Tag: nevin manimala

PLoS One. 2022 May 6;17(5):e0267794. doi: 10.1371/journal.pone.0267794. eCollection 2022.

ABSTRACT

BACKGROUND: Heart failure (HF) is a serious health condition, associated with high health care costs, and poor outcomes. Patient empowerment and self-care are a key component of successful HF management. The emergence of telehealth may enable providers to remotely monitor patients’ statuses, support adherence to medical guidelines, improve patient wellbeing, and promote daily awareness of overall patients’ health.

OBJECTIVE: To assess the feasibility of a voice activated technology for monitoring of HF patients, and its impact on HF clinical outcomes and health care utilization.

METHODS: We conducted a randomized clinical trial; ambulatory HF patients were randomized to voice activated technology or standard of care (SOC) for 90 days. The system developed for this study monitored patient symptoms using a daily survey and alerted healthcare providers of pre-determined reported symptoms of worsening HF. We used summary statistics and descriptive visualizations to study the alerts generated by the technology and to healthcare utilization outcomes.

RESULTS: The average age of patients was 54 years, the majority were Black and 45% were women. Almost all participants had an annual income below $50,000. Baseline characteristics were not statistically significantly different between the two arms. The technical infrastructure was successfully set up and two thirds of the invited study participants interacted with the technology. Patients reported favorable perception and high comfort level with the use of voice activated technology. The responses from the participants varied widely and higher perceived symptom burden was not associated with hospitalization on qualitative assessment of the data visualization plot. Among patients randomized to the voice activated technology arm, there was one HF emergency department (ED) visit and 2 HF hospitalizations; there were no events in the SOC arm.

CONCLUSIONS: This study demonstrates the feasibility of remote symptom monitoring of HF patients using voice activated technology. The varying HF severity and the wide range of patient responses to the technology indicate that personalized technological approaches are needed to capture the full benefit of the technology. The differences in health care utilization between the two arms call for further study into the impact of remote monitoring on health care utilization and patients’ wellbeing.

PMID:35522660 | DOI:10.1371/journal.pone.0267794

PLoS One. 2022 May 6;17(5):e0265411. doi: 10.1371/journal.pone.0265411. eCollection 2022.

ABSTRACT

BACKGROUND: Kangaroo mother care is a key procedure in reducing neonatal mortality and morbidity associated with preterm birth. In Ethiopia, neonatal death remains a serious problem, and this study aims to determine the prevalence of the knowledge, attitudes and practice of kangaroo mother care among Ethiopia women.

METHODS: PubMed, Web of Science, Google Scholar, EMBASE and the Ethiopian University online library were searched. Data were extracted using Microsoft Excel and analysed using STATA statistical software (v. 11). Publication bias was checked by forest plot, Begg’s rank test and Egger’s regression test. To look for heterogeneity, I2 were computed and an overall estimated analysis carried out. Subgroup analysis was done by region, study setting, publication, gestational age, birth weight and component of kangaroo care. The Joanna Briggs Institute risk of bias assessment tool was used. We carried out a leave one out sensitivity analysis.

RESULTS: Out of 273 articles retrieved, 16 studies met the eligibility criteria and are thus included in this study. Those 16 studies had a total of 12,345 respondents who reported kangaroo mother practice, with five (comprising 1,232 participants combined) reporting that both knowledge and attitude were used to determine the overall estimation. The pooled estimates of good knowledge, positive attitude and poor practice of kangaroo mother care were found to be 64.62% (95% CI: 47.15%-82.09%; I2 = 97.8%), 61.55% (49.73%-73.38%; I2 = 94.8%) and 45.7% (95% CI: 37.23%-54.09%; I2 = 98.5%), respectively. This study is limited to postnatal women and does not take account their domestic partners or health providers.

CONCLUSION: The findings revealed significant gaps in the knowledge, attitudes and practice of kangaroo mother care in Ethiopia when compared with other developing countries. Therefore, kangaroo mother care training to women, along with further studies on domestic partners and health providers.

PMID:35522657 | DOI:10.1371/journal.pone.0265411

PLoS One. 2022 May 6;17(5):e0267349. doi: 10.1371/journal.pone.0267349. eCollection 2022.

