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10,006 results for “randomness”
Data from: Home-based TB contact investigation in Uganda: a household-randomized trial
Introduction: The World Health Organization(WHO) recommends household tuberculosis(TB) contact investigation in low-income countries, but most contacts do not complete evaluation. Methods: We performed a randomized trial of home-based, SMS-facilitated, household TB contact investigation in Kampala, Uganda. Community health workers(CHWs) visited homes of index patients with pulmonary TB to screen household contacts for TB. Entire households were randomly allocated to clinic(standard-of-care) or home(intervention) evaluation. In the intervention arm, CHWs offered adults HIV testing; collected sputum from symptomatic contacts and persons living with HIV(PLWH) if ≥5 years; and transported sputum for microbiologic testing. CHWs referred PLWH, children <5, and anyone unable to complete sputum testing to clinic. Sputum-testing results and/or follow-up instructions were returned by automated SMS. The primary outcome was completion of TB evaluation within 14 days; secondary, TB and HIV diagnoses and treatments among screened contacts. Results: There were 471 contacts of 190 index patients allocated to the intervention and 448 contacts of 182 index patients allocated to the standard-of-care. CHWs identified 190/471(40%) intervention and 213/448(48%) standard-of-care contacts requiring TB evaluation. In the intervention arm, CHWs obtained sputum from 35/91(39%) sputum-eligible contacts and SMS were sent to 95/190(50%) contacts. Completion of TB evaluation in intervention and standard-of-care arms at 14 days(14% vs 15%; difference -1%, 95%CI -9% to +7%, p=0.81) and yields of confirmed TB(1.5% vs 1.1%, p=0.62) and new HIV(2.0% vs. 1.8%, p=0.90) diagnoses were similar. Conclusions: Home-based, SMS-facilitated evaluation did not improve completion or yield of household TB contact investigation, likely due to challenges delivering the intervention components.
Stability properties of a projector-splitting scheme for dynamical low rank approximation of random parabolic equations - Numerical tests
<p>Code used to obtain numerical results for the work titled "Stability properties of a projector-splitting scheme for dynamical low rank approximation of random parabolic equations".</p> <p>Associated publication (pre-print) is available at https://arxiv.org/abs/2006.05211</p>
Randomized control trial of SMS for postpartum behaviors and family planning in Kiambu County, Kenya
<p><strong>Background </strong></p> <p>It is estimated that one third of maternal deaths in Kenya in 2014 could have been prevented by more timely care-seeking. Mobile health interventions are increasingly being recognized as tools for the delivery of health education and promotion. Many maternal deaths occur in the first few weeks after delivery and mothers who are given adequate care in the postpartum period have better health outcomes. Kiambu County, Kenya has a high level of literacy and phone ownership amongst mothers delivering in public hospitals and was chosen as a site for a postpartum short message service intervention. </p> <p><strong>Methods </strong></p> <p>Women were recruited after delivery and randomized to receive a package of mobile messages or standard of care only. Messages covered danger signs, general postpartum topics, and family planning. Endline phone surveys were conducted at 8 weeks postpartum to assess knowledge, care seeking behavior and family planning uptake. Analysis was conducted using Stata and is presented in odds ratios. </p> <p><strong>Results </strong></p> <p>Women who received the danger sign messages were 1.6 times more likely to be able to list at least 1 danger sign and 3.51 times more likely to seek treatment if they experienced postpartum danger signs. There was no significant difference in routine postpartum care seeking or care seeking behaviors concerning newborns. Women who received family planning messages were 1.85 times more likely to uptake family planning services compared to controls and 2.1 times more likely to choose a longacting method.</p> <p><strong>Conclusions </strong></p> <p>Simple, low-cost mobile interventions can support women in the early postpartum period when the information is targeted to particular points in the postpartum continuum. Additional research is needed to understand the interplay between healthcare providers and mobile health interventions. Health policy makers should consider direct mobile interventions for women as an option for supporting positive maternal health outcomes in certain populations.</p>
Data from: Scrambler therapy improves pain in neuromyelitis optica: a randomized controlled trial
