Vision Encoder-Decoder Models for AI Coaching

This research paper introduces an innovative AI coaching approach by integrating vision-encoder-decoder models. The feasibility of this method is demonstrated using a Vision Transformer as the encoder and GPT-2 as the decoder, achieving a seamless integration of visual input and textual interaction. Departing from conventional practices of employing distinct models for image recognition and text-based coaching, our integrated architecture directly processes input images, enabling natural question-and-answer dialogues with the AI coach. This unique strategy simplifies model architecture while enhancing the overall user experience in human-AI interactions. We showcase sample results to demonstrate the capability of the model. The results underscore the methodology's potential as a promising paradigm for creating efficient AI coach models in various domains involving visual inputs. Importantly, this potential holds true regardless of the particular visual encoder or text decoder chosen. Additionally, we conducted experiments with different sizes of GPT-2 to assess the impact on AI coach performance, providing valuable insights into the scalability and versatility of our proposed methodology.Comment: 6 pages, 2 figure

ALTERED ARTERIAL DOPPLER FLOW PATTERN AND PERINATAL OUTCOME IN INTRAUTERINE GROWTH RESTRICTION

ABSTRACTObjectives: Intrauterine growth restriction (IUGR) is one of the common conditions that interfere with the growth of the fetus accounting for 10-15%of pregnant woman. Literature explores a wide range of incidence of perinatal complication including mortality among IUGR pregnancies. Limiteddata available on these complications confined to coastal Karnataka and its association with abnormal arterial Doppler flow pattern. To study theperinatal complications associated with IUGR pregnancies and its prevalence in comparison to healthy controls of comparable gestational age.Methods: This cohort study screened 53 IUGR fetuses by an antenatal scan at gestational age of 27 weeks or more. The diagnosis of IUGR was madeaccording to established criteria from SOGC clinical practice guidelines August 2013. The data also included 48 appropriate for gestational age fetuseswith healthy mothers with the comparable gestational week. Experienced cardiac sonographer and gynecologist performed fetal echocardiography(ECHO) using Vivid 7, GE health-care system ECHO machine with the convex transducer of frequency 1.7-2.4 MHz. The study was conducted at southIndian tertiary care center.Results: This study included 53 IUGR cases and 48 non-IUGR controls. The mean age was 27±4.37 and 26.88±3.14 years in IUGR and non-IUGRgroups, respectively. Fetal Doppler study variables showed a significant decrease in peak aortic velocity and velocity time integral which was notevident on other valves, though mitral antegrade flow during atrial contraction was found to be lower among IUGR group. In two-dimensional chamberquantification of IUGR group revealed significant increase in pulmonary artery dimension, right ventricular (RV) dimension and RV thickness than thecontrol group (p<0.05). The anthropometric parameters such as weight and length; abdomen circumference was significantly lower in IUGR group,whereas head circumference found to be more in IUGR group (p<0.001). The gestational weeks at delivery was significantly different among twogroups with IUGR group depicting the early delivery group. p<0.001(35.58±2.92 and 38.5±0.96 in IUGR and non-IUGR groups, respectively). IUGRgroup also had prolonged neonatal intensive care unit stay when compared to controls (p<0.001).Conclusions: IUGR carries profound course in altered Doppler indices and cardiac function which explore its prediction on mortality and adverseperinatal outcome. This study showed significant perinatal mortality accounting for 5.6% among IUGR cases when compared to normal. Althoughtissue Doppler indices show normal variants, IUGR possesses significant adverse perinatal outcome, however with lesser incidence compared tosevere form of IUGR subsets who show altered tissue annular velocities.Keywords: Intrauterine growth restriction, Echocardiography, Doppler, Perinatal

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Effectiveness of music on anxiety and pain among cardiac surgery patients: A quantitative systematic review and meta-analysis of randomized controlled trials

AIM: The aim of this study is to evaluate the effectiveness of music on anxiety and pain among patients following cardiac surgery. BACKGROUND: Cardiac surgery affects patients physically, psychologically and socially. Anxiety and pain are the usual problems among patients following cardiac surgery. DESIGN: The study design is a systematic review and meta-analysis. DATA SOURCES: The Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CENTRAL), Excerpta Medica database (EMBASE) and Web of Science databases were searched for randomized controlled trials from January 2000 to December 2017. REVIEW METHODS: The Cochrane collaboration guidelines were followed and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was used to summarize the quality of evidence. RESULTS: Fourteen studies were included in systematic review and 13 in meta-analysis. The meta-analysis revealed that there was a significant reduction in anxiety and pain among patients who received musical intervention compared with those who did not. CONCLUSION: Music has positive benefits on anxiety and pain. However, well-designed and high-quality trials are needed to generate higher quality evidence

Preferences and barriers for continuing professional development among dental practitioners in the twin cities of Hubli-Dharwad, India

Introduction: Advances in the field of dentistry is occurring at an exponential rate, and there is an immense pressure and challenge for the dentist to keep up with it to remain competent across the full spectrum of dental profession. Aim: To assess the frequency of attending the continuing professional development (CPD) courses as well as to assess the preferences and barriers for CPD among dental practitioners in Hubli-Dharwad, India. Materials and Methods: A self-administered questionnaire inquired on the frequency of attending CPD courses, and three questions on preferences and barriers for the same among 112 practitioners. Pearson's Chi-square test was used to find any association with gender and qualification with dependent variables. Results: Consent for the study was given by 92.9% practicing dentists. The mean age was 32.3 years. A majority of practitioners (45.2%) said that they attended CDE courses at least once in 6 months, 32.7% attended at least once in a year, and 22.1% attended rarely or never. A majority of dentists preferred esthetic dentistry. Most preferred methods for CPD courses were hands-on treatment on live patients and hands-on in clinically simulated situations. Lack of time was perceived as the most important barrier. Conclusions: A little less than half of the practitioners attended CPD courses once in 6 months with a substantial number attending very rarely or never. Most of them preferred esthetic dentistry and hands-on courses and lack of time was the most important barrier for attending CPD courses by Hubli-Dharwad dentists

