Tag: nevin manimala

Med Teach. 2022 Apr 29:1-8. doi: 10.1080/0142159X.2022.2064736. Online ahead of print.

ABSTRACT

CONTEXT: In Team Based Learning (TBL), it is, based on theory, assumed that knowledge development in each phase contributes to the subsequent phase and to learning performance. However, there is no empirical evidence for this assumption.

AIM: In order to find support for the relation between TBL and the underlying theory, we determined to what extent each phase of TBL is associated with the knowledge development in the next phase and with the total learning performance.

METHODS: We measured the scientific concepts recalled by 56 second-year undergraduate medical students before TBL, after each of the three phases and after TBL. We used multivariate regression analysis to determine the statistical association between the phases as well as the total learning performance.

RESULTS: Results showed that in each phase, students produced new concepts in addition to those previously recalled. Regression models showed statistically significant explained variance ranging from 0.19 to 0.26, between the three phases and the total learning performance.

DISCUSSION: Each phase of the TBL is significantly associated with knowledge development in the subsequent phase and with the total learning performance, and therefore matters. This study contributes to the scientific underpinning of TBL and offers leads to more elaborate research and interventions to improve TBL.

PMID:35486870 | DOI:10.1080/0142159X.2022.2064736

JMIR Diabetes. 2022 Apr 20. doi: 10.2196/36181. Online ahead of print.

ABSTRACT

BACKGROUND: Lockdown restrictions reduce COVID-19 community transmission; however, they may pose challenges for non-communicable disease management. A 112-day hard lockdown in Victoria, Australia (commencing March 23, 2020), coincided with an intervention trial of reducing and breaking up sitting time in desk workers with type 2 diabetes who were using a provided consumer grade activity tracker (Fitbit).

OBJECTIVE: To compare continuously recorded activity levels preceding and during COVID-19 lockdown restrictions among working adults with type 2 diabetes participating in a sitting less and moving more intervention.

METHODS: Eleven participants (8/11 male; mean [SD] age 52.8 [5.0] years) in Melbourne, Australia had Fitbit activity tracked before (mean [SD]: 122.7 [47.9] days) and during (99.7 [62.5] days) city-wide COVID-19 lockdown restrictions. Regression models compared device (Fitbit Inspire HR)-derived activity (steps; METs [metabolic equivalents], mean time in sedentary, lightly, fairly, and very active minutes, and usual bout durations) during restrictions, to pre-restriction. Changes in activity were statistically significant when estimates (Δ%) did not intercept zero.

RESULTS: Overall, there was a decrease in mean: steps (-1,584 steps/day; Δ% : 9%; 95%CI: -11, -7); METs (-83 METs/day; Δ% : -5%; 95%CI: -6, -5); and, lightly active (Δ% : -4%; 95%CI: -8, -1), fairly active (Δ% : -8%; 95%CI: -21, -15), and very active (Δ% : -8%; 95%CI: -11, -5) intensity minutes per day, and increases in mean sedentary minutes per day (+51 mins/day; Δ% : +3%; 95%CI: 1, 6). Only very active (+5.1 mins) and sedentary (+4.3 mins) bout durations changed significantly.

CONCLUSIONS: In a convenience sample of adults with type 2 diabetes, COVID-19 lockdown restrictions were associated with decreases in overall activity levels and increases in very active and sedentary bout durations. A Fitbit monitor provided meaningful continuous long-term data in this context.

CLINICALTRIAL: Australian New Zealand Clinical Trials Registry ANZCTRN12618001159246.

PMID:35486904 | DOI:10.2196/36181

Stat Med. 2022 Apr 29. doi: 10.1002/sim.9419. Online ahead of print.

