79 research outputs found

    Exploring Driver Responses to Unexpected and Expected Events Using Probabilistic Topic Models

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    Drivers’ expectations influence their responses to events in complex ways. In particular, covert and sustained hazards, like crosswinds, might require complex vehicle control adaptations. We investigated differences between drivers’ lateral responses in unexpected and expected (repeated) crosswind events using probabilistic topic modeling. First, each driver’s event-based steering wheel movements (angle and rate, 5 Hz) were transformed into symbolic words. Then, probabilistic topic modeling was used to discover patterns in the steering wheel movement data across the event conditions. Results indicate that drivers may make fewer abrupt steering wheel movements when they encounter unexpected crosswinds. On the contrary, drivers are more likely to make continuous faster steering corrections to compensate crosswinds when they are expected. The topic models also classify unexpected and expected crosswind events better than traditional models that use single aggregated values across events (maximum steering wheel angle and rate). These preliminary insights show an advantage for granular, time-series based analysis of driving data, and suggest a viable machinelearning based technique to conduct such investigations

    Sociodemographic, obstetric and psychological determinants of obesity among women in early to mid-pregnancy in South India

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    Background: Worldwide, the occurrence of obesity has markedly increased over the past decades with serious public health consequences. Obese pregnant women are more likely to develop hypertension, pre-eclampsia and gestational diabetes, resulting in obstetric complications which in turn may contribute to an increase in adverse child outcomes and maternal mortality. The present study was done to determine the prevalence of obesity and its association with socio-demographic variables, obstetric history and mental health. Methods: This study was nested within an ongoing cohort study, CASCADE, in a public hospital in Bangalore. The study participants comprised of 280 pregnant women who were 18 years of age and above, with a gestational age of less than 24 weeks, enrolled between a period of August 1st, 2017 until April 30th, 2018. Weight and height were measured using calibrated devices to calculate the body mass index. Results: The prevalence of obesity was observed to be 33.9% among the pregnant mothers. Obesity was found to be significantly associated with age, history of abortion, gravidity on multivariate logistic regression. No association was found with depression and anxiety. Conclusions: Obesity is an important health concern among urban pregnant women in the region of South India. The prevalence is much higher than that reported in other studies. Increasing age, multigravidity and past history of abortion were significantly associated with maternal obesity.</ns4:p

    Prenatal Depression and Its Associated Risk Factors Among Pregnant Women in Bangalore: A Hospital Based Prevalence Study

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    BACKGROUND The most common psychological problem that affects a woman during her perinatal period worldwide is depression. The risk of prenatal depression increases significantly as pregnancy progresses and clinically significant depressive symptoms are common in mid and late trimesters. Studies from various countries around the world have shown a prevalence rate ranging from as low as 4% to as high as 81%. The prevalence of depression in India is shown to vary from 9.18% in one study to 36.75 % reported in another. There is paucity of research on depression during the prenatal period, especially in India. Given this background, the present study aimed to assess the prevalence of prenatal depression and its associated risk factors among pregnant women in Bangalore, Southern India. METHODS: The study was nested within an on-going cohort study. The study participants comprised of pregnant women attending the antenatal clinic at Jaya Nagar General Hospital (Sanjay Gandhi Hospital) in Bangalore. The data was collected using standardised questionnaires. Edinburgh Postnatal Depression Scale (EPDS), Multidimensional Scale of Perceived Social Support Scale (MSPSS), Revised Dyadic Adjustment Scale, The Modified Conflict Tactics scale, Modified Kuppuswamy socio economic scale, Pregnancy related anxiety Scales were used. RESULTS: Of the 280 pregnant mothers, the proportion of them who screened positive for prenatal depression was 35.7%. Presence of domestic violence was found to impose a five times higher and highly significant risk of developing prenatal depression among the respondents. Pregnancy related anxiety was also found to be a positive predictor of prenatal depression. Presence of catastrophic events in the past one year was found to impose a two times higher and significant risk of developing prenatal depression among the respondents. CONCLUSION: The present study showed a higher prevalence of prenatal depression among the study participants which is suggestive of the public health importance in the study region. Health care plans therefore can include screening and diagnosis of prenatal depression in the antenatal care along with other health care facilities provided

