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Scientific Data May 2024Adult spine deformity (ASD) is prevalent and leads to a sagittal misalignment in the vertebral column. Computational methods, including Finite Element (FE) Models, have...
Adult spine deformity (ASD) is prevalent and leads to a sagittal misalignment in the vertebral column. Computational methods, including Finite Element (FE) Models, have emerged as valuable tools for investigating the causes and treatment of ASD through biomechanical simulations. However, the process of generating personalised FE models is often complex and time-consuming. To address this challenge, we present a dataset of FE models with diverse spine morphologies that statistically represent real geometries from a cohort of patients. These models are generated using EOS images, which are utilized to reconstruct 3D surface spine models. Subsequently, a Statistical Shape Model (SSM) is constructed, enabling the adaptation of a FE hexahedral mesh template for both the bone and soft tissues of the spine through mesh morphing. The SSM deformation fields facilitate the personalization of the mean hexahedral FE model based on sagittal balance measurements. Ultimately, this new hexahedral SSM tool offers a means to generate a virtual cohort of 16807 thoracolumbar FE spine models, which are openly shared in a public repository.
Topics: Adult; Humans; Finite Element Analysis; Lumbar Vertebrae; Thoracic Vertebrae
PubMed: 38811573
DOI: 10.1038/s41597-024-03351-8 -
Frontiers in Public Health 2024To evaluate the extent to which patient-users reporting symptoms of five severe/acute conditions requiring emergency care to an AI-based virtual triage (VT) engine had...
OBJECTIVE
To evaluate the extent to which patient-users reporting symptoms of five severe/acute conditions requiring emergency care to an AI-based virtual triage (VT) engine had no intention to get such care, and whose acuity perception was misaligned or decoupled from actual risk of life-threatening symptoms.
METHODS
A dataset of 3,022,882 VT interviews conducted over 16 months was evaluated to quantify and describe patient-users reporting symptoms of five potentially life-threatening conditions whose pre-triage healthcare intention was other than seeking urgent care, including myocardial infarction, stroke, asthma exacerbation, pneumonia, and pulmonary embolism.
RESULTS
Healthcare intent data was obtained for 12,101 VT patient-user interviews. Across all five conditions a weighted mean of 38.5% of individuals whose VT indicated a condition requiring emergency care had no pre-triage intent to consult a physician. Furthermore, 61.5% intending to possibly consult a physician had no intent to seek emergency medical care. After adjustment for 13% VT safety over-triage/referral to ED, a weighted mean of 33.5% of patient-users had no intent to seek professional care, and 53.5% had no intent to seek emergency care.
CONCLUSION
AI-based VT may offer a vehicle for early detection and care acuity alignment of severe evolving pathology by engaging patients who believe their symptoms are not serious, and for accelerating care referral and delivery for life-threatening conditions where patient misunderstanding of risk, or indecision, causes care delay. A next step will be clinical confirmation that when decoupling of patient care intent from emergent care need occurs, VT can influence patient behavior to accelerate care engagement and/or emergency care dispatch and treatment to improve clinical outcomes.
Topics: Humans; Triage; Female; Male; Referral and Consultation; Middle Aged; Adult; Early Diagnosis; Patient Acuity; Emergency Service, Hospital; Aged; Emergency Medical Services; Patient Acceptance of Health Care
PubMed: 38807993
DOI: 10.3389/fpubh.2024.1362246 -
BioRxiv : the Preprint Server For... May 2024Intra-cortical microstimulation (ICMS) is a technique to provide tactile sensations for a somatosensory brain-machine interface (BMI). A viable BMI must function within...
Intra-cortical microstimulation (ICMS) is a technique to provide tactile sensations for a somatosensory brain-machine interface (BMI). A viable BMI must function within the rich, multisensory environment of the real world, but how ICMS is integrated with other sensory modalities is poorly understood. To investigate how ICMS percepts are integrated with visual information, ICMS and visual stimuli were delivered at varying times relative to one another. Both visual context and ICMS current amplitude were found to bias the qualitative experience of ICMS. In two tetraplegic participants, ICMS and visual stimuli were more likely to be experienced as occurring simultaneously when visual stimuli were more realistic, demonstrating an effect of visual context on the temporal binding window. The peak of the temporal binding window varied but was consistently offset from zero, suggesting that multisensory integration with ICMS can suffer from temporal misalignment. Recordings from primary somatosensory cortex (S1) during catch trials where visual stimuli were delivered without ICMS demonstrated that S1 represents visual information related to ICMS across visual contexts.
PubMed: 38798438
DOI: 10.1101/2024.05.13.593529 -
International Journal of Environmental... Apr 2024To assess the association between clinical orthodontic indicators and oral-health-related quality of life, adjusted for socio-demographic factors, focusing on...
