Excessive use of electronic devices among children and adolescents is associated with musculoskeletal symptoms, visual symptoms, psychosocial health, and quality of life: a cross-sectional study

Data availability statement: The original contributions presented in the study are included in the article/Supplementary material, further inquiries can be directed to the corresponding author.Supplementary material: The Supplementary material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpubh.2023.1178769/full#supplementary-materialCopyright © 2023 Tsang, Cheing, Lam, Siu, Pang, Yip, Chan and Jensen. Objective: Electronic devices have become an indispensable part of our daily lives. The frequency and duration of device use in children and adolescents have increased drastically over the years and the study of its negative musculoskeletal, visual and psychosocial health impacts is necessary. Materials and methods: This cross-sectional study aimed to evaluate the associations between electronic device use and the prevalence and severity of musculoskeletal symptoms, visual symptoms, psychosocial health, and quality of life in children and adolescents studying at primary and secondary schools. Data were collected through confidential online and paper-and-pencil questionnaires. Primary 4–5 and Secondary 1–4 students were recruited from 3 schools in Hong Kong. Demographics, frequency and duration of electronic device use, frequencies of musculoskeletal symptoms, visual symptoms, psychosocial health, and quality of life outcomes were measured. Results: 1,058 children and adolescents aged 9–17  years participated. Sixty-one percent and 78% of all students spent more than 2  h per day using electronic devices during school days and weekend/holidays, respectively. Extended electronic device use was associated with increased prevalence and severity of musculoskeletal symptoms (ρ’s = 0.28–0.33, P’s < 0.001), visual symptoms (ρ’s = 0.33–0.35, P’s < 0.001), and poorer device use-related psychosocial health (ρ’s = 0.38–0.47, P’s < 0.001). Secondary school students reported greater device use and severity of symptoms than primary school students. Conclusion: Excessive electronic device use was associated with increased prevalence and severity of physical and psychosocial symptoms, and such use is more prevalent in adolescents when compared to the children. The findings have important health implications for children and adolescents, suggesting that early intervention is needed to reduce the risk of developing device use-related disorders.This research was supported by Health and Medical Research Fund, Health Bureau of Hong Kong (project number.: 02180348)

Causes of delay and cost overrun in Malaysian construction industry

The construction industry in Malaysia drives the economic growth and development of the country. However, the industry is plagued with delays and cost overrun which transforms what should have been successful projects to projects incurring additional costs, disagreements, litigation and in some cases abandonment of projects. This research studied the causes of delays and cost overrun in the industry and ranked them according to their perceived importance to the contractors, with a view to establishing those to be addressed by the contractors. Online questionnaires were used for data collection for this research. A total of 69 responses were analysed using principal component analysis (PCA) (factor analysis) to identify the main causes. The result of the analysis showed that delay in preparation of design document, poor schedule and control of time, delay in delivery of material to site, lack of knowledge about the different defined execution methods, shortage of labour and material in market, and changes in scope of work were the main causes of delay and cost overrun. The identified causes if properly addressed would reduce the rate of delays and cost overrun in construction projects, thus enhancing the economic growth and development of the country

Nucleic acid amplification tests in the diagnosis of tuberculous pleuritis: a systematic review and meta-analysis

BACKGROUND: Conventional tests for tuberculous pleuritis have several limitations. A variety of new, rapid tests such as nucleic acid amplification tests – including polymerase chain reaction – have been evaluated in recent times. We conducted a systematic review to determine the accuracy of nucleic acid amplification (NAA) tests in the diagnosis of tuberculous pleuritis. METHODS: A systematic review and meta-analysis of 38 English and Spanish articles (with 40 studies), identified via searches of six electronic databases, hand searching of selected journals, and contact with authors, experts, and test manufacturers. Sensitivity, specificity, and other measures of accuracy were pooled using random effects models. Summary receiver operating characteristic curves were used to summarize overall test performance. Heterogeneity in study results was formally explored using subgroup analyses. RESULTS: Of the 40 studies included, 26 used in-house ("home-brew") tests, and 14 used commercial tests. Commercial tests had a low overall sensitivity (0.62; 95% confidence interval [CI] 0.43, 0.77), and high specificity (0.98; 95% CI 0.96, 0.98). The positive and negative likelihood ratios for commercial tests were 25.4 (95% CI 16.2, 40.0) and 0.40 (95% CI 0.24, 0.67), respectively. All commercial tests had consistently high specificity estimates; the sensitivity estimates, however, were heterogeneous across studies. With the in-house tests, both sensitivity and specificity estimates were significantly heterogeneous. Clinically meaningful summary estimates could not be determined for in-house tests. CONCLUSIONS: Our results suggest that commercial NAA tests may have a potential role in confirming (ruling in) tuberculous pleuritis. However, these tests have low and variable sensitivity and, therefore, may not be useful in excluding (ruling out) the disease. NAA test results, therefore, cannot replace conventional tests; they need to be interpreted in parallel with clinical findings and results of conventional tests. The accuracy of in-house nucleic acid amplification tests is poorly defined because of heterogeneity in study results. The clinical applicability of in-house NAA tests remains unclear

