Hemichorea-hemiballismus as a rare presentation of non-ketotic hyperglycemia: a case report

Hemichorea-hemiballismus is a hyperkinetic movement disorder on one side of the body resulting from involvement of the contralateral basal ganglia and striatum mainly. A 50-year-old female presented with a 5-days history of choreiform movements affecting the left upper and lower limb along with hemiface. Her plasma glucose was 576 mgl/dl and her urinary ketones were negative suggesting non-ketotic hyperglycemia. Computed tomography revealed hyper-density in right caudate and putamen consistent with diabetic striatopathy. Non-ketotic hyperglycemia is a rare cause of hemichorea-hemiballismus syndrome. Hemichorea-hemiballismus can be an unusual and rare presentation of diabetic elderly population especially females. Early diagnosis and treatment of hyperglycemia yields an excellent prognosis

A clinical study of foreign bodies in air passages

Background: Foreign body in the airways is a serious event and fatal if not managed properly in time. Accident resulting from the inhalation of the foreign body continues to take formidable toll of lives every year.Objecti ve: This study was undertaken to find out the incidence of foreign bodies in air passages in this part of the country and types of foreign bodies, to establish the role of radiological investigations, and to find out the effective measures which are valuable in decreasing the post endoscopic complications and morbidity. Methods: This retrospective study was conducted in all suspected cases of foreign body in the air passages attending as well as referred to the Department of Otolaryngology of a Medical College of Rajasthan from January 2014 to December 2015. In each case, a procedure like direct laryngoscopy or bronchoscopy was done depending on the site of the foreign body. Results: Out of 100 cases, 58 were males and 42 were females. 88% of the patients were children below the age of 12 years. The most common foreign body extracted was betel nut in 47% of the cases. Commonest sign observed was decreased air entry in the lung (83%). Commonest radiological finding was obstructive collapse (37%). 48% of the total foreign bodies were present in right bronchus while 32% were lodged in the left bronchus and 3% at the carina. Conclusion: A diagnostic bronchoscopy should always be done in refractory cases of chronic respiratory infection, allergy or pneumonia. A negative radiological examination does not exclude a foreign body

Heterogeneity in the effectiveness of non-pharmaceutical interventions during the first SARS-CoV2 wave in the United States

Background: Attempts to quantify effect sizes of non-pharmaceutical interventions (NPI) to control COVID-19 in the US have not accounted for heterogeneity in social or environmental factors that may influence NPI effectiveness. This study quantifies national and sub-national effect sizes of NPIs during the early months of the pandemic in the US. Methods: Daily county-level COVID-19 cases and deaths during the first wave (January 2020 through phased removal of interventions) were obtained. County-level cases, doubling times, and death rates were compared to four increasingly restrictive NPI levels. Socio-demographic, climate and mobility factors were analyzed to explain and evaluate NPI heterogeneity, with mobility used to approximate NPI compliance. Analyses were conducted separately for the US and for each Census regions (Pacific, Mountain, east/West North Central, East/West South Central, South Atlantic, Middle Atlantic and New England). A stepped-wedge cluster-randomized trial analysis was used, leveraging the phased implementation of policies. Results: Aggressive (level 4) NPIs were associated with slower COVID-19 propagation, particularly in high compliance counties. Longer duration of level 4 NPIs was associated with lower case rates (log beta -0.028, 95% CI -0.04 to -0.02) and longer doubling times (log beta 0.02, 95% CI 0.01–0.03). Effects varied by Census region, for example, level 4 effects on doubling time in Pacific states were opposite to those in Middle Atlantic and New England states. NPI heterogeneity can be explained by differential timing of policy initiation and by variable socio-demographic county characteristics that predict compliance, particularly poverty and racial/ethnic population. Climate exhibits relatively consistent relationships across Census regions, for example, higher minimum temperature and specific humidity were associated with lower doubling times and higher death rates for this period of analysis in South Central, South Atlantic, Middle Atlantic, and New England states. Conclusion and Relevance: Heterogeneity exists in both the effectiveness of NPIs across US Census regions and policy compliance. This county-level variability indicates that control strategies are best designed at community-levelswhere policies can be tuned based on knowledge of local disparities and compliance with public health ordinances.Peer ReviewedPostprint (published version

