A profiling analysis of contributions of cigarette smoking, dietary calcium intakes, and physical activity to fragility fracture in the elderly

Fragility fracture and bone mineral density (BMD) are influenced by common and modifiable lifestyle factors. In this study, we sought to define the contribution of lifestyle factors to fracture risk by using a profiling approach. The study involved 1683 women and 1010 men (50+ years old, followed up for up to 20 years). The incidence of new fractures was ascertained by X-ray reports. A “lifestyle risk score” (LRS) was derived as the weighted sum of effects of dietary calcium intake, physical activity index, and cigarette smoking. Each individual had a unique LRS, with higher scores being associated with a healthier lifestyle. Baseline values of lifestyle factors were assessed. In either men or women, individuals with a fracture had a significantly lower age-adjusted LRS than those without a fracture. In men, each unit lower in LRS was associated with a 66% increase in the risk of total fracture (non-adjusted hazard ratio [HR] 1.66; 95% CI, 1.26 to 2.20) and still significant after adjusting for age, weight or BMD. However, in women, the association was uncertain (HR 1.30; 95% CI, 1.11 to 1.53). These data suggest that unhealthy lifestyle habits are associated with an increased risk of fracture in men, but not in women, and that the association is mediated by BMD

Effects of salinity and alkalinity on growth and survival of all-male giant freshwater prawn (Macrobrachium rosenbergii De Man, 1879) juveniles

All-male giant freshwater prawns (AMGFPs) have been a popular crop cultivated in the Mekong Delta, Vietnam, due to their proven production efficiency compared to all-female or mixed-sex prawn cultures. However, the crucial water quality factors impacting AMGFP aquaculture efficiency have yet to be elaborately investigated. Two separate experiments were randomly arranged with three replicates to evaluate the effects of salinity or alkalinity on the growth and survival of AMGFP juveniles during the grow-out period. The results show that the prawn survival rate in the salinity range of 0–15‰ varied from 66.1 to 74.8％ and in a salinity range of 0–5‰ was relatively low compared to the range of 10-15‰; however, the difference was not significant among salinities after 90 days of culture (p > 0.05). All the prawn growth performance parameters significantly decreased with increasing salinities of 0, 5, 10, and 15‰ after 30, 60, and 90 days of culture (p 0.05), and both were significantly higher than those at salinities of 10 and 15‰ (p < 0.05) after 90 days of culture. In addition, the survival rate reached 82.5–84.4％ and did not significantly differ among alkalinities of 80, 100, 120, 140, and 160 mgCaCO3 L−1. However, the growth performance parameters and yield of AMGFPs at an alkalinity of 160 mg L−1 were significantly higher than those at lower alkalinities (80, 100, 120, and 140 mg CaCO3 L−1) after 90 days of culture. Therefore, it is recommended that a salinity range of 0–5‰ and alkalinity of 160 mgCaCO3 L−1 is optimal for the growth-out culture of AMGFP juveniles

ANOVA_robust: A SAS Macro for Parametric Tests of Mean Differences in One-Factor ANOVA Models

Testing the equality of several independent group means is a common statistical practice in the social sciences. The traditional analysis of variance (ANOVA) is one of the most popular methods. However, the ANOVA F test is sensitive to violations of the homogeneity of variance assumption. Many alternative tests have been developed in response to this problem of the F test. These tests include some modifications of the ANOVA F test and others based on the structured means modeling technique. This paper provides a SAS macro for testing the equality of group means using thirteen methods including the regular ANOVA F test. In addition, this paper summarizes the results of a simulation study that compares the performance of these tests in terms of their Type I error rate under different conditions, especially under violations of the homogeneity of variance assumption

A randomized controlled trial of a pharmacist-led intervention to enhance knowledge of Vietnamese patients with type 2 diabetes mellitus

OBJECTIVES: We aimed to assess whether a pharmacist-led intervention enhances knowledge, medication adherence and glycemic control in patients with type 2 diabetes mellitus (T2DM). METHODS: We conducted a single-blinded randomized controlled trial in Vietnam. Individuals with T2DM were recruited from a general hospital and randomly allocated to intervention and routine care. The intervention group received routine care plus counselling intervention by a pharmacist, including providing drug information and answering individual patients' queries relating to T2DM and medications, which had not been done in routine care. We assessed the outcomes: knowledge score as measured by the Diabetes Knowledge Questionnaire, self-reported adherence and fasting blood glucose (FBG) at the 1-month follow-up. KEY FINDINGS: A total of 165 patients (83 intervention, 82 control) completed the study; their mean age was 63.33 years, and 49.1% were males. The baseline characteristics of the patients were similar between the groups. At 1-month follow-up, the pharmacist's intervention resulted in an improvement in all three outcomes: knowledge score [B = 5.527; 95% confidence intervals (CI): 3.982 to 7.072; P < 0.001], adherence [odds ratio (OR) = 9.813; 95% CI: 2.456 to 39.205; P = 0.001] and attainment of target FBG (OR = 1.979; 95% CI: 1.029 to 3.806; P = 0.041). CONCLUSIONS: The pharmacist-led intervention enhanced disease knowledge, medication adherence and glycemic control in patients with T2DM. This study provides evidence of the benefits of pharmacist counselling in addition to routine care for T2DM outpatients in a Vietnam population

