Tag: nevin manimala

IEEE Trans Neural Syst Rehabil Eng. 2023 Sep 18;PP. doi: 10.1109/TNSRE.2023.3316749. Online ahead of print.

ABSTRACT

Understanding the lower-limb coordination of individuals with unilateral transfemoral amputation (uTFA) while walking is essential to understand their gait mechanisms. Continuous relative phase (CRP) analysis provides insights into gait coordination patterns of the neuromusculoskeletal system based on movement kinematics. Fourteen individuals with uTFA and their age-matched able-bodied individuals participated in this study. Kinematic data of the lower limbs of the participants were collected during walking. The joint angles, segment angles, and CRP values of the thigh-shank and shank-foot couplings were investigated. The curves among the lower limbs of the participants were compared using a statistical parametric mapping test. Compensatory strategies were found in the lower limbs from coordination patterns. In thigh-shank coupling, although distinct coordination traits in stance and swing phases among the lower limbs were found, the lower limbs in both groups were discovered to remain in a similar coordination pattern during gait. For individuals with uTFA, in shank-foot coupling, intact limbs demonstrated a short period of foot-leading pattern which was significantly different from that of the other limbs during mid-stance to compensate for the weaker force generation by prosthetic limbs. The findings offer normative coordination patterns on the walking of individuals with uTFA, which could benefit prosthetic gait rehabilitation and development.

PMID:37721878 | DOI:10.1109/TNSRE.2023.3316749

Phys Rev Lett. 2023 Sep 1;131(9):091802. doi: 10.1103/PhysRevLett.131.091802.

ABSTRACT

The time-integrated CP asymmetry in the Cabibbo-suppressed decay D^{0}→K^{-}K^{+} is measured using proton-proton collision data, corresponding to an integrated luminosity of 5.7 fb^{-1} collected at a center-of-mass energy of 13 TeV with the LHCb detector. The D^{0} mesons are required to originate from promptly produced D^{*+}→D^{0}π^{+} decays, and the charge of the companion pion is used to determine the flavor of the charm meson at production. The time-integrated CP asymmetry is measured to be A_{CP}(K^{-}K^{+})=[6.8±5.4±1.6]×10^{-4} where the first uncertainty is statistical and the second systematic. The direct CP asymmetries in D^{0}→K^{-}K^{+} and D^{0}→π^{-}π^{+} decays, a_{K^{-}K^{+}}^{d} and a_{π^{-}π^{+}}^{d}, are derived by combining A_{CP}(K^{-}K^{+}) with the time-integrated CP asymmetry difference, ΔA_{CP}=A_{CP}(K^{-}K^{+})-A_{CP}(π^{-}π^{+}), and other inputs, giving a_{K^{-}K^{+}}^{d}=(7.7±5.7)×10^{-4},a_{π^{-}π^{+}}^{d}=(23.2±6.1)×10^{-4},with a correlation coefficient corresponding to ρ=0.88. The compatibility of these results with CP symmetry is 1.4 and 3.8 standard deviations for D^{0}→K^{-}K^{+} and D^{0}→π^{-}π^{+} decays, respectively. This is the first evidence for direct CP violation in a specific D^{0} decay.

PMID:37721849 | DOI:10.1103/PhysRevLett.131.091802

Phys Rev Lett. 2023 Sep 1;131(9):091903. doi: 10.1103/PhysRevLett.131.091903.

ABSTRACT

A search for the rare η→μ^{+}μ^{-}μ^{+}μ^{-} double-Dalitz decay is performed using a sample of proton-proton collisions, collected by the CMS experiment at the CERN LHC with high-rate muon triggers during 2017 and 2018 and corresponding to an integrated luminosity of 101 fb^{-1}. A signal having a statistical significance well in excess of 5 standard deviations is observed. Using the η→μ^{+}μ^{-} decay as normalization, the branching fraction B(η→μ^{+}μ^{-}μ^{+}μ^{-})=[5.0±0.8(stat)±0.7(syst)±0.7(B_{2μ})]×10^{-9} is measured, where the last term is the uncertainty in the normalization channel branching fraction. This work achieves an improved precision of over 5 orders of magnitude compared to previous results, leading to the first measurement of this branching fraction, which is found to agree with theoretical predictions.

PMID:37721839 | DOI:10.1103/PhysRevLett.131.091903

JMIR Form Res. 2023 Sep 18;7:e45490. doi: 10.2196/45490.