<p>Objective: The primary objective aimed to determine if Scrambler therapy is an effective, acceptable and feasible treatment of persistent central neuropathic pain in patients with neuromyelitis optica spectrum disorder (NMOSD). The secondary objective explored the effect of Scrambler therapy on co-occurring symptoms.</p> <p>Methods: We conducted a randomized single blind, sham-controlled trial in patients with NMOSD who have central neuropathic pain using Scrambler therapy for 10 consecutive weekdays. Pain severity, pain interference, anxiety, depression and sleep disturbance were assessed at baseline, end of treatment, and at 30- and 60-day follow-up.</p> <p>Results: Twenty-two patients (11 per arm) were enrolled into and completed this trial. The median baseline NRS pain score decreased from 5.0 to 1.5 following 10 days of treatment with Scrambler therapy, whereas the median NRS score did not significantly decrease in the sham arm. Depression was also reduced in the treatment arm, and anxiety was decreased in a subset of patients who responded to treatment. These symptoms were not impacted in the sham arm. The safety profiles were similar between groups.</p> <p>Conclusions: Scrambler therapy is an effective, feasible and safe intervention for central neuropathic pain in patients with NMOSD. Decreasing pain with Scrambler therapy may additionally improve depression and anxiety. Clinicaltrials.gov identifier NCT03452176 Classification of Evidence This study provides Class II evidence for patients with NMOSD and persistent central neuropathic pain that Scrambler therapy significantly reduces pain.</p>
Data from: BCI training to move a virtual hand reduces phantom limb pain: a randomized crossover trial
<p>Objective: To determine whether training with a brain–computer interface (BCI) to control an image of a phantom hand, which moves based on cortical currents estimated from magnetoencephalographic signals, reduces phantom limb pain.</p> <p>Methods: Twelve patients with chronic phantom limb pain of the upper limb due to amputation or brachial plexus root avulsion participated in a randomized single-blinded crossover trial. Patients were trained to move the virtual hand image controlled by the BCI with a real decoder, which was constructed to classify intact hand movements from motor cortical currents, by moving their phantom hands for 3 days ("real training"). Pain was evaluated using a visual analogue scale (VAS) before and after training, and at follow-up for an additional 16 days. As a control, patients engaged in the training with the same hand image controlled by randomly changing values ("random training"). The two trainings were randomly assigned to the patients. This trial is registered at UMIN-CTR (UMIN000013608).</p> <p>Results: VAS at day 4 was significantly reduced from the baseline after real training (45.3 [24.2] to 30.9 [20.6], 1/100mm, mean [SDs]; P=0.009<0.025), but not after random training (P=0.047>0.025). Compared to VAS at day 1, VAS at days 4 and 8 was significantly reduced by 32% and 36%, respectively, after real training and was significantly lower than VAS after random training (P<0.01).</p> <p>Conclusion: Three-day training to move the hand images controlled by BCI significantly reduced pain for one week.<br> Classification of evidence: This study provides Class &#8546; evidence that BCI reduces phantom limb pain.</p> <p> </p>
Supplementary material for: Neural effects of oxytocin and mimicry in frontotemporal dementia: A randomized cross-over study
<p><span>OBJECTIVE: Reduced empathy is one of the hallmark and untreatable symptoms of frontotemporal dementia (FTD). The objective of this study was to determine whether intranasal oxytocin, alone or in combination with instructed mimicry of facial expressions, would augment neural activity in patients with FTD in brain regions associated with empathy, emotion processing and the simulation network, as indexed by blood-oxygen-level dependent (BOLD) signal during functional magnetic resonance imaging (fMRI).</span></p> <p><span>METHODS: In a placebo-controlled, randomized cross-over design, 28 patients with FTD received 72 IU of intranasal oxytocin or placebo and then completed a fMRI facial expression mimicry task. </span></p> <p><span>RESULTS: Oxytocin alone, and in combination with instructed mimicry, increased activity in regions of the simulation network and in limbic regions associated with emotional expression processing. </span></p> <p><span>CONCLUSIONS: The findings demonstrate latent capacity to augment neural activity in affected limbic and other frontal and temporal regions during social cognition in patients with FTD, and support the promise and need for further investigation of these interventions as therapeutics in FTD.</span></p> <p><span><a>CLASSIFICATION OF EVIDENCE:</a> This study provides Class III evidence that a single dose of 72 IU intranasal oxytocin augments BOLD signal in patients with FTD during viewing of emotional facial expressions.</span></p>
Random gas mixtures for efficient gas sensor calibration: Dataset
