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Frontiers in Psychiatry 2024COVID-19 necessitated a rapid move from face-to-face services to remote care for eating disorders/eating distress (EDs). This study explores the advantages and...
INTRODUCTION
COVID-19 necessitated a rapid move from face-to-face services to remote care for eating disorders/eating distress (EDs). This study explores the advantages and challenges of remote care, identifying future implications for service provision. Remote care has been considered in the broadest of terms, including therapeutic care (e.g., Cognitive Behavioural Therapy, peer support, forums, one-to-one and group care options).
METHODS
Using a mixed methods approach, data were collected from 211 people with lived experience of EDs (PWLE), with and without formal diagnosis. 27 participants took part in semi-structured interviews/workshops and a further 184 participants took part via an online survey. Participants reported on their ED status, the impact of the pandemic on symptoms, the benefits, and challenges of remote care (and type of support accessed), and any reasons for not accessing support. Participants were invited to make future care recommendations.
RESULTS
ED symptoms were reported as worsening during the pandemic with contributing factors including isolation, lack of routine, negative emotions, and feeling like the external situation was outside of one's control. Remote care was positively attributed to increased flexibility and facilitation of social connection. Identified barriers to access included lack of awareness about support availability, digital access/literacy, and competing commitments. Further challenges included approaches being perceived as too clinical (e.g., ED information and support presented using clinical language and/or limited to support within medical care settings, without acknowledging the broader context of disordered eating), uncertainty around remote care quality, and concerns that remote platforms may facilitate masking of symptoms. Participants reported distress caused by online platforms where self-view is the default during video calls. They expressed a need for more holistic approaches to remote care, including: "real stories" of recovery, and hybrid (online and offline) options for greater flexibility and widening of access and choice. Participants also expressed a need for appropriate digital literacy training.
DISCUSSION
Future recommendations emphasise user-centred holistic and hybrid approaches to ED remote support, with training to address digital literacy barriers and facilitate user control of platform functionalities (e.g., self-view). This study underscores the need for continued remote care with a focus on inclusivity and user empowerment.
PubMed: 38903648
DOI: 10.3389/fpsyt.2024.1383080 -
Frontiers in Sociology 2024In September 2021 I made a collection of interview transcripts available for public use under a CreativeCommons license through the Princeton DataSpace. The interviews...
In September 2021 I made a collection of interview transcripts available for public use under a CreativeCommons license through the Princeton DataSpace. The interviews include 39 conversations I had with gig workers at AmazonFlex, Uber, and Lyft in 2019 as part of a study on automation efforts within these organizations. I made this decision because (1) I was required to contribute to a publicly available data set as a requirement of my funding and (2) I saw it as an opportunity to engage in the collaborative qualitative science experiments emerging in Science and Technology studies. This article documents my thought process and step-by-step design decisions for designing a study, gathering data, masking it, and publishing it in a public archive. Importantly, once I decided to publish these data, I determined that each choice about how the study would be designed and implemented had to be assessed for risk to the interviewee in a very deliberate way. It is not meant to be comprehensive and cover every possible condition a researcher may face while producing qualitative data. I aimed to be transparent both in my interview data and the process it took to gather and publish these data. I use this article to illustrate my thought process as I made each design decision for this study in hopes that it could be useful to a future researcher considering their own data publishing process.
PubMed: 38903395
DOI: 10.3389/fsoc.2024.1157514 -
Scientific Reports Jun 2024As interest in using machine learning models to support clinical decision-making increases, explainability is an unequivocal priority for clinicians, researchers and...
