Tag: pubmed

PLoS One. 2021 May 7;16(5):e0250639. doi: 10.1371/journal.pone.0250639. eCollection 2021.

ABSTRACT

INTRODUCTION: The number of older individuals relocating from their homes to old age homes is increasing in Nepal. This study was conducted to assess the reasons why older people chose to move to old age homes, the status and forms of abuse they experienced, and the risk factors associated with their abuse before moving to old age homes.

MATERIALS AND METHODS: This study was a cross sectional study conducted among older adults currently residing in all the old age homes of Pokhara Lekhnath Metropolitan City. Complete enumeration of the respondents was done and data was collected consecutively, using a semi-structured interview schedule, from all older adults aged 60 years and above who had been living in the homes for at least a month. The total sample size was 109. The collected data was analyzed using descriptive statistics and binary logistic regression was used as an inferential statistics to determine the predictors of abuse.

RESULTS: A majority of the respondents (56.0%) came to old age homes on their own volition, 24.7% reported that they came to the homes because they were physically weak and they had no one to care for them at their residence, while 11% reported that they were forcefully sent by their caregivers. Out of total respondents, 60.6% reported that they experienced some form of abuse before they came to the old age home: most frequent was caregiver neglect (34.9%) and verbal abuse (34.9%), while few experienced financial abuse (2.8%). Women were at a higher risk of abuse than men (p<0.05, OR = 4.430, CI = 1.695-11.577) prior to their transfer to old age homes.

CONCLUSIONS: A majority of the older adults who transferred to old age homes in Pokhara Lekhnath Metropolitan city had been earlier abused by their caregivers, mainly through neglect and verbal abuse, and women were at a higher risk for abuse than men.

PMID:33961644 | DOI:10.1371/journal.pone.0250639

IEEE Trans Cybern. 2021 May 7;PP. doi: 10.1109/TCYB.2021.3070227. Online ahead of print.

ABSTRACT

Prognostic prediction is the task of estimating a patient’s risk of disease development based on various predictors. Such prediction is important for healthcare practitioners and patients because it reduces preventable harm and costs. As such, a prognostic prediction model is preferred if: 1) it exhibits encouraging performance and 2) it can generate intelligible rules, which enable experts to understand the logic of the model’s decision process. However, current studies usually concentrated on only one of the two features. Toward filling this gap, in the present study, we develop a novel knowledge-aware Bayesian model taking into consideration accuracy and transparency simultaneously. Real-world case studies based on four years’ territory-wide electronic health records are conducted to test the model. The results show that the proposed model surpasses state-of-the-art prognostic prediction models in accuracy and c-statistic. In addition, the proposed model can generate explainable rules.

PMID:33961578 | DOI:10.1109/TCYB.2021.3070227

PLoS One. 2021 May 7;16(5):e0249434. doi: 10.1371/journal.pone.0249434. eCollection 2021.

ABSTRACT

The present article provides a detailed analysis of the Darcy Forchheimer flow of hybrid nanoliquid past an exponentially extending curved surface. In the porous space, the viscous fluid is expressed by Darcy-Forchheimer. The cylindrical shaped carbon nanotubes (SWCNTs and MWCNTs) and Fe3O4 (iron oxide) are used to synthesize hybrid nanofluid. At first, the appropriate similarity transformation is used to convert the modeled nonlinear coupled partial differential equations into nonlinear coupled ordinary differential equations. Then the resulting highly nonlinear coupled ordinary differential equations are analytically solved by the utilization of the “Homotopy analysis method” (HAM) method. The influence of sundry flow factors on velocity, temperature, and concentration profile are sketched and briefly discussed. The enhancement in both volume fraction parameter and curvature parameter k results in raises of the velocity profile. The uses of both Fe3O4 and CNTs nanoparticles are expressively improving the thermophysical properties of the base fluid. Apart from this, the numerical values of some physical quantities such as skin friction coefficients, local Nusselt number, and Sherwood number for the variation of the values of pertinent parameters are displayed in tabular forms. The obtained results show that the hybrid nanofluid enhances the heat transfer rate 2.21%, 2.1%, and 2.3% using the MWCNTs, SWCNTs, and Fe3O4 nanomaterials.

PMID:33961625 | DOI:10.1371/journal.pone.0249434

PLoS One. 2021 May 7;16(5):e0248697. doi: 10.1371/journal.pone.0248697. eCollection 2021.

ABSTRACT

BACKGROUND: Improving institutional delivery service is the most crucial strategies to reduce maternal and neonatal mortalities. In developing countries, only 50% of pregnant women deliver in health facilities and in Ethiopia only 48% of pregnant women deliver in health facilities. Maternal mortality remains the highest in Ethiopia. This study assessed intention to use institutional delivery service and its predictors among pregnant women using theory of planned behavior.