ABSTRACT

DNA methylation is closely related to senescence, so it has been used to develop statistical models, called clock models, to predict chronological ages accurately. However, because the training data always have a biased age distribution, the model performance becomes weak for the samples with a small age distribution density. To solve this problem, we developed the R package eClock, which uses a bagging-SMOTE method to adjust the biased distribution and predict age with an ensemble model. Moreover, it also provides a bootstrapped model based on bagging only and a traditional clock model. The performance on three datasets showed that the bagging-SMOTE model significantly improved rare sample age prediction. In addition to model construction, the package also provides other functions such as data visualization and methylation feature conversion to facilitate the research in relevant areas.

PMID:35522643 | DOI:10.1371/journal.pone.0267349

IEEE J Biomed Health Inform. 2022 May 6;PP. doi: 10.1109/JBHI.2022.3172956. Online ahead of print.

ABSTRACT

Hospitals can predetermine the admission rate and facilitate resource allocation based on valid emergency requests and bed capacity estimation. The excess unoccupied beds can be determined with the help of forecasting the number of discharged patients. Extracting predictive features and mining the temporal patterns from historical observations are crucial for accurate and reliable forecasts. Machine learning algorithms have demonstrated the ability to learn temporal knowledge and make predictions for unseen inputs. This paper utilizes several machine learning algorithms to forecast the inpatient discharges of Singapore hospitals and compare them with statistical methods. A novel ensemble deep learning algorithm based on random vector functional links is established to predict inpatient discharges. The ensemble deep learning framework is optimized in a greedy layer-wise fashion. Several forecasting metrics and statistical tests are utilized to demonstrate the proposed method’s superiority. The proposed algorithm statistically outperforms the benchmark with a ranking of 1.875. Finally, practical implications and future directions are discussed.

PMID:35522640 | DOI:10.1109/JBHI.2022.3172956

PLoS Med. 2022 May 6;19(5):e1003983. doi: 10.1371/journal.pmed.1003983. eCollection 2022 May.

ABSTRACT

BACKGROUND: Current benzodiazepine (BZD) prescription guidelines recommend short-term use to minimize the risk of dependence, cognitive impairment, and falls and fractures. However, many clinicians overprescribe BZDs and chronic use by patients is common. There is limited evidence on the effectiveness of interventions delivered by general practitioners (GPs) on reducing prescriptions and long-term use of BZDs. We aimed to evaluate the effectiveness of a multicomponent intervention for GPs that seeks to reduce BZD prescriptions and the prevalence of long-term users.

METHODS AND FINDINGS: We conducted a multicenter two-arm, cluster randomized controlled trial in 3 health districts in Spain (primary health centers [PHCs] in Balearic Islands, Catalonia, and Valencian Community) from September 2016 to May 2018. The 81 PHCs were randomly allocated to the intervention group (n = 41; 372 GPs) or the control group (n = 40; 377 GPs). GPs were not blinded to the allocation; however, pharmacists, researchers, and trial statisticians were blinded to the allocation arm. The intervention consisted of a workshop about the appropriate prescribing of BZDs and tapering-off long-term BZD use using a tailored stepped dose reduction with monthly BZD prescription feedback and access to a support web page. The primary outcome, based on 700 GPs (351 in the control group and 349 in the intervention group), compared changes in BZD prescriptions in defined daily doses (DDDs) per 1,000 inhabitants per day after 12 months. The 2 secondary outcomes were the proportion of long-term users (≥6 months) and the proportion of long-term users over age 65 years. Intention-to-treat (ITT) analysis was used to assess all clinical outcomes. Forty-nine GPs (21 intervention group and 28 control group) were lost to follow-up. However, all GPs were included in the ITT analysis. After 12 months, there were a statistically significant decline in total BZD prescription in the intervention group compared to the control group (mean difference: -3.24 DDDs per 1,000 inhabitants per day, 95% confidence interval (CI): -4.96, -1.53, p < 0.001). The intervention group also had a smaller number of long-term users. The adjusted absolute difference overall was -0.36 (95% CI: -0.55, -0.16, p > 0.001), and the adjusted absolute difference in long-term users over age 65 years was -0.87 (95% CI: -1.44, -0.30, p = 0.003). A key limitation of this clustered design clinical trial is the imbalance of some baseline characteristics. The control groups have a higher rate of baseline BZD prescription, and more GPs in the intervention group were women, GPs with a doctorate degree, and trainers of GP residents.

