ResearchPad - electronics https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Model based estimation of QT intervals in non-invasive fetal ECG signals]]> https://www.researchpad.co/article/elastic_article_7659 The end timing of T waves in fetal electrocardiogram (fECG) is important for the evaluation of ST and QT intervals which are vital markers to assess cardiac repolarization patterns. Monitoring malignant fetal arrhythmias in utero is fundamental to care in congenital heart anomalies preventing perinatal death. Currently, reliable detection of end of T waves is possible only by using fetal scalp ECG (fsECG) and fetal magnetocardiography (fMCG). fMCG is expensive and less accessible and fsECG is an invasive technique available only during intrapartum period. Another safer and affordable alternative is the non-invasive fECG (nfECG) which can provide similar assessment provided by fsECG and fMECG but with less accuracy (not beat by beat). Detection of T waves using nfECG is challenging because of their low amplitudes and high noise. In this study, a novel model-based method that estimates the end of T waves in nfECG signals is proposed. The repolarization phase has been modeled as the discharging phase of a capacitor. To test the model, fECG signals were collected from 58 pregnant women (age: (34 ± 6) years old) bearing normal and abnormal fetuses with gestational age (GA) 20-41 weeks. QT and QTc intervals have been calculated to test the level of agreement between the model-based and reference values (fsECG and Doppler Ultrasound (DUS) signals) in normal subjects. The results of the test showed high agreement between model-based and reference values (difference < 5%), which implies that the proposed model could be an alternative method to detect the end of T waves in nfECG signals.

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<![CDATA[Parametric CAD modeling for open source scientific hardware: Comparing OpenSCAD and FreeCAD Python scripts]]> https://www.researchpad.co/article/N836ce8d9-e17d-43c0-9509-c554011a4818

Open source hardware for scientific equipment needs to provide source files and enough documentation to allow the study, replication and modification of the design. In addition, parametric modeling is encouraged in order to facilitate customization for other experiments. Parametric design using a solid modeling programming language allows customization and provides a source file for the design. OpenSCAD is the most widely used scripting tool for parametric modeling of open source labware. However, OpenSCAD lacks the ability to export to standard parametric formats; thus, the parametric dimensional information of the model is lost. This is an important deficiency because it is key to share the design in the most accessible formats with no information loss. In this work we analyze OpenSCAD and compare it with FreeCAD Python scripts. We have created a parametric open source hardware design to compare these tools. Our findings show that although Python for FreeCAD is more arduous to learn, its advantages counterbalance the initial difficulties. The main benefits are being able to export to standard parametric models; using Python language with its libraries; and the ability to use and integrate the models in its graphical interface. Thus, making it more appropriate to design open source hardware for scientific equipment.

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<![CDATA[Energy expenditure and body composition changes after an isocaloric ketogenic diet in overweight and obese men: A secondary analysis of energy expenditure and physical activity]]> https://www.researchpad.co/article/N6924c77f-ef46-47bb-9a2b-08f320f77ea8

Background

A previously published pilot study assessed energy expenditure (EE) of participants with overweight and obesity after they were switched from a baseline high-carbohydrate diet (BD) to an isocaloric low-carbohydrate ketogenic diet (KD). EE measured using metabolic chambers increased transiently by what was considered a relatively small extent after the switch to the KD, whereas EE measured using doubly labeled water (EEDLW) increased to a greater degree after the response in the chambers had waned. Using a publicly available dataset, we examined the effect of housing conditions on the magnitude of the increase in EEDLW after the switch to the KD and the role of physical activity in that response.

Methods

The 14-day EEDLW measurement period included 4 days when subjects were confined to chambers instead of living in wards. To determine the effect on EEDLW only for the days subjects were living in the wards, we calculated non-chamber EE (EEnonchamber). To assess the role of physical activity in the response to the KD, we analyzed chamber and non-chamber accelerometer data for the BD and KD EEDLW measurement periods.

Results

In comparison with the increase in average 14-day EEDLW of 151 kcal/d ± 63 (P = 0.03) after the switch to the KD, EEnonchamber increased by 203 ± 89 kcal/d (P = 0.04) or 283 ± 116 kcal/d (P = 0.03) depending on the analytical approach. Hip accelerometer counts decreased significantly (P = 0.01) after the switch to the KD, whereas wrist and ankle accelerometer counts did not change.

