Tag: nevin manimala

JMIR Res Protoc. 2025 May 30;14:e69577. doi: 10.2196/69577.

ABSTRACT

BACKGROUND: The COVID-19 pandemic has had disproportionate economic and health impacts on self-employed workers in Nigeria, particularly self-employed women and youth. Though uniquely different, the COVID-19 pandemic shares similarities with events such as childbirth, family, and health emergencies. Self-employed young women lack adequate support structures to cope with disruptive life events, which have negative consequences for their well-being. This is concerning, as 86% of women in the Nigerian labor force are self-employed.

OBJECTIVE: The project’s first objective is to conduct a gendered situational analysis to address the question of how the COVID-19 pandemic and other life events affect the paid and unpaid work and the physical, mental, and social well-being of self-employed young women in Nigeria; their strategies for coping with such events; and how their experiences compare with those of self-employed young men. Informed by this analysis, the second objective is to coproduce and pilot-test a gender-transformative intervention that integrates social protection and promotes well-being.

METHODS: This multimethod project has 3 components. The first is a situational analysis of the impact of the pandemic and other significant life events on the work and well-being of self-employed young women vis-à-vis self-employed young men. This involves qualitative interviews with approximately 60 self-employed young women and men and a digital storytelling initiative to represent some of these stories in video format. Secondary data analysis of the Nigerian General Household Survey and the COVID-19 Longitudinal Phone Survey will be conducted. Furthermore, a scoping review of the impact of significant life events, including the COVID-19 pandemic, on self-employed workers in low- and middle-income countries will be conducted. The second component is the coproduction of interventions involving qualitative interviews with self-employed young women, members of their support network, and policy makers to find out their views on how to support self-employed women. It also entails an analysis of policies relevant to self-employed women in Nigeria and theory of change workshops to create a map for achieving the long-term goal of improving their resilience. Furthermore, a systematic review of interventions to improve the job quality and well-being of self-employed workers will be conducted. The third component is a pilot of the coproduced interventions in a quasi-experimental study involving 300 participants to assess feasibility, acceptability, cost, and potential effectiveness.

RESULTS: This project was funded in October 2022. Data collection for the project commenced in May 2023 and will end in November 2025. Data collection for the situational analysis and coproduction of intervention phases have been completed while the pilot of intervention packages is underway.

CONCLUSIONS: This project will advance knowledge of the impact of the COVID-19 pandemic and other significant disruptive life events on the work and well-being of self-employed young Nigerian women and provide coproduced solutions to mitigate their effects.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/69577.

PMID:40446295 | DOI:10.2196/69577

JMIR Med Inform. 2025 May 30;13:e74940. doi: 10.2196/74940.

ABSTRACT

BACKGROUND: The development of sepsis in the intensive care unit (ICU) is rapid, the golden rescue time is short, and the effective way to reduce mortality is rapid diagnosis and early warning. Therefore, real-time prediction models play a key role in the clinical diagnosis and management of sepsis. However, the existing sepsis prediction models based on artificial intelligence still have limitations, such as poor real-time performance and insufficient interpretation.

OBJECTIVE: Our objective is to develop a real-time sepsis prediction model that integrates high timeliness and clinical interpretability. The model is designed to dynamically predict the risk of sepsis in ICU patients and establish a practical, tailored sepsis prediction platform.

METHODS: Within a retrospective analysis framework, the model comprises a real-time prediction module and an interpretability module. The real-time prediction module leverages 3-hour dynamic temporal features derived from 8 noninvasive, real-time physiological indicators: heart rate, respiratory rate, blood oxygen saturation, mean arterial pressure, systolic blood pressure, diastolic blood pressure, body temperature, and blood glucose. Three linear parameters (mean, SD, and endpoint value) were calculated to construct the prediction model using multiple ML algorithms. The interpretability module uses the TreeSHAP (Tree-Based Shapley Additive Explanations) method to enhance model transparency through both individual prediction and global explanations. Further, it added a link between the output interpretation of the explainable artificial intelligence method and its potential physiological or pathophysiological significance, including the relationship among the output interpretation and the patient’s hemodynamics, thermoregulatory response, and the balance between oxygen delivery and oxygen consumption. Finally, a web-based platform was developed to integrate prediction and interpretability functions.

RESULTS: The sepsis prediction model demonstrated robust performance in the test cohort (224 patients), achieving an accuracy of 0.7 (95% CI 0.68-0.71), precision of 0.69 (95% CI 0.68-0.71), F₁-score of 0.69 (95% CI 0.67-0.70), and area under the receiver operating characteristic curve of 0.76 (95% CI 0.74-0.77). The TreeSHAP method effectively visualized feature contributions, enabling clinicians to interpret the model’s prediction logic and identify anomalies. The link between the output interpretation of the model and its potential physiological or pathophysiological significance improved the interpretability and credibility of the explainable artificial intelligence method. The web-based platform significantly enhanced clinical utility by providing real-time risk assessment, statistical summaries, trend analysis, and actionable insights.