As interest in using machine learning models to support clinical decision-making increases, explainability is an unequivocal priority for clinicians, researchers and regulators to comprehend and trust their results. With many clinical datasets containing a range of modalities, from the free-text of clinician notes to structured tabular data entries, there is a need for frameworks capable of providing comprehensive explanation values across diverse modalities. Here, we present a multimodal masking framework to extend the reach of SHapley Additive exPlanations (SHAP) to text and tabular datasets to identify risk factors for companion animal mortality in first-opinion veterinary electronic health records (EHRs) from across the United Kingdom. The framework is designed to treat each modality consistently, ensuring uniform and consistent treatment of features and thereby fostering predictability in unimodal and multimodal contexts. We present five multimodality approaches, with the best-performing method utilising PetBERT, a language model pre-trained on a veterinary dataset. Utilising our framework, we shed light for the first time on the reasons each model makes its decision and identify the inclination of PetBERT towards a more pronounced engagement with free-text narratives compared to BERT-base's predominant emphasis on tabular data. The investigation also explores the important features on a more granular level, identifying distinct words and phrases that substantially influenced an animal's life status prediction. PetBERT showcased a heightened ability to grasp phrases associated with veterinary clinical nomenclature, signalling the productivity of additional pre-training of language models.
Topics: Animals; Pets; Electronic Health Records; Machine Learning; United Kingdom; Risk Factors; Cats; Dogs
PubMed: 38902282
DOI: 10.1038/s41598-024-64551-1 -
NPJ Biofilms and Microbiomes Jun 2024During the COVID-19 pandemic, facemasks played a pivotal role in preventing person-person droplet transmission of viral particles. However, prolonged facemask wearing...
During the COVID-19 pandemic, facemasks played a pivotal role in preventing person-person droplet transmission of viral particles. However, prolonged facemask wearing causes skin irritations colloquially referred to as 'maskne' (mask + acne), which manifests as acne and contact dermatitis and is mostly caused by pathogenic skin microbes. Previous studies revealed that the putative causal microbes were anaerobic bacteria, but the pathogenesis of facemask-associated skin conditions remains poorly defined. We therefore characterized the role of the facemask-associated skin microbiota in the development of maskne using culture-dependent and -independent methodologies. Metagenomic analysis revealed that the majority of the facemask microbiota were anaerobic bacteria that originated from the skin rather than saliva. Previous work demonstrated direct interaction between pathogenic bacteria and antagonistic strains in the microbiome. We expanded this analysis to include indirect interaction between pathogenic bacteria and other indigenous bacteria classified as either 'pathogen helper (PH)' or 'pathogen inhibitor (PIn)' strains. In vitro screening of bacteria isolated from facemasks identified both strains that antagonized and promoted pathogen growth. These data were validated using a mouse skin infection model, where we observed attenuation of symptoms following pathogen infection. Moreover, the inhibitor of pathogen helper (IPH) strain, which did not directly attenuate pathogen growth in vitro and in vivo, functioned to suppress symptom development and pathogen growth indirectly through PH inhibitory antibacterial products such as phenyl lactic acid. Taken together, our study is the first to define a mechanism by which indirect microbiota interactions under facemasks can control symptoms of maskne by suppressing a skin pathogen.
Topics: Animals; Mice; Masks; Microbiota; Humans; COVID-19; Skin; Acne Vulgaris; SARS-CoV-2; Female; Metagenomics; Disease Models, Animal; Bacteria; Microbial Interactions; Dermatitis, Contact
PubMed: 38902263
DOI: 10.1038/s41522-024-00512-w -
Human Brain Mapping Jun 2024Free water fraction (FWF) represents the amount of water per unit volume of brain parenchyma, which is not bound to macromolecules. Its excess in multiple sclerosis (MS)...