CONCLUSIONS: A multicomponent intervention that targeted GPs and included educational meeting, feedback about BZD prescriptions, and a support web page led to a statistically significant reduction of BZD prescriptions and fewer long-term users. Although the effect size was small, the high prevalence of BZD use in the general population suggests that large-scale implementation of this intervention could have positive effects on the health of many patients.

TRIAL REGISTRATION: ISRCTN ISRCTN28272199.

PMID:35522626 | DOI:10.1371/journal.pmed.1003983

PLoS One. 2022 May 6;17(5):e0268185. doi: 10.1371/journal.pone.0268185. eCollection 2022.

ABSTRACT

BACKGROUND: Although Nigeria has made some progress in malaria control, there are variations across States. We investigated the factors associated with utilisation of long-lasting insecticide-treated net (LLIN) and parasitaemia among under-five children in 13 States with high malaria burden.

METHOD: Data from the 2015 Nigeria Malaria Indicator Survey and 2018 Demographic and Health Survey were obtained and analysed. The 2015 and 2018 data were compared to identify States with increase or reduction in parasitaemia. Analysis was done for all the 13 study States; four States with increased parasitaemia and nine States with reduction. Random-effects logit models were fitted to identify independent predictors of LLIN utilisation and parasitaemia.

RESULTS: LLIN was used by 53.4% of 2844 children, while parasitaemia prevalence was 26.4% in 2018. Grandchildren (AOR = 5.35, CI: 1.09-26.19) were more likely to use LLIN while other relatives (AOR = 0.33, CI: 0.11-0.94) were less likely compared to children of household-heads. LLIN use was more common in children whose mother opined that only weak children could die from malaria (AOR = 1.83, CI: 1.10-3.10). Children whose mothers obtained net from antenatal or immunisation clinics (AOR = 5.30, CI: 2.32-12.14) and campaigns (AOR = 1.77, CI: 1.03-3.04) were also more likely to use LLIN. In contrast, LLIN utilisation was less likely among children in female-headed households (AOR = 0.51, CI: 0.27-0.99) and those in poor-quality houses (AOR = 0.25, CI: 0.09-0.72). Children aged 24-59 months compared to 0-11 months (AOR = 1.78, CI: 1.28-2.48), those in whom fever was reported (AOR = 1.31, CI: 1.06-1.63) and children of uneducated women (AOR = 1.89, CI: 1.32-2.70) were more likely to have parasitaemia. The likelihood of parasitaemia was higher among children from poor households compared to the rich (AOR = 2.06, CI: 1.24-3.42). The odds of parasitaemia were 98% higher among rural children (AOR = 1.98, CI: 1.37-2.87).

CONCLUSION: The key drivers of LLIN utilisation were source of net and socioeconomic characteristics. The latter was also a key factor associated with parasitaemia. These should be targeted as part of integrated malaria elimination efforts.

PMID:35522617 | DOI:10.1371/journal.pone.0268185

Evolution. 2022 May 6. doi: 10.1111/evo.14512. Online ahead of print.

ABSTRACT

Simulation-based and permutation-based inferential methods are commonplace in phylogenetic comparative methods, especially as evolutionary data have become more complex and parametric methods more limited for their analysis. Both approaches simulate many random outcomes from a null model to empirically generate sampling distributions of statistics. Although simulation-based and permutation-based methods seem commensurate in purpose, results from analysis of variance (ANOVA) based on the distributions of random -statistics produced by these methods can be quite different in practice. Differences could be from either the null model process that generates variation across many simulations or random permutations of the data, or different estimation methods for linear model coefficients and statistics. Unfortunately, because null model process and coefficient estimation are intrinsically linked in phylogenetic ANOVA methods, the precise reason for methodological differences has not been fully considered. Here we show that the null model processes of phylogenetic simulation and randomization of residuals in a permutation procedure (RRPP) are indeed commensurate, and that both also produce results consistent with parametric ANOVA, for cases where parametric ANOVA is possible. We also provide results that caution against using ordinary least-squares estimation along with phylogenetic simulation; a typical phylogenetic ANOVA implementation. This article is protected by copyright. All rights reserved.

PMID:35522593 | DOI:10.1111/evo.14512

Phys Rev Lett. 2022 Apr 22;128(16):162001. doi: 10.1103/PhysRevLett.128.162001.