ABSTRACT

The Finkelstein and Schoenfeld (FS) test is a popular generalized pairwise comparison approach to analyze prioritized composite endpoints (eg, components are assessed in order of clinical importance). Power and sample size estimation for the FS test, however, are generally done via simulation studies. This simulation approach can be extremely computationally burdensome, compounded by increasing number of composite endpoints and with increasing sample size. Here we propose an analytical solution to calculate power and sample size for commonly encountered two-component hierarchical composite endpoints. The power formulas are derived assuming underlying distributions in each of the component outcomes on the population level, which provide a computationally efficient and practical alternative to the standard simulation approach. Monte Carlo simulation results demonstrate that performance of the proposed power formulas are consistent with that of the simulation approach, and have generally desirable objective properties including robustness to mis-specified distributional assumptions. We demonstrate the application of the proposed formulas by calculating power and sample size for the Transthyretin Amyloidosis Cardiomyopathy Clinical Trial.

PMID:35486817 | DOI:10.1002/sim.9419

Cannabis Cannabinoid Res. 2022 Apr 29. doi: 10.1089/can.2021.0193. Online ahead of print.

ABSTRACT

Background: Synthetic cannabinoids (SCs) users appeared to have heightened risk for cardiac arrhythmias; however, current line of research is insufficient in terms of demonstrating both conventional and novel electrocardiographic arrhythmia risk indicators in this population. Objective(s): We aimed to investigate P-wave dispersion (Pwd), corrected QT interval (QTc), QTc dispersion (QTcd), T_peak-T_end (Tp-e), Tp-e/QT ratio, corrected JT interval (JTc), and JTc dispersion (JTcd), which are shown among the risk factors for emergence of an arrhythmia, among SCs users, suggestive of possible adverse effects of SCs on the cardiac rhythm. Methods: Forty-one male SCs user patients who met Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) substance use disorder criteria and 41 healthy male controls included in the study. Substance-related characteristics were recorded. Electrocardiography recordings under standardized procedure of all participants were performed and arrhythmia risk markers were calculated from electrocardiograms (ECGs). Results: Age and heart rate per minute did not significantly differ between the groups. SCs user group had significantly higher Pwd, QTc, QTcd, Tp-e, Tp-e/QTc ratio, JTc, and JTcd values compared with controls. Among risk markers, only Pwd was significantly correlated with duration of SCs use. Conclusions: Alterations in ECG-derived markers of arrhythmia, which are acquired through an easy and cheap method, should be evaluated for the prediction and prevention of severe cardiac conditions in patients with SCs use.

PMID:35486856 | DOI:10.1089/can.2021.0193

JMIR Public Health Surveill. 2022 Apr 26. doi: 10.2196/34438. Online ahead of print.

ABSTRACT

BACKGROUND: The Surveillance Outbreak Response Management and Analysis System (SORMAS) contains a management module to support countries in epidemic response. It consists of documentation, linkage, and follow-up of cases, contacts, and events. To allow SORMAS users to visualise data, compute essential surveillance indicators, and estimate epidemiological parameters from such network data in real-time, we developed the SORMAS Statistics (SORMAS-Stats) application.

OBJECTIVE: This study aims to describe the essential visualisations, surveillance indicators, and epidemiological parameters implemented in the SORMAS-Stats application and illustrates the application of SORMAS-Stats in response to the COVID-19 outbreak.

METHODS: Based on findings from a rapid review and SORMAS user requests, we included the following visualisation and estimation of parameters in SORMAS-Stats: transmission network diagram, serial interval (SI), time-varying reproduction number R(t), dispersion parameter (k) and additional surveillance indicators presented in graphs and tables. We estimated SI by fitting lognormal, gamma, and Weibull distributions to the observed distribution of the number of days between symptom onset dates of infector-infectee pairs. We estimated k by fitting a negative binomial distribution to the observed number of infectees per infector. Furthermore, we applied the Markov Chain Monte Carlo approach and estimated R(t) using the incidence data and the observed SI computed from the transmission network data.

RESULTS: Using COVID-19 contact-tracing data of confirmed cases reported between July 31 and October 29, 2021, in the Bourgogne-Franche-Comté region of France, we constructed a network diagram containing 63570 nodes. The network comprises 1.75% (1115/63570) events, 19.59% (12452/63570) case persons, and 78.66% (50003/63570) exposed persons, 1238 infector-infectee pairs, 3860 transmission chains with 24.69% (953/3860) having events as the index infector. The distribution with the best fit to the observed SI data was lognormal distribution with a mean of 4.30 days (95% CI, 4.09-4.51 days). We estimated the dispersion parameter k of 21.11 (95% CI, 7.57-34.66) and an effective reproduction number R of 0.9 (95% CI, 0.58-0.60). The weekly estimated R(t) values ranged from 0.80 to 1.61.

