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Computers in Biology and Medicine Jun 2024Characteristics such as low contrast and significant organ shape variations are often exhibited in medical images. The improvement of segmentation performance in medical...
Characteristics such as low contrast and significant organ shape variations are often exhibited in medical images. The improvement of segmentation performance in medical imaging is limited by the generally insufficient adaptive capabilities of existing attention mechanisms. An efficient Channel Prior Convolutional Attention (CPCA) method is proposed in this paper, supporting the dynamic distribution of attention weights in both channel and spatial dimensions. Spatial relationships are effectively extracted while preserving the channel prior by employing a multi-scale depth-wise convolutional module. The ability to focus on informative channels and important regions is possessed by CPCA. A segmentation network called CPCANet for medical image segmentation is proposed based on CPCA. CPCANet is validated on two publicly available datasets. Improved segmentation performance is achieved by CPCANet while requiring fewer computational resources through comparisons with state-of-the-art algorithms. Our code is publicly available at https://github.com/Cuthbert-Huang/CPCANet.
PubMed: 38941900
DOI: 10.1016/j.compbiomed.2024.108784 -
PloS One 2024This study began as a single-blind randomized controlled trial (RCT) to investigate the efficacy and safety of electroconvulsive therapy (ECT) for severe... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
This study began as a single-blind randomized controlled trial (RCT) to investigate the efficacy and safety of electroconvulsive therapy (ECT) for severe treatment-refractory agitation in advanced dementia. The aims are to assess agitation reduction using the Cohen-Mansfield Agitation Inventory (CMAI), evaluate tolerability and safety outcomes, and explore the long-term stability of agitation reduction and global functioning. Due to challenges encountered during implementation, including recruitment obstacles and operational difficulties, the study design was modified to an open-label format and other protocol amendments were implemented.
METHODS
Initially, the RCT randomized participants 1:1 to either ECT plus usual care or simulated ECT plus usual care (S-ECT) groups. As patients were enrolled, data were collected from both ECT and simulated ECT (S-ECT) patients. The study now continues in an open-label study design where all patients receive actual ECT, reducing the targeted sample size from 200 to 50 participants.
RESULTS
Study is ongoing and open to enrollment.
CONCLUSION
The transition of the ECT-AD study design from an RCT to open-label design exemplifies adaptive research methodologies in response to real-world challenges. Data from both the RCT and open-label phases of the study will provide a unique perspective on the role of ECT in managing severe treatment-refractory agitation in dementia, potentially influencing future clinical practices and research approaches.
Topics: Humans; Electroconvulsive Therapy; Psychomotor Agitation; Dementia; Single-Blind Method; Female; Male; Treatment Outcome; Aged; Aberrant Motor Behavior in Dementia
PubMed: 38941338
DOI: 10.1371/journal.pone.0303894 -
PloS One 2024Drought stress following climate change is likely a scenario that will have to face crop growers in tropical regions. In mitigating this constraint, the best option...
Identifying critical growth stage and resilient genotypes in cowpea under drought stress contributes to enhancing crop tolerance for improvement and adaptation in Cameroon.
Drought stress following climate change is likely a scenario that will have to face crop growers in tropical regions. In mitigating this constraint, the best option should be the selection and use of resilient varieties that can withstand drought threats. Therefore, a pot experiment was conducted under greenhouse conditions at the Research and Teaching Farm of the Faculty of Agronomy and Agricultural Sciences of the University of Dschang. The objectives are to identify sensitive growth stage, to identify drought-tolerant genotypes with the help of yield-based selection indices and to identify suitable selection indices that are associated with yield under non-stress and stress circumstances. Eighty-eight cowpea genotypes from the sahelian and western regions of Cameroon were subjected to drought stress at vegetative (VDS) and flowering (FDS) stages by withholding water for 28 days, using a split plot design with two factors and three replications. Seed yields under stress (Ys) and non-stress (Yp) conditions were recorded. Fifteen drought indices were calculated for the two drought stress levels against the yield from non-stress plants. Drought Intensity Index (DII) under VDS and FDS were 0.71 and 0.84 respectively, indicating severe drought stress for both stages. However, flowering stage was significantly more sensitive to drought stress compared to vegetative stage. Based on PCA and correlation analysis, Stress Tolerance Index (STI), Relative Efficiency Index (REI), Geometric Mean Productivity (GMP), Mean Productivity (MP), Yield Index (YI) and Harmonic Mean (HM) correlated strongly with yield under stress and non-stress conditions and are therefore suitable to discriminate high-yielding and tolerant genotypes under both stress and non-stress conditions. Either under VDS and FDS, CP-016 exhibited an outstanding performance under drought stress and was revealed as the most drought tolerant genotype as shown by ranking, PCA and cluster analysis. Taking into account all indices, the top five genotypes namely CP-016, CP-021, MTA-22, CP-056 and CP-060 were identified as the most drought-tolerant genotypes under VDS. For stress activated at flowering stage (FDS), CP-016, CP-056, CP-021, CP-028 and MTA-22 were the top five most drought-tolerant genotypes. Several genotypes with insignificant Ys and irrelevant rank among which CP-037, NDT-001, CP-036, CP-034, NDT-002, CP-031, NDT-011 were identified as highly drought sensitive with low yield stability. This study identified the most sensitive stage and drought tolerant genotypes that are proposed for genetic improvement of cowpea.