Predicting Customer Preferences in Non-experimental Retail Settings

This thesis investigates the application of computational statistics and Machine Learning in consumer preference prediction, with specific reference to the challenges imposed by real world operational retail environments. Some retailers base their competitiveness on Machine Learning. For instance, Dunnhumby analyzes more than 400 million online consumer records for retailers, such as Tesco, to optimise business decisions. The experiments in this thesis investigate three main challenges commonly presented in operational scenarios that hinder the application of Machine Learning in retail environments: 1. The measurement of correlation of feature factors for Machine Learning in a noisy setting; 2. The exploration and exploitation balance for predicting purchase preferences on new products; 3. The model adaptability to the changing dynamics over time. A design of a distributed Machine Learning framework for building practical applications of consumer preference prediction is also presented. Experiment 1: Correlation between Contextual Information and Purchase Behaviours under a Non-experimental Retail Environment The first experiment applies statistical methodologies, namely odds ratio and Mantel-Haenszel method, to analyze contextual information in a retail business. More specifically, it investigates the correlation between customers’ recent online browsing behaviours on Boots.com and their in-store purchase behaviours at Boots’ retail stores nationally in a non-experimental noisy setting. Methodologies such as stratified analysis with K-means clustering are proposed to detect and eliminate confounding factors that affect the evaluation of the correlation. The dataset for this experiment, provided by Boots UK, is the first year of a 2-year anonymised real in-store and online purchase records data. It contains profiles of 10,217,972 unique consumers who are Advantage Card holders and 2,939 unique selected products under 10 different brands. Experiment 2: Resources Allocation of Exploration and Exploitation for New Products under Retail Constraints The second experiment provides a two-stage batch solution based on matrix factorization and binary integer programming to optimise the customer response rate to new products of a simulated group buying system. This experiment investigates how the balance between the exploration of new products and the exploitation of existing known model affects overall business gains through purchase prediction and recommendation. In this experiment, the products are new with no prior profile and the number of new products a retailer can recommend to each customer is limited. The effectiveness of one of the traditional experimental design techniques in improving the learning efficiency during the exploration process is evaluated. Experiment 3: Continuous Model Selection for a Changing Retail Environment The third experiment investigates, using root-mean-square error and mean average precision measures, the adaptability of data model for consumer purchase prediction in a non-static retail environment. In particular, it analyzes the prediction accuracy of data models with static parameters over time. A continuous model selection approach by using an automatic hyperparameter tuning technique, namely random search, is proposed and is evaluated. The results challenge the traditional assumption that a one-off initial model selection is sufficient. The dataset for this experiment is a 2-year anonymised real in-store and online purchase records data provided by Boots UK. System Design: A Distributed Machine Learning Framework with Automated Modeling This system design outlines the concept and system architecture. It also demonstrates scenarios of a distributed Machine Learning framework for (i) evaluating, comparing and deploying scalable learning algorithms, (ii) tuning hyperparameters of algorithms manually or automatically and (iii) evaluating model training status. The design has become the foundation of a popular open-source software project - PredictionIO. The project is followed by over 5000 data scientists and practitioners on Github. Contributions to Science The major contribution of this thesis is to offer robust research-based methodologies to handle prediction challenges in real world operational environment for retail businesses. Computational statistics and Machine Learning methodologies are proposed to 1) identify contextual factors that are relevant to consumer preference in noisy non-experimental setting; 2) determine the importance of exploration and exploitation for new products under real-world constraints; 3) adjust data model continuously to adapt to changes in retail environments. This thesis contributes to the existing literature in a number of ways. First, this research proposes a novel statistical method to isolates the influence of confounding factors in correlation analysis for consumer preference prediction. It is a topic that received little attention in empirical literature. Second, this research proves the existence of the correlation between consumer online browsing and in-store purchase behaviours in a real retail dataset. This is a significant finding for the retail industry to improve prediction accuracy in the future. Third, this research examines the influence of the balance between exploration and exploitation of new product profiles on maximising business gains. Forth, this research proves that random selection surprisingly outperforms D-optimal experimental design in some retail cases. Fifth, this research challenges the existing assumption that model selection is needed only once at the initial stage. It proves that prediction accuracy can be improved significantly by continuous model selection. Sixth, this thesis presents the implementation of a continuous model selection approach by using automatic hyperparameter tuning techniques. Finally, this thesis presents a design of a distributed system that can be used for building predictive retail applications

