Tag: nevin manimala

IEEE Trans Neural Syst Rehabil Eng. 2023 Feb 14;PP. doi: 10.1109/TNSRE.2023.3245286. Online ahead of print.

ABSTRACT

Gait variability of healthy adults exhibits Long-Range Autocorrelations (LRA), meaning that the stride interval at any time statistically depends on previous gait cycles; and this dependency spans over several hundreds of strides. Previous works have shown that this property is altered in patients with Parkinson’s disease, such that their gait pattern corresponds to a more random process. Here, we adapted a model of gait control to interpret the reduction in LRA that characterized patients in a computational framework. Gait regulation was modeled as a Linear-Quadratic-Gaussian control problem where the objective was to maintain a fixed velocity through the coordinated regulation of stride duration and length. This objective offers a degree of redundancy in the way the controller can maintain a given velocity, resulting in the emergence of LRA. In this framework, the model suggested that patients exploited less the task redundancy, likely to compensate for an increased stride-to-stride variability. Furthermore, we used this model to predict the potential benefit of an active orthosis on the gait pattern of patients. The orthosis was embedded in the model as a low-pass filter on the series of stride parameters. We show in simulations that, with a suitable level of assistance, the orthosis could help patients recovering a gait pattern with LRA comparable to that of healthy controls. Assuming that the presence of LRA in a stride series is a marker of healthy gait control, our study provides a rationale for developing gait assistance technology to reduce the fall risk associated with Parkinson’s disease.

PMID:37022872 | DOI:10.1109/TNSRE.2023.3245286

IEEE Trans Neural Netw Learn Syst. 2023 Feb 14;PP. doi: 10.1109/TNNLS.2023.3242361. Online ahead of print.

ABSTRACT

Root cause diagnosis of process industry is of significance to ensure safe production and improve production efficiency. Conventional contribution plot methods have challenges in root cause diagnosis due to the smearing effect. Other traditional root cause diagnosis methods, such as Granger causality (GC) and transfer entropy, have unsatisfactory performance in root cause diagnosis for complex industrial processes due to the existence of indirect causality. In this work, a regularization and partial cross mapping (PCM)-based root cause diagnosis framework is proposed for efficient direct causality inference and fault propagation path tracing. First, generalized Lasso-based variable selection is performed. The Hotelling T² statistic is formulated and the Lasso-based fault reconstruction is applied to select candidate root cause variables. Second, the root cause is diagnosed through the PCM and the propagation path is drawn out according to the diagnosis result. The proposed framework is studied in four cases to verify its rationality and effectiveness, including a numerical example, the Tennessee Eastman benchmark process, the wastewater treatment process (WWTP), and the decarburization process of high-speed wire rod spring steel.

PMID:37022853 | DOI:10.1109/TNNLS.2023.3242361

IEEE Trans Neural Syst Rehabil Eng. 2023 Feb 8;PP. doi: 10.1109/TNSRE.2023.3243554. Online ahead of print.

ABSTRACT

Afferent and efferent visual dysfunction are prominent features of multiple sclerosis (MS). Visual outcomes have been shown to be robust biomarkers of the overall disease state. Unfortunately, precise measurement of afferent and efferent function is typically limited to tertiary care facilities, which have the equipment and analytical capacity to make these measurements, and even then, only a few centers can accurately quantify both afferent and efferent dysfunction. These measurements are currently unavailable in acute care facilities (ER, hospital floors). We aimed to develop a moving multifocal steady-state visual evoked potential (mfSSVEP) stimulus to simultaneously assess afferent and efferent dysfunction in MS for application on a mobile platform. The brain-computer interface (BCI) platform consists of a head-mounted virtual-reality headset with electroencephalogram (EEG) and electrooculogram (EOG) sensors. To evaluate the platform, we recruited consecutive patients who met the 2017 MS McDonald diagnostic criteria and healthy controls for a pilot cross-sectional study. Nine MS patients (mean age 32.7 years, SD 4.33) and ten healthy controls (24.9 years, SD 7.2) completed the research protocol. The afferent measures based on mfSSVEPs showed a significant difference between the groups (signal-to-noise ratio of mfSSVEPs for controls: 2.50 ± 0.72 vs. MS: 2.04 ± 0.47) after controlling for age (p = 0.049). In addition, the moving stimulus successfully induced smooth pursuit movement that can be measured by the EOG signals. There was a trend for worse smooth pursuit tracking in cases vs. controls, but this did not reach nominal statistical significance in this small pilot sample. This study introduces a novel moving mfSSVEP stimulus for a BCI platform to evaluate neurologic visual function. The moving stimulus showed a reliable capability to assess both afferent and efferent visual functions simultaneously.