<p>The dataset was created at the Lab for Measurement Technology (Saarland University). It consists the raw signals (proportional to the logarithmic conductance) of two temperature-modulated semiconductor metaloxide gas sensors (ScioSense AS-MLV and AS-MLV-P2, former AppliedSensor, ams).</p> <p>An exact description of the measurement setup and its results can be found in the open access article:</p> <p>Baur, T., Bastuck, M., Schultealbert, C., Sauerwald, T., and Schütze, A.: Random gas mixtures for efficient gas sensor calibration, J. Sens. Sens. Syst., 9, 411–424, 2020, https://doi.org/10.5194/jsss-9-411-2020</p> <p><strong>Dataset:</strong><br> The mat-file comprises diffrent datasets:</p> <ul> <li><strong>as_mlv: </strong>raw signal (~ logarithmic conductance) of the AS-MLV containing 12202 sensor cycles with 12000 data points (@ 100 Hz)</li> <li><strong>as_mlv_p2: </strong>raw signal (~ logarithmic conductance) of the AS-MLV-P2 containing 12202 sensor cycles with 12000 data points (@ 100 Hz)</li> <li><strong>as_mlv_targets and as_mlv_p2_targets:</strong> <ul> <li><strong>acetone: </strong>acetone concentration in ppb</li> <li><strong>benzene</strong>: benzene concentration in ppb</li> <li><strong>formaldehyde</strong>: formaldehyde concentration in ppb, NaN values are undefined formaldehyde concentrations</li> <li><strong>toluene</strong>: toluene concentration in ppb</li> <li><strong>carbon_monoxide</strong>: carbon monoxide concentration in ppb</li> <li><strong>hydrogen</strong>: hydrogen concentration in ppb</li> <li><strong>humidity</strong>: relative humidity in %RH</li> <li><strong>voc_sum_ppb: </strong>sum of all VOC concentations (acetone, toluene, formaldehyde, benzene) in ppb </li> <li><strong>voc_sum_ugm3: </strong>sum of all VOC concentations (acetone, toluene, formaldehyde, benzene) in µg/m<sup>3</sup></li> <li><strong>count</strong>: number of the gas mixture exposure, each gas mixture exposure contains approx.10 sensor cycles</li> <li><strong>measurement</strong>: number of the measurement, each measurement contains approx.100 gas exposures</li> <li><strong>ranges</strong>: marked cycles for the data evaluation with group number</li> </ul> </li> </ul> <p> </p>
Data from: Life-history dimensions indicate non-random assembly processes in tropical island tree communities
<p>Community assembly processes on islands are often non-random. The mechanisms behind non-random assembly, however, are generally difficult to disentangle. Functional diversity in combination with a null model approach that accounts for differences in species richness among islands can be used to test for non-random assembly processes, but has been applied rarely to island communities. By linking functional diversity of trees on islands with a null model approach, we bridge this gap and test for the role of stochastic vs. non-random trait-mediated assembly processes in shaping communities by studying functional diversity-area relationships. We measured 11 plant functional traits linked to species dispersal and resource acquisition strategies of 57 tree species on 40 tropical islands. We grouped traits into four life-history dimensions representing (i) dispersal ability, (ii) growth strategy, (iii) light acquisition, and (iv) nutrient acquisition. To test for non-random assembly processes, we used null models that account for differences in species richness among the islands. Our results reveal contrasting responses of the four life-history dimensions to island area. The dispersal and the growth strategy dimensions were underdispersed on smaller islands, whereas the light acquisition dimension was overdispersed. The nutrient acquisition dimension did not deviate from null expectations. With increasing island area, shifts in the strength of non-random assembly processes increased the diversity of dispersal and acquisition strategies in island communities. Our results suggest that smaller islands may be more difficult to colonize and provide more limited niche space compared to larger islands, whose tree communities are likely determined by stochastic processes and higher niche diversity. Our null model approach highlights that analysing the functional diversity of different life-history dimensions provides a powerful framework to unravel community assembly processes on islands. These complex, non-random assembly processes are masked by measures of functional diversity that do not account for differences in species richness between islands.</p>
Data from: Initiating Antiretroviral Therapy for HIV at a Patient's First Clinic Visit: The RapIT Randomized Controlled Trial
<p><strong>Background:</strong> High rates of patient attrition from care between HIV testing and antiretroviral therapy (ART) initiation have been documented in sub-Saharan Africa, contributing to persistently low CD4 cell counts at treatment initiation. One reason for this is that starting ART in many countries is a lengthy and burdensome process, imposing long waits and multiple clinic visits on patients. We estimated the effect on uptake of ART and viral suppression of an accelerated initiation algorithm that allowed treatment-eligible patients to be dispensed their first supply of antiretroviral medications on the day of their first HIV-related clinic visit.