Conclusions

Switching from the BD to the KD substantially increased EEDLW, but apparently only on days subjects were living in the ward outside the metabolic chamber. Increased physical activity as measured by accelerometry did not appear to account for this effect.

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<![CDATA[Amperometric biosensing system directly powered by button cell battery for lactate]]> https://www.researchpad.co/article/5c897724d5eed0c4847d2544

The development of new signal systems for electrical biosensors could provide exciting new opportunities for biomedical analysis, pollutant monitoring, and explosive detection. The signal systems for commercial portable sensors involve the integration of a battery and a circuit conditioning system to power an amperometric biosensor. However, this increases the size and complexity of the entire system. In this study, we develop a simple amperometric biosensor that is directly powered by a button cell battery for the detection of lactate. A two-electrode sensing transducer was printed on cardboard or integrated on a ring. It was directly powered by a button cell battery, and connected to a multimeter for current measurement. This sensor showed a sensitive detection range of 0.04762–9.21429 mM and short measuring time of 2 min. These results show that this system can achieve an excellent sensing performance, and the construction of this new sensing system directly powered by a button cell battery offers a new method for further developing a wide range of miniaturized, flexible, portable, or wearable sensing systems, and these could be used in detecting various analytes that are important in medical diagnosis and environmental monitoring.

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<![CDATA[Indirect treatment comparisons including network meta-analysis: Lenvatinib plus everolimus for the second-line treatment of advanced/metastatic renal cell carcinoma]]> https://www.researchpad.co/article/5c8823dbd5eed0c484639163

Background

In the absence of clinical trials providing direct efficacy results, this study compares different methods of indirect treatment comparison (ITC), and their respective impacts on efficacy estimates for lenvatinib (LEN) plus everolimus (EVE) combination therapy compared to other second-line treatments for advanced/metastatic renal cell carcinoma (a/mRCC).

Methods

Using EVE alone as the common comparator, the Bucher method for ITC compared LEN + EVE with cabozantinib (CAB), nivolumab (NIV), placebo (PBO) and axitinib (AXI). Hazard ratios (HR) for overall survival (OS) and progression-free survival (PFS) estimated the impact of applying three versions of the LEN+EVE trial data in separate ITCs. Last, to overcome exchangeability bias and potential violations to the proportional hazards assumption, a network meta-analysis using fractional polynomials was performed.

Results

Bucher ITCs demonstrated LEN + EVE superiority over EVE for PFS, indirect superiority to NIV, AXI, and PBO, and no difference to CAB. For OS, LEN + EVE was superior to EVE and indirectly superior to PBO, applying original HOPE 205 data. Using European Medicines Agency data, LEN + EVE was directly superior to EVE for OS. Fractional polynomial HRs for PFS and OS substantially overlapped with Bucher estimates, demonstrating LEN+EVE superiority over EVE, alone, NIV, and CAB. However, there were no statistically significant results as the credible intervals for HR crossed 1.0.

Conclusions

Comparing three Bucher ITCs, LEN + EVE demonstrated superior PFS when indirectly compared to NIV, AXI, and PBO, and mixed results for OS. While fractional polynomial modelling for PFS and OS failed to find statistically significant differences in LEN + EVE efficacy, the overall HR trends were comparable.

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<![CDATA[Description of network meta-analysis geometry: A metrics design study]]> https://www.researchpad.co/article/5c76fe29d5eed0c484e5b60f

Background

The conduction and report of network meta-analysis (NMA), including the presentation of the network-plot, should be transparent. We aimed to propose metrics adapted from graph theory and social network-analysis literature to numerically describe NMA geometry.

Methods

A previous systematic review of NMAs of pharmacological interventions was performed. Data on the graph’s presentation were collected. Network-plots were reproduced using Gephi 0.9.1. Eleven geometric metrics were tested. The Spearman test for non-parametric correlation analyses and the Bland-Altman and Lin’s Concordance tests were performed (IBM SPSS Statistics 24.0).