PMID:37022841 | DOI:10.1109/TNSRE.2023.3243554

IEEE J Biomed Health Inform. 2023 Feb 9;PP. doi: 10.1109/JBHI.2023.3243698. Online ahead of print.

ABSTRACT

The present paper introduces a novel method to decode imagined movement from electroencephalographic (EEG) signals. Decoding the imagined movement with good accuracy is a challenging topic in motor imagery (MI) BCIs, poor accuracy may indeed hinder the application of such systems in practice. The present paper introduces an extension of the well-established Filter Bank Common Spatial Patterns (FBCSP) algorithm, named AutoEncoder(AE)-FBCSP, to benefit from the ability of AE to learn how to map data from the feature space onto a latent space where information relevant for classification are is embedded. The proposed method is based on a global (cross-subject) and subsequent transfer learning subject-specific (intra-subject) approach. A multi-way extension of AE-FBCSP is also introduced in this paper. The proposed methodology consists of recording high-density EEG (64 electrodes). Features are extracted by means of FBCSP and used to train a custom AE, in an unsupervised way, to project the features into a compressed latent space. Latent features then are used to train a supervised classifier (feed forward neural network) to decode the imagined movement. The algorithm was tested using a dataset of EEG extracted from a publicly available database of data collected from 109 subjects. AE-FBCSP was extensively tested in the 3-way (right-hand vs left-hand motor imagery vs resting) classification and also in the 2-way, 4-way and 5-way ones, both in cross- and intra-subject analysis. AE-FBCSP outperformed standard FBCSP in a statistically significant way (p 0.05) and outperformed also comparable methods in the literature applied to the same dataset. AE-FBCSP achieved an average accuracy of 89.09% in the 3-way subject-specific classification. With AE-FBCSP, 71.43% of subjects achieved a very high accuracy ( 87.68%) whereas no subject achieved an accuracy 87.68% with FBCSP. One of the most interesting outcomes is that AE-FBCSP remarkably increased the number of subjects that responded with a very high accuracy, which is a fundamental requirement for BCI systems to be applied in practice.

PMID:37022818 | DOI:10.1109/JBHI.2023.3243698

LGBT Health. 2023 Apr 5. doi: 10.1089/lgbt.2022.0249. Online ahead of print.

ABSTRACT

Purpose: The purpose of this study was to utilize a systematic review and meta-analysis to assess the existing body of literature to understand the mental health impacts of the coronavirus disease-19 (COVID-19) pandemic among sexual and gender minority (SGM) people. Methods: The search strategy was developed by an experienced librarian and used five bibliographical databases, specifically PubMed, Embase, APA PsycINFO (EBSCO), Web of Science, and LGBTQ+ Source (EBSCO), for studies (published 2020 to June, 2021) examining the psychological impact of the COVID-19 pandemic among SGM people. Articles were screened by two reviewers. The quality of the articles was assessed using the National Institutes of Health quality assessment tool for observational studies. A double extraction method was used for data abstraction. Heterogeneity among studies was assessed by I² statistic. The random-effects model was utilized to obtain the pooled prevalence. Publication bias was assessed by Funnel plot and Egger’s linear regression test. Results: Of a total of 37 studies, 15 studies were included in the meta-analysis with 17,973 SGM participants. Sixteen studies were U.S. based, seven studies were multinational studies, and the remaining studies were from Portugal, Brazil, Chile, Taiwan, the United Kingdom, France, Italy, Canada, and several other countries. A majority of studies used psychometric valid tools for the cross-sectional surveys. The pooled prevalence of anxiety, depression, psychological distress, and suicidal ideation was 58.6%, 57.6%, 52.7%, and 28.8%, respectively. Conclusions: Findings of this study serve as evidence to develop appropriate interventions to promote psychological wellbeing among vulnerable population subgroups, such as SGM individuals.

PMID:37022764 | DOI:10.1089/lgbt.2022.0249

J Clin Psychiatry. 2023 Apr 3;84(2):23f14874. doi: 10.4088/JCP.23f14874.