The effects of therapeutic hip exercise with abdominal core activation on recruitment of the hip muscles

2017-2018 > Academic research: refereed > Publication in refereed journal201805 bcrcVersion of RecordSelf-fundedPublishe

Omalizumab for severe atopic dermatitis in 4- to 19-year-olds: the ADAPT RCT

Abstract Background Evidence for systemic treatments for severe childhood eczema is limited. Systemic immunosuppressants are unlicensed for use in children and are associated with unwanted side effects. Objective To examine the role of anti-immunoglobulin E (IgE) [omalizumab (Xolair®, Novartis Pharmaceuticals UK Ltd, Frimley, UK)] in children and young people with severe eczema. Design A double-blind, placebo-controlled, parallel-arm randomised (1 : 1) trial. Setting A single specialist centre – Guy’s and St Thomas’ NHS Foundation Trust, London. Participants Atopic children and young people (aged 4–19 years) with severe eczema. Interventions Treatment with omalizumab or placebo for 24 weeks. Main outcome measures The primary outcome was eczema severity, measured using the objective SCORing Atopic Dermatitis (SCORAD) at 24 weeks. Secondary outcomes included validated measures of eczema severity, quality of life (QoL) and potent topical steroid use. Results Sixty-two participants, with a median baseline total IgE level of 8373 kU/l, received treatment with omalizumab (n = 30) or placebo (n = 32). The unadjusted mean objective SCORAD score at week 24 was 43.1 [standard deviation (SD) 12.5] for participants in the omalizumab arm and 49.2 (SD 11.3) for participants in the placebo arm. After adjustment for baseline objective SCORAD score, age and IgE level, the mean difference between arms at 24 weeks was –6.9 [95% confidence interval (CI) –12.2 to –1.5; p = 0.013], in favour of omalizumab. The mean objective SCORAD scores improved by –12.4 and –5.1 in the omalizumab and placebo arms, respectively, by 24 weeks. Secondary outcome measure estimates were also in favour of omalizumab for eczema severity at 24 weeks: the adjusted mean treatment arm difference was –8.3 (95% CI –15.1 to –1.1; p = 0.024) for total combined objective and subjective SCORAD and –6.7 (95% CI –13.2 to –0.1; p = 0.046) for the Eczema Area and Severity Index, with less effect on the Patient-Oriented Eczema Measure (POEM; –1.1, 95% CI –4.6 to 2.4; p = 0.527). Treatment estimate precision was limited by the sample size. The QoL measures favoured omalizumab, with an improvement (reduction) in both (Children’s) Dermatology Life Quality Index [(C)DLQI] score (mean –3.5, 95% CI –6.4 to –0.5; p = 0.022) and Paediatric Allergic Disease Quality of Life Questionnaire score (mean –0.5, 95% CI –0.9 to 0.0; p = 0.050). The mean (C)DLQI score improved by 50%, from 17.0 (SD 5.6) at baseline to 8.5 (SD 5.9) at week 24, for patients treated with omalizumab. Improvements were seen despite lower potent topical steroid use in the omalizumab arm, with 48% more days of use than (109 days in the placebo arm vs. 161 days in the omalizumab arm) and twice the body surface area coverage of (15.5% in the placebo arm vs. 31.3% in the omalizumab arm) the placebo arm. There were fewer treatment failures and new systemic immunosuppression initiations in the omalizumab arm. There was no difference in the numbers of cases of infective eczema and eczema exacerbation. There was one suspected severe adverse reaction in the omalizumab arm. In each arm, six participants reported a total of seven severe adverse events that were unrelated to treatment. Non-serious respiratory and dermatological adverse event rates were higher in the placebo arm (incidence rate ratio 0.69, 95% CI 0.49 to 0.96). Conclusions Omalizumab, in a highly atopic paediatric population with severe eczema, reduced eczema severity and improved QoL despite a reduction in potent steroid use and highly elevated total IgE levels. Omalizumab, with its favourable side effect profile, warrants further study as a treatment option for this difficult-to-manage population. Further studies are needed to clarify the role of omalizumab. Treatment benefit became more apparent towards 24 weeks and persisted after treatment stopped. The optimal duration of treatment needs to be determined. Trial registration This trial is registered as ISRCTN15090567, EudraCT 2010-020841-29 and ClinicalTrials.gov NCT02300701