</p> <p><strong>Methods and Findings: </strong>RapIT was an unblinded randomized controlled trial of single-visit ART initiation in two public sector clinics in South Africa (a primary health clinic (PHC) and a hospital-based HIV clinic). Adult (≥18), non-pregnant patients receiving a positive HIV test or first treatment-eligible CD4 count were randomized to standard or rapid initiation. Rapid arm patients received a point-of-care (POC) CD4 count if needed; those ART-eligible received a POC TB test if symptomatic, POC blood tests, physical exam, education, counseling, and ARV dispensing. Standard arm patients followed standard clinic procedures (3-5 additional clinic visits over 2-4 weeks prior to ARV dispensing). Follow up was by record review only. The primary outcome was viral suppression, defined as initiated, retained in care, and suppressed (<=400 copies/ml) ≤ 10 months of study enrollment. Secondary outcomes included initiation of ART ≤ 90 days of study enrollment; retention in care; time to ART initiation; patient-level predictors of primary outcomes; prevalence of TB symptoms; and the feasibility and acceptability of the intervention. A survival analysis was conducted comparing attrition from care after ART initiation between the groups among those who initiated within 90 days. 377 patients were enrolled in the study between May 8, 2013 and August 29, 2014 (median CD4 count 210 cells/mm<sup>3</sup>). In the rapid arm, 119/187 patients (64%) initiated and were suppressed at 10 months, compared to 96/190 (51%) in the standard arm (RR 1.26 [1.05-1.50]. In the rapid arm 182/187 (97%) initiated ART ≤ 90 days, compared to 136/190 (72%) in the standard arm (relative risk [95% CI] 1.36 [1.24-1.49]. Among 318 patients who did initiate ART within 90 days, the hazard of attrition within the first 10 months did not differ between the treatment arms (HR 1.06; 95% CI 0.61-1.84). The study was limited by the small number of sites and small sample size and the generalizability of the results to other settings and to non-research conditions is uncertain.</p> <p><strong>Conclusions: </strong>Offering single-visit ART initiation to adult patients in South Africa increased uptake of ART by 36% and viral suppression by 26%. It should be considered for adoption in the public sector in Africa.</p>
Gut microbiota in non-obese adolescent girls with polycystic ovary syndrome: effects of randomized treatments
<p class="Paragraph"><span><span><span><span><span><span><span><span><span><span><span><b>Context:</b> Women and obese adolescent girls with polycystic ovary syndrome (PCOS) have altered gut microbiota. </span></span></span></span></span></span></span></span></span></span></span></p> <p class="Paragraph"><span><span><span><span><span><span><span><span><span><span><span><b>Objective:</b> To study the gut microbiota composition of non-obese adolescent girls with PCOS and the effects of randomized pharmacological treatments.</span></span></span></span></span></span></span></span></span></span></span></p> <p class="Paragraph"><span><span><span><span><span><span><span><span><span><span><span><b>Design:</b> Randomized, open-label, single-center controlled trial. </span></span></span></span></span></span></span></span></span></span></span></p> <p class="Paragraph"><span><span><span><span><span><span><span><span><span><span><span><b>Settings:</b> Endocrinology Department, University Hospital. </span></span></span></span></span></span></span></span></span></span></span></p> <p class="Paragraph"><span><span><span><span><span><span><span><span><span><span><span><b>Participants: </b>30 girls with PCOS [age 15.8 years; body mass index (BMI) 25 kg/ m<sup>2</sup>] and 31 controls [age 15.9 years; BMI 22 kg/ m<sup>2</sup>]. </span></span></span></span></span></span></span></span></span></span></span></p> <p class="Paragraph"><span><span><span><span><span><span><span><span><span><span><span><b>Intervention:</b> PCOS girls were randomized to receive an oral contraceptive (OC, N= 15) or spironolactone-pioglitazone-metformin (SPIOMET, N= 15) for 1 year. </span></span></span></span></span></span></span></span></span></span></span></p> <p class="Paragraph"><span><span><span><span><span><span><span><span><span><span><span><b>Outcomes: </b>16S ribosomal subunit gene amplicon sequencing was used to describe and quantify microbial diversity and taxonomic profiles in stool samples from all subjects. Samples from 23 out of 30 girls with PCOS (OC, N= 11; SPIOMET, N= 12) were available for analysis post-treatment. Correlations between bacterial results and endocrine-metabolic variables were performed before and after randomized treatments. </span></span></span></span></span></span></span></span></span></span></span></p> <p class="Paragraph"><span><span><span><span><span><span><span><span><span><span><span><b>Results:</b> Girls with PCOS had decreased diversity alpha, altered microbiota pattern and taxonomic profile with more abundance of <i>Family XI</i> (<i>P</i>= 0.002), and less abundance of family <i>Prevotellaceae</i> (<i>P</i>= 0.0006) and the genus <i>Prevotella</i> (<i>P</i>= 0.0001) and <i>Senegalimassilia</i> (<i>P</i>< 0.0001), as compared to controls. <i>Family XI</i>abundance related positively to hepato-visceral fat (R= 0.453; <i>P</i>= 0.0003). SPIOMET treatment, but not OC, normalized the abundance of <i>Family XI</i>. <i>Prevotellaceae</i>, <i>Prevotella</i> and <i>Senegalimassilia</i> abundance remained unchanged after either treatment. </span></span></span></span></span></span></span></span></span></span></span></p> <p class="Paragraph"><span><span><span><span><span><span><span><span><span><span><span><b>Conclusion:</b> SPIOMET's spectrum of normalizing effects in non-obese girls with PCOS is herewith broadened as to include <i>Family XI</i> abundance in gut microbiota. </span></span></span></span></span></span></span></span></span></span></span></p>