Free water fraction (FWF) represents the amount of water per unit volume of brain parenchyma, which is not bound to macromolecules. Its excess in multiple sclerosis (MS) is related to increased tissue loss. The use of mcDESPOT (multicomponent driven single pulse observation of T1 and T2), a 3D imaging method which exploits both the T1 and T2 contrasts, allows FWF to be derived in clinically feasible times. However, this method has not been used to quantify changes of FWF and their potential clinical impact in MS. The aim of this study is to investigate the changes in FWF in MS patients and their relationship with tissue damage and cognition, under the hypothesis that FWF is a proxy of clinically meaningful tissue loss. To this aim, we tested the relationship between FWF, MS lesion burden and information processing speed, evaluated via the Symbol Digit Modalities Test (SDMT). In addition to standard sequences, used for T1- and T2-weighted lesion delineation, the mcDESPOT sequence with 1.7 mm isotropic resolution and a diffusion weighted imaging protocol (b = 0, 1200 s/mm, 40 diffusion directions) were employed at 3 T. The fractional anisotropy map derived from diffusion data was used to define a subject-specific white matter (WM) atlas. Brain parenchyma segmentation returned masks of gray matter (GM) and WM, and normal-appearing WM (NAWM), in addition to the T1 and T2 lesion masks (T1L and T2L, respectively). Ninety-nine relapsing-remitting MS patients (age = 43.3 ± 9.9 years, disease duration 12.3 ± 7.7 years) were studied, together with twenty-five healthy controls (HC, age = 38.8 ± 11.0 years). FWF was higher in GM and NAWM of MS patients, compared to GM and WM of HC (both p < .001). In MS patients, FWF was the highest in the T1L and GM, followed by T2L and NAWM, respectively. FWF increased significantly with T1L and T2L volume (ρ ranging from 0.40 to 0.58, p < .001). FWF in T2L was strongly related to both T1L volume and the volume ratio T1L/T2L (ρ = 0.73, p < .001). MS patients performed worse than HC in the processing speed test (mean ± SD: 54.1 ± 10.3 for MS, 63.8 ± 10.8 for HC). FWF in GM, T2L, perilesional tissue and NAWM increased with SDMT score reduction (ρ = -0.30, -0.29, -0.33 respectively and r = -.30 for T2L, all with p < .005). A regional analysis, conducted to determine which NAWM regions were of particular importance to explain the relationship between FWF and cognitive impairment, revealed that FWF spatial variance was negatively related to SDMT score in the corpus callosum and the superior longitudinal fasciculus, WM structures known to be associated with cognitive impairment, in addition to the left corticospinal tract, the sagittal stratum, the right anterior limb of internal capsule. In conclusion, we found excess free water in brain parenchyma of MS patients, an alteration that involved not only MS lesions, but also the GM and NAWM, impinging on brain function and negatively associated with cognitive processing speed. We suggest that the FWF metric, derived from noninvasive, rapid MRI acquisitions and bearing good biological interpretability, may prove valuable as an MRI biomarker of tissue damage and associated cognitive impairment in MS.
Topics: Humans; Female; Male; Adult; Middle Aged; Brain; Multiple Sclerosis; Diffusion Magnetic Resonance Imaging; Water; Cognitive Dysfunction; Parenchymal Tissue; White Matter; Gray Matter; Processing Speed
PubMed: 38895882
DOI: 10.1002/hbm.26761 -
Open Mind : Discoveries in Cognitive... 2024The comparison between conscious and unconscious perception is a cornerstone of consciousness science. However, most studies reporting above-chance discrimination of...
The comparison between conscious and unconscious perception is a cornerstone of consciousness science. However, most studies reporting above-chance discrimination of unseen stimuli do not control for criterion biases when assessing awareness. We tested whether observers can discriminate subjectively invisible offsets of Vernier stimuli when visibility is probed using a bias-free task. To reduce visibility, stimuli were either backward masked or presented for very brief durations (1-3 milliseconds) using a modern-day Tachistoscope. We found some behavioral indicators of perception without awareness, and yet, no conclusive evidence thereof. To seek more decisive proof, we simulated a series of Bayesian observer models, including some that produce visibility judgements alongside type-1 judgements. Our data are best accounted for by observers with slightly suboptimal conscious access to sensory evidence. Overall, the stimuli and visibility manipulations employed here induced mild instances of blindsight-like behavior, making them attractive candidates for future investigation of this phenomenon.
PubMed: 38895041
DOI: 10.1162/opmi_a_00145 -
Frontiers in Neuroscience 2024Single-pulse transcranial magnetic stimulation (spTMS) applied to the Early Visual Cortex (EVC) has demonstrated the ability to suppress the perception on visual...