OBJECTIVE
To assess the association between clinical orthodontic indicators and oral-health-related quality of life, adjusted for socio-demographic factors, focusing on 16-year-old patients with cleft lip and/or palate (CL/P).
PARTICIPANTS
One hundred and twenty-two patients with CL/P, representing cleft-lip (CL), cleft-palate (CP), unilateral/bilateral cleft-lip-palate (UCLP/BCLP), enrolled in the national CLP-Team, Bergen, Norway.
METHOD
A cross-sectional study by two orthodontists assessing the number of teeth, intermaxillary sagittal relation (ANB-angle), dental arch and occlusion of 16-year-old patients with CL/P. All completed a digital questionnaire including self-reported socio-demographic variables, OHIP-14 questionnaire and dental aesthetics. Cross-tabulations with Pearson's Chi-square test were used to identify associations between self-reported OHRQoL and socio-demographic and clinical indicators. Multiple variable analyses were conducted with binary logistic regression analysis using the odds ratio (OR) and 95% confidence interval (CI) to assess associations between OHRQoL and clinical indicators adjusted for socio-demographic variables. Ethical approval was granted by the regional ethics committee.
RESULTS
Patients with UCLP and BCLP had poorer clinical indicators compared to patients with CL and CP ( < 0.05). A total of 80% of the patients had OHIP-14 > 0. The highest oral impact was reported for psychological domains and articulation and the least for functional domains. Respondents with BCLP and those with poor intermaxillary relationships (ANB < 0°) reported a high impact on OHRQoL ( < 0.05). No statistically significant associations between other clinical indicators and socio-demographic variables such as gender, educational aspiration, and place of residence were reported.
CONCLUSIONS
The study revealed an association between severe cleft diagnosis, missing teeth, misaligned teeth, negative overjet, and poor OHRQoL, but a statistically significant association was found only between OHRQoL and poor intermaxillary sagittal relations (unfavorable profile). To improve OHRQoL among patients with clefts, there is a need for an individual follow-up and prioritization of oral healthcare.
Topics: Humans; Cleft Lip; Cleft Palate; Adolescent; Quality of Life; Male; Female; Norway; Oral Health; Cross-Sectional Studies; Surveys and Questionnaires; Malocclusion
PubMed: 38791765
DOI: 10.3390/ijerph21050550 -
PLOS Global Public Health 2024Oral habits such as nail biting, thumb/digit sucking and teeth grinding could be harmful, and may lead to teeth misalignment, anterior open bite, protruded or flared...
Oral habits such as nail biting, thumb/digit sucking and teeth grinding could be harmful, and may lead to teeth misalignment, anterior open bite, protruded or flared upper anterior teeth especially if they persist into adolescence. Such orofacial dysfunction may result to impairment of the Oral Health Related Quality of Life (OHRQoL) of an individual. The extent to which oral habits affect the major domains of the self-reported outcomes remains understudied especially during adolescence, a unique period of growth, where there is increased aesthetic desire, increased self-awareness, and unique social and psychological needs. The aim of this study, therefore, was to determine the prevalence of oral habits and its association with oral health related quality of life of adolescents. This cross-sectional study was conducted among 700 adolescents aged 10 to 19 years (with mean age 14.6 (±1.3) years) attending 14 secondary schools in Ibadan, Nigeria. Data were collected using a self-administered questionnaire, which assessed sociodemographic characteristics of the students, oral habits and OHRQoL with Oral Health Impact Profile 5 (OHIP-5). Data were analyzed with SPSS and p value was at <5%. Mann Whitney U statistics was used to test for associations between OHIP-5 scores and presence or absence of oral habits. Logistic regression was used for multivariate analysis. A total of 363 (51.9%; 95%CI = 48.1%-55.6%) bite their nails, 216 (30.9%; 95%CI = 27.5%-34.4%) breathe with their mouth, 122 (17.4%; 95%CI = 14.7%-20.4%) suck their lips, 89 (12.7%; 95%CI = 10.3%-15.4%) grind their teeth together and 32 (4.6%; 95%CI = 3.1%-6.7%) sucked their thumbs. A total of 403 (81.1%) adolescents who engaged in at least an oral habit reported an impairment of their OHRQoL. Painful aching in the mouth was the most frequently affected OHRQoL item reported by the adolescents who engaged in oral habits. Those who sucked their thumbs (OR = 2.3, 95%CI = 1.1-4.7, p = 0.028) and those who sucked their lips were more likely to have poorer OHRQoL (OR = 1.6, 95%CI = 1.1-2.5, p = 0.024). Oral habits were prevalent among the adolescents and affected their OHRQoL. Those who sucked their thumbs and lips were more likely to report poorer OHRQoL than those who did not.