CONCLUSIONS: This platform provides real-time dynamic warnings for sepsis risk in critically ill ICU patients, supporting timely clinical decision-making.

PMID:40446292 | DOI:10.2196/74940

J Med Internet Res. 2025 May 30;27:e62696. doi: 10.2196/62696.

ABSTRACT

BACKGROUND: The 21st Century Cures Act mandated instant digital access for patients to see their test results and clinical notes (eg, via patient portals). Entirely using and understanding such health information requires some degree of personal health literacy.

OBJECTIVE: This study aims to assess the associations between ease of understanding online health information and various factors, including sociodemographics, health-related variables, numeracy, and technology-related factors.

METHODS: This cross-sectional study used data from the National Cancer Institute’s 2022 Health Information National Trends Survey (HINTS), a nationally representative survey of US adults that tracks individuals’ access and use of their health information. Data was collected from March to December 2022. The survey was conducted across various US settings using a stratified multistage sampling technique to ensure national representation. Our analysis included 3016 respondents with data for all variables of interest. We conducted bivariate and multivariate analyses to assess the odds of finding health information in online medical records or patient portals as “very easy” to understand compared with “not very easy.”

RESULTS: In the multivariate analysis, age group (with the 35-49 years group being 1.9 times more likely compared to the ≥75 years group; P=.03), female birth sex (1.4 times more likely; P=.04), ease of understanding medical statistics (8.5 times more likely for those finding it “very easy”; P<.001), patient-provider communication score (increase of 1.1 odds per 1 unit increase; P<.001), and mode of accessing online records (1.8 times more likely via an app and 1.4 times more likely via both an app and website, P=.01 and P=.003, respectively, versus using a website alone) were significant predictors for finding health information “very easy” to understand.

CONCLUSIONS: Sociodemographic factors, numeracy, patient-provider communication, and method of accessing online records were associated with ease of understanding health information in online medical records or patient portals. Findings from this study may inform interventions to make patient portals and online medical records more patient-centered and easier to navigate.

PMID:40446288 | DOI:10.2196/62696

Phys Rev Lett. 2025 May 16;134(19):191901. doi: 10.1103/PhysRevLett.134.191901.

ABSTRACT

Using (2712.4±14.3)×10^{6} ψ(3686) events collected with the BESIII detector at BEPCII, a partial wave analysis of the decay ψ(3686)→ϕηη^{‘} is performed with the covariant tensor approach. In addition to the established states h_{1}(1900) and ϕ(2170), an axial-vector state with a mass near 2.3 GeV/c^{2} is observed for the first time. Its mass and width are measured to be 2316±9_{stat}±30_{syst} MeV/c^{2} and 89±15_{stat}±26_{syst} MeV, respectively. The product branching fractions of B[ψ(3686)→X(2300)η^{‘}]B[X(2300)→ϕη] and B[ψ(3686)→X(2300)η]B[X(2300)→ϕη^{‘}] are determined to be (4.8±1.3_{stat}±0.7_{syst})×10^{-6} and (2.2±0.7_{stat}±0.7_{syst})×10^{-6}, respectively. The branching fraction B[ψ(3686)→ϕηη^{‘}] is measured for the first time to be (3.14±0.17_{stat}±0.24_{syst})×10^{-5}. The first uncertainties are statistical and the second are systematic.

PMID:40446269 | DOI:10.1103/PhysRevLett.134.191901

Phys Rev Lett. 2025 May 16;134(19):196302. doi: 10.1103/PhysRevLett.134.196302.

ABSTRACT

A novel localization phenomenon, termed erratic non-Hermitian skin localization, has been identified in disordered globally reciprocal non-Hermitian lattices. Unlike conventional non-Hermitian skin effect and Anderson localization, it features macroscopic eigenstate localization at irregular, disorder-dependent positions with subexponential decay. Using the Hatano-Nelson model with disordered imaginary gauge fields as a case study, this effect is linked to stochastic interfaces governed by the universal order statistics of random walks. Finite-size scaling analysis confirms the localized nature of the eigenstates. This discovery challenges conventional wave localization paradigms, offering new avenues for understanding and controlling localization phenomena in non-Hermitian physics.

PMID:40446237 | DOI:10.1103/PhysRevLett.134.196302

Phys Rev Lett. 2025 May 16;134(19):190602. doi: 10.1103/PhysRevLett.134.190602.