Results

From the 477 identified NMAs only 167 graphs could be reproduced because they provided enough information on the plot characteristics. The median nodes and edges were 8 (IQR 6–11) and 10 (IQR 6–16), respectively, with 22 included studies (IQR 13–35). Metrics such as density (median 0.39, ranged 0.07–1.00), median thickness (2.0, IQR 1.0–3.0), percentages of common comparators (median 68%), and strong edges (median 53%) were found to contribute to the description of NMA geometry. Mean thickness, average weighted degree and average path length produced similar results than other metrics, but they can lead to misleading conclusions.

Conclusions

We suggest the incorporation of seven simple metrics to report NMA geometry. Editors and peer-reviews should ensure that guidelines for NMA report are strictly followed before publication.

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<![CDATA[Association between physical activity and change in renal function in patients after acute myocardial infarction]]> https://www.researchpad.co/article/5c75abf7d5eed0c484d07f41

Background

Combined renal dysfunction worsens the subsequent prognosis in patients after acute myocardial infarction (AMI). Therefore, establishing a therapeutic modality to maintain or improve renal function in AMI patients is necessary. This study aimed to elucidate the association between physical activity level and change in renal function in such patients.

Design

Prospective and observational study.

Methods

We enrolled 41 patients (35 men; average age, 67.5 ± 12.6 years) after AMI onset. Blood biochemistry, urinalysis, and physical function tests were conducted at discharge and 3 months after discharge. Renal function was evaluated based on cystatin C based-estimated glomerular filtration rate (eGFRcys). The number of steps was recorded for 3 months post-discharge. Generalized estimating equations (GEE) was used to test the association between physical activity level and within-patient changes in eGFRcys.

Results

Patients were stratified into low (n = 21; number of steps, 2335 ± 1219 steps/day) and high groups (n = 20; number of steps, 7102 ± 2365 steps/day). eGFRcys significantly increased from baseline to after 3 months in the high group (76.5 ± 13.8 to 83.2 ± 16.0 mL/min/1.73 m2, q = 0.004), whereas no significant change was observed in the low group (65.1 ± 15.9 to 62.2 ± 20.2 mL/min/1.73 m2, q = 0.125). Result of GEE adjusted for potential confounding variables showed a significant positive association between physical activity level and within-patient changes in eGFRcys (p = 0.003). Changes in eGFRcys was -2.9 mL/min/1.73 m2 among low group versus +6.7 mL/min/1.73 m2 among high group.

Conclusions

Physical activity level was positively associated with changes in renal function, demonstrating that high physical activity may suppress renal function decline in patients after AMI.

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<![CDATA[Patients’ experiences with a behaviour change intervention to enhance physical activity in primary care: A mixed methods study]]> https://www.researchpad.co/article/5c6c757cd5eed0c4843cfe09

Objective

To explore the experiences of patients at risk for cardiovascular disease in primary care with the Activate intervention in relation to their success in increasing their physical activity.

Methods

A convergent mixed methods study was conducted, parallel to a cluster-randomised controlled trial in primary care, using a questionnaire and semi-structured interviews. Questionnaires from 67 patients were analysed, and semi-structured interviews of 22 patients were thematically analysed. Experiences of patients who had objectively increased their physical activity (responders) were compared to those who had not (non-responders). Objective success was analysed in relation to self-perceived success.

Results

The questionnaire and interview data corresponded, and no substantial differences among responders and non-responders emerged. Participating in the intervention increased patients’ awareness of their physical activity and their physical activity level. Key components of the intervention were the subsequent support of nurses with whom patients’ have a trustful relationship and the use of self-monitoring tools. Patients highly valued jointly setting goals, planning actions, receiving feedback and review on their goal attainment and jointly solving problems. Nurses’ support, the use of self-monitoring tools, and involving others incentivised patients to increase their physical activity. Internal circumstances and external circumstances challenged patients’ engagement in increasing and maintaining their physical activity.

Conclusion

Patients experienced the Activate intervention as valuable to increase and maintain their physical activity, irrespective of their objective change in physical activity. The findings enable the understanding of the effectiveness of the intervention and implementation in primary care.

Trial registration

ClinicalTrials.gov NCT02725203.