BACKGROUND
Single-pulse transcranial magnetic stimulation (spTMS) applied to the Early Visual Cortex (EVC) has demonstrated the ability to suppress the perception on visual targets, akin to the effect of visual masking. However, the reported spTMS suppression effects across various studies have displayed inconsistency.
OBJECTIVE
We aim to test if the heterogeneity of the spTMS effects can be attributable to variations in experimental factors.
METHODS
We conducted a meta-analysis using data collected from the PubMed and Web of Science databases spanning from 1995 to March 2024. The meta-analysis encompassed a total of 40 independent experiments drawn from 33 original articles.
RESULTS
The findings unveiled an overall significant spTMS suppression effect on visual perception. Nevertheless, there existed substantial heterogeneity among the experiments. Univariate analysis elucidated that the spTMS effects could be significantly influenced by TMS intensity, visual angle of the stimulus, coil type, and TMS stimulators from different manufacturers. Reliable spTMS suppression effects were observed within the time windows of -80 to 0 ms and 50 to 150 ms. Multivariate linear regression analyses, which included SOA, TMS intensity, visual angle of the stimulus, and coil type, identified SOA as the key factor influencing the spTMS effects. Within the 50 to 150 ms time window, optimal SOAs were identified as 112 ms and 98 ms for objective and subjective performance, respectively. Collectively, multiple experimental factors accounted for 22.9% ( = 0.3353) and 39.9% ( = 0.3724) of the variance in objective and subjective performance, respectively. Comparing univariate and multivariate analyses, it was evident that experimental factors had different impacts on objective performance and subjective performance.
CONCLUSION
The present study provided quantitative recommendations for future experiments involving the spTMS effects on visual targets, offering guidance on how to configure experimental factors to achieve the optimal masking effect.
PubMed: 38894939
DOI: 10.3389/fnins.2024.1351399 -
Antimicrobial Resistance and Infection... Jun 2024In the initial phase of the SARS-CoV-2 pandemic, masking has been widely accepted in healthcare institutions to mitigate the risk of healthcare-associated infection.... (Observational Study)
Observational Study
Association of institutional masking policies with healthcare-associated SARS-CoV-2 infections in Swiss acute care hospitals during the BA.4/5 wave (CH-SUR study): a retrospective observational study.
BACKGROUND
In the initial phase of the SARS-CoV-2 pandemic, masking has been widely accepted in healthcare institutions to mitigate the risk of healthcare-associated infection. Evidence, however, is still scant and the role of masks in preventing healthcare-associated SARS-CoV-2 acquisition remains unclear.We investigated the association of variation in institutional mask policies with healthcare-associated SARS-CoV-2 infections in acute care hospitals in Switzerland during the BA.4/5 2022 wave.
METHODS
SARS-CoV-2 infections in hospitalized patients between June 1 and September 5, 2022, were obtained from the "Hospital-based surveillance of COVID-19 in Switzerland"-database and classified as healthcare- or community-associated based on time of disease onset. Institutions provided information regarding institutional masking policies for healthcare workers and other prevention policies. The percentage of healthcare-associated SARS-CoV-2 infections was calculated per institution and per type of mask policy. The association of healthcare-associated SARS-CoV-2 infections with mask policies was tested using a negative binominal mixed-effect model.
RESULTS
We included 2'980 SARS-CoV-2 infections from 13 institutions, 444 (15%) were classified as healthcare-associated. Between June 20 and June 30, 2022, six (46%) institutions switched to a more stringent mask policy. The percentage of healthcare-associated infections subsequently declined in institutions with policy switch but not in the others. In particular, the switch from situative masking (standard precautions) to general masking of HCW in contact with patients was followed by a strong reduction of healthcare-associated infections (rate ratio 0.39, 95% CI 0.30-0.49). In contrast, when compared across hospitals, the percentage of health-care associated infections was not related to mask policies.