Topics: Cameroon; Droughts; Genotype; Vigna; Adaptation, Physiological; Stress, Physiological; Crops, Agricultural; Seeds
PubMed: 38941312
DOI: 10.1371/journal.pone.0304674 -
IEEE Transactions on Neural Networks... Jun 2024The affinity graph is regarded as a mathematical representation of the local manifold structure. The performance of locality-preserving projections (LPPs) and its...
The affinity graph is regarded as a mathematical representation of the local manifold structure. The performance of locality-preserving projections (LPPs) and its variants is tied to the quality of the affinity graph. However, there are two drawbacks in current approaches. First, the pre-designed graph is inconsistent with the actual distribution of data. Second, the linear projection way would cause damage to the nonlinear manifold structure. In this article, we propose a nonlinear dimensionality reduction model, named deep locality-preserving projections (DLPPs), to solve these problems simultaneously. The model consists of two loss functions, each employing deep autoencoders (AEs) to extract discriminative features. In the first loss function, the affinity relationships among samples in the intermediate layer are determined adaptively according to the distances between samples. Since the features of samples are obtained by nonlinear mapping, the manifold structure can be kept in the low-dimensional space. Additionally, the learned affinity graph is able to avoid the influence of noisy and redundant features. In the second loss function, the affinity relationships among samples in the last layer (also called the reconstruction layer) are learned. This strategy enables denoised samples to have a good manifold structure. By integrating these two functions, our proposed model minimizes the mismatch of the manifold structure between samples in the denoising space and the low-dimensional space, while reducing sensitivity to the initial weights of the graph. Extensive experiments on toy and benchmark datasets have been conducted to verify the effectiveness of our proposed model.
PubMed: 38941200
DOI: 10.1109/TNNLS.2024.3408835 -
JMIR Research Protocols Jun 2024The lack of regular physical activity (PA) in individuals with spinal cord injury (SCI) in the United States is an ongoing health crisis. Regular PA and exercise-based... (Randomized Controlled Trial)
Randomized Controlled Trial
mHealth-Based Just-in-Time Adaptive Intervention to Improve the Physical Activity Levels of Individuals With Spinal Cord Injury: Protocol for a Randomized Controlled Trial.
BACKGROUND
The lack of regular physical activity (PA) in individuals with spinal cord injury (SCI) in the United States is an ongoing health crisis. Regular PA and exercise-based interventions have been linked with improved outcomes and healthier lifestyles among those with SCI. Providing people with an accurate estimate of their everyday PA level can promote PA. Furthermore, PA tracking can be combined with mobile health technology such as smartphones and smartwatches to provide a just-in-time adaptive intervention (JITAI) for individuals with SCI as they go about everyday life. A JITAI can prompt an individual to set a PA goal or provide feedback about their PA levels.
OBJECTIVE
The primary aim of this study is to investigate whether minutes of moderate-intensity PA among individuals with SCI can be increased by integrating a JITAI with a web-based PA intervention (WI) program. The WI program is a 14-week web-based PA program widely recommended for individuals with disabilities. A secondary aim is to investigate the benefit of a JITAI on proximal PA, defined as minutes of moderate-intensity PA within 120 minutes of a PA feedback prompt.