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<![CDATA[Leave or stay? Video-logger revealed foraging efficiency of humpback whales under temporal change in prey density]]> https://www.researchpad.co/article/5c63392dd5eed0c484ae6172

Central place foraging theory (CPF) has been used to predict the optimal patch residence time for air-breathing marine predators in response to patch quality. Humpback whales (Megaptera novaeangliae) forage on densely aggregated prey, which may induce drastic change in prey density in a single feeding event. Thus, the decision whether to leave or stay after each feeding event in a single dive in response to this drastic change, should have a significant effect on prey exploitation efficiency. However, whether humpback whales show adaptive behavior in response to the diminishing prey density in a single dive has been technically difficult to test. Here, we studied the foraging behavior of humpback whales in response to change in prey density in a single dive and calculated the efficiency of each foraging dive using a model based on CPF approach. Using animal-borne accelerometers and video loggers attached to whales, foraging behavior and change in relative prey density in front of the whales were successfully quantified. Results showed diminishing rate of energy intake in consecutive feeding events, and humpback whales efficiently fed by bringing the rate of energy intake close to maximum in a single dive cycle. This video-based method also enabled us to detect the presence of other animals around the tagged whales, showing an interesting trend in behavioral changes where feeding duration was shorter when other animals were present. Our results have introduced a new potential to quantitatively investigate the effect of other animals on free-ranging top predators in the context of optimal foraging theory.

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<![CDATA[Dose-response relationship between very vigorous physical activity and cardiovascular health assessed by heart rate variability in adults: Cross-sectional results from the EPIMOV study]]> https://www.researchpad.co/article/5c5ca2c1d5eed0c48441ea3d

The minimum amount of physical activity needed to obtain health benefits has been widely determined. Unlikely, the impact of extreme amounts of very vigorous physical activity (VVPA, ≥ 8 metabolic equivalents) to the heart remains controversial. We aimed to evaluate the dose-response relationship between VVPA and heart rate variability (HRV) in adults. We selected 1040 asymptomatic individuals (60% women, 42 ± 15 years, 28 ± 6 kg/m2) from the Epidemiology and Human Movement Study (EPIMOV). Participants remained in the supine position for 10 min, and we selected an intermediate 5-min window for HRV analysis. The standard deviation of the RR intervals, root mean square of RR intervals, successive RR intervals that differ > 50 ms, powers of the low-and high-frequency bands and Poincaré plot standard deviations were quantified. Participants used a triaxial accelerometer (Actigraph GT3x+) above the dominant hip for 4–7 consecutive days for quantifying their physical activity. We also evaluated the maximum oxygen uptake (V˙O2max) during an exercise test. We stratified participants into five groups according to the VVPA in min/week (group 1, ≤ 1.50; 2, 1.51–3.16; 3, 3.17–3.54; 4, 3.55–20.75; and 5, > 20.75). The linear trends of the HRV through the quintiles of VVPA were investigated. We used logarithmic transformations to compare the five groups adjusted for age, sex, cardiovascular risk, and V˙O2max. We found a better HRV with increased VVPA for all HRV indices studied (p trend < 0.05). However, group 5 did not differ from group 4 (p > 0.05) for none of the indices. We conclude that there is an incremental benefit of VVPA on HRV of asymptomatic adults. Since we found neither additional benefits nor the harmful impact of amounts of VVPA as high as 22 min/week on HRV, our results should not discourage asymptomatic adults to perform VVPA.

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<![CDATA[Multi-sensor movement analysis for transport safety and health applications]]> https://www.researchpad.co/article/5c5ca2c0d5eed0c48441ea09

Recent increases in the use of and applications for wearable technology has opened up many new avenues of research. In this paper, we consider the use of lifelogging and GPS data to extend fine-grained movement analysis for improving applications in health and safety. We first design a framework to solve the problem of indoor and outdoor movement detection from sensor readings associated with images captured by a lifelogging wearable device. Second we propose a set of measures related with hazard on the road network derived from the combination of GPS movement data, road network data and the sensor readings from a wearable device. Third, we identify the relationship between different socio-demographic groups and the patterns of indoor physical activity and sedentary behaviour routines as well as disturbance levels on different road settings.