ABSTRACT

A small proportion of women with anxiety, insomnia, and other conditions may require benzodiazepines or z-hypnotics intermittently or daily sometime during pregnancy. This article provides an update on pregnancy outcomes associated with pre-gestational or gestational exposure to benzodiazepines and z-hypnotics based on results from 2 meta-analyses, 2 registry-based studies, and 2 large retrospective cohort studies. In summary, the meta-analyses found that exposure was associated with an increased risk of spontaneous abortion, induced abortion, preterm birth, low birth weight, small for gestational age, low Apgar scores at 5 min, and neonatal intensive care unit admission. Whereas meta-analyses and registry studies found that first trimester exposure to benzodiazepines and/or z-hypnotics was not associated with increased risk of congenital malformations, a nationwide observational study with 10 times as many exposed pregnancies as in all the previous studies combined found that first trimester exposure to benzodiazepines was associated with a small but statistically significantly increased risk of overall malformations as well as, specifically, cardiac malformations; in this study, analyses that examined the potential role of confounding by indication suggested that the adverse findings may not have been due to confounding. Finally, a large observational study found that exposure to benzodiazepines in the 90 days before conception was associated with an increased risk of ectopic pregnancy; in this study, as well, the findings were consistent in analyses that examined possible confounding by indication. In no reviewed study could residual confounding be ruled out. The take-home message is that benzodiazepine and z-drug exposure before and during pregnancy is associated with many adverse gestational outcomes, but it is unclear to what extent the findings are due to exposure to drugs vs exposure to the indication for treatment. Therefore, all treatment decisions need to be tailored to context and shared between health care professionals, patients, and their caregivers.

PMID:37022751 | DOI:10.4088/JCP.23f14874

LGBT Health. 2023 Apr 5. doi: 10.1089/lgbt.2021.0384. Online ahead of print.

ABSTRACT

Purpose: This study aimed to describe the gynecological care provided to Brazilian women who have sex with women (WSW). Methods: Respondent-driven sampling was used to recruit Brazilian WSW. The survey questions, concerning gynecological care, were designed in Portuguese by medical professionals, medical students, and LGBTQIA+ community members, including the authors. The statistical analyses were weighted to account for the likelihood of recruitment. Results: From January to August of 2018, 299 participants were recruited in 14 recruitment waves. The mean age of the WSW was 25.3 years. Most (54.9%) identified as lesbian and had been involved in past-year sexual intercourse mainly with cisgender women (86.1%). The WSW also reported having sex with cisgender men (22.2%), transgender men (5.3%), nonbinary people (2.3%), and transgender women (5.3%) in the last year. More than a quarter of the WSW did not have regular appointments with a gynecologist: 8.0% (95% confidence interval [CI] = 4.2-11.6) and 19% (95% CI = 12.8-25.2) stated that they had never gone to the gynecologist or they had only gone for emergencies, respectively. Almost one-third had never had cervical cancer screening (cervical cytology, Pap test or Pap smear). Most women justified avoiding the test because they felt healthy, thought it would hurt, or feared a health professional might mistreat them. Conclusion: Gynecologists should avoid heteronormative assumptions, inquire about sexual practices, orientation, and identity separately, and provide Pap tests as advised to WSW.

PMID:37022728 | DOI:10.1089/lgbt.2021.0384

Environ Health Perspect. 2023 Apr;131(4):45001. doi: 10.1289/EHP11899. Epub 2023 Apr 6.

ABSTRACT

BACKGROUND: Epidemiological studies are increasingly going beyond the evaluation of health effects of individual chemicals to consider chemical mixtures. To our knowledge, the advantages and disadvantages of addressing chemical mixtures for informing regulatory decisions-as opposed to obtaining a more comprehensive understanding of etiology-has not been carefully considered.

OBJECTIVES: We offer a framework for the study of chemical mixtures in epidemiological research intended to inform regulatory decisions. We identify a) the different ways mixtures originate (product source, pollution source, shared mode of action, or shared effect on health outcome), b) the use of indicator chemicals to address mixtures, and c) the requirements for epidemiological studies to be informative for regulatory purposes.

DISCUSSION: The principal advantage of considering mixtures is to obtain a more complete understanding of the role of the chemical environment as a determinant of health. Incorporating other exposures may improve the assessment of the net effect of the chemicals of interest. However, the increased complexity and potential loss of generalizability may limit the value of studies of mixtures, especially for mixtures based on mode of action or shared health outcomes. Our recommended strategy is to successively assess the marginal contribution of individual chemicals, joint effects with other specific chemicals, and hypothesis-driven evaluation of mixtures rather than applying hypothesis-free data exploration methods. Although more ambitious statistical approaches to mixtures may, in time, be helpful for guiding regulation, the authors believe conventional methods for assessing individual and combined effects of chemicals remain preferable. https://doi.org/10.1289/EHP11899.