The effect of UV irradiation on PSf/TiO2 mixed matrix membrane for chromium rejection

The study investigated a novel approach for surface modification of membranes and sustainable water recovery from chromium contaminated water by employing a lab scale dead-end cell filtration unit. Various PSf/TiO2 composite membranes prepared with different concentrations of TiO2 nanoparticles were exposed to UV radiations for surface modification. On exposure to UV light, TiO2 nanoparticles emit electrons and create a surface roughness with a charge on the membranes which resulted in enhanced chromium rejection as well as flux. The surface modification has been analyzed by AFM and SEM (surface and cross sectional) images. The structural modification was investigated by ATR-IR and UV–Visible spectroscopy. The expected enhancement in hydrophilicity was studied by water uptake and contact angle measurements. The analysis of water flux and chromium rejection performed in a dead end filtration unit revealed a high water flux and 100% chromium rejection with 2 wt.% of TiO2 composite membrane in acidic pH. The pH of feed plays an important role in chromium rejection. The rejection of chromium decreases with an increase in feed concentration due to the variation in ion distribution. The effect of interference of other metals in chromium rejection is investigated. The overall work not only demonstrates the positive effects of surface modification, but also effective removal of hazardous chromium

Efficacy of mHealth Interventions for Improving Maternal and Neonatal Outcomes Among Pregnant Women With Hypertensive Disorders: Protocol for a Systematic Review

BackgroundHypertension is one of the most prevalent medical conditions that arise during pregnancy, resulting in maternal and neonatal complications. Mobile health (mHealth) has emerged as an innovative intervention for delivering maternal and child health care services. The evidence on the effectiveness of mHealth interventions in improving the health outcomes of pregnant women with hypertensive disorders is lacking. Therefore, there is a need for evidence synthesis using systematic review methods to address this evidence gap. ObjectiveThis review aims to determine the efficacy of mHealth interventions in improving maternal and neonatal outcomes among pregnant women with hypertensive disorders. The review will answer the following research questions: (1) What are the types of mHealth interventions used in pregnant women with hypertensive disorders? (2) Are the various mHealth interventions effective in improving maternal and neonatal health outcomes, health behaviors, and their knowledge of the disease? and (3) Are mHealth interventions effective in supporting health care providers to make health care decisions for pregnant women with hypertensive disorders? MethodsThis review will include randomized controlled trials, nonrandomized controlled trials, and cohort studies focusing on mHealth interventions for pregnant women with hypertensive disorders. Studies reporting health care providers use of mHealth interventions in caring for pregnant women with hypertensive disorders will be included. The search strategy will be tailored to each database using database-specific search terms. The search will be conducted in PubMed-MEDLINE, ProQuest, CINAHL, Scopus, Web of Science, and CENTRAL. Other literature sources, such as trial registries and bibliographies of relevant studies, will be additionally searched. Studies published in English from January 2000 to January 2023 will be included. A total of 2 review authors will independently perform the data extraction and the quality appraisal. For quality appraisal of randomized controlled trials, the Cochrane Risk of Bias 2 tool will be used. The Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-1) tool will be used for nonrandomized controlled trials, and the Critical Appraisal Skills Programme checklist for cohort studies will be used. Any disagreements between the 2 reviewers will be resolved through discussion and a third reviewer if required. A meta-analysis will be performed based on the availability of the data. ResultsAs per the protocol, the study methodology was followed, and 2 independent reviewers conducted the search in 6 databases and clinical registries. Currently, the review is in the full-text screening stage. The review will publish the results in the first quarter of 2024. ConclusionsThe evidence synthesized from this systematic review will help guide future research, support health care decisions, and inform policy makers on the effectiveness of mHealth interventions in improving the maternal and neonatal outcomes of pregnant women with hypertensive disorders. International Registered Report Identifier (IRRID)PRR1-10.2196/5179

Laser Raman spectroscopy: some clinical applications

Recent advances in lasers, multichannel detectors and PC-based spectroscopic instrumentation have made Raman spectroscopy an invaluable tool for characterization of clinical samples like tissue, body fluids and cytological smears. Efforts are being made at present to develop Raman spectroscopy techniques for optical pathology, early detection of neoplasia, analysis of body fluids, optical imaging, spectral markers for identifying clinical conditions, etc. Some of the results which will lead to such applications are presented in this paper

Genome-wide analysis correlates Ayurveda Prakriti

The practice of Ayurveda, the traditional medicine of India, is based on the concept of three major constitutional types (Vata, Pitta and Kapha) defined as ``Prakriti''. To the best of our knowledge, no study has convincingly correlated genomic variations with the classification of Prakriti. In the present study, we performed genome-wide SNP (single nucleotide polymorphism) analysis (Affymetrix, 6.0) of 262 well-classified male individuals (after screening 3416 subjects) belonging to three Prakritis. We found 52 SNPs (p <= 1 x 10(-5)) were significantly different between Prakritis, without any confounding effect of stratification, after 10(6) permutations. Principal component analysis (PCA) of these SNPs classified 262 individuals into their respective groups (Vata, Pitta and Kapha) irrespective of their ancestry, which represent its power in categorization. We further validated our finding with 297 Indian population samples with known ancestry. Subsequently, we found that PGM1 correlates with phenotype of Pitta as described in the ancient text of Caraka Samhita, suggesting that the phenotypic classification of India's traditional medicine has a genetic basis; and its Prakriti-based practice in vogue for many centuries resonates with personalized medicine

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