Tag: nevin manimala

Health Rep. 2023 Feb 15;34(2):3-16. doi: 10.25318/82-003-x202300200001-eng.

ABSTRACT

BACKGROUND: Mortality rates in Canada have been shown to vary by population group (e.g., Indigenous peoples, immigrants) and social economic status (e.g., income levels). Mortality patterns for some groups, including Black individuals, are not as well known. The objective of this study was to assess cause-specific mortality for Black adults living in Canada.

METHODS: Mortality inequalities between Black and White cohort members were estimated by sex using Cox proportional hazard models, based on data from the 2001, 2006 and 2011 Canadian Census Health and Environment Cohorts (CanCHECs). The CanCHEC cycles were combined and followed for mortality between Census Day and December 31, 2016 or 2019, resulting in a follow-up period of 15.6, 13.6 or 8.6 years, depending on the CanCHEC cycle.

RESULTS: Ischemic heart disease mortality was the leading cause of death among adult Black males (12.9%) and females (9.8%), as it is for adult White males (16.4%) and females (12.4%). Despite reduced risk of all-cause mortality among Black males and females, compared with White cohort members, there was notable increased risk for some cause-specific mortality. For instance, in the age-adjusted model, among the 25 causes of death examined, Black males had an increased risk of dying from four causes (HIV/AIDS, prostate cancer, diabetes mellitus and cerebrovascular disease), compared with White males. Similarly, Black females were at an increased risk for 6 causes of death (HIV/AIDS, stomach cancer, corpus uteri cancer, lymphomas and multiple myeloma, diabetes mellitus, and endocrine disorders) out of the 27 causes of death examined. These relative increased risks persisted for most causes of death after adjustment for differences in important social determinants of health.

INTERPRETATION: Results showed substantial variability in the risk of dying by cause of death between Black and White cohort members. An important step in reducing health inequities is the routine identification and surveillance of different health outcomes by population groups. This study helps fill that information gap.

PMID:36791269 | DOI:10.25318/82-003-x202300200001-eng

Environ Sci Technol. 2023 Feb 15. doi: 10.1021/acs.est.2c06117. Online ahead of print.

ABSTRACT

In the marine environment, discarded cigarette filters (CFs) deteriorate and leach filter-associated chemicals. The study aim was to assess the effects of smoked CFs (SCFs) and non-smoked CFs (NCFs) particles on individual life-history traits in the deposit-feeding polychaete Capitella teleta and extrapolate these to possible population-level effects. C. teleta was exposed to sediment-spiked particles of NCFs and SCFs at an environmentally realistic concentration (0.1 mg particles g^-1 dw sed) and a 100-fold higher (10 mg particles g^-1 dw sed) concentration. Experimental setup incorporated 11 individual endpoints and lasted approximately 6 months. There were significant effects on all endpoints, except from adult body volume and egestion rate, in worms exposed to 10 mg SCF particles g^-1 dw sed. Although not statistically significant, there was ≥50% impact on time between reproductive events and number of eggs per female at 0.1 mg SCF particles g^-1 dw sed. None of the endpoints was significantly affected by NCFs. Results suggest that SCFs are likely to affect individual life-history traits of C. teleta, whereas the population model suggests that these effects might not transform into population-level effects. The results further indicate that chemicals associated with CFs are the main driver causing the effects rather than the CF particles.

PMID:36791268 | DOI:10.1021/acs.est.2c06117

Sci Adv. 2023 Feb 15;9(7):eabn3999. doi: 10.1126/sciadv.abn3999. Epub 2023 Feb 15.

ABSTRACT

Probabilistic machine learning increasingly informs critical decisions in medicine, economics, politics, and beyond. To aid the development of trust in these decisions, we develop a taxonomy delineating where trust in an analysis can break down: (i) in the translation of real-world goals to goals on a particular set of training data, (ii) in the translation of abstract goals on the training data to a concrete mathematical problem, (iii) in the use of an algorithm to solve the stated mathematical problem, and (iv) in the use of a particular code implementation of the chosen algorithm. We detail how trust can fail at each step and illustrate our taxonomy with two case studies. Finally, we describe a wide variety of methods that can be used to increase trust at each step of our taxonomy. The use of our taxonomy highlights not only steps where existing research work on trust tends to concentrate and but also steps where building trust is particularly challenging.

PMID:36791188 | DOI:10.1126/sciadv.abn3999

J Med Internet Res. 2023 Feb 15;25:e42985. doi: 10.2196/42985.

ABSTRACT

BACKGROUND: By the end of 2022, more than 100 million people were infected with COVID-19 in the United States, and the cumulative death rate in rural areas (383.5/100,000) was much higher than in urban areas (280.1/100,000). As the pandemic spread, people used social media platforms to express their opinions and concerns about COVID-19-related topics.