PubMed: 38781142
DOI: 10.1371/journal.pgph.0003218 -
Heliyon May 2024In perovskite solar cells (PSCs), the charge carrier recombination obstacles mainly occur at the ETL/perovskite and HTL/perovskite interfaces, which play a decisive role...
In perovskite solar cells (PSCs), the charge carrier recombination obstacles mainly occur at the ETL/perovskite and HTL/perovskite interfaces, which play a decisive role in the solar cell performance. Therefore, this study aims to enhance the flexible PSC (FPSC) efficiency by adding the newly designed CBz-PAI-interlayer (simply CBz-PAI-IL) at the perovskite/HTL interface. In addition, substantial work has been carried out on five different HTLs (Se/Te-CuO, CuGaO, VO and CuSCN, including conventional Spiro-OMeTAD as a reference HTL with and without CBz-PAI-IL), using drift-diffusion simulation to find suitable FPSC design to attain the maximum PCE. Interestingly, PET/ITO/AZO/ZnO NWs/FACsPbBrI/CBz-PAI/Se/Te-CuO/Au device architecture demonstrates the highest achievable power conversion efficiency (PCE) of 27.9 %. The findings of this study confirmed that the reference device (without IL) displays a large valence band edge (VBE)/highest occupied molecular orbital (HOMO) energy level misalignment compared to the modified interface device (with CBz-PAI-IL that reduces VBE/HOMO level mismatch) that eases the hole transport, simultaneously, it reduces the charge carrier recombinations at the interface, resulting in diminished V losses in the device. Furthermore, the influence of perovskite absorber thickness and defect density, parasitic resistances, and working temperature are systematically examined to govern the superior FPSC efficiency and concurrently understand the device physics.
PubMed: 38778989
DOI: 10.1016/j.heliyon.2024.e31138 -
American Journal of Public Health May 2024We conducted focus groups with staff from 5 community-based organizations (21 participants; 86% female, 52% Hispanic/Latino/a/x and 24% Mexican/Mexican American) between...
We conducted focus groups with staff from 5 community-based organizations (21 participants; 86% female, 52% Hispanic/Latino/a/x and 24% Mexican/Mexican American) between August and October 2021. Results highlighted community partner perceptions of practices congruent (e.g., communication that built trust and dismantled power dynamics, a shared mission) and incongruent (e.g., intervention-community misalignment, research driven decision-making) with equitable implementation in the development, implementation, and evaluation of a intervention to increase COVID-19 testing and preventive behaviors among Latinx communities in Oregon. (. 2024;114(S5):S377-S383. https://doi.org/10.2105/AJPH.2024.307686).
Topics: Humans; Female; COVID-19; Male; Oregon; Hispanic or Latino; Focus Groups; Qualitative Research; Health Promotion; Adult; SARS-CoV-2; Middle Aged; Trust
PubMed: 38776501
DOI: 10.2105/AJPH.2024.307686 -
EClinicalMedicine Jun 2024Timing drug administration to endogenous circadian rhythms may enhance treatment efficacy. In the Chronotype sub-study of the Treatment in Morning versus Evening (TIME)...
Effect of timed dosing of usual antihypertensives according to patient chronotype on cardiovascular outcomes: the Chronotype sub-study cohort of the Treatment in Morning versus Evening (TIME) study.
BACKGROUND
Timing drug administration to endogenous circadian rhythms may enhance treatment efficacy. In the Chronotype sub-study of the Treatment in Morning versus Evening (TIME) clinical trial we examined whether timing of usual antihypertensive medications according to patient chronotype (a behavioural marker of personal circadian rhythm) may influence clinical cardiovascular outcomes.
METHODS
This was a cohort sub-study of TIME, a prospective, randomised, open-label, blinded-endpoint, UK clinical trial of morning versus evening dosing of usual antihypertensive medications and cardiovascular outcomes. On August 3rd, 2020, all active TIME participants were invited to complete a validated chronotype questionnaire. Chronotype was quantitatively assessed as the mid sleep time on free days corrected for sleep debt on workdays (MSFsc). We analysed associations between chronotype and antihypertensive dosing time and explored their combined effect on cardiovascular outcomes (a composite endpoint of hospitalisation for non-fatal myocardial infarction (MI) or non-fatal stroke, and single components) using proportional hazard time-to-event models adjusted for baseline covariates. These were used to specifically test for interactions between dosing time and chronotype.
FINDINGS
Between August 3, 2020, and March 31, 2021, 5358 TIME participants completed the online questionnaire. 2778 were previously randomised to morning dosing and 2580 to evening dosing of their usual antihypertensives. Chronotype was symmetrically distributed around a median MSFsc of 3:07 am. The composite endpoint increased for later MSFsc (later chronotype) dosed in the morning but not in those dosed in the evening (hazard ratios 1.46 [95% CI 1.14-1.86] and 0.96 [95% CI 0.70-1.30] per hour of MSFsc, respectively; interaction p = 0.036). Later chronotype was associated with increased risk of hospitalisation for non-fatal MI in the morning dosing group, and reduced risk in the evening dosing group (hazard ratios 1.62 [95% CI 1.18-2.22] and 0.66 [95% CI 0.44-1.00] per hour of MSFsc, respectively; interaction p < 0.001). No interaction between chronotype and antihypertensive dosing time was observed for stroke events.
