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European Journal of Psychotraumatology Mar 2021: British Armed Forces' and Police Forces' personnel are trained to operate in potentially traumatic conditions. Consequently, they may experience post-traumatic stress...
: British Armed Forces' and Police Forces' personnel are trained to operate in potentially traumatic conditions. Consequently, they may experience post-traumatic stress disorder (PTSD), which is often comorbid with harmful alcohol use. : We aimed to assess the proportions, and associations, of probable PTSD and harmful alcohol use among a covariate-balanced sample of male military personnel and police employees. : Proportions of probable PTSD, harmful alcohol use, and daily binge drinking, were explored using data from the police Airwave Health Monitoring Study (2007-2015) ( = 23,826) and the military Health and Wellbeing Cohort Study (phase 2: 2007-2009, phase 3: 2014-2016) ( = 7,399). Entropy balancing weights were applied to the larger police sample to make them comparable to the military sample on a range of pre-specified variables (i.e. year of data collection, age and education attainment). Multinomial and logistic regression analyses determined sample differences in outcome variables, and associated factors (stratified by sample). : Proportions of probable PTSD were similar in military personnel and police employees (3.67% vs 3.95%), although the large sample size made these borderline significant (Adjusted Odds Ratio (AOR): 0.84; 95% Confidence Intervals (CI): 0.72 to 0.99). Clear differences were found in harmful alcohol use among military personnel, compared to police employees (9.59% vs 2.87%; AOR: 2.79; 95% CI: 2.42 to 3.21). Current smoking, which was more prevalent in military personnel, was associated with harmful drinking and binge drinking in both samples but was associated with PTSD in military personnel only. : It is generally assumed that both groups have high rates of PTSD from traumatic exposures, however, low proportions of PTSD were observed in both samples, possibly reflecting protective effects of unit cohesion or resilience. The higher level of harmful drinking in military personnel may relate to more prominent drinking cultures or unique operational experiences.
PubMed: 33968324
DOI: 10.1080/20008198.2021.1891734 -
International Journal of Environmental... Mar 2020Timely stroke diagnosis and intervention are necessary considering its high prevalence. Previous studies have mainly focused on stroke prediction with balanced data....
Timely stroke diagnosis and intervention are necessary considering its high prevalence. Previous studies have mainly focused on stroke prediction with balanced data. Thus, this study aimed to develop machine learning models for predicting stroke with imbalanced data in an elderly population in China. Data were obtained from a prospective cohort that included 1131 participants (56 stroke patients and 1075 non-stroke participants) in 2012 and 2014, respectively. Data balancing techniques including random over-sampling (ROS), random under-sampling (RUS), and synthetic minority over-sampling technique (SMOTE) were used to process the imbalanced data in this study. Machine learning methods such as regularized logistic regression (RLR), support vector machine (SVM), and random forest (RF) were used to predict stroke with demographic, lifestyle, and clinical variables. Accuracy, sensitivity, specificity, and areas under the receiver operating characteristic curves (AUCs) were used for performance comparison. The top five variables for stroke prediction were selected for each machine learning method based on the SMOTE-balanced data set. The total prevalence of stroke was high in 2014 (4.95%), with men experiencing much higher prevalence than women (6.76% vs. 3.25%). The three machine learning methods performed poorly in the imbalanced data set with extremely low sensitivity (approximately 0.00) and AUC (approximately 0.50). After using data balancing techniques, the sensitivity and AUC considerably improved with moderate accuracy and specificity, and the maximum values for sensitivity and AUC reached 0.78 (95% CI, 0.73-0.83) for RF and 0.72 (95% CI, 0.71-0.73) for RLR. Using AUCs for RLR, SVM, and RF in the imbalanced data set as references, a significant improvement was observed in the AUCs of all three machine learning methods ( < 0.05) in the balanced data sets. Considering RLR in each data set as a reference, only RF in the imbalanced data set and SVM in the ROS-balanced data set were superior to RLR in terms of AUC. Sex, hypertension, and uric acid were common predictors in all three machine learning methods. Blood glucose level was included in both RLR and RF. Drinking, age and high-sensitivity C-reactive protein level, and low-density lipoprotein cholesterol level were also included in RLR, SVM, and RF, respectively. Our study suggests that machine learning methods with data balancing techniques are effective tools for stroke prediction with imbalanced data.