OBJECTIVE: This study aimed to (1) identify the primary COVID-19-related topics in the contiguous United States communicated over Twitter and (2) compare the sentiments urban and rural users expressed about these topics.

METHODS: We collected tweets containing geolocation data from May 2020 to January 2022 in the contiguous United States. We relied on the tweets’ geolocations to determine if their authors were in an urban or rural setting. We trained multiple word2vec models with several corpora of tweets based on geospatial and timing information. Using a word2vec model built on all tweets, we identified hashtags relevant to COVID-19 and performed hashtag clustering to obtain related topics. We then ran an inference analysis for urban and rural sentiments with respect to the topics based on the similarity between topic hashtags and opinion adjectives in the corresponding urban and rural word2vec models. Finally, we analyzed the temporal trend in sentiments using monthly word2vec models.

RESULTS: We created a corpus of 407 million tweets, 350 million (86%) of which were posted by users in urban areas, while 18 million (4.4%) were posted by users in rural areas. There were 2666 hashtags related to COVID-19, which clustered into 20 topics. Rural users expressed stronger negative sentiments than urban users about COVID-19 prevention strategies and vaccination (P<.001). Moreover, there was a clear political divide in the perception of politicians by urban and rural users; these users communicated stronger negative sentiments about Republican and Democratic politicians, respectively (P<.001). Regarding misinformation and conspiracy theories, urban users exhibited stronger negative sentiments about the “covidiots” and “China virus” topics, while rural users exhibited stronger negative sentiments about the “Dr. Fauci” and “plandemic” topics. Finally, we observed that urban users’ sentiments about the economy appeared to transition from negative to positive in late 2021, which was in line with the US economic recovery.

CONCLUSIONS: This study demonstrates there is a statistically significant difference in the sentiments of urban and rural Twitter users regarding a wide range of COVID-19-related topics. This suggests that social media can be relied upon to monitor public sentiment during pandemics in disparate types of regions. This may assist in the geographically targeted deployment of epidemic prevention and management efforts.

PMID:36790847 | DOI:10.2196/42985

JMIR Res Protoc. 2023 Feb 15;12:e44456. doi: 10.2196/44456.

ABSTRACT

BACKGROUND: The World Federation of Obesity warns that the main health problem of the next decade will be childhood obesity. It is known that factors such as gestational obesity produce profound effects on fetal programming and are strong predictors of overweight and obesity in children. Therefore, establishing healthy eating behaviors during pregnancy is the key to the primary prevention of the intergenerational transmission of obesity. Mobile health (mHealth) programs are potentially more effective than face-to-face interventions, especially during a public health emergency such as the COVID-19 outbreak.

OBJECTIVE: This study aims to evaluate the effectiveness of an mHealth intervention to reduce excessive weight gain in pregnant women who attend family health care centers.

METHODS: The design of the intervention corresponds to a classic randomized clinical trial. The participants are pregnant women in the first trimester of pregnancy who live in urban and semiurban areas. Before starting the intervention, a survey will be applied to identify the barriers and facilitators perceived by pregnant women to adopt healthy eating behaviors. The dietary intake will be estimated in the same way. The intervention will last for 12 weeks and consists of sending messages through a multimedia messaging service with food education, addressing the 3 domains of learning (cognitive, affective, and psychomotor). Descriptive statistics will be used to analyze the demographic, socioeconomic, and obstetric characteristics of the respondents. The analysis strategy follows the intention-to-treat principle. Logistic regression analysis will be used to compare the intervention with routine care on maternal pregnancy outcome and perinatal outcome.

RESULTS: The recruitment of study participants began in May 2022 and will end in May 2023. Results include the effectiveness of the intervention in reducing the incidence of excessive gestational weight gain. We also will examine the maternal-fetal outcome as well as the barriers and facilitators that influence the weight gain of pregnant women.

CONCLUSIONS: Data from this effectiveness trial will determine whether mami-educ successfully reduces rates of excessive weight gain during pregnancy. If successful, the findings of this study will generate knowledge to design and implement personalized prevention strategies for gestational obesity that can be included in routine primary care.

TRIAL REGISTRATION: ClinicalTrials.gov NCT05114174; https://clinicaltrials.gov/ct2/show/NCT05114174.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/44456.

PMID:36790846 | DOI:10.2196/44456

JMIR Med Educ. 2023 Feb 15;9:e40040. doi: 10.2196/40040.

ABSTRACT

BACKGROUND: Remote and virtual simulations have gained prevalence during the COVID-19 pandemic as institutions maintain social distancing measures. Because of the challenges of cost, flexibility, and feasibility in traditional mannequin simulation, many health care educators have used videos as a remote simulation modality; however, videos provide minimal interactivity.