METHODS
Individuals with SCI (N=196) will be randomized to a WI arm or a WI+JITAI arm. Within the WI+JITAI arm, a microrandomized trial will be used to randomize participants several times a day to different tailored feedback and PA recommendations. Participants will take part in the 24-week study from their home environment in the community. The study has three phases: (1) baseline, (2) WI program with or without JITAI, and (3) PA sustainability. Participants will provide survey-based information at the initial meeting and at the end of weeks 2, 8, 16, and 24. Participants will be asked to wear a smartwatch every day for ≥12 hours for the duration of the study.
RESULTS
Recruitment and enrollment began in May 2023. Data analysis is expected to be completed within 6 months of finishing participant data collection.
CONCLUSIONS
The JITAI has the potential to achieve long-term PA performance by delivering tailored, just-in-time feedback based on the person's actual PA behavior rather than a generic PA recommendation. New insights from this study may guide intervention designers to develop engaging PA interventions for individuals with disability.
TRIAL REGISTRATION
ClinicalTrials.gov NCT05317832; https://clinicaltrials.gov/study/NCT05317832.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
DERR1-10.2196/57699.
Topics: Humans; Spinal Cord Injuries; Exercise; Telemedicine; Male; Female; Adult; Middle Aged; Exercise Therapy; Randomized Controlled Trials as Topic
PubMed: 38941145
DOI: 10.2196/57699 -
International Ophthalmology Jun 2024Compared to Shack-Hartmann wavefront sensor (SHWS), the parameters of virtual SHWS (vSHWS) can be easily adjusted to obtain the optimal performance of aberration...
PURPOSE
Compared to Shack-Hartmann wavefront sensor (SHWS), the parameters of virtual SHWS (vSHWS) can be easily adjusted to obtain the optimal performance of aberration measurement. Its current optimal parameters are obtained with only a set of statistical aberrations and not statistically significant. Whether the above parameters are consistent with the statistical results of the optimal parameters corresponding to each set of aberrations, and which performance is better if not? The purpose of this study was to answer these questions.
METHODS
The optimal parameters to reconstruct 624 sets of clinical ocular aberrations in the highest accuracy, including the numbers of sub-apertures (NSAs) and the expansion ratios (ERs) of electric field zero-padding, were determined sequentially in this work. By using wavefront-reconstruction accuracy as an evaluation index, the statistical optimal parameter configuration was selected from some possible configurations determined by the optimal NSAs and ERs.
RESULTS
The statistical optimal parameters are consistent for normal and abnormal eyes. They are different from the optimal parameters obtained with a set of statistical aberrations from the same 624 sets of aberrations, and the performance using the former is better than that using the latter. The performance using a fixed set of statistical optimal parameters is even close to that using the respective optimal parameters corresponding to each set of aberrations.
CONCLUSION
The vSHWS configured with a fixed set of statistical optimal parameters can be used for high-precision aberration measurement of both normal and abnormal eyes. The statistical optimal parameters are more suitable for vSHWS than the parameters obtained with a set of statistical aberrations. These conclusions are significant for the designs of vSHWS and also SHWS.
Topics: Humans; Corneal Wavefront Aberration; Corneal Topography; Aberrometry; Refraction, Ocular; Visual Acuity
PubMed: 38940969
DOI: 10.1007/s10792-024-03176-9 -
Clinical Oral Investigations Jun 2024Evaluate the efficacy of denture cleaners on the adhesion of Candida albicans and their effects on the surface, optical, and mechanical properties of resins for...
OBJECTIVES
Evaluate the efficacy of denture cleaners on the adhesion of Candida albicans and their effects on the surface, optical, and mechanical properties of resins for conventional, milled, and 3D-printed denture bases.
MATERIALS AND METHODS
A total of 240 resin samples were made, 120 for testing Candida albicans adhesion, optical stabilities (ΔE), roughness (Ra), hydrophilicity (°), surface free energy (Owens-Wendt) and 120 samples for testing Candida albicans adhesion, surface microhardness (Knoop), flexural strength and modulus of elasticity in a three-point test, in which they were divided into 3 groups of denture resin (n = 40) and subdivided into 5 cleaners of dentures (n = 8). Data were evaluated by two-way ANOVA and Tukey's test for multiple comparisons (α = 0.05).