METHODS: Community-based cross-sectional study was conducted among 645 Yilmana Densa District Pregnant women using multi-stage followed by cluster sampling technique. Data were entered into Epi Data version 4.6.0.2 and analyzed with STATA version 14. Binary logistic regression analysis was done to identify independent predictors of intention at 95% confidence level and P < 0.05 was used to determine statistically significant predictors.

RESULTS: Intention of pregnant women to use institutional delivery service was 74.3% (CI; 70.71%, 77.6%). In the multivariable logistic regression; those who had 1-3 and 4 &above antenatal care 2.85(1.41, 5.75) and 3.14(1.16, 8.45) respectively, those who had past experience of institutional delivery (AOR = 3.39, 95%CI: 1.72, 6.71), parity of 1-3 and 4 & above % (AOR = 0.37, 0.19, 0.71) and (AOR = 0.25, 95%CI: 0.12, 0.55) respectively, rural residence (AOR = 0.51, 95%CI: 0.27, 0.96), favorable attitude (AOR = 2.93, 95%CI: 1.56, 5.50), favorable perceived behavioral control (AOR = 2.60, 95%CI: 1.44, 4.69) were factors significantly associated with intention to use institutional delivery service.

CONCLUSION AND RECOMMENDATION: Majority of the pregnant women were intended to deliver in the institution. Good Knowledge on institutional delivery, antenatal care visit, past experience of institutional delivery, rural residence, parity, attitude and perceived behavioral control were identified factors significantly associated with intention to use institutional delivery service. So, strengthening awareness creation and behavioral change communication programs are required at all levels of health system to raise intention of residents towards institutional delivery.

PMID:33961637 | DOI:10.1371/journal.pone.0248697

Surg Innov. 2021 May 7:15533506211014857. doi: 10.1177/15533506211014857. Online ahead of print.

ABSTRACT

Background. The COVID-19 pandemic leads to several debates regarding the possible risk for healthcare professionals during surgery. SAGES and EAES raised the issue of the transmission of infection through the surgical smoke during laparoscopy. They recommended the use of smoke evacuation devices (SEDs) with CO₂ filtering systems. The aim of the present study is to compare the efficacy of different SEDs evaluating the CO₂ environmental dispersion in the operating theater. Methods. We prospectively evaluated the data of 4 group of patients on which we used different SEDs or standard trocars: AIRSEAL system (S1 group), a homemade device (S2 group), an AIRSEAL system + homemade device (S3 group), and with standard trocars and without SED (S4 group). Quantitative analysis of CO2 environmental dispersion was carried out associated to the following data in order to evaluate the pneumoperitoneum variations: a preset insufflation pressure, real intraoperative pneumoperitoneum pressure, operative time, total volume of insufflated CO₂, and flow rate index. Results. 16 patients were prospectively enrolled. The [CO₂] mean value was 711 ppm, 641 ppm, 593 ppm, and 761 ppm in S1, S2, S3, and S4 groups, respectively. The comparison between data of all groups showed statistically significant differences in the measured ambient CO₂ concentration. Conclusion. All tested SEDs seem to be useful to reduce the CO₂ environmental dispersion respect to the use of standard trocars. The association of AIRSEAL system and a homemade device seems to be the best solution combining an adequate smoke evacuation and a stable pneumoperitoneum during laparoscopic surgery.

PMID:33961529 | DOI:10.1177/15533506211014857

IEEE Trans Neural Netw Learn Syst. 2021 May 7;PP. doi: 10.1109/TNNLS.2021.3073248. Online ahead of print.

ABSTRACT

Although deep neural networks have been proved effective in many applications, they are data hungry, and training deep models often requires laboriously labeled data. However, when labeled data contain erroneous labels, they often lead to model performance degradation. A common solution is to assign each sample with a dynamic weight during optimization, and the weight is adjusted in accordance with the loss. However, those weights are usually unreliable since they are measured by the losses of corrupted labels. Thus, this scheme might impede the discriminative ability of neural networks trained on noisy data. To address this issue, we propose a novel reweighting method, dubbed self-reweighting from class centroids (SRCC), by assigning sample weights based on the similarities between the samples and our online learned class centroids. Since we exploit statistical class centers in the image feature space to reweight data samples in learning, our method is robust to noise caused by corrupted labels. In addition, even after reweighting the noisy data, the decision boundaries might still suffer distortions. Thus, we leverage mixed inputs that are generated by linearly interpolating two random images and their labels to further regularize the boundaries. We employ the learned class centroids to evaluate the confidence of our generated mixed data via measuring feature similarities. During the network optimization, the class centroids are updated as more discriminative feature representations of original images are learned. In doing so, SRCC will generate more robust weighting coefficients for noisy and mixed data and facilitates our feature representation learning in return. Extensive experiments on both the synthetic and real image recognition tasks demonstrate that our method SRCC outperforms the state of the art on learning with noisy data.

PMID:33961567 | DOI:10.1109/TNNLS.2021.3073248

JCO Oncol Pract. 2021 May 7:OP2001081. doi: 10.1200/OP.20.01081. Online ahead of print.