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<![CDATA[Predicting ambulatory energy expenditure in lower limb amputees using multi-sensor methods]]> https://www.researchpad.co/article/5c5ca28cd5eed0c48441e5dd

Purpose

To assess the validity of a derived algorithm, combining tri-axial accelerometry and heart rate (HR) data, compared to a research-grade multi-sensor physical activity device, for the estimation of ambulatory physical activity energy expenditure (PAEE) in individuals with traumatic lower-limb amputation.

Methods

Twenty-eight participants [unilateral (n = 9), bilateral (n = 10) with lower-limb amputations, and non-injured controls (n = 9)] completed eight activities; rest, ambulating at 5 progressive treadmill velocities (0.48, 0.67, 0.89, 1.12, 1.34m.s-1) and 2 gradients (3 and 5%) at 0.89m.s-1. During each task, expired gases were collected for the determination of V˙O2 and subsequent calculation of PAEE. An Actigraph GT3X+ accelerometer was worn on the hip of the shortest residual limb and, a HR monitor and an Actiheart (AHR) device were worn on the chest. Multiple linear regressions were employed to derive population-specific PAEE estimated algorithms using Actigraph GT3X+ outputs and HR signals (GT3X+HR). Mean bias±95% Limits of Agreement (LoA) and error statistics were calculated between criterion PAEE (indirect calorimetry) and PAEE predicted using GT3X+HR and AHR.

Results

Both measurement approaches used to predict PAEE were significantly related (P<0.01) with criterion PAEE. GT3X+HR revealed the strongest association, smallest LoA and least error. Predicted PAEE (GT3X+HR; unilateral; r = 0.92, bilateral; r = 0.93, and control; r = 0.91, and AHR; unilateral; r = 0.86, bilateral; r = 0.81, and control; r = 0.67). Mean±SD percent error across all activities were 18±14%, 15±12% and 15±14% for the GT3X+HR and 45±20%, 39±23% and 34±28% in the AHR model, for unilateral, bilateral and control groups, respectively.

Conclusions

Statistically derived algorithms (GT3X+HR) provide a more valid estimate of PAEE in individuals with traumatic lower-limb amputation, compared to a proprietary group calibration algorithm (AHR). Outputs from AHR displayed considerable random error when tested in a laboratory setting in individuals with lower-limb amputation.

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<![CDATA[Validation of the Fitbit Charge 2 compared to the ActiGraph GT3X+ in older adults with knee osteoarthritis in free-living conditions]]> https://www.researchpad.co/article/5c5b52a5d5eed0c4842bcd46

Objective

To evaluate physical activity (PA) and sedentary time in subjects with knee osteoarthritis (OA) measured by the Fitbit Charge 2 (Fitbit) and a wrist-worn ActiGraph GT3X+ (AGW) compared to the hip-worn ActiGraph (AGH).

Design

We recruited a cohort of subjects with knee OA from rheumatology clinics. Subjects wore the AGH for four weeks, AGW for two weeks, and Fitbit for two weeks over a four-week study period. We collected accelerometer counts (ActiGraphs) and steps (ActiGraphs, Fitbit) and calculated time spent in sedentary, light, and moderate-to-vigorous activity. We used triaxial PA intensity count cut-points from the literature for ActiGraph and a stride length-based cadence algorithm to categorize Fitbit PA. We compared Fitbit wear times calculated from a step-based algorithm and a novel algorithm that incorporates steps and heart rate (HR).

Results

We enrolled 15 subjects (67% female, mean age 68 years). Relative to AGH, Fitbit, on average, overestimated steps by 39% and sedentary time by 37% and underestimated MVPA by 5 minutes. Relative to AGH, AGW overestimated steps 116%, underestimated sedentary time by 66%, and captured 281 additional MVPA minutes. The step-based wear time Fitbit algorithm captured 14% less wear time than the HR-based algorithm.

Conclusions

Fitbit overestimates steps and underestimates MVPA in knee OA subjects. Cut-offs validated for AGW should be developed to support the use of AGW for PA assessment. The HR-based Fitbit algorithm captured more wear time than the step-based algorithm. These data provide critical insight for researchers planning to use commercially-available accelerometers in pragmatic studies.