RESULTS
Denture cleaners with an alkaline solution and dilute acid composition were those that showed the greatest effectiveness in reducing Candida albicans (P < 0.001), however 1% NaOCl significantly affected the properties of the resins (P < 0.05). Denture 3D-printed showed that the surface microhardness was significantly lower for all cleansers (P < 0.05).
CONCLUSIONS
Listerine demonstrated superior efficacy in reducing Candida albicans with minimal effect on denture properties, whereas 1% NaOCl had a significant negative impact on the properties. The mechanical properties were significantly lower in 3D-printed resin than in other resins for all denture cleansers.
CLINICAL RELEVANCE
Denture base materials are being sold to adapt to the CAD/CAM system, increasing the number of users of dentures manufactured with this system. Despite this, there is little investigation into denture cleaners regarding the adhesion capacity of microorganisms and the optical, surface and mechanical properties of dentures, thus requiring further investigation.
Topics: Candida albicans; Denture Bases; Denture Cleansers; Surface Properties; Printing, Three-Dimensional; Materials Testing; Computer-Aided Design; Hardness; Flexural Strength; Dental Materials
PubMed: 38940942
DOI: 10.1007/s00784-024-05801-4 -
Public Health Research (Southampton,... Jun 2024Stronger social and emotional well-being during primary school is positively associated with the health and educational outcomes of young people. However, there is... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Stronger social and emotional well-being during primary school is positively associated with the health and educational outcomes of young people. However, there is little evidence on which programmes are the most effective for improving social and emotional well-being.
OBJECTIVE
The objective was to rigorously evaluate the Social and Emotional Education and Development (SEED) intervention process for improving pupils' social and emotional well-being.
DESIGN
This was a stratified cluster randomised controlled trial with embedded process and economic evaluations. Thirty-eight primary schools were randomly assigned to the SEED intervention or to the control group. Hierarchical regression analysis allowing for clustering at school learning community level was conducted in R (statistical package).
SETTING
The SEED intervention is a whole-school intervention; it involved all school staff and two cohorts of pupils, one starting at 4 or 5 years of age and the second starting at 8 or 9 years of age, across all 38 schools.
PARTICIPANTS
A total of 2639 pupils in Scotland.
INTERVENTION
The SEED intervention used an iterative process that involved three components to facilitate selection and implementation of school-based actions: (1) questionnaire completion, (2) benchmarked feedback to all staff and (3) reflective discussions (all staff and an educational psychologist).
MAIN OUTCOME MEASURE
The primary outcome was pupils' Strengths and Difficulties Questionnaire-Total Difficulties Score when pupils were 4 years older than at baseline.
RESULTS
The primary outcome, pupils' Strengths and Difficulties Questionnaire-Total Difficulties Score at follow-up 3, showed improvements for intervention arm pupils, compared with those in the control arm [relative risk -1.30 (95% confidence interval -1.87 to -0.73), standardised effect size -0.27 (95% confidence interval -0.39 to -0.15)]. There was no evidence of intervention effects according to deprivation: the results were significant for both affluent and deprived pupils. Subgroup analysis showed that all effect sizes were larger for the older cohort, particularly boys [relative risk -2.36 (95% confidence interval -3.62 to -1.11), standardised effect size -0.42 (95% confidence interval -0.64 to -0.20)]. Although there was no statistically significant difference in incremental cost and quality-adjusted life-years, the probability that the intervention is cost-effective at a willingness-to-pay threshold of £20,000 per quality-adjusted life-year was high, at 88%. Particularly valued mechanisms of the SEED intervention were its provision of time to reflect on and discuss social and emotional well-being and its contribution to a culture of evaluating practice.
LIMITATIONS
It was a challenge to retain schools over five waves of data collection.
CONCLUSIONS
This trial demonstrated that the SEED intervention is an acceptable, cost-effective way to modestly improve pupil well-being and improve school climate, particularly for older boys and those with greater levels of psychological difficulties. It was beneficial during the transition from primary to secondary school, but this diminished after 6 years. The SEED intervention can be implemented alongside existing systems for addressing pupil well-being and can be complementary to other interventions.
FUTURE WORK
Assess whether or not the SEED intervention has a beneficial impact on academic attainment, is transferable to other countries and other organisational settings, would be strengthened by adding core training elements to the intervention process and is transferable to secondary schools. Understand the gender differences illustrated by the outcomes of this trial. Conduct further statistical research on how to handle missing data in longitudinal studies of complex social interventions.