ABSTRACT

BACKGROUND: Type 2 diabetes (T2D) is a growing global health concern, including in Singapore. Diabetes education programs have been shown to be effective in improving health outcomes and diabetes self-management skills. Mobile health apps have emerged as useful tools for diabetes education; however, their use and acceptance by the target population remain inconsistent. Therefore, end-user participation in the design and development of a mobile health app is crucial for designing an acceptable app that can improve outcomes for populations with a chronic disease.

OBJECTIVE: The objective of this study was to apply an end-user participatory approach to co-design a diabetes education app prototype for people living with T2D by exploring their perceptions, acceptance, and usability of an app prototype, as well as their diabetes experience and perspectives on digital diabetes education.

METHODS: A total of 8 people with T2D, who were recruited from diabetes management Facebook groups, participated in 4 web-based surveys via Qualtrics and 2 structured interviews via Zoom (Zoom Video Communications, Inc) between August 20, 2021, and January 28, 2022. Descriptive statistics and thematic analyses of the discussion and iterative feedback on the app prototype were used to assess the participants’ perceptions of living with T2D, attitudes toward digital diabetes education, and acceptance of the prototype.

RESULTS: Analyses of the surveys and interview data revealed 3 themes: challenges of living with T2D; validation, acceptability, and usability of the diabetes education app prototype; and perspectives on digital diabetes education. In the first theme, participants highlighted the importance of solitary accountability, translating knowledge into practice, and developing pragmatic self-consciousness. The second theme indicated that the diabetes education app prototype was acceptable, with information and appearance being key; revealed ambivalent and polarized opinions toward the chatbot; and confirmed potential impact of the app on diabetes self-management skills and practice. The third theme comprised the necessity of using a variety of information-seeking strategies and recommendations for desired content and app qualities, including accessibility, adaptability, autonomy, evidence-based design and content, gamification, guidance, integration, personalization, and up-to-date content. The findings were used to reiterate the app design.

CONCLUSIONS: Despite a small sample size, the study demonstrated the feasibility of engaging and empowering people living with T2D to consider digital therapeutics for diabetes self-management skills and practice. Participants gave rather positive feedback on the design and content of the app prototype, with some recommendations for improvements. The findings suggest that incorporating end-user feedback into app design can lead to the creation of feasible and acceptable tools for diabetes education, potentially improving outcomes for populations with a chronic disease. Further research is needed to test the impact of the refined diabetes education app prototype on diabetes self-management skills and practice and quality of life.

PMID:37721799 | DOI:10.2196/45490

JAMA Netw Open. 2023 Sep 5;6(9):e2331140. doi: 10.1001/jamanetworkopen.2023.31140.

NO ABSTRACT

PMID:37721758 | DOI:10.1001/jamanetworkopen.2023.31140

JAMA Netw Open. 2023 Sep 5;6(9):e2334532. doi: 10.1001/jamanetworkopen.2023.34532.

ABSTRACT

IMPORTANCE: School-based health centers (SBHCs) are primary care clinics colocated at schools. SBHCs have the potential to improve health care access and reduce disparities, but there is limited rigorous evidence on their effectiveness at the national level.

OBJECTIVE: To determine whether county-level adoption of SBHCs was associated with access, utilization, and health among children from low-income families and to measure reductions in income-based disparities.

DESIGN, SETTING, AND PARTICIPANTS: This survey study used a difference-in-differences design and data from a nationally representative sample of children in the US merged with SBHC indicators from the National Census of School-Based Health Centers. The main sample included children aged 5 to 17 years with family incomes that were less than 200% of the federal poverty level observed in the National Health Interview Survey, collected between 1997 to 2018. The sample was restricted to children living in a county that adopted a center between 2003 and 2013 or that did not have a center at any time during the study period. Analyses of income-based disparities included children from higher income families (ie, 200% or higher than the federal poverty level). Data were analyzed between January 2020 and July 2023.

EXPOSURE: County-by-year SBHC adoption.

MAIN OUTCOMES AND MEASURES: Outcomes included access (usual source of care, insurance status, barriers), ambulatory care use (general physician, eye doctor, dental, mental health visits), and health (general health status, missed school days due to illness). P values were adjusted for multiple comparisons using the sharpened q value method.