Effect of vitamin D supplementation in patients with chronic hepatitis C after direct-acting antiviral treatment: a randomized, double-blind, placebo-controlled trial
<p><b>Background: </b>Replacement of vitamin D (VD) among patients with chronic hepatitis C (CHC) before viral eradication has demonstrated a protective effect on serum markers associated with hepatic fibrogenesis. We therefore hypothesized that VD may facilitate further fibrosis amelioration following curative treatment with direct-acting antivirals (DAA). </p> <p><b>Methods: </b>This study was a randomized, double-blind, placebo-controlled trial conducted between February 2018 and August 2018. Patients with CHC and VD deficiency were randomized in a 1:1 ratio to either receive ergicalciferol or placebo over 6 weeks. Biochemical analysis indicators, including 25-hydroxyvitamin D (25(OH)D), fibrogenic markers [(transforming growth factor beta 1 (TGF-β1) and tissue inhibitors of matrix metalloproteinases 1 (TIMP-1)], and fibrolytic markers [matrix metalloproteinase 9 (MMP-9) and amino terminal type III procollagen peptide (P3NP)], were assessed at baseline and at 6 weeks. Serum 25(OH)D was analyzed by a chemiluminescence immunoassay. Serum hepatic fibrogenesis markers were measured using a quantitative sandwich enzyme-linked immunosorbent assay.</p> <p><b>Results: </b>Seventy-five patients with CHC and VD deficiency were randomly assigned to VD (n=37) and placebo (n=38) groups. At the end of the study, the mean serum 25(OH)D level had risen to a normal level in the VD group, but was still deficient in the placebo group (41.8±9.1 vs. 18.1±4.6 ng/mL, p<0.001). Upon restoration of the VD level, there were no significant mean differences in the change from baseline for TGF-β1 (-0.6 ng/mL (95% confidence interval (95%CI) -2.8 – 1.7), p=0.63), TIMP-1 (-5.5 ng/mL (95%CI -26.4 – 15.3), p=0.60), MMP-9 (122.9 ng/mL (95%CI -69.0 – 314.8), p=0.21), and P3NP (-0.1 ng/mL (95%CI -2.4 – 2.2), p=0.92) between the VD and placebo groups. </p> <p><b>Conclusion: </b>Short-term VD supplementation after DAA treatment in patients with CHC does not improve serum fibrogenesis markers and may not expedite the residual liver fibrosis healing process. Future studies are warranted to evaluate the long-term effect of VD supplementation on hepatic fibrosis regression.</p>
Data from: The effect of atomoxetine on random and directed exploration in humans
The adaptive regulation of the trade-off between pursuing a known reward (exploitation) and sampling lesser-known options in search of something better (exploration) is critical for optimal performance. Theory and recent empirical work suggest that humans use at least two strategies for solving this dilemma: a directed strategy in which choices are explicitly biased toward information seeking, and a random strategy in which decision noise leads to exploration by chance. Here we examined the hypothesis that random exploration is governed by the neuromodulatory locus coeruleus-norepinephrine system. We administered atomoxetine, a norepinephrine transporter blocker that increases extracellular levels of norepinephrine throughout the cortex, to 22 healthy human participants in a double-blind crossover design. We examined the effect of treatment on performance in a gambling task designed to produce distinct measures of directed exploration and random exploration. In line with our hypothesis we found an effect of atomoxetine on random, but not directed exploration. However, contrary to expectation, atomoxetine reduced rather than increased random exploration. We speculate that our results may be due to interactions with other neuromodulators that are also affected by atomoxetine, or that the reduction in random exploration was driven by a drug-related increase in phasic norepinephrine activity rather than in baseline norepinephrine levels.
Data from: Morphological, cellular and molecular evidences of chromosome random elimination in vivo upon haploid induction in maize
The mechanism of maternal in vivo haploid induction is not fully understood. In this study, the young embryos were identified by morphology, cytology and simple sequence repeat (SSR) markers at different developmental stages in the cross HZ514 (sweet corn) × HZI1 (inducer). The results indicated that the low seed setting rate was determined by the inducer pollen during the process of fertilization. The mosaic endosperm kernels and the different percentages of aneuploidy, mixploidy, lagged chromosome, micronuclei, chromosomal bridge and ring chromosome were found in the cross; 7.37% of the haploid embryos carried chromosome segments from HZI1. About 1% twin seedlings resulted from the cross and were analyzed by cytology and SSR markers. Four pairs of twin seedlings had different chromosome numbers (2n = 20 and 2n = 10–20) and there were some chromosome fragments from HZI1. Aneuploidy, mixploidy and the abnormal chromosomes occurred in the in vivo haploid induction by HZI1, which is the cytological basis for haploid induction and indicates that the inducer's chromosomes are prone to be lost during mitotic and meiotic divisions. Morphological, cellular and molecular evidences reveal that complete or partial chromosome elimination from inducer HZI1 controls the maize in vivo haploid induction.