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<![CDATA[Towards large scale automated cage monitoring – Diurnal rhythm and impact of interventions on in-cage activity of C57BL/6J mice recorded 24/7 with a non-disrupting capacitive-based technique]]> https://www.researchpad.co/article/5c61e922d5eed0c48496f84a

Background and aims

Automated recording of laboratory animal’s home cage behavior is receiving increasing attention since such non-intruding surveillance will aid in the unbiased understanding of animal cage behavior potentially improving animal experimental reproducibility.

Material and methods

Here we investigate activity of group held female C57BL/6J mice (mus musculus) housed in standard Individually Ventilated Cages across three test-sites: Consiglio Nazionale delle Ricerche (CNR, Rome, Italy), The Jackson Laboratory (JAX, Bar Harbor, USA) and Karolinska Insititutet (KI, Stockholm, Sweden). Additionally, comparison of female and male C57BL/6J mice was done at KI. Activity was recorded using a capacitive-based sensor placed non-intrusively on the cage rack under the home cage collecting activity data every 250 msec, 24/7. The data collection was analyzed using non-parametric analysis of variance for longitudinal data comparing sites, weekdays and sex.

Results

The system detected an increase in activity preceding and peaking around lights-on followed by a decrease to a rest pattern. At lights off, activity increased substantially displaying a distinct temporal variation across this period. We also documented impact on mouse activity that standard animal handling procedures have, e.g. cage-changes, and show that such procedures are stressors impacting in-cage activity.

These key observations replicated across the three test-sites, however, it is also clear that, apparently minor local environmental differences generate significant behavioral variances between the sites and within sites across weeks. Comparison of gender revealed differences in activity in the response to cage-change lasting for days in male but not female mice; and apparently also impacting the response to other events such as lights-on in males. Females but not males showed a larger tendency for week-to-week variance in activity possibly reflecting estrous cycling.

Conclusions

These data demonstrate that home cage monitoring is scalable and run in real time, providing complementary information for animal welfare measures, experimental design and phenotype characterization.

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<![CDATA[Marriage and divorce after military deployment to Afghanistan: A matched cohort study from Sweden]]> https://www.researchpad.co/article/5c5df36dd5eed0c4845812b6

Aim

To investigate the probability of marriage and divorce among Swedish military veterans deployed to Afghanistan relative to non-deployed matched comparators.

Study design and setting

Matched cohort study in Sweden.

Participants

Military veterans were identified through Swedish military personnel registers regarding foreign deployments, and comparators from the Military Service Conscription Register (1969–2013). Of 1,882,411 eligible conscripts, 7041 had served in Afghanistan at some point in time between 2002 and 2013. To each military veteran, up to 5 non-deployed comparators who underwent conscription were matched by age, sex, psychological assessment, cognitive ability, psychiatric history and social characteristics. After matching there were 4896 (82%) unmarried and 1069 (18%) married deployed military veterans. The main outcome was marriage or divorce after deployment to Afghanistan. Data on marital status were retrieved from Statistics Sweden until December 31, 2014.

Results

During a median follow-up of 4.1 years after deployment of married individuals, 124 divorces were observed among deployed military veterans and 399 in the matched non-deployed comparator cohort (277 vs. 178 per 10,000 person-years; adjusted hazard ratio 1.61, 95%CI 1.31–1.97). During a median follow-up of 4.7 years after deployment in the unmarried cohort, 827 new marriages were observed among deployed military veterans and 4363 in the matched non-deployed comparators cohort (399 vs. 444 per 10,000 person-years; adjusted hazard ratio 0.89, 95%CI 0.83–0.96).

Conclusion

Military veterans were more likely to divorce and less likely to marry after deployment compared with matched non-deployed comparators.

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<![CDATA[An interventional study for improving the manual dexterity of dentistry students]]> https://www.researchpad.co/article/5c5df320d5eed0c484580d5f

Objectives

Traditionally, the acquisition of manual skills in most dental schools worldwide is based on exercises on plastic teeth placed in a "phantom head simulator". No manual trainings are done at home. Studies revealed that preliminary training of one motoric task leads to significant improvement in performance of the required motoric task that has similar components. Performing tasks indirectly via a dental mirror are complicated for the young dental students. We hypothesized that instructed training of basic skills required in dentistry at home on a tool simulating the phantom laboratory will improve the capabilities of the students and will be reflected by their clinical grades.