INTERPRETATION
Alignment of dosing time of usual antihypertensives with personal chronotype could lower the incidence of non-fatal MI compared to a 'misaligned' dosing time regimen. Future studies are warranted to establish whether synchronizing administration time of antihypertensive therapy with individual chronotype reduces risk of MI.
FUNDING
The TIME study was funded by the British Heart Foundation (CS/14/1/30659) with support from the British and Irish Hypertension Society.
PubMed: 38774676
DOI: 10.1016/j.eclinm.2024.102633 -
PloS One 2024In the Australian maternity system, general practitioners play a vital role in advising and directing prospective parents to maternity models of care. Optimising model...
BACKGROUND
In the Australian maternity system, general practitioners play a vital role in advising and directing prospective parents to maternity models of care. Optimising model of care discussions and the decision-making process avoids misaligning women with over or under specialised care, reduces the potential for disruptive care transitions and unnecessary healthcare costs, and is critical in ensuring consumer satisfaction. Current literature overwhelmingly focusses on women's decision-making around model of care discussions and neglects the gatekeeping role of the General Practitioner (GP). This study aimed to explore and describe the factors influencing Australian GPs decision-making when referring pregnant women to maternity models of care.
METHODS
This study used a qualitative descriptive approach. General practitioners (N = 12) with experience referring women to maternity models of care in Australia participated in a semi-structured interview. Interviews occurred between October and November 2021 by telephone or videoconference. Reflexive thematic analysis was facilitated by NVivo-12 data management software to codify and interpret themes from the data.
FINDINGS
Two broad themes were interpreted from the data. The first theme entitled 'GP Factors', incorporated three associated sub-themes including '1) GPs Previous Model of Care Experience', '2) Gaps in GP Knowledge' and '3) GP Perception of Models of Care'. The second theme, entitled 'Woman's Factors', encapsulated two associated sub-themes including the '4) Woman's Preferences' and '5) Access to Models'.
CONCLUSIONS
This study provides novel evidence regarding general practitioner perspectives of the factors influencing model of care decision-making and referral. Predominant findings suggest that gaps in GP knowledge regarding the available models of care are present and are largely informed by prior personal and professional experience. Most GPs described referring to models of care they perceive positively and centring their model of care discussions on the woman's preferences and accessibility. The exploration and description of factors influencing model of care decisions provide unique insight into the ways that all stakeholders can experience access to a broader range of models of care including midwifery-led continuity of care models aligned with consumer-demand. In addition, the role of national primary health networks is outlined as a means to achieving this.
Topics: Humans; Female; Referral and Consultation; Pregnancy; Australia; Maternal Health Services; General Practice; General Practitioners; Adult; Qualitative Research; Decision Making; Male; Middle Aged
PubMed: 38771817
DOI: 10.1371/journal.pone.0296537 -
PloS One 2024The planning of human resources and the management of enterprises consider the organization's size, the amount of effort put into operations, and the level of...
The planning of human resources and the management of enterprises consider the organization's size, the amount of effort put into operations, and the level of productivity. Inefficient allocation of resources in organizations due to skill-task misalignment lowers production and operational efficiency. This study addresses organizations' poor resource allocation and use, which reduces productivity and the efficiency of operations, and inefficiency may adversely impact company production and finances. This research aims to develop and assess a Placement-Assisted Resource Management Scheme (PRMS) to improve resource allocation and usage and businesses' operational efficiency and productivity. PRMS uses expertise, business requirements, and processes that are driven by data to match resources with activities that align with their capabilities and require them to perform promptly. The proposed system PRMS outperforms existing approaches on various performance metrics at two distinct levels of operations and operating levels, with a success rate of 0.9328% and 0.9302%, minimal swapping ratios of 12.052% and 11.658%, smaller resource mitigation ratios of 4.098% and 4.815%, mean decision times of 5.414s and 4.976s, and data analysis counts of 6387 and 6335 Success and data analysis increase by 9.98% and 8.2%, respectively, with the proposed strategy. This technique cuts the switching ratio, resource mitigation, and decision time by 6.52%, 13.84%, and 8.49%. The study concluded that PRMS is a solid, productivity-focused corporate improvement method that optimizes the allocation of resources and meets business needs.
Topics: Humans; Big Data; Resource Allocation; Efficiency, Organizational
PubMed: 38768218
DOI: 10.1371/journal.pone.0303297