Data from: The impact of hotspot-targeted interventions on malaria transmission in Rachuonyo south district in the western Kenyan highlands: a cluster-randomized controlled trial
Background: Malaria transmission is highly heterogeneous, generating malaria hotspots that can fuel malaria transmission across a wider area. Targeting hotspots may represent an efficacious strategy for reducing malaria transmission. We determined the impact of interventions targeted to serologically defined malaria hotspots on malaria transmission both inside hotspots and in surrounding communities. Methods and Findings: Twenty-seven serologically defined malaria hotspots were detected in a survey conducted from 24 June to 31 July 2011 that included 17,503 individuals from 3,213 compounds in a 100-km2 area in Rachuonyo South District, Kenya. In a cluster-randomized trial from 22 March to 15 April 2012, we randomly allocated five clusters to hotspot-targeted interventions with larviciding, distribution of long-lasting insecticide-treated nets, indoor residual spraying, and focal mass drug administration (2,082 individuals in 432 compounds); five control clusters received malaria control following Kenyan national policy (2,468 individuals in 512 compounds). Our primary outcome measure was parasite prevalence in evaluation zones up to 500 m outside hotspots, determined by nested PCR (nPCR) at baseline and 8 wk (16 June–6 July 2012) and 16 wk (21 August–10 September 2012) post-intervention by technicians blinded to the intervention arm. Secondary outcome measures were parasite prevalence inside hotpots, parasite prevalence in the evaluation zone as a function of distance from the hotspot boundary, Anopheles mosquito density, mosquito breeding site productivity, malaria incidence by passive case detection, and the safety and acceptability of the interventions. Intervention coverage exceeded 87% for all interventions. Hotspot-targeted interventions did not result in a change in nPCR parasite prevalence outside hotspot boundaries (p ≥ 0.187). We observed an average reduction in nPCR parasite prevalence of 10.2% (95% CI −1.3 to 21.7%) inside hotspots 8 wk post-intervention that was statistically significant after adjustment for covariates (p = 0.024), but not 16 wk post-intervention (p = 0.265). We observed no statistically significant trend in the effect of the intervention on nPCR parasite prevalence in the evaluation zone in relation to distance from the hotspot boundary 8 wk (p = 0.27) or 16 wk post-intervention (p = 0.75). Thirty-six patients with clinical malaria confirmed by rapid diagnostic test could be located to intervention or control clusters, with no apparent difference between the study arms. In intervention clusters we caught an average of 1.14 female anophelines inside hotspots and 0.47 in evaluation zones; in control clusters we caught an average of 0.90 female anophelines inside hotspots and 0.50 in evaluation zones, with no apparent difference between study arms. Our trial was not powered to detect subtle effects of hotspot-targeted interventions nor designed to detect effects of interventions over multiple transmission seasons. Conclusions: Despite high coverage, the impact of interventions targeting malaria vectors and human infections on nPCR parasite prevalence was modest, transient, and restricted to the targeted hotspot areas. Our findings suggest that transmission may not primarily occur from hotspots to the surrounding areas and that areas with highly heterogeneous but widespread malaria transmission may currently benefit most from an untargeted community-wide approach. Hotspot-targeted approaches may have more validity in settings where human settlement is more nuclear. Trial registration: ClinicalTrials.gov NCT01575613.
Data from: Randomized study of the impact of a therapeutic education program on patients suffering from chronic low-back pain who are treated with transcutaneous electrical nerve stimulation
Background: Transcutaneous electrical nerve stimulation (TENS) is often used for the treatment of low-back pain (LBP). However, its effectiveness is controversial. Objective: To determine the efficacy of TENS in the treatment LBP when associated to a therapeutic education program (TEP). Design: Open randomized monocentric study. Setting: University hospital between 2010 and 2014. Patients: A total of 97 patients suffering from LBP. Interventions: Routine care (TENS group) or routine care plus a therapeutic education program (TENS-TEP group) based on consultation support by a pain resource nurse Main outcome measures: EIFEL and Dallas Pain Questionnaire scores. Results: Twenty-two patients (44%) were still assessable at the end-of-study visit, whereas 33 (70%) were assessable at the same time point in the TENS-TEP group (P = 0.013). The EIFEL score and the Dallas score had a similar evolution over time between groups (p = 0.18 and p = 0.50 respectively). Similarly, there were no significant differences between the groups with respect to resting pain scores (p = 0.94 for back pain and p = 0.16 for leg pain) and movement pain scores (p = 0.52 for back pain and p = 0.56 for leg pain). At Month 6, there was no significant difference between the groups (p = 0.85) with regard to analgesics and social impact. Two patients presented a serious adverse event during the study (one in each group) but non-attributable to the treatment studied. Conclusion: This study does not support the use of TENS in the treatment of patients with chronic LBP even though patients benefited from a therapeutic education program by a pain resource nurse. However, the higher number of premature withdrawals in the TENS group may be due to early withdrawal of patients who did not experience improvement of their symptoms.
Data from: Effect of ecological momentary assessment, goal-setting and personalized phone-calls on adherence to interval walking training using the InterWalk application among patients with type 2 diabetes – a pilot randomized controlled trial
Objectives: The objective was to investigate the feasibility and usability of structured text-messages, goal-setting and phone-calls on adherence to a 12-week self-conducted interval walking training (IWT) program, delivered by the InterWalk smartphone among patients with type 2 diabetes (T2D). Methods: In a two-arm pilot randomized controlled trial (Denmark, March 2014 to February 2015), patients with T2D (18-80 years with a Body Mass Index of 18 and 40 kg/m2) were randomly allocated to 12 weeks of IWT with (intervention) or without additional support (control). The primary outcome was the difference between groups in accumulated time of interval walking training across 12 weeks. All patients were encouraged to use the InterWalk application to perform IWT for ≥90 minute/week. Patients in the intervention group made individual goals regarding lifestyle change, received automated text-messages once a week, inquiring about exercise adherence. In case of consistent non-adherence, the patients would receive a phone-call inquiring about the reason for non-adherence. The control group did not receive additional support. Information about training adherence was assessed objectively. Usability of structured text-messages was assessed based on response rates and self-reported satisfaction after 12-weeks. Results: Thirty-seven patients with T2D (66 years, 65% female, hemoglobin 1Ac 50.3 mmol/mol) where included (n=18 and n=19 in intervention and control group, respectively). The retention rate was 83%. The intervention group accumulated [95%CI] 345 -7, 698 minutes of IWT more than the control group. The response rate for the text-messages was 83% (68% for males and 90% for females). Forty-one percent of the intervention and 25% of the control group were very satisfied with their participation. Conclusion: The combination of structured text-messages, goal-setting with the possibility of follow-up phone calls are considered feasible interventions to attain training adherence when using the InterWalk app during a 12-week period in patients with T2D. Some uncertainty about the effect size of adherence remains.