Ebselen prevents cigarette smoke-induced gastrointestinal dysfunction in mice

Gastrointestinal (GI) dysfunction is a common comorbidity of chronic obstructive pulmonary disease (COPD) for which a major cause is cigarette smoking (CS). The underlying mechanisms and precise effects of CS on gut contractility, however, are not fully characterised. Therefore, the aim of the present study was to investigate whether CS impacts GI function and structure in a mouse model of CS-induced COPD. We also aimed to investigate GI function in the presence of ebselen, an antioxidant that has shown beneficial effects on lung inflammation resulting from CS exposure. Mice were exposed to CS for 2 or 6 months. GI structure was analysed by histology and immunofluorescence. After 2 months of CS exposure, ex vivo gut motility was analysed using video-imaging techniques to examine changes in colonic migrating motor complexes (CMMCs). CS decreased colon length in mice. Mice exposed to CS for 2 months had a higher frequency of CMMCs and a reduced resting colonic diameter but no change in enteric neuron numbers. Ten days cessation after 2 months CS reversed CMMC frequency changes but not the reduced colonic diameter phenotype. Ebselen treatment reversed the CS-induced reduction in colonic diameter. After 6 months CS, the number of myenteric nitric-oxide producing neurons was significantly reduced. This is the first evidence of colonic dysmotility in a mouse model of CS-induced COPD. Dysmotility after 2 months CS is not due to altered neuron numbers; however, prolonged CS-exposure significantly reduced enteric neuron numbers in mice. Further research is needed to assess potential therapeutic applications of ebselen in GI dysfunction in COPD

Religião e espiritualidade: experiência de famílias de crianças com Insuficiência Renal Crônica Religiosidad y espiritualidad: la experiencia de familias de niños con Insuficiencia Renal Crónica Religion and spirituality: the experience of families of children with Chronic Renal Failure

OBJETIVO: Descrever as manifestações de religiosidade e espiritualidade de famílias de crianças com Insuficiência Renal Crônica em diálise peritoneal. MÉTODO: Trata-se de uma pesquisa qualitativa, com a característica de estudo de caso com múltiplos sujeitos. A análise de conteúdo adotada foi a de significados, optando-se pelo tipo temático, tendo como referência a promoção de saúde em enfermagem familiar. RESULTADOS: Participaram do estudo quatro famílias, totalizando quatorze participantes. A religião e a espiritualidade se apresentam como recursos importantes para os familiares no enfrentamento da doença crônica, principalmente diante de prognósticos ameaçadores. CONCLUSÃO: Destacamos a importância de compreender a religião e a espiritualidade da família no processo de adoecimento, para o enfermeiro atuar na promoção da saúde.<br>OBJETIVO: Describir las manifestaciones de religiosidad y espiritualidad de familias de niños con Insuficiencia Renal Crónica en diálisis peritoneal. MÉTODOS: Se trata de una investigación cualitativa, con la característica de estudio de caso con múltiples sujetos. El análisis de contenido adoptado fue el de significados, eligiendo el tipo temático, teniendo como referencia la promoción de salud en enfermería familiar. RESULTADOS: Participaron del estudio cuatro familias, totalizando catorce participantes. La religión y la espiritualidad se presentan como recursos importantes para familiares en el enfrentamiento de la enfermedad crónica, principalmente ante pronósticos amenazadores. CONCLUSIÓN: Destacamos la importancia de comprender la religión y la espiritualidad de la familia en el proceso de adolecer, para el enfermero actuar en la promoción de la salud.<br>OBJECTIVE: To describe the manifestations of religiosity and spirituality in families of children with Chronic Kidney Failure undergoing peritoneal dialysis. METHODS: This qualitative research is a case study with multiple subjects. Meaningful content analysis was adopted, using the thematic type, in the framework of family nursing in health promotion. RESULTS: Four families participated in the study, totaling fourteen participants. Religion and spirituality appear as important resources for family members in coping with the chronic disease, mainly in view of threatening prognoses. CONCLUSION: It is important for nurses to understand the family's religious and spirituality in the disease process, with a view to their work in health promotion