OBJECTIVE: In this study, we aimed to evaluate the role of interactivity in students’ simulation experiences. We analyzed students’ perceptions of technology acceptance and authenticity in interactive and noninteractive simulations.

METHODS: Undergraduate nursing students participated in interactive and noninteractive simulations. The interactive simulation was conducted using interactive video simulation software that we developed, and the noninteractive simulation consisted of passively playing a video of the simulation. After each simulation, the students completed a 10-item technology acceptance questionnaire and 6-item authenticity questionnaire. The data were analyzed using the Wilcoxon signed-rank test. In addition, we performed an exploratory analysis to compare technology acceptance and authenticity in interactive local and remote simulations using the Mann-Whitney U test.

RESULTS: Data from 29 students were included in this study. Statistically significant differences were found between interactive and noninteractive simulations for overall technology acceptance (P<.001) and authenticity (P<.001). Analysis of the individual questionnaire items showed statistical significance for 3 out of the 10 technology acceptance items (P=.002, P=.002, and P=.004) and 5 out of the 6 authenticity items (P<.001, P<.001, P=.001, P=.003, and P=.005). The interactive simulation scored higher than the noninteractive simulation in all the statistically significant comparisons. Our exploratory analysis revealed that local simulation may promote greater perceptions of technology acceptance (P=.007) and authenticity (P=.027) than remote simulation.

CONCLUSIONS: Students’ perceptions of technology acceptance and authenticity were greater in interactive simulation than in noninteractive simulation. These results support the importance of interactivity in students’ simulation experiences, especially in remote or virtual simulations in which students’ involvement may be less active.

PMID:36790842 | DOI:10.2196/40040

J Infect Dis. 2023 Feb 15:jiad043. doi: 10.1093/infdis/jiad043. Online ahead of print.

ABSTRACT

INTRODUCTION: We assessed the incidence and risk factors for first detection and redetection with the same human papillomavirus (HPV) genotype, and prevalence of cytological lesions during HPV redetections.

METHODS: The Ludwig-McGill cohort study followed women aged 18-60 years from São Paulo, Brazil in 1993-1997 for up to 10 years. Women provided cervical samples for cytology testing and HPV DNA testing at each visit. A redetection was defined as a recurring genotype-specific HPV positive result after one or more intervening negative visits. Predictors of genotype-specific redetection were assessed using adjusted hazard ratios (aHR) with Cox regression modeling.

RESULTS: 2184 women contributed 2368 incident HPV genotype-specific first detections and 308 genotype-specific redetections over a median follow-up of 6.5 years. The cumulative incidence of redetection with the same genotype was 6.6% at 1 year and 14.8% at 5 years after the loss of positivity of the first detection. Neither age (aHR 0.90, 95%CI 0.54-1.47 for ≥45y vs. <25y) nor new sexual partner acquisition (aHR 0.98, 95%CI 0.70-1.35) were statistically associated with genotype-specific redetection. High-grade squamous intraepithelial lesion prevalence was similar during first HPV detections (2.9%) and redetection (3.2%).

CONCLUSIONS: Our findings suggest many HPV redetections were likely reactivations of latent recurring infections.

PMID:36790831 | DOI:10.1093/infdis/jiad043

Mol Biol Evol. 2023 Feb 15:msad027. doi: 10.1093/molbev/msad027. Online ahead of print.

ABSTRACT

Genomic regions under positive selection harbour variation linked for example to adaptation. Most tools for detecting positively selected variants have computational resource requirements rendering them impractical on population genomic datasets with hundreds of thousands of individuals or more. We have developed and implemented an efficient haplotype-based approach able to scan large datasets and accurately detect positive selection. We achieve this by combining a pattern matching approach based on the positional Burrows-Wheeler transform with model-based inference which only requires the evaluation of closed-form expressions. We evaluate our approach with simulations, and find it to be both sensitive and specific. The computational resource requirements quantified using UK Biobank data indicate that our implementation is scalable to population genomic datasets with millions of individuals. Our approach may serve as an algorithmic blueprint for the era of ‘big data’ genomics: a combinatorial core coupled with statistical inference in closed form.

PMID:36790822 | DOI:10.1093/molbev/msad027

Transl Vis Sci Technol. 2023 Feb 1;12(2):23. doi: 10.1167/tvst.12.2.23.

ABSTRACT

PURPOSE: (1) To assess the performance of geometric deep learning in diagnosing glaucoma from a single optical coherence tomography (OCT) scan of the optic nerve head and (2) to compare its performance to that obtained with a three-dimensional (3D) convolutional neural network (CNN), and with a gold-standard parameter, namely, the retinal nerve fiber layer (RNFL) thickness.