Locating Influential Agents in Social Networks: Budget-Constrained Seed Set Selection

The study of information spread in social networks has applications in viral marketing, rumour modelling, and opinion dynamics. Often, it is crucial to identify a small set of influential agents that maximize the spread of information (cases which we refer to as being budget-constrained). These nodes are believed to have special topological properties and reside in the core of a network. We introduce the concept of nucleus decomposition, a clique based extension of core decomposition of graphs, as a new method to locate influential nodes. Our analysis shows that influential nodes lie in the k-nucleus subgraphs and that these nodes outperform lower-order decomposition techniques such as truss and core, while simultaneously focusing on a smaller set of seed nodes. Examining different diffusion models on real-world networks, we provide insights as well into the value of the degree centrality heuristic

Dementia symptoms among senior citizens living in geriatric homes of kathmandu valley

Background With increasing age, the older population becomes more susceptible to mental disorders. It is important to recognize and develop an understanding of psychiatric morbidity particularly among the residents of geriatric homes in resource-poor settings. Objective To assess the prevalence and associated factors of dementia symptoms among Nepalese senior citizens living in geriatric homes of Kathmandu valley. Method A cross-sectional study was conducted among 304 senior citizens living in geriatric homes of Kathmandu valley. Cognitive Impairment Test (CIT), was used to assess dementia symptoms. Bivariate and multivariate logistic regressions were performed. All the variables that were significant at p < 0.05 level in the bivariate analysis were included in the multivariate regression model and statistical significance was declared at p < 0.05 with a 95.00% confidence interval (CI). Result This study showed 75.65%, of the participants, had dementia symptoms. In the multivariate logistic regression analysis, female respondents (AOR=2.94, 95% CI=1.31-6.57), respondents never received geriatric allowances (AOR=2.46, 95% CI=1.22-4.98), respondent's history of alcohol consumption habits (AOR=2.04, 95% CI=1.01-4.11) and non-vegetarian diet habits (AOR= 2.31, 95% CI=1.12-4.76) were found more likely to had higher dementia symptoms whereas, literate participants (AOR=0.19, 95% CI=0.08-0.43) were less likely to had dementia symptoms. Conclusion The high prevalence of dementia symptoms among senior citizens living in geriatric homes in the Kathmandu valley indicates an urgent need for early diagnosis and treatment of mental disorders among senior citizens to improve their quality of life and well-being

Predicting financial trouble using call data—On social capital, phone logs, and financial trouble

<div><p>An ability to understand and predict financial wellbeing for individuals is of interest to economists, policy designers, financial institutions, and the individuals themselves. According to the Nilson reports, there were more than 3 billion credit cards in use in 2013, accounting for purchases exceeding US$ 2.2 trillion, and according to the Federal Reserve report, 39% of American households were carrying credit card debt from month to month. Prior literature has connected individual financial wellbeing with social capital. However, as yet, there is limited empirical evidence connecting social interaction behavior with financial outcomes. This work reports results from one of the largest known studies connecting financial outcomes and phone-based social behavior (180,000 individuals; 2 years’ time frame; 82.2 million monthly bills, and 350 million call logs). Our methodology tackles highly imbalanced dataset, which is a pertinent problem with modelling credit risk behavior, and offers a novel hybrid method that yields improvements over, both, a traditional transaction data only approach, and an approach that uses only call data. The results pave way for better financial modelling of billions of unbanked and underbanked customers using non-traditional metrics like phone-based credit scoring.</p></div

AUCROC comparison across all periods.

<p>AUCROC comparison across all periods.</p

Top-10 features for each category, as well as the sign (positive or negative) of their Pearson’s correlation with the outcome variable (having financial trouble or not).

<p>Top-10 features for each category, as well as the sign (positive or negative) of their Pearson’s correlation with the outcome variable (having financial trouble or not).</p

T-test comparing call only and transaction only model.

<p>T-test comparing call only and transaction only model.</p