Data from: Improving rational use of ACTs through diagnosis-dependent subsidies: evidence from a cluster-randomized controlled trial in western Kenya
Background: More than half of artemisinin combination therapies (ACTs) consumed globally are dispensed in the retail sector where diagnostic testing is uncommon, leading to overconsumption and poor targeting. In many malaria-endemic countries, ACTs sold over-the-counter are available at heavily subsidized prices, further contributing to their misuse. Inappropriate use of ACTs can have serious implications for the spread of drug resistance and leads to poor outcomes for non-malaria patients treated with incorrect drugs. We evaluated the public health impact of an innovative strategy that targets ACT subsidies to confirmed malaria cases by coupling free diagnostic testing with a diagnosis-dependent ACT subsidy. Methods and Findings: We conducted a cluster-randomized controlled trial in 32 community clusters in western Kenya (population ~160,000). Eligible clusters had retail outlets selling ACTs and existing community health worker (CHW) programs and were randomly assigned 1:1 to control and intervention arms. In intervention areas, CHWs were available in their villages to perform malaria rapid diagnostic tests on demand for any individual >1 year of age experiencing a malaria-like illness. Malaria RDT positive individuals received a voucher for a discount on a quality-assured ACT, redeemable at a participating retail medicine outlet. In control areas, CHWs offered a standard package of health education, prevention and referral services. We conducted four population-based surveys, at baseline, 6 months, 12 months and 18 months, of a random sample of households with fever in the last 4 weeks to evaluate predefined, individual-level outcomes. The primary outcome was uptake of malaria diagnostic testing at 12 months. The main secondary outcome was rational ACT use, defined as the proportion of ACTs used by test-positive individuals. Analyses followed the intention-to-treat principle using generalized estimating equations to account for clustering with pre-specified adjustment for gender, age, education and wealth. All descriptive statistics and regressions were weighted to account for sampling design. Between July 2015 and May 2017, 32,404 participants were tested for malaria and 10,870 vouchers were issued. 7416 randomly-selected participants with recent fever from all 32 clusters were surveyed. The majority of recent fevers were in children under 18 years (62.9%, n=4653). The gender of enrolled participants was balanced in children (50.0%, n=2318 v 50.2%, n=2335), but more adult women were enrolled than men (78.0%, n=2139 v 22.0%, n=604). At baseline, 67.6% (n=1362) of participants took an ACT for their illness and 40.3% (n=810) of all participants took an ACT purchased from a retail outlet. At 12 months, 50.5% (n=454) in the intervention arm and 43.4% (n=389) in the control arm had a malaria diagnostic test for their recent fever (Adjusted Risk Difference=9 percentage points [pp], 95%CI: 2-15pp, p=0.015; Adjusted Risk Ratio=1.20, 95%CI:1.05-1.38, p=0.015). By 18-months, the ARR had increased to 1.25 (95%CI:1.09-1.44, p=0.005). Rational use of ACTs in the intervention area increased from 41.7% (n=279) at baseline to 59.6% (n=403) and was 40% higher in the intervention arm at 18 months (Adj RR 1.40, 95%CI: 1.19-1.64). While intervention effects increased between 12 and 18 months, we were not able to estimate longer-term impact of the intervention and could not independently evaluate the effects of the free testing and the voucher on uptake of testing. Conclusions: Diagnosis-dependent ACT subsidies and community-based interventions that include the private sector can have an important impact on diagnostic testing and population-wide rational use of ACTs. Targeting of the ACT subsidy itself to those with a positive malaria diagnostic test may also improve sustainability and reduce the cost of retail sector ACT subsidies.
Data from: Integration of Random Forest with population-based outlier analyses provides insight on the genomic basis and evolution of run timing in Chinook salmon (Oncorhynchus tshawytscha)
Anadromous Chinook salmon populations vary in the period of river entry at the initiation of adult freshwater migration, facilitating optimal arrival at natal spawning. Run timing is a polygenic trait that shows evidence of rapid parallel evolution in some lineages, signifying a key role for this phenotype in the ecological divergence between populations. Studying the genetic basis of local adaptation in quantitative traits is often impractical in wild populations. Therefore, we used a novel approach, Random Forest, to detect markers linked to run timing across 14 populations from contrasting environments in the Columbia River and Puget Sound, USA. The approach permits detection of loci of small effect on the phenotype. Divergence between populations at these loci was then examined using both principle component analysis and FST outlier analyses, to determine whether shared genetic changes resulted in similar phenotypes across different lineages. Sequencing of 9107 RAD markers in 414 individuals identified 33 predictor loci explaining 79.2% of trait variance. Discriminant analysis of principal components of the predictors revealed both shared and unique evolutionary pathways in the trait across different lineages, characterized by minor allele frequency changes. However, genome mapping of predictor loci also identified positional overlap with two genomic outlier regions, consistent with selection on loci of large effect. Therefore, the results suggest selective sweeps on few loci and minor changes in loci that were detected by this study. Use of a polygenic framework has provided initial insight into how divergence in a trait has occurred in the wild.