RESULTS: This study included 12 624 unweighted children from low-income families and 24 631 unweighted children from higher income families. The weighted percentage of children in low-income families who resided in counties with SBHC adoption included 50.0% aged 5 to 10 years. The weighted percentages of the race and ethnicity of these children included 36.7% Hispanic children, 25.2% non-Hispanic Black children, and 30.6% non-Hispanic White children. The weighted percentages of children in the counties that never adopted SBHCs included 50.1% aged 5 to 10 years. The weighted percentages of the race and ethnicity of these children included 20.7% Hispanic children, 22.4% non-Hispanic Black children, and 52.9% non-Hispanic White children. SBHC adoption was associated with a 6.4 percentage point increase in dental visits (95% CI, 3.2-9.6 percentage points; P < .001), an 8.0 percentage point increase in having a usual source of care (95% CI, 4.5-11.5 percentage points; P < .001), and a 5.2 percentage point increase in insurance (95% CI, 1.2-9.2 percentage points; P = .03). No other statistically significant associations were found with other outcomes. SBHCs were associated with relative reductions in income-based disparities to dental visits by 76% (4.9 percentage points; 95% CI, 2.0-7.7 percentage points), to insured status by 63% (3.5 percentage points; 95% CI, 1.3-5.7 percentage points), and to having a usual source of care by 98% (7.2 percentage points; 95% CI, 5.4-9.1 percentage points).

CONCLUSIONS AND RELEVANCE: In this survey study with difference-in-differences analysis of SBHC adoption, SBHCs were associated with access to care and reduced income-based disparities. These findings support additional SBHC expansion.

PMID:37721750 | DOI:10.1001/jamanetworkopen.2023.34532

JAMA Pediatr. 2023 Sep 18. doi: 10.1001/jamapediatrics.2023.3643. Online ahead of print.

ABSTRACT

IMPORTANCE: It is unclear whether increased television (TV) and DVD viewing in early childhood from age 1 year decreases development or whether poor development increases TV/DVD viewing.

OBJECTIVE: To investigate the directional association between TV/DVD screen time and performance on developmental screeners in children aged 1 to 3 years.

DESIGN, SETTING, AND PARTICIPANTS: This longitudinal cohort study analyzed data from 57 980 children and mothers from a national birth cohort, the Japan Environment and Children’s Study. Data were collected in collaboration with 15 regional centers across Japan. The mothers were recruited between January 2011 and March 2014. Analyses using random intercept, cross-lagged panel models were performed for children aged 1, 2, and 3 years. Of 100 303 live births, children with missing developmental screening test scores and screen time data, those with congenital diseases or cerebral palsy, and those diagnosed with an autism spectrum disorder were excluded. Statistical analyses were conducted from October 2022 to July 2023.

EXPOSURES: TV and DVD screen time.

MAIN OUTCOMES AND MEASURES: Child development at ages 1, 2, and 3 years was assessed via the mother’s or guardian’s report using the Ages and Stages Questionnaire, third edition.

RESULTS: Of 57 980 included children, 29 418 (50.7%) were male, and the mean (SD) maternal age at delivery was 31.5 (4.9) years. A negative association between screen time and developmental scores was observed. Increased TV/DVD screen times at age 1 and 2 years were associated with lower developmental scores at age 2 and 3 years, respectively (2 years: β = -0.05; 95% CI, -0.06 to -0.04; 3 years: β = -0.08; 95% CI, -0.09 to -0.06). An obverse association was observed from the Ages and Stages Questionnaires, third edition, score in the communication domain at age 1 and 2 years to subsequent screen time (2 years: γ = -0.03; 95% CI, -0.04 to -0.02; 3 years: γ = -0.06; 95% CI, -0.07 to -0.04).

CONCLUSIONS AND RELEVANCE: In this study, increased TV/DVD screen time from age 1 year negatively affected later development. To reduce the negative consequences of excessive media use, researchers and health care professionals should encourage family media management and recommend social support for parents who tend to rely on the media.

PMID:37721733 | DOI:10.1001/jamapediatrics.2023.3643

Minerva Dent Oral Sci. 2023 Sep 18. doi: 10.23736/S2724-6329.23.04855-6. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of the study was to make an objective quantitative assessment of effectiveness of procedures with the use of a therapeutic dose of ultrasounds in this nosological entity, in connection with improved biomechanical properties and alleviation of pain experienced in masseter muscles.

METHODS: The study included 40 patients with temporomandibular disorder. In group 1 (N.=20) ultrasound therapy (1.2 W/cm²) was carried out, while in group 2 (N.=20) sham therapy was applied. A total of 10 procedures were performed. Myotonometric measurements and assessment of pain intensity were carried out before treatment and after the completion of procedures.