A Robust Adaptive Control using Fuzzy Neural Network for Robot Manipulators with Dead-Zone

In this paper, a robust-adaptive-fuzzy-neural-network controller (RAFNNs) bases on dead zone compensator for industrial robot manipulators (RM) is proposed to dead the unknown model and external disturbance. Here, the unknown dynamics of the robot system is deal by using fuzzy neural network to approximate the unknown dynamics. The online training laws and estimation of the dead-zone are determined by Lyapunov stability theory and the approximation theory. In this proposal, the robust sliding-mode-control (SMC) is constructed to optimize parameter vectors, solve the approximation error and higher order terms. Therefore, the stability, robustness, and desired tracking performance of RAFNNs for RM are guaranteed. The simulations and experiments performed on three-link RM are provided in comparison with neural-network (NNs) and proportional-integral-derivative (PID) to demonstrate the robustness and effectiveness of the RAFNNs

On the Out of Distribution Robustness of Foundation Models in Medical Image Segmentation

Constructing a robust model that can effectively generalize to test samples under distribution shifts remains a significant challenge in the field of medical imaging. The foundational models for vision and language, pre-trained on extensive sets of natural image and text data, have emerged as a promising approach. It showcases impressive learning abilities across different tasks with the need for only a limited amount of annotated samples. While numerous techniques have focused on developing better fine-tuning strategies to adapt these models for specific domains, we instead examine their robustness to domain shifts in the medical image segmentation task. To this end, we compare the generalization performance to unseen domains of various pre-trained models after being fine-tuned on the same in-distribution dataset and show that foundation-based models enjoy better robustness than other architectures. From here, we further developed a new Bayesian uncertainty estimation for frozen models and used them as an indicator to characterize the model's performance on out-of-distribution (OOD) data, proving particularly beneficial for real-world applications. Our experiments not only reveal the limitations of current indicators like accuracy on the line or agreement on the line commonly used in natural image applications but also emphasize the promise of the introduced Bayesian uncertainty. Specifically, lower uncertainty predictions usually tend to higher out-of-distribution (OOD) performance.Comment: Advances in Neural Information Processing Systems (NeurIPS) 2023, Workshop on robustness of zero/few-shot learning in foundation model

Drug-Related Problems in Prescribing for Pediatric Outpatients in Vietnam

BACKGROUND: Our study was conducted to determine the prevalence of drug-related problems (DRPs) in outpatient prescriptions, the impact of DRPs on treatment efficacy, safety, and cost, and the determinants of DRPs in prescribing for pediatric outpatients in Vietnam. METHODS: A retrospective cross-sectional study was conducted on pediatric outpatients at a pediatric hospital in Can Tho, Vietnam. DRPs were classified according to the Pharmaceutical Care Network Europe classification (PCNE) of 2020. The study determined prevalence of DRPs and their impacts on efficacy, safety, and cost. Multivariate regression was used to identify the determinants of DRPs. RESULTS: The study included 4339 patients (mean age 4.3, 55.8% male), with a total of 3994 DRPs, averaging 0.92 DRP/prescription. The proportion of prescriptions with at least one DRP was 65.7%. DRPs included inappropriate drug selection (35.6%), wrong time of dosing relative to meals (35.6%), inappropriate dosage form (9.3%), inappropriate indication (7.1%), and drug-drug interactions (0.3%). The consensus of experts was average when evaluating each aspect of efficiency reduction, safety reduction, and treatment cost increase, with Fleiss' coefficients of 0.558, 0.511, and 0.541, respectively (p < 0.001). Regarding prescriptions, 50.1% were assessed as reducing safety. The figures for increased costs and decreased treatment effectiveness were 29.0% and 23.9%, respectively. Patients who were ≤2 years old were more likely to have DRPs than patients aged 2 to 6 years old (OR = 0.696; 95% CI = 0.599-0.809) and patients aged over 6 years old (OR = 0.801; 95% CI = 0.672-0.955). Patients who had respiratory system disease were more likely to have DRPs than patients suffering from other diseases (OR = 0.715; 95% CI = 0.607-0.843). Patients with comorbidities were less likely to have DRPs than patients with no comorbidities (OR = 1.421; 95% CI = 1.219-1.655). Patients prescribed ≥5 drugs were more likely to have DRPs than patients who took fewer drugs (OR = 3.677; 95% CI = 2.907-4.650). CONCLUSION: The proportion of prescriptions in at least one DRP was quite high. Further studies should evaluate clinical significance and appropriate interventions, such as providing drug information and consulting doctors about DRPs