Data from: A single session of hyperbaric oxygen therapy demonstrates acute and long-lasting neuroplasticity effects in humans: a replicated, randomized controlled clinical trial
Purpose: Animal studies have demonstrated anti-inflammatory, and anti-nociceptive properties of hyperbaric oxygen therapy (HBOT). However, physiological data are scarce in humans. In a recent experimental study, the authors used the burn injury (BI) model observing a decrease in secondary hyperalgesia area (SHA) in the HBOT-group compared to a control-group.Surprisingly, a long-lasting neuroplasticity effect mitigating the BI-induced SHA-response was seen in the HBOT-preconditioned group. The objective of the present study, therefore, was to confirm our previous findings using an examiner-blinded, block-randomized, controlled, crossover study design. Patients and methods: Nineteen healthy subjects attended two BI-sessions with an inter-session interval of ≥28 days. The BIs were induced on the lower legs by a contact thermode (12.5 cm2, 47C°, 420 s). The subjects were block-randomized to receive HBOT (2.4 ATA, 100% O2, 90 min) or ambient conditions ([AC]; 1 ATA, 21% O2), dividing cohorts equally into two sequence allocations: HBOT-AC or AC-HBOT. All sensory assessments performed during baseline, BI, and post-intervention phases were at homologous time points irrespective of sequence allocation. The primary outcome was SHA, comparing interventions and sequence allocations. Data are mean (95% CI). Results: During HBOT-sessions a mitigating effect on SHAs was demonstrated compared to AC-sessions, ie, 18.8 (10.5–27.0) cm2 vs 32.0 (20.1–43.9) cm2 (P=0.021), respectively. In subjects allocated to the sequence AC-HBOT a significantly larger mean difference in SHA in the AC-session vs the HBOT-session was seen 25.0 (5.4–44.7) cm2 (P=0.019). In subjects allocated to the reverse sequence, HBOT-AC, no difference in SHA between sessions was observed (P=0.55), confirming a preconditioning, long-lasting (≥28 days) effect of HBOT. Conclusion: Our data demonstrate that a single HBOT-session compared to control is associated with both acute and long-lasting mitigating effects on BI-induced SHA, confirming central anti-inflammatory, neuroplasticity effects of hyperbaric oxygen therapy.
Data from: Auriculotherapy in the prevention of postoperative urinary retention in patients with thoracotomy and thoracic epidural analgesia: a randomized, double-blinded trial
Background: Thoracic epidural analgesia is associated with a high rate of postoperative urine retention (POUR). Auriculotherapy can reduce visceral dysfunction and can be helpful in anesthesiology and pain control. The aim of this study was to test the efficacy of preoperative auriculotherapy to decrease the occurrence of POUR. Methods: This single-center, double-blinded, two-arm randomized study was performed between January 2015 and May 2016 in a tertiary care university hospital. Male patients scheduled for an elective lung surgical procedure under combined general anesthesia and thoracic epidural analgesia were included. Auriculotherapy (A group) was performed once the patient was under general anesthesia with five semi-permanent needles inserted in both ears at the "Shen Men", "bladder", "pelvic parasympathetic", "anterior hypothalamus", and "frontal lobe" points). Five small round patches of adhesive pads were positioned bilaterally at the same points in the Control group (C group). The main outcome measure was the requirement for bladder catheterization during the day and the first night following surgery. Results: Fifty-three patients were randomized and 25 analyzed in each group. Requirement for bladder catheterization was different between groups: 24 C group patients (96%) and 18 A group patients (72%) (p=0.049, Fisher exact test; Odds Ratio=0.11 [0.01–0.95]. The number of patients needed to treat with auriculotherapy to avoid one case of bladder catheterization was four. No adverse effect was observed due to auriculotherapy. Conclusion: This study demonstrates that auriculotherapy is a safe and useful technique reducing POUR in thoracotomy patients benefiting from thoracic epidural analgesia.
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Allen Brain Atlas
Allen Brain Atlas is an Allen Institute collection of brain map atlases, datasets, APIs, and analysis tools covering mouse, human, and non-human primate brain resources.
Annotated Behaviour and Observability Dataset (ABODe)
ABODe is a University of Edinburgh DataShare dataset for behavior classification in group-housed mice using home-cage video, identities, bounding boxes, ground-plate positions, and annotator labels.
DANDI Archive for NWB datasets
DANDI is a BRAIN Initiative archive for publishing and sharing neurophysiology data, including electrophysiology, optophysiology, and behavioral data packaged as NWB and related standards.
International Brain Laboratory public data
The International Brain Laboratory public data releases expose standardized mouse decision-making experiments, including Neuropixels recordings, widefield calcium imaging, behavior, and session metadata accessed through the ONE API.
OpenNeuro
OpenNeuro is a free, open platform for sharing neuroimaging datasets, with public search, dataset pages, and download paths for web, S3, DataLad, and the OpenNeuro CLI.