ABSTRACT

PURPOSE: Emergency cancer care constitutes a significant health care and patient burden. The purpose of this study was to identify characteristics of patients most fitting for treatment in an oncology-dedicated emergency department (OED).

METHODS: Electronic files of patients with cancer seeking emergency services between April and June 2017 were retrospectively obtained from the hospital registry. Efficacy parameters were compared between patients treated in the OED and those treated in the general emergency department (GED). Using descriptive statistics and logistic regressions, patient- and treatment-related factors were correlated with effective care in the OED.

RESULTS: More than half of the total 799 patients presented initially to the OED, of which 10.4% required GED referral. Treatment in the GED was associated with a higher rate of consultations, imaging, and hospitalization (P < .001), with the cost of imaging alone four times that of the OED ($23,263 US dollars difference). The relative proportion of patients with cancer visiting the GED was reduced after founding the OED. In the OED, patient diagnoses included lung (33%), GI, and breast cancer, of which 85% were metastatic. Frequent chief complaints were pain (45%), GI, malaise, and respiratory symptoms. Referral to the GED was significant in those with genitourinary cancer, back pain (P < .001), and neurologic symptoms, on biologic therapy, and with suspected oncological emergencies; conversely, disease symptoms (30% admissions) were well-controlled in the OED (P = .003).

CONCLUSION: Using minimal resources, the OED provides efficacious, cancer-focused care, suitable for the majority of acute admissions. Careful triage is recommended, as high-risk patients should be referred to the GED, where advanced multidisciplinary management is more readily available.

PMID:33961497 | DOI:10.1200/OP.20.01081

Cancer Invest. 2021 May 7:1-17. doi: 10.1080/07357907.2021.1928166. Online ahead of print.

ABSTRACT

We analyzed the effect of anemia on tumor response of patients with primary invasive breast cancer (BC) receiving neoadjuvant chemotherapy (NACT). The patient collective was very homogenous; finally, 74 BC patients with identical medication and duration of NACT were enrolled. After completion of NACT, 49 patients (66.2%) had a post-NACT Hb level <12 g/dl. In the anemic group, we found a tendency of lower median tumor response compared to non-anemic patients at this time (15 versus 17 mm, retrospectively, p = 0.18). Age at diagnosis significantly correlated with the difference of Hb [before initiation – after completion of NACT] (correlation coefficient =0.40, p < 0.001).

PMID:33961512 | DOI:10.1080/07357907.2021.1928166

J Oncol Pharm Pract. 2021 May 7:10781552211015762. doi: 10.1177/10781552211015762. Online ahead of print.

ABSTRACT

PURPOSE: We aimed to determine the COVID-19 infection rate and determine the factors that affect hospitalization and prognosis in patients receiving systemic chemotherapy (CT), immunotherapy (IT) and molecular-targeted therapies at our hospital within three months after the onset of COVID-19 pandemic.

MATERIALS AND METHODS: The patients who received systemic treatment at chemotherapy unit with diagnosis of cancer between 11 March 2020 and 11 June 2020 were included. The clinical and demographic characteristics of patients, the systemic treatments that they received (CT, IT, targeted therapies), and the stage of disease were determined. For the parameters that affect the hospitalization of COVID-19 infected patients were also determined.

RESULTS: Among 1149 patients with cancer, 84 of them were infected with COVID-19, and the median age of infected patients was 61.0 (IQR: 21-84) and 60.7% of them were male. As a subtype of cancers lung cancer was more frequent in the patients who infected with COVID compared with non-infected ones and the difference was statistically significant when the underlying malignities were compared (32.1% vs 19.0%, p = 0.031). The hospitalization rate and receiving COVID-19 treatment were more frequent in metastatic patients who were receiving palliative therapy, and the difference was statistically significant (p = 0.01, p = 0.03). In our study, infection rate was similar among patients treated with CT, IT and CT plus targeted therapy; however, fewer COVID-19 infections were seen at patients who received only targeted therapy.

CONCLUSION: COVID-19 infection is more frequent in cancer patients and tends to be more severe in metastatic cancer patients receiving anticancer treatment, and the continuation of palliative cancer treatments in these patients may cause increased cancer and infection-related morbidity and mortality.

PMID:33961521 | DOI:10.1177/10781552211015762

Phys Rev Lett. 2021 Apr 23;126(16):163902. doi: 10.1103/PhysRevLett.126.163902.

ABSTRACT

We study the propagation of electromagnetic waves in disordered photonic time crystals: spatially homogenous media whose refractive index changes randomly in time. We find that the group velocity of a pulse propagating in such media decreases exponentially, eventually coming to a complete stop, while experiencing exponential growth in intensity. These effects greatly depend on the Floquet band structure of the photonic time crystal, with the strongest sensitivity to disorder occurring in superluminal modes. Finally, we analyze the ensemble statistics and find them to coincide with those of Anderson localization, exhibiting single parameter scaling.

PMID:33961479 | DOI:10.1103/PhysRevLett.126.163902