METHODS: Scans of the optic nerve head were acquired with OCT for 477 glaucoma and 2296 nonglaucoma subjects. All volumes were automatically segmented using deep learning to identify seven major neural and connective tissues. Each optic nerve head was then represented as a 3D point cloud with approximately 1000 points. Geometric deep learning (PointNet) was then used to provide a glaucoma diagnosis from a single 3D point cloud. The performance of our approach (reported using the area under the curve [AUC]) was compared with that obtained with a 3D CNN, and with the RNFL thickness.

RESULTS: PointNet was able to provide a robust glaucoma diagnosis solely from a 3D point cloud (AUC = 0.95 ± 0.01).The performance of PointNet was superior to that obtained with a 3D CNN (AUC = 0.87 ± 0.02 [raw OCT images] and 0.91 ± 0.02 [segmented OCT images]) and with that obtained from RNFL thickness alone (AUC = 0.80 ± 0.03).

CONCLUSIONS: We provide a proof of principle for the application of geometric deep learning in glaucoma. Our technique requires significantly less information as input to perform better than a 3D CNN, and with an AUC superior to that obtained from RNFL thickness.

TRANSLATIONAL RELEVANCE: Geometric deep learning may help us to improve and simplify diagnosis and prognosis applications in glaucoma.

PMID:36790820 | DOI:10.1167/tvst.12.2.23

JAMA Netw Open. 2023 Feb 1;6(2):e2255986. doi: 10.1001/jamanetworkopen.2022.55986.

ABSTRACT

IMPORTANCE: Screening adolescents in emergency departments (EDs) for suicidal risk is a recommended strategy for suicide prevention. Comparing screening measures on predictive validity could guide ED clinicians in choosing a screening tool.

OBJECTIVE: To compare the Ask Suicide-Screening Questions (ASQ) instrument with the Computerized Adaptive Screen for Suicidal Youth (CASSY) instrument for the prediction of suicidal behavior among adolescents seen in EDs, across demographic and clinical strata.

DESIGN, SETTING, AND PARTICIPANTS: The Emergency Department Study for Teens at Risk for Suicide is a prospective, random-series, multicenter cohort study that recruited adolescents, oversampled for those with psychiatric symptoms, who presented to the ED from July 24, 2017, through October 29, 2018, with a 3-month follow-up to assess the occurrence of suicidal behavior. The study included 14 pediatric ED members of the Pediatric Emergency Care Applied Research Network and 1 Indian Health Service ED. Statistical analysis was performed from May 2021 through January 2023.

MAIN OUTCOMES AND MEASURES: This study used a prediction model to assess outcomes. The primary outcome was suicide attempt (SA), and the secondary outcome was suicide-related visits to the ED or hospital within 3 months of baseline; both were assessed by an interviewer blinded to baseline information. The ASQ is a 4-item questionnaire that surveys suicidal ideation and lifetime SAs. A positive response or nonresponse on any item indicates suicidal risk. The CASSY is a computerized adaptive screening tool that always includes 3 ASQ items and a mean of 8 additional items. The CASSY’s continuous outcome is the predicted probability of an SA.

RESULTS: Of 6513 adolescents available, 4050 were enrolled, 3965 completed baseline assessments, and 2740 (1705 girls [62.2%]; mean [SD] age at enrollment, 15.0 [1.7] years; 469 Black participants [17.1%], 678 Hispanic participants [24.7%], and 1618 White participants [59.1%]) completed both screenings and follow-ups. The ASQ and the CASSY showed a similar sensitivity (0.951 [95% CI, 0.918-0.984] vs 0.945 [95% CI, 0.910-0.980]), specificity (0.588 [95% CI, 0.569-0.607] vs 0.643 [95% CI, 0.625-0.662]), positive predictive value (0.127 [95% CI, 0.109-0.146] vs 0.144 [95% CI, 0.123-0.165]), and negative predictive value (both 0.995 [95% CI, 0.991-0.998], respectively). Area under the receiver operating characteristic curve findings were similar among patients with physical symptoms (ASQ, 0.88 [95% CI, 0.81-0.95] vs CASSY, 0.94 [95% CI, 0.91-0.96]). Among patients with psychiatric symptoms, the CASSY performed better than the ASQ (0.72 [95% CI, 0.68-0.77] vs 0.57 [95% CI, 0.55-0.59], respectively).

CONCLUSIONS AND RELEVANCE: This study suggests that both the ASQ and the CASSY are appropriate for universal screening of patients in pediatric EDs. For the small subset of patients with psychiatric symptoms, the CASSY shows greater predictive validity.

PMID:36790810 | DOI:10.1001/jamanetworkopen.2022.55986