Methods

We developed a portable tool PhantHome which is composed of jaws, gingival tissue, rubber cover and a compatible stand. Specific teeth produced by a 3D printer with drills in different directions were placed in both jaws. Students were requested to insert pins by using tweezers and dental mirror according to instructions initiating with easy tasks and continue to ones that are more complicated. 106 first clinical year dental students participated in the study; 65 trained only in the traditional phantom lab (control). 41 trained at home by the PhantHome tool two weeks before and 2 months during the initial stage of phantom lab. The students grades routinely provided in the phantom laboratory at different stages were compared.

Results

Students who trained with the portable tool performed better than the control group in the first direct and second indirect preparations (p<0.05). These exams were taken when the PhantHome was available to the students. Then, the tool was returned and the phantom course continued regularly. We believe that this is why no differences between the grades of the groups were observed further on.

Conclusions

Training by the PhantHome improves motor skills and consequently the clinical performances.

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<![CDATA[The effect of 2 walking programs on aerobic fitness, body composition, and physical activity in sedentary office employees]]> https://www.researchpad.co/article/5c59ff0cd5eed0c4841359cb

Purpose

The present study examined changes in body composition, maximum oxygen uptake, and physical activity in sedentary office employees prescribed with two different walking programs during a 10-week intervention.

Methods

68 sedentary employees were randomly assigned to one of three groups: multiple bouts of walking (n = 24 (5 male, 19 female) Age = 46±9, BMI = 30.5±5.78 kg/m2), continuous walking (n = 22 (6 male, 16 female) Age = 48±9, BMI = 30.6±6.2 kg/m2) and the control group (n = 22 (5 male, 17 female) Age = 42±10, BMI = 27.5±5.23 kg/m2). Dual-energy X-ray absorptiometry (iDXA) assessed body composition and a Bruce protocol treadmill test assessed aerobic fitness at baseline and week 11. At baseline, week 6 and week 11 a waist worn accelerometer measured physical activity and sedentary behavior. Physical activity was measured throughout the program with a wrist worn accelerometer.

Results

The results from the mixed-design ANOVA show that fat mass (p < .000) and fat percentage (p < .000) decreased for all three groups as a main effect of time. Sedentary behavior did not change (p>0.05) for all three groups. Moderate intensity physical activity increased significantly from pre-test to week 6 (p<0.05), then decreased from week 6 to post-test (p<0.05), with no significant changes observed from pre-test to post-test (p>0.05) for all groups. No changes in VO2 were observed (p>0.05) for all groups.

Conclusions

Continuous or intermittent walking activity produce similar benefits on body weight, fat mass and body fat percentage in sedentary employees. Meanwhile, intermittent walking allowed these sedentary employees to increase lean mass and fat free mass. Intermittent walking could provide at least similar benefits on body composition compared to a continuous walking program.

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<![CDATA[Immunosuppressive treatment and the risk of diabetes in rheumatoid arthritis]]> https://www.researchpad.co/article/5c52181dd5eed0c4847973f1

Objective

Inflammation and anti-inflammatory treatments might influence the risk of diabetes. The objective of this study was to assess factors associated with incident diabetes in rheumatoid arthritis (RA).

Methods

The study population consisted of RA patients from a multi-center cohort study, Corrona. To assess risk associated with disease modifying antirheumatic drug (DMARD) exposure, we assessed five mutually exclusive DMARD groups. Additionally, we assessed the risk associated with body mass index (BMI, <25, 25–30, >30 kg/m2) and glucocorticoid usage. Incident cases of diabetes were confirmed through adjudication, and Cox regression models were fit to estimate the risk of incident diabetes.

Results

We identified 21,775 DMARD treatment regimens, the mean (SD) age at the index visit was 58 (13) years, disease duration 10 (10) years, and 30% used oral glucocorticoids at the time. Eighty-four incident cases of diabetes were confirmed within the treatment exposure periods. The hazard ratio (HR, 95% confidence interval) for diabetes was significantly reduced in patients receiving TNF inhibitors, HR 0.35 (0.13, 0.91), compared to patients treated with non-biologic DMARDs other than hydroxychloroquine and methotrexate. Hydroxychloroquine, methotrexate and use of other biologic DMARDs had a numerically reduced risk compared to the same group. Patients prescribed ≥7.5 mg of glucocorticoids had a HR of 2.33 (1.68, 3.22) of incident diabetes compared with patients not prescribed oral glucocorticoids. RA patients with a BMI >30 had a HR of 6.27 (2.97, 13.25) compared to patients with BMI ≤25.

