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PCN Reports : Psychiatry and Clinical... Jun 2024We investigated the effectiveness of an ultra-brief intervention (Ultra-BI) for patients with hazardous drinking behaviors admitted to a general hospital.
OBJECTIVE
We investigated the effectiveness of an ultra-brief intervention (Ultra-BI) for patients with hazardous drinking behaviors admitted to a general hospital.
METHOD
In a quasi-randomized controlled trial at a general hospital in Japan, we assigned participants to intervention or control groups based on the last digit of their patient ID (odd for intervention, even for control). The study included inpatients with Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) scores of ≥5 for men and ≥4 for women. The intervention involved providing advice and feedback within 1 min, accompanied by a leaflet on alcohol-related issues (Ultra-BI). The control group did not receive any intervention. The primary outcome was average weekly alcohol consumption at 3 months postintervention.
RESULTS
The study included 68 participants. The intervention group showed a reduction in average weekly alcohol consumption by -69.7 g/week compared to the control group (95% confidence interval [CI] -145.7 to 6.3 g/week, = 0.07). Post-hoc analysis, adjusting for baseline values, indicated a between-group difference of -78.7 g/week (95% CI -135.2 to -22.2 g/week, = 0.007).
CONCLUSION
This pilot trial suggests the potential effectiveness of the Ultra-BI in general hospital wards. Further large-scale studies are required to confirm these findings.
PubMed: 38904063
DOI: 10.1002/pcn5.216 -
Frontiers in Digital Health 2024With advancements in communication technologies and internet connectivity, avatar robots for children who cannot attend school in person due to illness or disabilities...
INTRODUCTION
With advancements in communication technologies and internet connectivity, avatar robots for children who cannot attend school in person due to illness or disabilities have become more widespread. Introducing these technologies to the classroom aims to offer possibilities of social and educational inclusion. While implementation is still at an experimental level, several of these avatars have already been introduced as a marketable service. However, various obstacles impede widespread acceptance.
METHODS
In our explorative qualitative case study we conducted semi-structured interviews with eight individuals involved in the implementation of the avatar robots AV1 in Germany and eleven participants involved with implementing OriHime in Japan. We analyzed and compared implementation processes, application areas, access and eligibility, and the potential and limitations of avatars at schools.
RESULTS
We identified structural similarities and differences in both countries. In the German cases the target is defined as temporary use for children who cannot attend school in person because of childhood illness, with the clear goal of returning to school. Whereas in Japan OriHime is also implemented for children with physical or developmental disabilities, or who cannot attend school in person for other reasons.
DISCUSSION
Our study suggests that avatar technologies bear high potential for children to stay socially and educationally connected. Yet, structures need establishing that grant equal access to avatar technologies. These include educational board regulations, budgets for funding avatar technologies and making them accessible to the public, and privacy protection standards that are adequate, yet do not create implementation hurdles that are too high. Furthermore, guidelines or training sessions on technical, educational and psychosocial aspects of including avatar technologies in the classroom for teachers are important for successful implementation. Since our Japanese cases suggest that expanding the area of application beyond childhood illness is promising, further research on the benefits for different groups is needed.
PubMed: 38904032
DOI: 10.3389/fdgth.2024.1273415 -
Journal of Hand Surgery Global Online Mar 2024The objective of this study was to determine the risk factors and the rate of reoperation after closed reduction percutaneous pinning (CRPP) of isolated closed...
PURPOSE
The objective of this study was to determine the risk factors and the rate of reoperation after closed reduction percutaneous pinning (CRPP) of isolated closed single-digit proximal phalanx fractures.
METHODS
A retrospective cohort study was conducted for patients who underwent CRPP of non-thumb closed proximal phalanx fractures between 2010 and 2020 at two level-I trauma centers and two community teaching hospitals. Demographics, fracture, and treatment characteristics were collected. The primary outcome measure was reoperation. Secondary outcome measures were complication and reoperation specifically for digital stiffness.
RESULTS
Of the 115 patients who underwent surgical treatment, 46 patients (40.0%) had a complication and 13 patients (11.3%) underwent reoperation at a mean of 6.7 months-most of which (84.6%) were for digital stiffness.
