14 research outputs found

    Koritala_2019_JBR_supple_2ndRevision_final_tracking – Supplemental material for Habitat-Specific Clock Variation and Its Consequence on Reproductive Fitness

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    Supplemental material, Koritala_2019_JBR_supple_2ndRevision_final_tracking for Habitat-Specific Clock Variation and Its Consequence on Reproductive Fitness by Bala S. C. Koritala, Craig Wager, Joshua C. Waters, Ryan Pachucki, Benedetto Piccoli, Yaping Feng, Laura B. Scheinfeldt, Sunil M. Shende, Sohyun Park, James I. Hozier, Parth Lalakia, Dibyendu Kumar and Kwangwon Lee in Journal of Biological Rhythms</p

    Does Age-Related Macular Degeneration (AMD) Treatment Influence Patient Falls and Mobility? A Systematic Review.

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    PURPOSE: Age-related macular degeneration (AMD), a leading cause of irreversible blindness, increases fall risk through impaired central vision. Falls place an enormous economic burden on healthcare systems. We hypothesized that AMD treatments may reduce patients\u27 falls risk. This systematic review (ID #: 172623) synthesized the current understanding of wet and dry AMD treatments\u27 impact on patient falls and mobility, connecting these two public health issues. METHODS: On April 17, 2020, PubMed, Scopus, CINAHL, and the Cochrane Central Register of Controlled Trials were queried. Clinical trials and observational studies were included, while non-English and non-primary studies were excluded. Two authors screened, extracted data, and assessed bias using RoB-2 and ROBINS-I. A third author served as a tie breaker. RESULTS: This database search resulted in 3,525 studies, with an additional 112 identified through bibliography review. Ten articles met eligibility criteria. Most studies featured the outcome of interest as a secondary outcome (n = 4) and patient-reported adverse events (n = 5), rather than a primary focus (n = 2). Ten out of the 11 outcomes had a moderate to serious risk of bias. No two studies used the same instrument to measure falls or mobility. CONCLUSION: Despite the potential positive impact of AMD treatments on patient falls and mobility, quality data on this relationship are lacking. This work underscores the need to broaden ophthalmologic research outcomes beyond visual parameters to include patient-centred, functional measures. Incorporating standardized methods to track falls and screen for difficulty with walking and balance would enable evaluation of AMD treatments on functional outcomes, potentially helping guide management

    Leveraging big data for pattern recognition of socio-demographic and climatic factors in correlation with eye disorders in Telangana State, India

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    Purpose: Big data is the new gold, especially in health care. Advances in collecting and processing electronic medical records (EMR) coupled with increasing computer capabilities have resulted in an increased interest in the use of big data in health care. Ophthalmology has been an area of focus where results have shown to be promising. The objective of this study was to determine whether the EMR at a multi-tier ophthalmology network in India can contribute to the management of patient care, through studying how climatic and socio-demographic factors relate to eye disorders and visual impairment in the State of Telangana. Methods: The study was designed by merging a dataset obtained from the Telangana State Development Society to an existing EMR of approximately 1 million patients, who presented themselves with different eye symptoms and diagnosed with several diseases from the years (2011–2019). The dataset obtained included weather and climatic variables to be tested alongside eye disorders. AI creative featuring techniques have been used to narrow down the variables most affected by climatic and demographic factors, with the application of the Cynefin Framework as a guide to simplify and structure the dataset for analysis. Results: Our findings revealed a high presence of cataract in the state of Telangana, mostly in rural areas and throughout the different weather seasons in India. Males tend to be the most affected as per the number of visits to the clinic, while home makers make the most visit to the hospital, in addition to employees, students, and laborers. While cataract is most dominant in the older age population, diseases such as astigmatism, conjunctivitis, and emmetropia, are more present in the younger age population. Conclusion: The study appeared useful for taking preventive measures in the future to manage the treatment of patients who present themselves with eye disorders in Telangana. The use of clinical big datasets helps to identify the burden of ocular disorders in the population. The overlaying of meteorological data on the clinical presentation of patients from a geographic region lends insight into the complex interaction of environmental factors on the prevalence of ocular disorders in them

    5-ALA-Induced Fluorescent Urine Cytology in Comparison with Conventional Cytology, BTA-TRAK, and NMP-22 Tests in the Diagnosis of Bladder Cancer

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    Introduction To assess the sensitivity fluorescent urine cytology induced by 5-aminolevulinic acid (5-ALA) in the diagnosis of bladder cancer and to compare the sensitivity and specificity with currently available markers approved by the United States Food and Drug Administration (FDA), bladder tumour antigen (BTA-TRAK, Bard Diagnostic Sciences, Redmond, WA, United States) assay based on enzyme-linked immunosorbent assay (ELISA), nuclear matrix protein 22 (NMP-22), and conventional cytology

    Interventions to address postpartum depression in South Asian countries: a scoping review.