Topics: Aged; China; Female; Forecasting; Humans; Machine Learning; Male; Prognosis; Prospective Studies; Stroke; Support Vector Machine
PubMed: 32178250
DOI: 10.3390/ijerph17061828 -
Frontiers in Psychology 2021Although the roles of exploratory and exploitative learning as alternative sales skills have been documented, there is not yet a clear consensus, and empirical evidence...
Although the roles of exploratory and exploitative learning as alternative sales skills have been documented, there is not yet a clear consensus, and empirical evidence in the online sales context is lacking. In addition, existing studies have tended to examine the two activities in parallel, without looking into the dyadic situation of balanced or imbalanced exploratory-exploitative learning. Grounded in the WeChat business context, this study explores how online sales agents' balanced and imbalanced ambidextrous learning influence customers' e-loyalty and, in turn, their patronage intention and behavior. Polynomial regression and response surface analysis are performed on 226 dyads, and the results support the hypothesized balance effect. Further, asymmetrical imbalance effects are identified, with customers exhibiting higher e-loyalty and better patronage outcomes when online sales agents adopt more exploitative learning than exploratory learning. This study helps improve understanding of the efficiency of personal selling in a virtual context.
PubMed: 34925196
DOI: 10.3389/fpsyg.2021.795899 -
Journal of Neuroengineering and... Mar 2021Upright standing requires control of an inherently unstable multi-joint human body within a small base of support, despite biological motor and / or sensory noise which...
BACKGROUND
Upright standing requires control of an inherently unstable multi-joint human body within a small base of support, despite biological motor and / or sensory noise which challenge balance. Without applying perturbations, system identification methods have been regarded as inadequate, because the relevant internal biological noise processes are not accessible to direct measurement. As a result, unperturbed balance studies have been limited to investigation of behavioral patterns rather than possible underlying control strategies.
METHODS
In this paper, we present a mathemathically rigorous system identification method that is applicable to study the dynamics and control of unperturbed balance. The method is derived from autocorrelation matrices with non-zero time lags and identifies the system matrix of a discrete-time dynamic system in the presence of unknown noise processes, without requiring any information about the strength of the noise.
RESULTS
Unlike reasonable 'least-squares' approaches, the performance of the new method is consistent across a range of different combinations of internal and measurement noise strengths, even when measurement noise is substantial. We present a numerical example of a model that simulates human upright balancing and show that its dynamics can be identified accurately. With a biomechanically reasonable choice of state and input variables, a state feedback controller can also be identified.
CONCLUSIONS
This study provides a new method to correctly identify the dynamics of human standing without the need for known external perturbations. The method was numerically validated using simulation that included realistic features of human balance. This method avoids potential issues of adaptation or possible reflex responses evoked by external perturbations, and does not require expensive in-lab, high-precision measurement equipment. It may eventually enable diagnosis and treatment of individuals with impaired balance, and the development of safe and effective assistive and / or rehabilitative technologies.
Topics: Adaptation, Physiological; Biomechanical Phenomena; Computer Simulation; Feedback; Humans; Models, Biological; Postural Balance
PubMed: 33752698
DOI: 10.1186/s12984-021-00843-1 -
Nursing Philosophy : An International... Jul 2022Person-centred care is founded on ethics as a basis for organizing care. In spite of healthcare systems claiming that they have implemented person-centred care, patients... (Review)
Review
Person-centred care is founded on ethics as a basis for organizing care. In spite of healthcare systems claiming that they have implemented person-centred care, patients report less satisfaction with care. These contrasting results require clarification of how to practice person-centred ethics using Paul Ricoeur's 'Little ethics', summarized as: 'aiming for the good life, with and for others in just institutions'. In this ethic Kantian morality is at once subordinate and complementary to Aristotelian ethics because the ethical goal needs to be critically assessed and passed through the examination of the norm in each care situation. This paper presents examples that describes a person-centred care practice that balance a critical review of care activities based on a conviction of aiming for patients' wellbeing. In contrast to patients' experiences of person-centred care in real life, research projects have shown that if the clinical performers comprehend and apply the practice of person-centred ethics, patients report positive outcomes. The implementation of person-centred care therefore demands that stakeholders and managers enables and requires that healthcare staff study ethics in the same way as studying for example pharmacology is required when handling patients' medicines.
