrence of adverse/unexpected events. Respiratory function (peak cough flow, maximal inspiratory/expiratory pressures) and swallow function (Penetration-Aspiration Scale and Bolus Residue Scale measured by videofluoroscopy) were recorded descriptive statistics, Student’s t test for numerical data, and Wilcoxon Test for ordinal variables were applied. SPPSS vs28 and STATA version 15.1 (StataCorp, College Station, TX, USA) were used for statistical analysis. P values 0.05 were considered significant.

RESULTS: Dysphagia was highly prevalent in severe COVID-19 patients (86.6%); all respiratory and swallow parameters improved after a 3-week intervention and 12 of 18 patients dependent on tube feeding resumed a normal diet (66.7%; McNemar P=0.03), and 84.09% attended a no restriction diet at discharge. Adherence to treatment was 85%. No significant adverse events were detected.

CONCLUSIONS: We conclude that a structured swallowing-exercise training intervention based on IEMT and NMES is feasible and safe in prolonged hospitalization post-COVID patients.

CLINICAL REHABILITATION IMPACT: To describe rehabilitation protocols used to treat dysphagia in post-COVID patients will help us to optimize the available techniques in each center and to induce a faster recovery avoiding potential complications.

PMID:38502558 | DOI:10.23736/S1973-9087.24.08234-0