ABSTRACT

Two narrow resonant states are observed in the Λ_{b}^{0}K^{-}π^{+} mass spectrum using a data sample of proton-proton collisions at a center-of-mass energy of 13 TeV, collected by the LHCb experiment and corresponding to an integrated luminosity of 6 fb^{-1}. The minimal quark content of the Λ_{b}^{0}K^{-}π^{+} system indicates that these are excited Ξ_{b}^{0} baryons. The masses of the Ξ_{b}(6327)^{0} and Ξ_{b}(6333)^{0} states are m[Ξ_{b}(6327)^{0}]=6327.28_{-0.21}^{+0.23}±0.12±0.24 and m[Ξ_{b}(6333)^{0}]=6332.69_{-0.18}^{+0.17}±0.03±0.22 MeV, respectively, with a mass splitting of Δm=5.41_{-0.27}^{+0.26}±0.12 MeV, where the uncertainties are statistical, systematic, and due to the Λ_{b}^{0} mass measurement. The measured natural widths of these states are consistent with zero, with upper limits of Γ[Ξ_{b}(6327)^{0}]<2.20(2.56) and Γ[Ξ_{b}(6333)^{0}]<1.60(1.92) MeV at a 90% (95%) credibility level. The significance of the two-peak hypothesis is larger than nine (five) Gaussian standard deviations compared to the no-peak (one-peak) hypothesis. The masses, widths, and resonant structure of the new states are in good agreement with the expectations for a doublet of 1D Ξ_{b}^{0} resonances.

PMID:35522517 | DOI:10.1103/PhysRevLett.128.162001

Phys Rev Lett. 2022 Apr 22;128(16):160601. doi: 10.1103/PhysRevLett.128.160601.

ABSTRACT

We analytically compute the full counting statistics of charge transfer in a classical automaton of interacting charged particles. Deriving a closed-form expression for the moment generating function with respect to a stationary equilibrium state, we employ asymptotic analysis to infer the structure of charge current fluctuations for a continuous range of timescales. The solution exhibits several unorthodox features. Most prominently, on the timescale of typical fluctuations the probability distribution of the integrated charge current in a stationary ensemble without bias is distinctly non-Gaussian despite diffusive behavior of dynamical charge susceptibility. While inducing a charge imbalance is enough to recover Gaussian fluctuations, we find that higher cumulants grow indefinitely in time with different exponents, implying singular scaled cumulants. We associate this phenomenon with the lack of a regularity condition on moment generating functions and the onset of a dynamical critical point. In effect, the scaled cumulant generating function does not, irrespectively of charge bias, represent a faithful generating function of the scaled cumulants, yet the associated Legendre dual yields the correct large-deviation rate function. Our findings hint at novel types of dynamical universality classes in deterministic many-body systems.

PMID:35522513 | DOI:10.1103/PhysRevLett.128.160601

J Environ Qual. 2022 May 6. doi: 10.1002/jeq2.20366. Online ahead of print.

ABSTRACT

Nitrate in subsurface tile drainage from Midwestern USA corn (Zea mays L.)-soybean [Glycine max (L.) Merr] systems is detrimental to water quality at local and national scales. The objective of this replicated plot study in Northwest Iowa, 2015-2020, was to investigate the influence of nitrogen (N) fertilizer timing on crop production and NO₃ load in subsurface (tile) drainage discharge. Four treatments applied to corn included fall anhydrous ammonia with a nitrification inhibitor (F), spring anhydrous ammonia (S), split-banded urea at planting and mid-vegetative growth (SS), and no N fertilizer (0N). Across crops and years, NO₃ -N concentration in subsurface drainage discharge was the same 11.7 mg L^-1 for F and S applied anhydrous ammonia (AA). Concentration was statistically lower with SS urea (10 mg L^-1 ) than F and S, and 0N was lower than SS at 8.3 mg L^-1 . Average annual NO₃ -N loads were not different between any treatments due to plot variability in drainage discharge. Corn responded to N application, with overall mean yield the same for F, S, and SS. There were no agronomic or water quality benefits for applying AA in the spring compared to fall, where the F included a nitrification inhibitor and was applied to cold soils. Split-applied urea had a small positive water quality impact but no crop yield enhancement. This study shows that there were improvements to NO₃ -N concentration in subsurface drainage discharge, but more nutrient reduction practices are needed than fertilizer N management alone to reduce nitrate load to surface water systems. This article is protected by copyright. All rights reserved.

PMID:35522457 | DOI:10.1002/jeq2.20366