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    BACKGROUND: Postpartum depression (PPD) can result in poor health outcomes in mothers, affect maternal-child bonding and have long-term effects on child development. AIMS: The aim of this review was to identify existing studies on PPD and characterise any gaps in literature. METHODS: We conducted a scoping review of 14 databases using a combination of search terms and phrases related to PPD and the respective Southern Asian countries. We applied the criteria from the PRISMA Extension for Scoping Reviews to identify relevant articles from Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka published between January 2004 and September 2024. RESULTS: We identified 20 studies conducted in only four of the South Asian countries: Pakistan, India, Bangladesh and Nepal. Fifteen were studies with clear post-intervention outcomes; five had process outcomes. Intervention studies used trained community health workers in a variety of psychosocial programs, many with culturally specific content, including adoption of language and integration of local activities. Among the 15 intervention studies, six had positive maternal mental health outcomes and three had positive pediatric-related findings. CONCLUSION: The 20 articles identified address the important problem of PPD in South Asia. The positive findings in both the large randomised control trials and small pilot studies identified in this article, combined with the studies' use of the resource of community health workers, suggest that the gap in the literature is less on identifying effective interventions and more on securing the political and policy resolution to address the problem of PPD

    Prevalence of chronic disease in older adults in multitier eye-care facilities in South India: Electronic medical records-driven big data analytics report

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    Purpose: To study the prevalence of systemic conditions in older adults, either self-reported or discovered during routine eye examinations, at multitier eye-care facilities over the past decade, and to explore their association with vision and common ocular disorders, including cataract, glaucoma, and retinopathy. Methods: Retrospective review of a large data set compiled from the electronic medical records of patients older than 60 years who presented to an eye facility of a multitier ophthalmology network located in 200 different geographical locations that included urban and rural eye-care centers spread across four states in India over a 10-year period. Results: 618,096 subjects aged 60 or older were identified as visiting an eye facility over the 10-year study period. The mean age of the study individuals was 67·28 (±6·14) years. A majority of older adults (66·96%) reported being free of systemic illnesses. Patients from lower socioeconomic status had a lower prevalence of chronic systemic disease, but the presenting vision was poorer. Hypertension (21·62%) and diabetes (18·77%) were the most commonly reported chronic conditions in patients who had concomitant systemic illness with visual concerns. Conclusion: The prevalence of chronic systemic illnesses in older adults presenting to multitier eye-care facilities is relatively low, except in those with diabetic retinopathy. These observations suggest a need to include active screening for common chronic diseases in standalone eye-care facilities to achieve a more accurate assessment of chronic disease burden in the older population

    Gender variations in neonatal and early infant mortality in India and Pakistan: A secondary analysis from the global network maternal newborn health registry

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    Background: To determine the gender differences in neonatal mortality, stillbirths, and perinatal mortality in south Asia using the Global Network data from the Maternal Newborn Health Registry.Methods: This study is a secondary analysis of prospectively collected data from the three south Asian sites of the Global Network. The maternal and neonatal demographic, clinical characteristics, rates of stillbirths, early neonatal mortality (1-7 days), late neonatal mortality (8-28 days), mortality between 29-42 days and the number of infants hospitalized after birth were compared between the male and female infants.Results: Between 2010 and 2018, 297,509 births [154,790 males (52.03%) and 142,719 females (47.97%)] from two Indian sites and one Pakistani site were included in the analysis [288,859 live births (97.1%) and 8,648 stillbirths (2.9%)]. The neonatal mortality rate was significantly higher in male infants (33.2/1,000 live births) compared to their female counterparts (27.4/1,000, p \u3c 0.001). The rates of stillbirths (31.0 vs. 26.9/1000 births) and early neonatal mortality (27.1 vs 21.6/1000 live births) were also higher in males. However, there were no significant differences in late neonatal mortality (6.3 vs. 5.9/1000 live births) and mortality between 29-42 days (2.1 vs. 1.9/1000 live births) between the two groups. More male infants were hospitalized within 42 days after birth (1.8/1000 vs. 1.3/1000 live births, p \u3c 0.001) than females.Conclusion: The risks of stillbirths, and early neonatal mortality were higher among male infants than their female counterparts. However, there was no gender difference in mortality after 7 days of age. Our results highlight the importance of stratifying neonatal mortality into early and late neonatal period to better understand the impact of gender on neonatal mortality. The information from this study will help in developing strategies and identifying measures that can reduce differences in sex-specific mortality