    Understanding the Effects of Both CD14-Mediated Innate Immunity and Device/Tissue Mechanical Mismatch in the Neuroinflammatory Response to Intracortical Microelectrodes

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    Intracortical microelectrodes record neuronal activity of individual neurons within the brain, which can be used to bridge communication between the biological system and computer hardware for both research and rehabilitation purposes. However, long-term consistent neural recordings are difficult to achieve, in large part due to the neuroinflammatory tissue response to the microelectrodes. Prior studies have identified many factors that may contribute to the neuroinflammatory response to intracortical microelectrodes. Unfortunately, each proposed mechanism for the prolonged neuroinflammatory response has been investigated independently, while it is clear that mechanisms can overlap and be difficult to isolate. Therefore, we aimed to determine whether the dual targeting of the innate immune response by inhibiting innate immunity pathways associated with cluster of differentiation 14 (CD14), and the mechanical mismatch could improve the neuroinflammatory response to intracortical microelectrodes. A thiol-ene probe that softens on contact with the physiological environment was used to reduce mechanical mismatch. The thiol-ene probe was both softer and larger in size than the uncoated silicon control probe. Cd14-/- mice were used to completely inhibit contribution of CD14 to the neuroinflammatory response. Contrary to the initial hypothesis, dual targeting worsened the neuroinflammatory response to intracortical probes. Therefore, probe material and CD14 deficiency were independently assessed for their effect on inflammation and neuronal density by implanting each microelectrode type in both wild-type control and Cd14-/- mice. Histology results show that 2 weeks after implantation, targeting CD14 results in higher neuronal density and decreased glial scar around the probe, whereas the thiol-ene probe results in more microglia/macrophage activation and greater blood–brain barrier (BBB) disruption around the probe. Chronic histology demonstrate no differences in the inflammatory response at 16 weeks. Over acute time points, results also suggest immunomodulatory approaches such as targeting CD14 can be utilized to decrease inflammation to intracortical microelectrodes. The results obtained in the current study highlight the importance of not only probe material, but probe size, in regard to neuroinflammation

    Some peace of mind: assessing a pilot intervention to promote mental health among widows of injecting drug users in north-east India

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    <p>Abstract</p> <p>Background</p> <p>HIV prevalence in north-east India is high and injecting drug use (IDU) is common. Due to HIV-related deaths there are increasing numbers of IDU widows, many of whom are HIV infected, and experiencing poor health, social isolation, discrimination and poverty, all factors likely to be compromising their mental health. There is increasing recognition of the links between HIV and mental health.</p> <p>Methods</p> <p>The aim of this study was to pilot a peer-facilitated, participatory action group (PAG) process and assess the impact of the intervention on the mental health of participants. The intervention consisted of 10 PAG meetings involving 74 IDU widows. Changes in quality of life (WHOQOL-BREF), mental health (GHQ12) and somatic symptoms were assessed. The value of the intervention from the perspective of the participants was captured using a qualitative evaluation method (Most Significant Change).</p> <p>Results</p> <p>Participants' quality of life, mental health and experience of somatic symptoms improved significantly over the course of the intervention, and the women told stories reflecting a range of 'significant changes'.</p> <p>Conclusion</p> <p>This pilot intervention study demonstrated that a participatory approach to mental health promotion can have a positive impact on the lives of vulnerable women, and the potential to contribute to HIV prevention. Further investigation is warranted.</p

    Multisite Investigation of Outcomes With Implementation of CYP2C19 Genotype-Guided Antiplatelet Therapy After Percutaneous Coronary Intervention

