Tag: nevin manimala

J Safety Res. 2023 Sep;86:164-173. doi: 10.1016/j.jsr.2023.05.007. Epub 2023 May 19.

ABSTRACT

INTRODUCTION: The role of real-time data capture (via telematics technology) is gathering prominence as a strategy to provide feedback to young drivers about important road safety issues.

METHOD: A naturalistic driving study was undertaken to determine whether providing personalized feedback (via a smartphone app) to young provisional drivers aged 17-20 years living in metropolitan and regional Western Australia (WA) reduced their risky driving behavior compared to a control group who did not receive feedback. Speeding over the posted speed limit, harsh decelerations (braking), harsh accelerations and overall driving performance, were recorded continuously using the smartphone app during the 11-week study. Four separate Generalised Estimating Equations (GEE) linear regression models were undertaken after accounting for relevant confounders including driving exposure to determine the difference between the intervention and control group for the 4 driving outcomes obtained from the smartphone app.

RESULTS: The study found that there was no significant change in overall driving scores between the intervention and control groups (p = 0.35). However, the overall driving score significantly improved by 0.19 points for young provisional drivers who lived in regional areas compared to those in the metropolitan area (p = 0.05) after adjusting for potential confounders. There was also no significant change in harsh braking scores (p = 0.46) and harsh acceleration scores between the intervention and control groups (p = 0.26) However, harsh acceleration scores improved by 0.37 points for females compared to males (p = 0.04). Lastly, there was no significant change in speed scores between the control and intervention groups (p = 0.72). However, the speed scores of participants who lived in regional WA improved by 0.22 points compared to those in the metropolitan area (p = 0.02). Furthermore, for every 1,000 km travelled, speed scores worsened by -0.08 points (p < 0.01) regardless of group.

CONCLUSIONS: The study did not find any statistical difference in the driving outcomes examined; however the treatment effects for feedback were consistently in the expected positive direction. Young drivers in regional WA also improved their speeding scores and overall driving performance scores compared to young drivers in the metropolitan area. Females, also significantly improved their harsh deceleration scores compared to males, regardless of group allocation. These results highlight the use of smartphone telematics as an opportunity to not only enhance the safety of provisional young drivers but also provide data-informed decision making and policy development.

PMID:37718043 | DOI:10.1016/j.jsr.2023.05.007

J Safety Res. 2023 Sep;86:118-126. doi: 10.1016/j.jsr.2023.05.004. Epub 2023 May 18.

ABSTRACT

INTRODUCTION: The civil construction industry (CCI) is one of the most dangerous sectors for occupational accidents. Studies conducted in several countries show that occupational accidents involving falls from height are the main cause of deaths in recent years.

METHOD: This article analyzed the combinations of causal factors with the highest likelihood of accidents involving falls from height in construction to assist in decision-making. The methodology was divided into four stages: accident collection and sample definition; accident analysis; probability determination; and obtaining the theoretical curve of an accident probability distribution. The methodology was applied to reports of fatal fall-from-height accidents that occurred in the United States between 1997 and 2020.

RESULTS: The results show that among the accidents analyzed, the highest probability of fatality is when a roofer aged between 31 and 44 years performs their activity on a roof between 10:00 and 11:59 am. It is also noted that the three causal factors most present in the accidents were: organizational process (97.7%); poor management of worker resources (96.6%); and organizational climate (95.4%). From the probability distribution curve, 68% of the fatal accidents occurred after reaching between 18 and 34 causal factors present in the HFACS method categories.

PMID:37718038 | DOI:10.1016/j.jsr.2023.05.004

Res Synth Methods. 2023 Sep 17. doi: 10.1002/jrsm.1668. Online ahead of print.

ABSTRACT

Conventional random-effects models in meta-analysis rely on large sample approximations instead of exact small sample results. While random-effects methods produce efficient estimates and confidence intervals for the summary effect have correct coverage when the number of studies is sufficiently large, we demonstrate that conventional methods result in confidence intervals that are not wide enough when the number of studies is small, depending not just on the configuration of sample sizes across studies, the degree of true heterogeneity and number of studies. We introduce two alternative variance estimators with better small sample properties, investigate degrees of freedom adjustments for computing confidence intervals, and study their effectiveness via simulation studies.

PMID:37717978 | DOI:10.1002/jrsm.1668

Saudi Med J. 2023 Sep;44(9):898-903. doi: 10.15537/smj.2023.44.9.20230441.

ABSTRACT

OBJECTIVES: To assess the specificity and sensitivity of prognostic biomarkers in individuals diagnosed with acute pulmonary embolism (PE).

METHODS: This study retrospectively enrolled 162 patients from the 741 patients who were hospitalized with acute PE and diagnosed using pulmonary computed tomography (CT) angiogram at 5 hospitals in Saudi Arabia between January 2015 and December 2019. Pulmonary embolism patients classified into survivor and non-survivor groups. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and red cell distribution width (RDW) were all recorded and were compared between the groups. The evaluation of mortality prediction, sensitivity, and specificity was carried out by employing receiver operating characteristic curves.