RESULTS: The analysis revealed a significant difference (P=0.011) between the values of decrement (D) measured on day 0 (2.08±0.45 [log]) and day 4 (1.80±0.55 [log]) in group 1. In group 2 no statistically significant differences were noted between the results obtained on consecutive days of the therapeutic cycle. A statistically significant difference in values of decrement (D) between group 1 (1.80±0.55 [log]) and group 2 (2.23±0.51 [log]) was noted on day 4 of the experiment (P=0.021). Both in group 1 and in group 2, a statistically significant reduction of pain intensity (VAS Scale) was obtained.

CONCLUSIONS: The masseter muscle was more elastic during ultrasound therapy. However, the effect was transient. The analgesic effect was also observed in the control group; therefore, a placebo effect cannot be excluded.

PMID:37721730 | DOI:10.23736/S2724-6329.23.04855-6

J Prosthodont. 2023 Sep 18. doi: 10.1111/jopr.13773. Online ahead of print.

ABSTRACT

PURPOSE: To retrospectively compare and analyze differences in tissue displacement of edentulous arches among three-dimensional (3D) files obtained using various impression-making techniques.

MATERIALS AND METHODS: Fourteen patients who underwent prosthodontic treatment for edentulous arches at Yonsei University Dental Hospital between June 2020 and April 2023 were included in the study. Three types of 3D files were used for the evaluation of each arch: a 3D scan file of a definitive cast (Group DEF), a preliminary cast (Group PRE), and an intraoral scan file (Group IOS). The files were superimposed on a reference 3D scan file of the definitive cast group through best-fit matching using metrology software. Seventeen measurement points (MP1-4, RC1-6, TB1-2, and PPS1-5 for the maxilla and RP1-2, RC1-7, BS1-4, and LS1-4 for the mandible) were selected for both the maxillary (n = 13) and mandibular arches (n = 6). The deviation considering the direction (DD) between the three groups and the absolute deviation (AD) between the three groups were recorded. Kruskal-Wallis and post-hoc Mann-Whitney tests were used for statistical analyses (α = 0.05 and α = 0.0167, respectively).

RESULTS: Concerning the DD values, at the RC4 point of the maxillary arch, Group PRE exhibited significantly higher values than Groups IOS (p = 0.006) and DEF (p < 0.001), and at the RC5 point of the maxillary arch, Group IOS exhibited significantly lower values than Groups PRE (p = 0.016) and DEF (p < 0.001). Group IOS showed significantly lower DD values in the mandibular arch than Group DEF at the RP2 and RC3 points (p < 0.167). The AD values in Groups PRE and IOS significantly differed from those in Group DEF (all p < 0.001) at all measurement points but did not exhibit significant differences between each other (p > 0.05).

CONCLUSIONS: Different impression-making methods yielded different amounts of tissue displacement. The tendency of 3D files regarding tissue displacement varied at certain residual ridge crest areas and retromolar pad areas. The absolute amount of tissue displacement observed in the intraoral scan data was comparable to that observed in the preliminary casts. This article is protected by copyright. All rights reserved.

PMID:37721728 | DOI:10.1111/jopr.13773

Int Ophthalmol. 2023 Sep 18. doi: 10.1007/s10792-023-02877-x. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate corneal endothelial cell changes following uncomplicated phacoemulsification in diabetic patients with PEX, compared with diabetic patients and non-diabetic patients with PEX.

METHODS: This prospective, comparative, non-randomized cohort study included 61 eyes of 61 patients who were diagnosed as having senile cataract. Patients were divided into three groups: Group (1) included 19 eyes of patients with DM and PEX, group (2) included 22 eyes of diabetic patients, and group (3) included 20 eyes of patients with PEX. All included patients had uncomplicated phacoemulsification with IOL implantation. Patients were examined by non-contact specular microscopy (NIDEK, CEM-530, Japan), preoperatively and postoperatively at regular follow-up periods (one, three, and six months postoperatively) with analysis of the endothelial cell density, percentage of hexagonal cells, CV, and CCT.

RESULTS: By the end of follow-up period, there was a statistically significant reduction in ECD and HEX with a significant increase in CV and CCT in group one (DM-PEX). In group two (DM), a statistically significant decrease in ECD and HEX with a significant increase in CCT was reported, while in group three (PEX), the only significant difference was found in the form of ECD reduction.

CONCLUSION: Patients with DM and PEX had significant changes regarding ECD, CV, HEX, and CCT which were more pronounced than in patients with DM only or PEX only. More attention should be paid while operating on diabetic patients with PEX to save corneal endothelium and decrease postoperative complications.

STUDY REGISTRATION NUMBER: The study was retrospectively registered (16 July 2021) on ClinicalTrials.gov (NCT04965168).

PMID:37721703 | DOI:10.1007/s10792-023-02877-x