CONCLUSIONS: We provide an application for real-time estimation of epidemiological parameters, essential for informing outbreak response strategies. The estimates are commensurate with findings from previous studies. SORMAS-Stats application would greatly assist public health authorities in the regions using SORMAS or similar tools by providing extensive visualisations and computation of surveillance indicators.

PMID:35486812 | DOI:10.2196/34438

Opt Lett. 2022 May 1;47(9):2194-2197. doi: 10.1364/OL.457314.

ABSTRACT

In this Letter, we have proposed an optically levitated conveyor belt based on periodic arrays of a polarization-dependent nanoslit-based metasurface lens (NBML) that is capable of realizing far-field capture, transport, and sorting. The NBML in arrays can be lit up in a relay way by rotating the polarization angle of the excitation beam and thereby provide a better stiffness for transporting particles. When excited at the wavelength of 1064 nm and power density of 0.3 mW/µm², the particles will follow the directional movement of hot spots with an alternative switch of polarization angle and the success ratio of transport can be up to 97.0% with the consideration of Brownian motion. Furthermore, the influence of polarization switching time and incident optical power densities on the efficiency of transport are investigated numerically from a statistical point of view. The sorting of particles with different sizes has also been proved in a given power density. With the analysis of numerical results, our research provides a new approach, to the best of our knowledge, for particle trapping and transport, which is beneficial to on-chip optofluidic applications.

PMID:35486758 | DOI:10.1364/OL.457314

Opt Lett. 2022 May 1;47(9):2170-2173. doi: 10.1364/OL.455599.

ABSTRACT

In this Letter, the mutual dynamics between synchronous solitons in a bidirectional mode-locked fiber laser are studied via dispersive Fourier transform methodology. We explore the spectral evolution and the statistical correlations between solitons with bidirectional propagation, indicating the low and high mutual linear dependences of the spectral energy jitters in stable and breathing mode-locking states, respectively. Moreover, to the best of our knowledge, the oscillating and sliding phase dynamics are experimentally revealed by the interference between bidirectional breathing solitons in ultrafast fiber lasers for the first time. Our findings enrich the understanding of the internal mutual dynamics between bidirectional solitons, which guides the extension of their potential applications, such as Sagnac-effect-based optical sensing.

PMID:35486752 | DOI:10.1364/OL.455599

Sci Adv. 2022 Apr 29;8(17):eabm6210. doi: 10.1126/sciadv.abm6210. Epub 2022 Apr 29.

ABSTRACT

The human retroviruses HTLV-1 (human T cell leukemia virus type 1) and HIV-1 persist in vivo as a reservoir of latently infected T cell clones. It is poorly understood what determines which clones survive in the reservoir. We compared >160,000 HTLV-1 integration sites (>40,000 HIV-1 sites) from T cells isolated ex vivo from naturally infected individuals with >230,000 HTLV-1 integration sites (>65,000 HIV-1 sites) from in vitro infection to identify genomic features that determine selective clonal survival. Three statistically independent factors together explained >40% of the observed variance in HTLV-1 clonal survival in vivo: the radial intranuclear position of the provirus, its genomic distance from the centromere, and the intensity of local host genome transcription. The radial intranuclear position of the provirus and its distance from the centromere also explained ~7% of clonal persistence of HIV-1 in vivo. Selection for the intranuclear and intrachromosomal location of the provirus and host transcription intensity favors clonal persistence of human retroviruses in vivo.

PMID:35486737 | DOI:10.1126/sciadv.abm6210

Am J Occup Ther. 2022 May 1;76(3):7603205020. doi: 10.5014/ajot.2022.048561.

ABSTRACT

IMPORTANCE: Veterans with mild traumatic brain injury (mTBI) and associated symptoms are at risk for suicide. Postconcussive symptoms (PCS) may heighten risk for suicidal thoughts by limiting veterans’ participation.