CONCLUSIONS
Surgeons and patients may be aware that CRPP of closed extra-articular proximal phalanx fractures carries considerable rates of complication and reoperation.
TYPE OF STUDY/LEVEL OF EVIDENCE
Therapeutic III.
PubMed: 38903843
DOI: 10.1016/j.jhsg.2023.11.004 -
Journal of Hand Surgery Global Online Mar 2024Function and cosmesis may be improved by replantation following digital amputation in pediatric patients. However, accurate failure and complication rate estimates may...
PURPOSE
Function and cosmesis may be improved by replantation following digital amputation in pediatric patients. However, accurate failure and complication rate estimates may be limited as most pertinent studies reflect single center/surgeon experience and therefore are limited by small sample sizes. The primary aim of this study was to assess the rate of failure (amputation) following pediatric digital replantation. Secondary aims include evaluating the rate of complications and associated resource utilization (intensive care unit stays, readmission rate, and hospital length of stay).
METHODS
Digital replantation patients were identified from 47 pediatric hospitals using the 2004 to 2020 Pediatric Health Information System nationwide database. Using applicable International Classification of Disease 9/10 and Current Procedural Terminology codes, we identified complications after replantation, including revision amputation, infection, surgical complications, medical complications, admission to intensive care unit (ICU), and length of stay.
RESULTS
Of the 348 patients who underwent replantation the mean age was 8.3 ± 5.1 years, and 27% were female. Mean hospital length of stay was 5.8 ± 4.7 (range, 1-28) days. Of the 53% of patients who required ICU admission, the mean ICU length of stay was 2.4 ± 3.3 days. Failure/amputation after replantation occurred in 71 (20.4%) patients, at a mean of 9.7 ± 27.2 days postoperatively. Surgical complications occurred in 58 (17%) patients, 30-day hospital readmissions occurred in 5.7% of patients, and 90-day readmissions occurred in 6.3% patients.
CONCLUSION
The estimated rate of failure following pediatric digit replantation was 20%. Our data on failure and complication rates and associated resource utilization may be useful in counseling pediatric replantation patients and their families and provide an update on prior literature.
LEVEL OF EVIDENCE
IV, Prognosis.
PubMed: 38903833
DOI: 10.1016/j.jhsg.2023.12.004 -
Frontiers in Psychology 2024We investigate the development of visuospatial and oculomotor reading skills in a cohort of elementary school children. Employing a longitudinal methodology, the study...
We investigate the development of visuospatial and oculomotor reading skills in a cohort of elementary school children. Employing a longitudinal methodology, the study applies the Topological serial digit Rapid Automated Naming (Top-RAN) battery, which evaluates visuospatial reading skills leveraging metrics addressing crowding, distractors, and voluntary attention orientation. The participant pool comprises 142 students (66 males, 76 females), including 46 non-native speakers (21 males, 25 females), representing a diverse range of ethnic backgrounds. The Top-RAN dataset encompasses performance, error, and self-correction metrics for each subtest and student, underscoring the significance of these factors in the process of reading acquisition. Analytical methods include dimensionality reduction, clustering, and classification algorithms, consolidated into a Python package to facilitate reproducible results. Our results indicate that visuospatial reading abilities vary according to the task and demonstrate a marked evolution over time, as seen in the progressive decrease in execution times, errors, and self-corrections. This pattern supports the hypothesis that the growth of oculomotor, attentional, and executive skills is primarily fostered by educational experiences and maturation. This investigation provides valuable insights into the dynamic nature of these skills during pivotal educational stages.
PubMed: 38903458
DOI: 10.3389/fpsyg.2024.1383969 -
Frontiers in Sports and Active Living 2024The present study aimed to evaluate the effect of acute aerobic exercise on certain cognitive functions known to be affected by Alzheimer's disease (AD), with a...
INTRODUCTION
The present study aimed to evaluate the effect of acute aerobic exercise on certain cognitive functions known to be affected by Alzheimer's disease (AD), with a particular emphasis on sex differences.