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    OBJECTIVES: This multicenter pragmatic investigation assessed outcomes following clinical implementation of CYP2C19 genotype-guided antiplatelet therapy after percutaneous coronary intervention (PCI). BACKGROUND: CYP2C19 loss-of-function alleles impair clopidogrel effectiveness after PCI. METHODS: After clinical genotyping, each institution recommended alternative antiplatelet therapy (prasugrel, ticagrelor) in PCI patients with a loss-of-function allele. Major adverse cardiovascular events (defined as myocardial infarction, stroke, or death) within 12 months of PCI were compared between patients with a loss-of-function allele prescribed clopidogrel versus alternative therapy. Risk was also compared between patients without a loss-of-function allele and loss-of-function allele carriers prescribed alternative therapy. Cox regression was performed, adjusting for group differences with inverse probability of treatment weights. RESULTS: Among 1,815 patients, 572 (31.5%) had a loss-of-function allele. The risk for major adverse cardiovascular events was significantly higher in patients with a loss-of-function allele prescribed clopidogrel versus alternative therapy (23.4 vs. 8.7 per 100 patient-years; adjusted hazard ratio: 2.26; 95% confidence interval: 1.18 to 4.32; p = 0.013). Similar results were observed among 1,210 patients with acute coronary syndromes at the time of PCI (adjusted hazard ratio: 2.87; 95% confidence interval: 1.35 to 6.09; p = 0.013). There was no difference in major adverse cardiovascular events between patients without a loss-of-function allele and loss-of-function allele carriers prescribed alternative therapy (adjusted hazard ratio: 1.14; 95% confidence interval: 0.69 to 1.88; p = 0.60). CONCLUSIONS: These data from real-world observations demonstrate a higher risk for cardiovascular events in patients with a CYP2C19 loss-of-function allele if clopidogrel versus alternative therapy is prescribed. A future randomized study of genotype-guided antiplatelet therapy may be of value

    Multisite Investigation of Outcomes With Implementation of CYP2C19 Genotype-Guided Antiplatelet Therapy After Percutaneous Coronary Intervention

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    OBJECTIVES: This multicenter pragmatic investigation assessed outcomes following clinical implementation of CYP2C19 genotype-guided antiplatelet therapy after percutaneous coronary intervention (PCI). BACKGROUND: CYP2C19 loss-of-function alleles impair clopidogrel effectiveness after PCI. METHODS: After clinical genotyping, each institution recommended alternative antiplatelet therapy (prasugrel, ticagrelor) in PCI patients with a loss-of-function allele. Major adverse cardiovascular events (defined as myocardial infarction, stroke, or death) within 12 months of PCI were compared between patients with a loss-of-function allele prescribed clopidogrel versus alternative therapy. Risk was also compared between patients without a loss-of-function allele and loss-of-function allele carriers prescribed alternative therapy. Cox regression was performed, adjusting for group differences with inverse probability of treatment weights. RESULTS: Among 1,815 patients, 572 (31.5%) had a loss-of-function allele. The risk for major adverse cardiovascular events was significantly higher in patients with a loss-of-function allele prescribed clopidogrel versus alternative therapy (23.4 vs. 8.7 per 100 patient-years; adjusted hazard ratio: 2.26; 95% confidence interval: 1.18 to 4.32; p = 0.013). Similar results were observed among 1,210 patients with acute coronary syndromes at the time of PCI (adjusted hazard ratio: 2.87; 95% confidence interval: 1.35 to 6.09; p = 0.013). There was no difference in major adverse cardiovascular events between patients without a loss-of-function allele and loss-of-function allele carriers prescribed alternative therapy (adjusted hazard ratio: 1.14; 95% confidence interval: 0.69 to 1.88; p = 0.60). CONCLUSIONS: These data from real-world observations demonstrate a higher risk for cardiovascular events in patients with a CYP2C19 loss-of-function allele if clopidogrel versus alternative therapy is prescribed. A future randomized study of genotype-guided antiplatelet therapy may be of value
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