TRIAL REGISTRATION
This trial is registered as ISRCTN51707384.
FUNDING
This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: 10/3006/13) and is published in full in ; Vol. 12, No. 6. See the NIHR Funding and Awards website for further award information.
Topics: Humans; Child; Male; Female; Scotland; Schools; Child, Preschool; Emotions; Surveys and Questionnaires; Cluster Analysis; School Health Services; Cost-Benefit Analysis
PubMed: 38940833
DOI: 10.3310/LYRQ5047 -
Journal of Cognitive Neuroscience Jun 2024Blood oxygen level dependent (BOLD) variability (SDBOLD) has emerged as a unique measure of the adaptive properties of neural systems that facilitate fast, stable...
Blood oxygen level dependent (BOLD) variability (SDBOLD) has emerged as a unique measure of the adaptive properties of neural systems that facilitate fast, stable responding, based on claims that SDBOLD is independent of mean BOLD signal (meanBOLD) and a powerful predictor of behavioral performance. We challenge these two claims. First, the apparent independence of SDBOLD and meanBOLD may reflect the presence of deactivations; we hypothesize that although SDBOLD may not be related to raw meanBOLD, it will be linearly related to "absolute" meanBOLD. Second, the observed relationship between SDBOLD and performance may be an artifact of using fixed-length trials longer than RTs. Such designs provide opportunities to toggle between on- and off-task states, and fast responders likely engage in more frequent state-switching, thereby artificially elevating SDBOLD. We hypothesize that SDBOLD will be higher and more strongly related to performance when using such fixed-length trials relative to self-paced trials that terminate upon a response. We test these two hypotheses in an fMRI study using blocks of fixed-length or self-paced trials. Results confirmed both hypotheses: (1) SDBOLD was robustly related with absolute meanBOLD, and (2) toggling between on- and off-task states during fixed-length trials reliably contributed to SDBOLD. Together, these findings suggest that a reappraisal of the functional significance of SDBOLD as a unique marker of cognitive performance is warranted.
PubMed: 38940728
DOI: 10.1162/jocn_a_02202 -
Nursing Open Jul 2024Family resilience and healthy family functioning are crucial for stroke survivors' rehabilitation. This study aimed to determine the mediating effects of self-efficacy...
AIM
Family resilience and healthy family functioning are crucial for stroke survivors' rehabilitation. This study aimed to determine the mediating effects of self-efficacy and confrontation coping on the relationship between family resilience and functioning among patients with first-episode stroke.
DESIGN
A cross-sectional design was applied.
METHODS
288 patients with first-episode stroke were recruited from 7 hospitals in Shangqiu and Shanghai, China, from July 2020 to October 2020. A shortened Chinese version of the Family Resilience Assessment Scale, family adaptation, partnership, growth, affection and resolve questionnaire, Medical Coping Modes Questionnaire, and Self-efficacy for Chronic Disease 6-item Scale were used to collect the self-reported data. The relationships among the studied variables were studied using spearman correlation and structural equation model.
RESULTS
The average level of family functioning among stroke patients was 7.87 (SD = 2.32). About 26.8% (n = 76) of patients reported family dysfunction. The structural equation model showed that family resilience directly affected patients' satisfaction with family functioning (r = 0.406, p < 0.001) and indirectly affected the mediating role of patients' self-efficacy and confrontation coping style (r = 0.119, p < 0.001). The model was with good fit (χ/df = 2.128, RMSEA = 0.065, GFI = 0.956, AGFI = 0.919, NFI = 0.949, and TLI = 0.956).
CONCLUSION
Family resilience and functioning among patients with first-episode stroke are positively associated with the mediating effects of the patients' confrontation coping style and self-efficacy between family resilience and functioning. The findings indicate that the professionals should pay special attention to families exhibiting poor family resilience or with patients who rarely use confrontation coping styles or with poor self-efficacy since they are more likely to suffer from low functioning.
Topics: Humans; Male; Female; Self Efficacy; Adaptation, Psychological; Cross-Sectional Studies; Middle Aged; Resilience, Psychological; Stroke; Survivors; Surveys and Questionnaires; China; Family; Aged; Adult
PubMed: 38940513
DOI: 10.1002/nop2.2230