METHODS
A total of 53 patients, with a mean age of 70.54 ± 0.88 years and moderate AD, voluntarily participated in the study. Participants were randomly assigned to two groups: the experimental group (EG), which participated in a 20-min moderate-intensity cycling session (60% of the individual maximum target heart rate recorded at the end of the 6-min walk test); and the control group (CG), which participated in a 20-min reading activity. Cognitive abilities were assessed before and after the physical exercise or reading session using the Stroop test for selective attention, the forward and backward digit span test for working memory, and the Tower of Hanoi task for problem-solving abilities.
RESULTS
At baseline, both groups had comparable cognitive performance ( > 0.05 in all tests). Regardless of sex, aerobic acute exercise improved attention in the Stroop test ( < 0.001), enhanced memory performance in both forward ( < 0.001) and backward ( < 0.001) conditions, and reduced the time required to solve the problem in the Tower of Hanoi task ( < 0.001). No significant differences were observed in the number of movements. In contrast, the CG did not significantly improve after the reading session for any of the cognitive tasks ( > 0.05). Consequently, the EG recorded greater performance improvements than the CG in most cognitive tasks tested ( < 0.0001) after the intervention session.
DISCUSSION
These findings demonstrate that, irrespective to sex, a single aerobic exercise session on an ergocycle can improve cognitive function in patients with moderate AD. The results suggest that acute aerobic exercise enhances cognitive function similarly in both female and male patients, indicating promising directions for inclusive therapeutic strategies.
PubMed: 38903391
DOI: 10.3389/fspor.2024.1383119 -
Cureus May 2024Introduction With technology advancing across all fields, the utility of digital screens is increasing among all age groups for various purposes. Research indicates...
Introduction With technology advancing across all fields, the utility of digital screens is increasing among all age groups for various purposes. Research indicates that while digital technology presents clear advantages, prolonged exposure can have detrimental effects on various aspects of health, behavior, emotions, and cognitive functions like attention and working memory. A crucial cognitive process for learning and information processing which is working memory, can be affected by factors including screen time. Studies have found that the impact of screen time on working memory can be negative, positive, or show no discernible relationship. However, earlier investigations are limited to smartphone use as screen time exposure and further to only active screen time. As there is a dearth of studies in the Indian context and young adults are more exposed to screen time, it is important to investigate along these lines. Hence, the present study aimed to investigate the impact of active and passive screen time exposure on modality-specific working memory in young adults. Methods Seventy-seven neurotypical individuals aged between 18 and 22 years were recruited. The study utilized auditory and visual reverse digit span tasks and the Corsi-backward task to measure working memory span. Screen time data of the participants were collected through a self-administered 18-item questionnaire covering active and background screen time domains. Results and discussion The present study concluded that only active screen time has a significant effect on visual reverse digit span and supports the notion of the visual superiority effect against an auditory superior effect as suggested by earlier findings. The preliminary findings of correlation observed exclusively within the visual domain in this study could be attributed to the potential impact of screen time exposure (active screen time and textual content). Screen usage demands effective switching between various visual stimuli and ongoing updates of information in memory. Nonetheless, interpreting this explanation and generalization requires caution, given the low ecological validity of the task employed in the study. Future investigations should aim to collect screen time exposure data more objectively, perhaps through online tracking techniques. Furthermore, it would be prudent to expand the correlation analysis to include other cognitive processes and populations.
PubMed: 38903378
DOI: 10.7759/cureus.60626 -
NPJ Digital Medicine Jun 2024The current prostate cancer (PCa) screen test, prostate-specific antigen (PSA), has a high sensitivity for PCa but low specificity for high-risk, clinically significant...