Topics: Delivery of Health Care; Humans; Moral Obligations; Morals; Palliative Care; Patient-Centered Care
PubMed: 35213781
DOI: 10.1111/nup.12382 -
BMC Musculoskeletal Disorders Oct 2019Recently, various studies have reported the importance of distinguishing between balanced and unbalanced SL, sustaining the importance of SL reduction in unbalanced...
BACKGROUND
Recently, various studies have reported the importance of distinguishing between balanced and unbalanced SL, sustaining the importance of SL reduction in unbalanced cases. In this study we present our experience in the treatment of isthmic spondylolisthesis in young patients, observing the correlation between SL reduction and sagittal correlation between spine and pelvis.
METHODS
This is a retrospective study of a series of patients treated surgically for isthmic spondylolisthesis. Inclusion criteria were L5-S1 isthmic spondylolisthesis of III° or IV°, pediatric age, clinical and radiographic follow up of at least 1 year. Radiographic evaluation included the following elements: grade and percentage of listhesis (%L), lumbar lordosis (LL), lumbar-sacral angle (LSA), pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT) distinguishing between "balanced" and "unbalanced" patients. Radiographic values were confronted by using Student's t- test, obtaining a statistically significant difference for values inferior to 0,05.
RESULTS
Based on inclusion criteria, 28 patients were selected for our retrospective analysis, 19 female and 9 male. Mean age at surgery was 15,6 years. Mean follow up was 3 years and 3 months (min. 1 year - max 6 years and 7 months). Spondylolisthesis reduction was statistically significant both in balanced and in unbalanced patients, but pelvic incidence values did not improve significantly. We observed fewer mechanical complications in patients treated with interbody support.
CONCLUSION
In our study, differences between pre-op and post-op spinopelvic alignment values were not statistically significant, even though spondylolisthesis reduction was statistically significant in all cases. Our study could be considered an initial attempt to correlate spinopelvic changes to spondylolisthesis reduction in a progressive manner, and possibly in the future, generate threshold values of reduction for ideal spinopelvic alignment in every different patient.
Topics: Adolescent; Child; Female; Follow-Up Studies; Humans; Lumbar Vertebrae; Male; Pelvic Bones; Postural Balance; Retrospective Studies; Sacrum; Spondylolisthesis
PubMed: 31664969
DOI: 10.1186/s12891-019-2865-9 -
Sensors (Basel, Switzerland) Jan 2021Total knee arthroplasty (TKA) surgery with manual instruments provides a quantitatively balanced knee in approximately 50% of cases. This study examined the effect of...
Total knee arthroplasty (TKA) surgery with manual instruments provides a quantitatively balanced knee in approximately 50% of cases. This study examined the effect of combining robotics technology with real-time intra-operative sensor feedback on the number of quantitatively balanced cases in a consecutive series of 200 robotic-assisted primary TKAs. The robotics platform was used to plan the implant component position using correctable poses in extension and a manual, centrally pivoting the balancer in flexion, prior to committing to the femoral cuts. During the initial trialing, the quantitative state of balance was assessed using an instrumented tibial tray that measured the intra-articular loads in the medial and lateral compartments. These sensor readings informed a number of surgical corrections, including bone recuts, soft-tissue corrections, and cement adjustments. During initial trialing, a quantitatively balanced knee was achieved in only 65% of cases. After performing the relevant soft-tissue corrections, bone recuts, and cement adjustments, 87% of cases ended balanced through the range of motion. Meanwhile, this resulted in a wide range of coronal alignment conditions, ranging from 6° valgus to 9° varus. It is therefore concluded that gaps derived from robotics navigation are not indicative for a quantitatively balanced knee, which was only consistently achieved when combining the robotics platform with real-time feedback from intra-operative load sensors.