RESULTS: The variables NLR and RDW exhibited a statistically significant correlation with increased mortality and disease severity. A total of 8 patients among the 162 patients died. At the cut-off value of 5.5, NLR was showed an association with all-cause mortality, demonstrating a sensitivity of 75% and a specificity of 82%. At the cut-off value of 18.15, RDW was found to be significantly associated with all-cause mortality, displaying a sensitivity of 63% and a specificity of 88%.

CONCLUSION: Multiple parameters have been implicated in the mortality and severity of PE. Our study revealed a statistically significant association between NLR, RDW, and PE mortality. These tests are easily accessible and may provide insights into the mortality associated with PE.

PMID:37717976 | DOI:10.15537/smj.2023.44.9.20230441

Saudi Med J. 2023 Sep;44(9):864-869. doi: 10.15537/smj.2023.44.9.20230243.

ABSTRACT

OBJECTIVES: To investigate the positive effects of intraperitoneal administration of alpha-lipolic acid (ALA) and dexpanthenol (DXP) on wound healing after tracheal surgery in rats.

METHODS: The study was carried out at Necmettin Erbakan University, Konya, Turkey, from January 2014-2019. A total of 30 healthy and adult Sprague-Dawley type female rats were included in the study. For the experiment, rats were randomly divided into 3 groups: ALA group (n=10), DXP group (n=10), and control group (n=10). After trachea surgery, 100 mg/kg/day ALA was given to group ALA and 100 mg/kg/day intraperitoneal DXP to group DXP for 15 days, and the rats were sacrificed on the 21st day. The excised tracheal sections were evaluated and graded for inflammatory cell infiltration, angiogenesis, fibroblast proliferation, collagen deposition, and epithelial regeneration to evaluate wound healing.

RESULTS: Inflammation was found to be less in both the ALA and DXP groups. With the Mann-Whitney test, it was determined that inflammation was less in the ALA group than in the DXP group (C-D [p=0.097] and C-A [p=0.024]). On the other hand, no statistically significant difference was found in epithelial regeneration (p=0.574; >0.05), angiogenesis (p=0.174; >0.05), fibroblast proliferation, and collagen deposition (p=0.102; >0.05).

CONCLUSION: Alpha-lipolic acid injected intravenously after tracheal reconstruction in patients can prevent restenosis by reducing inflammation without adversely affecting wound healing.

PMID:37717974 | DOI:10.15537/smj.2023.44.9.20230243

BMJ Glob Health. 2023 Sep;8(9):e013703. doi: 10.1136/bmjgh-2023-013703.

ABSTRACT

OBJECTIVES: Assess the relationship between income inequality and HIV incidence, AIDS mortality and COVID-19 mortality.

DESIGN: Multicountry observational study.

SETTING: 217 countries for HIV/AIDS analysis, 151 countries for COVID-19 analysis.

PARTICIPANTS: Used three samples of national-level data: a sample of all countries with available data (global sample), a subsample of African countries (African sample) and a subsample excluding African countries (excluding African sample).

MAIN OUTCOME MEASURES: HIV incidence rate per 1000 people, AIDS mortality rate per 100 000 people and COVID-19 excess mortality rate per 100 000 people. The Gini index of income inequality was the primary explanatory variable.

RESULTS: A positive and significant relationship exists between the Gini index of income inequality and HIV incidence across all three samples (p<0.01), with the effect of income inequality on HIV incidence being higher in the African sample than in the rest of the world. Also, a statistically positive association exists for all samples between income inequality and the AIDS mortality rate, as higher income inequality increases AIDS mortality (p<0.01). For COVID-19 excess mortality rate, a positive and statistically significant relationship exists with the Gini index for the entire sample and the excluding African sample (p<0.05), but the African sample alone did not deliver significant results (p<0.1).

CONCLUSION: COVID-19 excess deaths, HIV incidence and AIDS mortality are significantly associated with income inequality globally-more unequal countries have a higher HIV incidence, AIDS mortality and COVID-19 excess deaths than their more equal counterparts. Income inequality undercuts effective pandemic response. There is an urgent need for concerted efforts to tackle income inequality and to build pandemic preparedness and responses that are adapted and responsive to highly unequal societies, prioritising income inequality among other social determinants of health.

PMID:37717952 | DOI:10.1136/bmjgh-2023-013703

Clin Exp Ophthalmol. 2023 Sep 17. doi: 10.1111/ceo.14296. Online ahead of print.

ABSTRACT

BACKGROUND: Evaluation of ocular inflammation via common imaging modalities like optical coherence tomography (OCT) has emphasised cell visualisation, but automated detection of uveitic keratic precipitates (KPs) remains unexplored.