PMID:37022726 | DOI:10.1289/EHP11899

Eur Thyroid J. 2023 Apr 1:ETJ-22-0219. doi: 10.1530/ETJ-22-0219. Online ahead of print.

ABSTRACT

BACKGROUND: Purpose To determine whether thyroid stimulating hormone level ≥30 mU/l is necessary for radioiodine (131I) remnant ablation (RRA) in patients with differentiated thyroid cancer (DTC), as well as its influencing factors and predictors.

METHODS: 487 DTC patients were retrospectively enrolled in this study. They were divided into two groups (TSH <30 and ≥30 mU/l) and further divided into eight subgroups (0-<30, 30-<40, 40-<50, 50-<60, 60-<70, 70-<80, 80-<90, 90-<100 mU/l). The simultaneous serum lipids level, successful rate of RRA and its influencing factors in different groups were analyzed. The receiver operating characteristic curves derived from pre-ablative thyroglobulin (pre-Tg) and pre-Tg/TSH ratio were compared for RRA success prediction performance.

RESULTS: There was no statistical difference in success rates of RRA between the two groups (p=0.247) and eight subgroups (p=0.685). Levels of total cholesterol (p<0.001), triglyceride (p=0.006), high-density lipoprotein cholesterol (p=0.024), low-density lipoprotein cholesterol (p=0.001), apolipoprotein B (p<0.001) and apolipoprotein E (p=0.002) were significantly higher while apoA/apoB ratio (p=0.024) were significantly lower at TSH ≥30 mU/l group. Pre-Tg level, gender and N stage were influencing factors for RRA. The area under the curve of pre-Tg level and pre-Tg/TSH ratio were 0.7611 (p<0.0001), 0.7340 (p<0.0001) for all enrolled patients and 0.7310 (p=0.0145), 0.6524 (p=0.1068) for TSH <30 mU/l respectively.

CONCLUSION: TSH ≥30 mU/l may not be necessary for the success of RRA. Patients with higher serum TSH level prior RRA will suffer from severer hyperlipidemia. Pre-Tg level could be used as a predictor for the success of RRA, especially when TSH <30 mU/l.

PMID:37022724 | DOI:10.1530/ETJ-22-0219

JAMA Otolaryngol Head Neck Surg. 2023 Apr 6. doi: 10.1001/jamaoto.2023.0309. Online ahead of print.

ABSTRACT

IMPORTANCE: Loneliness is suggested to negatively affect physical and mental health and influence the development of disability; however, a consensus on the relationship between loneliness and disability has not been reached. Age-related hearing impairment worsens the daily-life activities of older adults, and the association between loneliness and the incidence of disability may be influenced by hearing impairment.

OBJECTIVE: To examine the association between loneliness and the incidence of disability among older adults stratified by hearing impairment.

DESIGN, SETTING, AND PARTICIPANTS: This prospective observational cohort study included 5563 community-dwelling adults 65 years or older who participated in functional health examinations in Tokai City, Aichi Prefecture, Japan, between September 2017 and June 2018. Data analysis was conducted from August 2022 to February 2023.

MAIN OUTCOMES AND MEASURES: Cox proportional hazards regression models were used to examine the association between loneliness and the incidence of disability stratified by hearing impairment.

RESULTS: Among the 4739 participants who met the inclusion criteria (mean [SD] age, 73.8 [5.5] years; 2622 [55.3%] female), 3792 (80.0%) were without hearing impairment and 947 (20.0%) were with hearing impairment. Of those who reported experiencing loneliness, 1215 (32.0%) were without hearing impairment, and 441 (46.6%) were with hearing impairment. After 2 years, the number of individuals with disabilities was 172 (4.5%) without hearing impairment and 79 (8.3%) with hearing impairment. Cox proportional hazards regression analysis showed no statistically significant association between loneliness and the incidence of disability in a model adjusted for potential confounding factors among community-dwelling older adults without hearing impairment (hazard ratio, 1.10; 95% CI, 0.80-1.52). Among community-dwelling older adults with hearing impairment, a model adjusted for potential confounding factors showed a statistically significant association between loneliness and the incidence of disability (hazard ratio, 1.71; 95% CI, 1.04-2.81).

CONCLUSIONS AND RELEVANCE: This cohort study found that the association between loneliness and the incidence of disability was moderated by the presence or absence of hearing impairment. Hearing impairment is the most common symptom of geriatric syndromes, showing that among the various risk factors, loneliness may require special attention in the prevention of disability in people with hearing impairment.

PMID:37022721 | DOI:10.1001/jamaoto.2023.0309