Conclusion

DMARDs, glucocorticoids and obesity influenced the risk of incident diabetes in a large cohort of RA patients. Monitoring for the occurrence of diabetes should be part of routine RA management with a focus on specific subgroups.

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<![CDATA[Postural control in healthy adults: Determinants of trunk sway assessed with a chest-worn accelerometer in 12 quiet standing tasks]]> https://www.researchpad.co/article/5c521837d5eed0c4847977f3

Many diseases and conditions decrease the ability to control balance. In clinical settings, there is therefore a major interest in the assessment of postural control. Trunk accelerometry is an easy, low-cost method used for balance testing and constitutes an alternative method to the posturography using force platforms. The objective was to assess the responsiveness of accelerometry in a battery of 12 quiet standing tasks. We evaluated the balance of 100 healthy adults with an accelerometer fixed onto the sternum. We used the average amplitude of acceleration as an indirect measure of postural sways. The tasks of increased difficulty were realized with or without vision. The battery of tasks was repeated four times on two different days to assess reliability. We analyzed the extent to which the task difficulty and the absence of vision affected the trunk sway. The influence of individual characteristics (age, height, mass, sex, and physical activity level) was also assessed. The reliability analysis revealed that four repetitions of the battery of tasks are needed to reach a high accuracy level (mean ICC = 0.85). The results showed that task difficulty had a very large effect on trunk sways and that the removal of vision further increased sways. Concerning the effects of individual characteristics, we observed that women tended to oscillate more than men did in tasks of low difficulty. Age and physical activity level also had significant effects, whereas height and mass did not. In conclusion, age, sex, and physical fitness are confounders that should be considered when assessing patients’ balance. A battery of simple postural tasks measured by upper-trunk accelerometry can be a useful method for simple balance evaluation in clinical settings.

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<![CDATA[RecoverNow: A mobile tablet-based therapy platform for early stroke rehabilitation]]> https://www.researchpad.co/article/5c644889d5eed0c484c2e894

Introduction

Stroke survivors frequently experience a range of post-stroke deficits. Specialized stroke rehabilitation improves recovery, especially if it is started early post-stroke. However, resource limitations often preclude early rehabilitation. Mobile technologies may provide a platform for stroke survivors to begin recovery when they might not be able to otherwise. The study objective was to demonstrate the feasibility of RecoverNow, a tablet-based stroke recovery platform aimed at delivering speech and cognitive therapy.

Methods

We recruited a convenience sample of 30 acute stroke patients to use RecoverNow for up to 3 months. Allied health professionals assigned specific applications based on standard of care assessments. Participants were encouraged to take home the RecoverNow tablets upon discharge from acute care. The study team contacted participants to return for a follow-up interview 3 months after enrollment. The primary outcome of interest was feasibility, defined using 5 facets: recruitment rate, adherence rate, retention rate, the proportion of successful follow-up interventions, and protocol deviations. We tracked barriers to tablet-based care as a secondary outcome.

Results

We successfully recruited 30 of 62 eligible patients in 15 weeks (48% recruitment rate). Participants were non-adherent to tablet-based therapy inside and outside of acute care, using RecoverNow for a median of 12 minutes a day. Retention was high with 23 of 30 patients participating in follow-up interviews (77% retention rate) and all but 3 of the 23 interviews (87%) were successfully completed. Only 2 major protocol deviations occurred: one enrollment failure and one therapy protocol violation. Barriers to tablet-based care were frequently encountered by study participants with many expressing the assigned applications were either too easy or too difficult.

Conclusions

Acute stroke patients are interested in attempting tablet-based stroke rehabilitation and are easily recruited early post-stroke. However, tablet-based therapy may be challenging due to patient, device and system-related barriers. Reducing the frequency of common barriers will be essential to keeping patients engaged in tablet-based therapy.

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