METHODS: Anterior segment (AS)-OCT dense volumes of the corneas of patients with uveitic KPs were collected at three timepoints: with active (T0), clinically improving (T1), and resolved (T2) inflammation. At each visit, visual acuity and clinical grading of the anterior chamber cells were assessed. A bespoke algorithm was used to create an en face rendering of the KPs and to calculate their volume and a ratio of the volume of precipitates over the analysed area. The variation of AS-OCT-derived measurements over time was assessed, and compared with clinical grading.

RESULTS: Twenty eyes from 20 patients (13 females, mean age 39 years) were studied. At T0, the mean volume of the corneal KPs was 0.1727 mm³ , and it significantly reduced to 0.1111 mm³ (p = 0.03) only at T2. The ratio between the volume of the KPs and the corneal area decreased from T0 (0.007) to T1 (0.006; p = 0.2) and T2 (0.004; p = 0.009). There was a statistically significant correlation between the AC cell count and the AS-OCT volume measurements of the KPs at the three time points.

CONCLUSIONS: AS-OCT can image uveitic KPs and through a bespoke algorithm we were able to create an en face rendering allowing us to extrapolate their volume. We found that objective quantification of KPs correlated with inflammatory cell counts in the anterior chamber.

PMID:37717946 | DOI:10.1111/ceo.14296

Pharm Stat. 2023 Sep 17. doi: 10.1002/pst.2338. Online ahead of print.

ABSTRACT

The sum of the longest diameter (SLD) of the target lesions is a longitudinal biomarker used to assess tumor response in cancer clinical trials, which can inform about early treatment effect. This biomarker is semicontinuous, often characterized by an excess of zeros and right skewness. Conditional two-part joint models were introduced to account for the excess of zeros in the longitudinal biomarker distribution and link it to a time-to-event outcome. A limitation of the conditional two-part model is that it only provides an effect of covariates, such as treatment, on the conditional mean of positive biomarker values, and not an overall effect on the biomarker, which is often of clinical relevance. As an alternative, we propose in this article, a marginalized two-part joint model (M-TPJM) for the repeated measurements of the SLD and a terminal event, where the covariates affect the overall mean of the biomarker. Our simulation studies assessed the good performance of the marginalized model in terms of estimation and coverage rates. Our application of the M-TPJM to a randomized clinical trial of advanced head and neck cancer shows that the combination of panitumumab in addition with chemotherapy increases the odds of observing a disappearance of all target lesions compared to chemotherapy alone, leading to a possible indirect effect of the combined treatment on time to death.

PMID:37717945 | DOI:10.1002/pst.2338

Behav Processes. 2023 Sep 15:104944. doi: 10.1016/j.beproc.2023.104944. Online ahead of print.

ABSTRACT

This study employs supervised machine learning algorithms to test whether locomotive features during exploratory activity in open field arenas can serve as predictors for the genotype of fruit flies. Because of the nonlinearity in locomotive trajectories, traditional statistical methods that are used to compare exploratory activity between genotypes of fruit flies may not reveal all insights. 10-minute-long trajectories of four different genotypes of fruit flies in an open-field arena environment were captured. Turn angles and step size features extracted from the trajectories were used for training supervised learning models to predict the genotype of the fruit flies. Using the first five minute locomotive trajectories, an accuracy of 83% was achieved in differentiating wild-type flies from three other mutant genotypes. Using the final 5minutes and the entire ten minute duration decreased the performance indicating that the most variations between the genotypes in their exploratory activity are exhibited in the first few minutes. Feature importance analysis revealed that turn angle is a better predictor than step size in predicting fruit fly genotype. Overall, this study demonstrates that features of trajectories can be used to predict the genotype of fruit flies through supervised machine learning methods.

PMID:37717930 | DOI:10.1016/j.beproc.2023.104944

Nanomedicine. 2023 Sep 15:102709. doi: 10.1016/j.nano.2023.102709. Online ahead of print.

ABSTRACT

According to the latest World Health Organization statistics, around 50 to 80 million people worldwide suffer from infertility, amongst which male factors are responsible for around 20 to 30 % of all infertility cases while 50 % were attributed to the female ones. As it is becoming a recurrent health problem worldwide, clinicians require more accurate methods for the improvement of both diagnosis and treatment schemes. By emphasizing the potential use of innovative methods for the rapid identification of the infertility causes, this review presents the news from this dynamic domain and highlights the benefits brought by emerging research fields. A systematic description of the standard techniques used in clinical protocols for diagnosing infertility in both genders is firstly provided, followed by the presentation of more accurate and comprehensive nanotechnology-related analysis methods such as nanoscopic-resolution imaging, biosensing approaches and assays that employ nanomaterials in their design. Consequently, the implementation of nanotechnology related tools in clinical practice, as recently demonstrated in the selection of spermatozoa, the detection of key proteins in the fertilization process or the testing of DNA integrity or the evaluation of oocyte quality, might confer excellent advantages both for improving the assessment of infertility, and for the success of the fertilization process.

PMID:37717928 | DOI:10.1016/j.nano.2023.102709