OBJECTIVE: To investigate whether participation mediates the relationship between PCS and suicidal ideation.

DESIGN: Cross-sectional, exploratory design. Structural equation models were used to investigate whether participation mediated the relationship between PCS and suicidal ideation.

SETTING: Community.

PARTICIPANTS: Veterans with mTBI (N = 145).

OUTCOMES AND MEASURES: The Ohio State University TBI Identification Method was used to establish mTBI diagnosis. We identified latent variables for PCS and participation using the Neurobehavioral Symptom Inventory and select domains of the Medical Outcomes Study Short Form-36, respectively. We used the Beck Scale for Suicide Ideation to measure the presence of suicidal ideation.

RESULTS: Participation mediated the relationship between PCS and the presence of suicidal ideation (odds ratio [OR] = 1.09, p = .011). More severe PCS were associated with lesser participation (β = -.86, p < .001); greater participation was associated with lower odds of suicidal ideation (OR = 0.92, p = .007).

CONCLUSIONS AND RELEVANCE: PCS may heighten risk for suicidal thoughts among veterans by limiting successful participation, a primary target of occupational therapy intervention. Thus, the results suggest that occupational therapy practitioners can play a substantial role in suicide prevention services for veterans with mTBI. Preventive services could mitigate suicide risk among veterans with mTBI by enabling sustained engagement in meaningful and health-promoting activity (e.g., reasons for living) and targeting PCS. What This Article Adds: Researchers have proposed that occupational therapy practitioners can help prevent veteran suicide by supporting their engagement in meaningful, health-promoting activity and by targeting suicide risk factors within their scope of practice. To the best of our knowledge, this is the first study to offer empirical support for such proposed suicide prevention efforts. Although additional research is needed, these results are promising and highlight a distinct role for occupational therapy in suicide prevention.

PMID:35486717 | DOI:10.5014/ajot.2022.048561

J Glob Health. 2022 Apr 30;12:04029. doi: 10.7189/jogh.12.04029.

ABSTRACT

BACKGROUND: An estimated 7 million episodes of severe newborn infections occur annually worldwide, with half a million newborn deaths, most occurring in low- and middle-income countries. Whilst injectable antibiotics are necessary to treat the infection, supportive care is also crucial in ending preventable mortality and morbidity. This study uses multi-country data to assess gaps in coverage, quality, and documentation of supportive care, considering implications for measurement.

METHODS: The EN-BIRTH study was conducted in five hospitals in Bangladesh, Nepal, and Tanzania (July 2017-July 2018). Newborns with an admission diagnosis of clinically-defined infection (sepsis, meningitis, and/or pneumonia) were included. Researchers extracted data from inpatient case notes and interviews with women (usually the mothers) as the primary family caretakers after discharge. The interviews were conducted using a structured survey questionnaire. We used descriptive statistics to report coverage of newborn supportive care components such as oxygen use, phototherapy, and appropriate feeding, and we assessed the validity of measurement through survey-reports using a random-effects model to generate pooled estimates. In this study, key supportive care components were assessment and correction of hypoxaemia, hyperbilirubinemia, and hypoglycaemia.

RESULTS: Among 1015 neonates who met the inclusion criteria, 89% had an admission clinical diagnosis of sepsis. Major gaps in documentation and care practices related to supportive care varied substantially across the participating hospitals. The pooled sensitivity was low for the survey-reported oxygen use (47%; 95% confidence interval (CI) = 30%-64%) and moderate for phototherapy (60%; 95% CI = 44%-75%). The pooled specificity was high for both the survey-reported oxygen use (85%; 95% CI = 80%-89%) and phototherapy (91%; 95% CI = 82%-97%).

CONCLUSIONS: The women’s reports during the exit survey consistently underestimated the coverage of supportive care components for managing infection. We have observed high variability in the inpatient documents across facilities. A standardised ward register for inpatient small and sick newborn care may capture selected supportive care data. However, tracking the detailed care will require standardised individual-level data sets linked to newborn case notes. We recommend investments in assessing the implementation aspects of a standardised inpatient register in resource-poor settings.

PMID:35486705 | DOI:10.7189/jogh.12.04029