ABSTRACT

This Letter augments the recently introduced stabilizer tensor network (STN) protocol with magic state injection, reporting a new framework with significantly enhanced ability to simulate circuits with an extensive number of non-Clifford operations. Specifically, for random T-doped N-qubit Clifford circuits the computational cost of circuits prepared with magic state injection scales as O[poly(N)] when the circuit has t≲N T gates compared to an exponential scaling for the STN approach, which is demonstrated in systems of up to 200 qubits. In the case of the hidden bit shift circuit, a paradigmatic benchmarking system for extended stabilizer methods with a tunable amount of magic, we report that our magic state injected STN framework can efficiently simulate 4000 qubits and 320T gates. These findings provide a promising outlook for the use of this protocol in the classical modeling of quantum circuits that are conventionally difficult to simulate efficiently.

PMID:40446235 | DOI:10.1103/PhysRevLett.134.190602

JMIR Mhealth Uhealth. 2025 May 30;13:e58703. doi: 10.2196/58703.

ABSTRACT

BACKGROUND: Patients undergoing major surgery are at risk of complications and delayed recovery. Prehabilitation has shown promise in improving postoperative outcomes. Offering prehabilitation by means of mHealth can help overcome barriers to participating in prehabilitation and empower patients prior to major surgery. We developed the Be Prepared mHealth app, which has shown potential in an earlier pilot study.

OBJECTIVE: This study aims to evaluate the effectiveness of the Be Prepared app on postoperative recovery of physical functioning (PF) in patients undergoing major elective surgery.

METHODS: This study was a multicenter randomized controlled trial with 2 arms. Adults scheduled for major elective surgery were randomly assigned to the control (usual care) or intervention group (Be Prepared app in addition to usual care). The Be Prepared app is a smartphone app with pre- and postoperative information and instructions on changing risk behavior for patients undergoing major elective surgery. The primary outcome was recovery of postoperative PF up to 12 weeks after hospital discharge measured with the Computer Adaptive Test Patient-Reported Outcomes Measurement Information System-PF. Secondary outcomes included social participation, self-reported recovery, health-related quality of life, postoperative outcomes, and patient satisfaction. Measurements were performed at 5 time points: before random assignment and 1, 3, 6, and 12 weeks after hospital discharge.

RESULTS: A total of 369 patients were analyzed, 181 in the control group and 188 in the intervention group. The result of the linear mixed effects model showed a mean slope difference in recovery of PF over 12 weeks of 2.97 (95% CI 0.90-5.02) in favor of the intervention group. However, this effect was not clinically relevant and was negated by the significantly lower PF score 1 week after hospital discharge in the intervention group (mean difference -1.72, 95% CI -3.38 to -0.07). Most secondary outcome measures did not show significantly greater improvements in the intervention group compared to the control group. Patient satisfaction with overall perioperative care was significantly higher in the intervention group compared to the control group and satisfaction with the Be Prepared app was high.

CONCLUSIONS: The use of the Be Prepared app as a stand-alone intervention does not seem beneficial for improving postoperative recovery in patients undergoing major surgery. However, satisfaction with perioperative care was higher in patients using the app. Given the advantages of digital technology in health care, it can be considered a basis for prehabilitation care pathways, complemented by guidance from health care professionals as needed.

PMID:40446217 | DOI:10.2196/58703

Neurology. 2025 Jun 24;104(12):e213782. doi: 10.1212/WNL.0000000000213782. Epub 2025 May 30.

ABSTRACT

BACKGROUND AND OBJECTIVES: Stroke remains a major global public health concern, particularly in China, where particulate matter (PM_2.5) pollution is a significant contributor to stroke mortality. This study systematically analyzes changes in stroke and subtype-specific mortality attributable to PM_2.5 in China from 1990 to 2021 and projects trends up to 2030.

METHODS: Data were obtained from the Global Burden of Disease database. The mortality and standardized data of stroke and its subtypes attributable to PM_2.5 in China were collected. Long-term trends were assessed using the joinpoint regression model. The age-period-cohort (a-p-c) model was applied to evaluate the effects of age, period, and birth cohort on stroke mortality. In addition, the Bayesian age-period-cohort model was used to forecast age-standardized mortality rate (ASMR) trends through 2030.

RESULTS: From 1990 to 2021, the ASMR of stroke attributable to PM_2.5 in China showed a declining trend and was projected to decrease to 32.0 per 100,000 by 2030. However, significant differences were observed across stroke subtypes, age groups, and sexes. Subarachnoid hemorrhage (SAH) exhibited the largest decline while ischemic stroke (IS) had the smallest reduction. Local drift analysis showed that IS and intracerebral hemorrhage (ICH) declined fastest in those aged 45-60 years while SAH declined most in those aged 75-80 years. a-p-c model analysis demonstrated that stroke mortality increased with age, with IS mortality surpassing that of ICH in individuals aged 75 years and older and the gap widening with age. Stroke mortality risk declined over time, with younger cohorts showing greater reductions. The stroke burden remained higher in men than in women.