CONCLUSIONS
Our findings suggest switching to a more stringent mask policy may be beneficial during increases of healthcare-associated SARS-CoV-2 infections at an institutional level.
Topics: Humans; COVID-19; Switzerland; Masks; Retrospective Studies; Cross Infection; SARS-CoV-2; Female; Male; Middle Aged; Adult; Hospitals; Aged; Health Personnel; Infection Control; Organizational Policy; Aged, 80 and over
PubMed: 38886813
DOI: 10.1186/s13756-024-01422-4 -
PloS One 2024Organ segmentation has become a preliminary task for computer-aided intervention, diagnosis, radiation therapy, and critical robotic surgery. Automatic organ...
Organ segmentation has become a preliminary task for computer-aided intervention, diagnosis, radiation therapy, and critical robotic surgery. Automatic organ segmentation from medical images is a challenging task due to the inconsistent shape and size of different organs. Besides this, low contrast at the edges of organs due to similar types of tissue confuses the network's ability to segment the contour of organs properly. In this paper, we propose a novel convolution neural network based uncertainty-driven boundary-refined segmentation network (UDBRNet) that segments the organs from CT images. The CT images are segmented first and produce multiple segmentation masks from multi-line segmentation decoder. Uncertain regions are identified from multiple masks and the boundaries of the organs are refined based on uncertainty data. Our method achieves remarkable performance, boasting dice accuracies of 0.80, 0.95, 0.92, and 0.94 for Esophagus, Heart, Trachea, and Aorta respectively on the SegThor dataset, and 0.71, 0.89, 0.85, 0.97, and 0.97 for Esophagus, Spinal Cord, Heart, Left-Lung, and Right-Lung respectively on the LCTSC dataset. These results demonstrate the superiority of our uncertainty-driven boundary refinement technique over state-of-the-art segmentation networks such as UNet, Attention UNet, FC-denseNet, BASNet, UNet++, R2UNet, TransUNet, and DS-TransUNet. UDBRNet presents a promising network for more precise organ segmentation, particularly in challenging, uncertain conditions. The source code of our proposed method will be available at https://github.com/riadhassan/UDBRNet.
Topics: Humans; Neural Networks, Computer; Tomography, X-Ray Computed; Uncertainty; Organs at Risk; Image Processing, Computer-Assisted; Algorithms; Lung
PubMed: 38885241
DOI: 10.1371/journal.pone.0304771 -
Journal of Pharmacy & Bioallied Sciences Apr 2024The aim of this study was to evaluate the effect of the resin infiltration technique and remineralization of induced enamel caries with fluoride solution on the color...
AIM OF THE STUDY
The aim of this study was to evaluate the effect of the resin infiltration technique and remineralization of induced enamel caries with fluoride solution on the color masking of white spot lesions and surface roughness.
MATERIALS AND METHODS
A total of 45 sound teeth were used in this study. All the teeth were sectioned along the long axes into two halves, lingual and buccal to get 90 specimens. All specimens were immersed in a demineralized solution for 7 days. The specimens were divided randomly into three equal groups ( = 30) according to the type of treatment; Group 1 ( = 30) was treated with fluoride varnish (Clinpro); Group 2 ( = 30) was treated by resin infiltration (Icon); and Group 3 ( = 30) was used as a control group with no treatment. The color and surface roughness were measured three times at baseline (T1), directly after induction of artificial white spot lesions (WSLs) (T2), and directly after application of the treatment options (T3). The colors were measured using a portable reflective spectrophotometer and the 3D surface roughness was measured using a Light Sectioning Vision System. Data were collected and statistically analyzed using T test and Mann-Whitney U test.
THE RESULTS
Surface roughness was almost equal in the study groups with no statistically significant differences reported. Icon showed slightly higher color scores than that of ClinPro.
CONCLUSIONS
The Icon produced favorable esthetic results compared to the fluoride therapy while no significant differences were reported regarding the surface roughness.
PubMed: 38882736
DOI: 10.4103/jpbs.jpbs_973_23