As portable chest X-rays are an efficient means of triaging emergent cases, their increased use has raised the question as to whether imaging carries additional prognostic utility for survival among patients with COVID-19. This study assessed the importance of known risk factors on in-hospital mortality and to investigate the predictive utility of radiomic texture features using various machine learning approaches. We detected incremental improvements in survival prognostication utilizing texture features derived from emergent chest X-rays, particularly among older patients or those with higher comorbidity burden. Important features included age, oxygen saturation, blood pressure, and certain comorbid conditions, as well as image features related to the intensity and variability of the pixel distribution. Thus, widely available chest X-rays, in conjunction with clinical information, may be predictive of survival outcomes of patients with COVID-19, especially older, sicker patients, and can aid in disease management by providing additional information.
ObjectivesThe main purpose of this study was to quantify the risk of mortality linked to various regimens of hypertonic peritoneal dialysis (PD) solution.MethodsA retrospective cohort study of patients using home-based PD was carried out. The prescribed regimen of glucose-based PD solution for all patients, determined on the basis of their individual conditions, was extracted from their medical chart records. The primary outcome was death. The treatment regimens were categorized into 3 groups according to the type of PD solution used: original PD (1.5% glucose), shuffle PD (1.5 and 2.5% glucose), and serialized PD (2.5 and 4.5% glucose). Multivariate analysis (using the Weibull model) was applied to comprehensively examine survival probabilities related to the explanatory variable, while adjusting for other potential confounders.ResultsOf 300 consecutive patients, 38% died over a median follow-up time of 30 months (interquartile range: 15-46 months). Multivariate analysis showed that a treatment regimen with continued higher-strength PD solution (serialized PD) resulted in a lower survival rate than when the conventional strength solution was used (adjusted hazard ratio, 2.6; 95% confidence interval, 1.6 to 4.6, p<0.01). Five interrelated risk factors (age, length of time on PD, hemoglobin levels, albumin levels, and oliguria) were significant predictors contributing to the outcome.ConclusionsFrequent exposure to high levels of glucose PD solution significantly contributed to a 2-fold higher rate of death, especially when hypertonic glucose was prescribed continuously.
As portable chest X-rays are an efficient means of triaging emergent cases, their use has raised the question as to whether imaging carries additional prognostic utility for survival among patients with COVID-19. This study assessed the importance of known risk factors on in-hospital mortality and investigated the predictive utility of radiomic texture features using various machine learning approaches. We detected incremental improvements in survival prognostication utilizing texture features derived from emergent chest X-rays, particularly among older patients or those with a higher comorbidity burden. Important features included age, oxygen saturation, blood pressure, and certain comorbid conditions, as well as image features related to the intensity and variability of pixel distribution. Thus, widely available chest X-rays, in conjunction with clinical information, may be predictive of survival outcomes of patients with COVID-19, especially older, sicker patients, and can aid in disease management by providing additional information.
Sleep problem or insomnia is one of the most common causes of health problems, affecting around 10 - 20 % of the world population. Traditional Thai massage (TTM) is a popular alternative treatment in Thailand for reducing fatigue and improving sleep quality. This study aimed to examine the effect of traditional Thai massage on sleep quality in adults. Twenty-eight adults with poor sleep quality (based on Verran and Snyder-Halpern sleep scale) participated. They were randomly allocated into a control group (n = 14) and a TTM group (n = 14). Participants in the TTM group received three 90-min whole body traditional Thai massage sessions within one week, whereas the control group participants maintained their daily lives. Quality of sleep was assessed before and a day after the massage sessions. The outcome measure was the Verran and Snyder-Halpern sleep scale. The within-group data was analyzed by Paired t-test, whereas ANCOVA did the between-group data.
The results showed that the participants in the TTM group had significantly decreased score of sleep disturbance (31.63 ± 2.95 vs 45.47 ± 3.24, p < 0.001) and increased the effectiveness score (70.73 ± 7.33 vs 53.47 ± 4.23, p < 0.001) after the last session of massage as compared to those of the control group. We conclude that TTM could significantly improve sleep quality without any adverse effects.
HIGHLIGHTS
The overall prevalence of insomnia in Thai adults was 40.8 % and is commonly found in the Thai population
Sleep quality was associated with all the academic performance in adolescents and cognitive function in adults
Traditional Thai massage could significantly improve sleep quality without any adverse effects
Since this treatment is generally safe and comfortable, it could be used as an alternative therapy to treat people with sleep problems
GRAPHICAL ABSTRACT
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