The current prostate cancer (PCa) screen test, prostate-specific antigen (PSA), has a high sensitivity for PCa but low specificity for high-risk, clinically significant PCa (csPCa), resulting in overdiagnosis and overtreatment of non-csPCa. Early identification of csPCa while avoiding unnecessary biopsies in men with non-csPCa is challenging. We built an optimized machine learning platform (ClarityDX) and showed its utility in generating models predicting csPCa. Integrating the ClarityDX platform with blood-based biomarkers for clinically significant PCa and clinical biomarker data from a 3448-patient cohort, we developed a test to stratify patients' risk of csPCa; called ClarityDX Prostate. When predicting high risk cancer in the validation cohort, ClarityDX Prostate showed 95% sensitivity, 35% specificity, 54% positive predictive value, and 91% negative predictive value, at a ≥ 25% threshold. Using ClarityDX Prostate at this threshold could avoid up to 35% of unnecessary prostate biopsies. ClarityDX Prostate showed higher accuracy for predicting the risk of csPCa than PSA alone and the tested model-based risk calculators. Using this test as a reflex test in men with elevated PSA levels may help patients and their healthcare providers decide if a prostate biopsy is necessary.
PubMed: 38902526
DOI: 10.1038/s41746-024-01167-9 -
NPJ Digital Medicine Jun 2024Middle-ear conditions are common causes of primary care visits, hearing impairment, and inappropriate antibiotic use. Deep learning (DL) may assist clinicians in...
Middle-ear conditions are common causes of primary care visits, hearing impairment, and inappropriate antibiotic use. Deep learning (DL) may assist clinicians in interpreting otoscopic images. This study included patients over 5 years old from an ambulatory ENT practice in Strasbourg, France, between 2013 and 2020. Digital otoscopic images were obtained using a smartphone-attached otoscope (Smart Scope, Karl Storz, Germany) and labeled by a senior ENT specialist across 11 diagnostic classes (reference standard). An Inception-v2 DL model was trained using 41,664 otoscopic images, and its diagnostic accuracy was evaluated by calculating class-specific estimates of sensitivity and specificity. The model was then incorporated into a smartphone app called i-Nside. The DL model was evaluated on a validation set of 3,962 images and a held-out test set comprising 326 images. On the validation set, all class-specific estimates of sensitivity and specificity exceeded 98%. On the test set, the DL model achieved a sensitivity of 99.0% (95% confidence interval: 94.5-100) and a specificity of 95.2% (91.5-97.6) for the binary classification of normal vs. abnormal images; wax plugs were detected with a sensitivity of 100% (94.6-100) and specificity of 97.7% (95.0-99.1); other class-specific estimates of sensitivity and specificity ranged from 33.3% to 92.3% and 96.0% to 100%, respectively. We present an end-to-end DL-enabled system able to achieve expert-level diagnostic accuracy for identifying normal tympanic aspects and wax plugs within digital otoscopic images. However, the system's performance varied for other middle-ear conditions. Further prospective validation is necessary before wider clinical deployment.
PubMed: 38902477
DOI: 10.1038/s41746-024-01159-9 -
NPJ Digital Medicine Jun 2024Sleep monitoring has become widespread with the rise of affordable wearable devices. However, converting sleep data into actionable change remains challenging as diverse...
Sleep monitoring has become widespread with the rise of affordable wearable devices. However, converting sleep data into actionable change remains challenging as diverse factors can cause combinations of sleep parameters to differ both between people and within people over time. Researchers have attempted to combine sleep parameters to improve detecting similarities between nights of sleep. The cluster of similar combinations of sleep parameters from a night of sleep defines that night's sleep phenotype. To date, quantitative models of sleep phenotype made from data collected from large populations have used cross-sectional data, which preclude longitudinal analyses that could better quantify differences within individuals over time. In analyses reported here, we used five million nights of wearable sleep data to test (a) whether an individual's sleep phenotype changes over time and (b) whether these changes elucidate new information about acute periods of illness (e.g., flu, fever, COVID-19). We found evidence for 13 sleep phenotypes associated with sleep quality and that individuals transition between these phenotypes over time. Patterns of transitions significantly differ (i) between individuals (with vs. without a chronic health condition; chi-square test; p-value < 1e-100) and (ii) within individuals over time (before vs. during an acute condition; Chi-Square test; p-value < 1e-100). Finally, we found that the patterns of transitions carried more information about chronic and acute health conditions than did phenotype membership alone (longitudinal analyses yielded 2-10× as much information as cross-sectional analyses). These results support the use of temporal dynamics in the future development of longitudinal sleep analyses.
PubMed: 38902390
DOI: 10.1038/s41746-024-01125-5