Topics: Aged; Arthroplasty, Replacement, Knee; Female; Humans; Knee; Knee Joint; Male; Osteoarthritis, Knee; Range of Motion, Articular
PubMed: 33451019
DOI: 10.3390/s21020535 -
Personality & Social Psychology Bulletin Dec 2023What does it mean to be in solitude? Researchers building this nascent field are learning much about the potential affordances of solitude, but lack an agreed-upon...
What does it mean to be in solitude? Researchers building this nascent field are learning much about the potential affordances of solitude, but lack an agreed-upon definition or set of definitions. Arriving at that meaning is crucial to forming a solid foundation for studies that use both naturalistic and laboratory designs to explore outcomes of solitude. This study identified themes from semi-structured interviews with adults aged 19 to 80 from diverse backgrounds. We concluded that solitude is a state in which the dominant relationship is with the self. If not physically alone, people in solitude are mentally distanced from others and away from active technology-mediated interactions. Complete solitude involves both physical separation and inner focus, but solitude is best defined through a taxonomy that recognizes physical separation and internal focus as independent, sufficient characteristics. An internal focus benefits from (but is not defined by) balancing solitude with social time, quiet, and choice.
Topics: Adult; Humans; Young Adult; Middle Aged; Aged; Aged, 80 and over; Psychological Distance
PubMed: 36062325
DOI: 10.1177/01461672221115941 -
JCI Insight Aug 2022NK cell exhaustion is caused by chronic exposure to activating stimuli during viral infection, tumorigenesis, and prolonged cytokine treatment. Evidence suggests that...
NK cell exhaustion is caused by chronic exposure to activating stimuli during viral infection, tumorigenesis, and prolonged cytokine treatment. Evidence suggests that exhaustion may play a role in disease progression. However, relative to T cell exhaustion, the mechanisms underlying NK cell exhaustion and methods of reversing it are poorly understood. Here, we describe a potentially novel in vitro model of exhaustion that uses plate-bound agonists of the NK cell activating receptors NKp46 and NKG2D to induce canonical exhaustion phenotypes. In this model, prolonged activation resulted in downregulation of activating receptors, upregulation of checkpoint markers, decreased cytokine production and cytotoxicity in vitro, weakened glycolytic capacity, and decreased persistence, function, and tumor control in vivo. Furthermore, we discovered a beneficial effect of NK cell inhibitory receptor signaling during exhaustion. By simultaneously engaging the inhibitory receptor NKG2A during activation in our model, cytokine production and cytotoxicity defects were mitigated, suggesting that balancing positive and negative signals integrated by effector NK cells can be beneficial for antitumor immunity. Together, these data uncover some of the mechanisms underlying NK cell exhaustion in humans and establish our in vitro model as a valuable tool for studying the processes regulating exhaustion.
Topics: Carrier Proteins; Cytokines; Humans; Killer Cells, Natural; Neoplasms
PubMed: 35727627
DOI: 10.1172/jci.insight.150079 -
Scientific Reports Apr 2021Humans and other complex organisms exhibit intelligent behaviors as individual agents and as groups of coordinated agents. They can switch between independent and...
Humans and other complex organisms exhibit intelligent behaviors as individual agents and as groups of coordinated agents. They can switch between independent and collective modes of behavior, and flexible switching can be advantageous for adapting to ongoing changes in conditions. In the present study, we investigated the flexibility between independent and collective modes of behavior in a simulated social foraging task designed to benefit from both modes: distancing among ten foraging agents promoted faster detection of resources, whereas flocking promoted faster consumption. There was a tradeoff between faster detection versus faster consumption, but both factors contributed to foraging success. Results showed that group foraging performance among simulated agents was enhanced by loose coupling that balanced distancing and flocking among agents and enabled them to fluidly switch among a variety of groupings. We also examined the effects of more sophisticated cognitive capacities by studying how human players improve performance when they control one of the search agents. Results showed that human intervention further enhanced group performance with loosely coupled agents, and human foragers performed better when coordinating with loosely coupled agents. Humans players adapted their balance of independent versus collective search modes in response to the dynamics of simulated agents, thereby demonstrating the importance of adaptive flexibility in social foraging.
PubMed: 33875697
DOI: 10.1038/s41598-021-87717-7