DISCUSSION: China has made significant progress in stroke prevention and air pollution control; however, disparities remain in the effectiveness of prevention across stroke subtypes and population groups. Further efforts should focus on strengthening pollution control, optimizing prevention strategies for each stroke subtype, enhancing hypertension management in middle-aged populations, improving metabolic risk control in older adults, and ensuring efficient health care resource allocation. Priority should be given to high-risk populations, particularly older individuals and men, to address the challenges posed by aging and the increasing burden of chronic diseases.

PMID:40446199 | DOI:10.1212/WNL.0000000000213782

PLoS One. 2025 May 30;20(5):e0323135. doi: 10.1371/journal.pone.0323135. eCollection 2025.

ABSTRACT

OBJECTIVES: To examine the prevalence of the maternal postnatal six-week check (SWC) in women with epilepsy compared to a sample of the postnatal population without epilepsy, and assess whether the SWC is associated with health outcomes in the first year postpartum.

METHODS: Clinical Practice Research Datalink Aurum and Hospital Episode Statistics data were used to identify births between January1998-March2020 to women with epilepsy (n = 23,533) and a random sample of births to women without epilepsy (n = 317,369). The adjusted risk ratio (aRR) for not having a SWC in women with compared to without epilepsy was estimated using modified Poisson regression. The association between receiving a SWC and postpartum health outcomes was assessed using Cox regression.

RESULTS: The likelihood of not having a SWC did not differ between those with and without epilepsy (42.7% vs 43.4%, aRR = 1.01, 95%CI = 0.99-1.03). Among all women, not having a SWC was associated with a lower subsequent likelihood of being prescribed prophylactic (aHR = 0.59, 95%CI = 0.58-0.60) and emergency (aHR = 0.95, 95%CI = 0.91-0.99) contraception and having urinary and/or faecal incontinence (aHR = 0.67, 95%CI = 0.61-0.73) or dyspareunia, perineal and/or pelvic pain (aHR = 0.70, 95%CI = 0.65-0.75) recorded in the year postpartum, with no evidence these associations differed according to whether a woman had epilepsy. Not having a SWC was also associated with a lower likelihood of having depression and/or anxiety recorded in the first year postpartum among those without (aHR = 0.86, 95%CI = 0.84-0.89) but not with epilepsy (aHR = 1.01, 95%CI = 0.93-1.09). The SWC was not associated with epilepsy relevant outcomes (Accident and emergency visits or unplanned hospital admission for epilepsy, mortality).

CONCLUSIONS: Around 2 in every 5 women had no evidence of a maternal SWC, with no evidence epileptic women had a different prevalence to the general postnatal population. The maternal SWC may play a role in increasing the use of contraception and the detection or treatment of adverse health outcomes in the first year postpartum.

PMID:40446192 | DOI:10.1371/journal.pone.0323135

PLoS One. 2025 May 30;20(5):e0324460. doi: 10.1371/journal.pone.0324460. eCollection 2025.

ABSTRACT

BACKGROUND: Preeclampsia is a serious complication of pregnancy characterized by hypertension and proteinuria that adversely affects both maternal and fetal health. This study aimed to investigate hematological and biochemical alterations in cord blood associated with preeclampsia, with a focus on hemoglobin variants and blood gas parameters.

METHODS: A case‒control study involving 54 participants, including 24 women diagnosed with preeclampsia and 30 normotensive controls, was conducted. Cord blood samples were analyzed for total hemoglobin (Hb), blood gas, and complete blood count (CBC) indices. Statistical analyses included independent t tests for parametric data and Mann‒Whitney U tests for nonparametric data, with significance set at p < 0.05.

RESULTS: The results revealed significant differences in hemoglobin concentrations, with cord blood collected from preeclamptic women exhibiting lower levels of adult hemoglobin (HbA) (64.0% ± 32.0% vs. 76.2% ± 25.7%, p = 0.004) and higher fetal hemoglobin (HbF) concentrations (35.9% ± 32.1% vs. 23.7% ± 25.6%, p = 0.004) than controls. Blood gas parameters, including pH and bicarbonate and carbon dioxide levels, were not significantly different between the groups. However, CBC results revealed a lower platelet count in the cord blood of the preeclamptic group than in the cord blood of the preeclampsia group, (213.7*103/µL ± 112*103/µL vs. 314.6*103/µL ± 70.8*103/µL, p = 0.0005).

CONCLUSIONS: While our study reveals significant alterations in fetal hemoglobin variants and CBC indices in the cord blood of preeclamptic pregnancies, the clinical applicability of these markers for early detection is currently limited by the inaccessibility of fetal blood before delivery. Nevertheless, these findings offer important insights into the hematological changes linked to preeclampsia. Future studies should explore the potential of detecting similar alterations in maternal blood as a more feasible and non-invasive approach for early diagnosis and risk assessment of preeclampsia.

PMID:40446190 | DOI:10.1371/journal.pone.0324460