    Feasibility, acceptability, and preliminary impact of an mHealth supported breastfeeding peer counselor intervention in rural India

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    OBJECTIVE: To evaluate the feasibility of an mHealth-supported breastfeeding peer counselor intervention implemented in rural India and the preliminary impact of the intervention on maternal breastfeeding behaviors, including exclusive breastfeeding (EBF). METHODS: In this quasi-experimental pilot study, participants received either the intervention plus usual care (n = 110) or usual care alone (n = 112). The intervention group received nine in-home visits during and after pregnancy from peer counselors who provided education about and support for EBF and other optimal infant feeding practices and were aided with an mHealth tool. The control group received routine prenatal and postnatal health education. Progress notes and surveys were used to assess feasibility. Logistic regression models were used for between-group comparisons of optimal infant feeding outcomes, including EBF for six months. RESULTS: The intervention was delivered as intended, maintained over the study period, and had high acceptability ratings. There were statistically significant differences in all outcomes between groups. The intervention group had a significantly higher likelihood of EBF at six months compared to the control group (adjusted odds ratio 3.57, 95% CI 1.80–7.07). CONCLUSION: Integration of mHealth with community-based peer counselors to educate women about EBF is feasible and acceptable in rural India and impacts maternal breastfeeding behaviors

    Design, Development, and Testing of BEST4Baby, an mHealth Technology to Support Exclusive Breastfeeding in India: Pilot Study.

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    Background: Exclusive breastfeeding (EBF) at 6 months of age in most low- and middle-income countries, including India, is surprisingly low. There is a relative lack of mobile health apps that specifically focus on leveraging the use of peer counselors (PCs) to support mothers as a means of increasing EBF practices in low- and middle-income countries. Objective: This study aimed to design, develop, and test the usability of Breastfeeding Education Support Tool for Baby (BEST4Baby), a mobile health app specifically designed to support PCs in providing in-home breastfeeding counseling support to mothers in rural India on optimal breastfeeding practices. Methods: A user-centered design process with an agile development methodology was used. The approach involved stakeholders and mothers who were trained to serve as PCs to guide BEST4Baby\u27s design and development, including the app\u27s content and features. PCs were engaged through focus groups with interactive wireframes. During the 24-month pilot study period, we conducted a feasibility test of the BEST4Baby app with 22 PCs who supported home visits with mothers residing in rural India. The intervention protocol required PCs to provide education and follow mothers using the BEST4Baby app, with 9 scheduled home visits from the late prenatal stage to 6 months post partum. BEST4Baby\u27s usability from the PCs\u27 perspective was assessed using the translated System Usability Scale (SUS). Results: The findings of this study align with best practices in user-centered design (ie, understanding user experience, including context with iterative design with stakeholders) to address EBF barriers. This led to the cultural tailoring and contextual alignment of an evidence-based World Health Organization breastfeeding program with an iterative design and agile development of the BEST4Baby app. A total of 22 PCs tested and rated the BEST4Baby app as highly usable, with a mean SUS score of 85.3 (SD 9.1), placing it over the 95th percentile for SUS scores. The approach translated into a highly usable BEST4Baby app for use by PCs in breastfeeding counseling, which also statistically increased EBF practices. Conclusions: The findings suggest that BEST4Baby was highly usable and accepted by mothers serving as PCs to support other mothers in their EBF practices and led to positive outcomes in the intervention group\u27s EBF rates. The pilot study demonstrated that using the specially designed BEST4Baby app was an important support tool for mothers to serve as PCs during the 9 home visits. Trial registration: Clinicaltrials.gov NCT03533725; https://clinicaltrials.gov/ct2/show/NCT03533725
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