Assessment of Vigilance Level during Work: Fitting a Hidden Markov Model to Heart Rate Variability.

This study aimed to enhance the real-time performance and accuracy of vigilance assessment by developing a hidden Markov model (HMM). Electrocardiogram (ECG) signals were collected and processed to remove noise and baseline drift. A group of 20 volunteers participated in the study. Their heart rate variability (HRV) was measured to train parameters of the modified hidden Markov model for a vigilance assessment. The data were collected to train the model using the Baum-Welch algorithm and to obtain the state transition probability matrix A^ and the observation probability matrix B^. Finally, the data of three volunteers with different transition patterns of mental state were selected randomly and the Viterbi algorithm was used to find the optimal state, which was compared with the actual state. The constructed vigilance assessment model had a high accuracy rate, and the accuracy rate of data prediction for these three volunteers exceeded 80%. Our approach can be used in wearable products to improve their vigilance level assessment functionality or in other fields that have key positions with high concentration requirements and monotonous repetitive work.

Feasibility and Satisfaction of Using NET VITALS Self-assessment Tool Among Patients With Neuroendocrine Tumors.

OBJECTIVES: There is a lack of effective patient education regarding diagnosis/treatment of neuroendocrine tumors (NETs), possibly related to their rare incidence. METHODS: In this cross-sectional survey study, NET patients attending the 2019 Annual Los Angeles NET Education Conference were approached to complete NET VITALS, a self-assessment tool gauging patients' perception/awareness of their NET diagnosis/treatment, and a satisfaction survey. Feasibility of NET VITALS, patient satisfaction with NET VITALS, and patients' perception/awareness of their NET diagnosis/treatment were evaluated. RESULTS: This analysis included 68 patients (median age, 63 years; 47.1% gastrointestinal NETs; 88.2% metastatic disease). Participation was 88.3% (68/77), with a median of 85.7% of items completed (range, 61.9%-100.0%). More than 30% of the patients answered "Don't know/Not familiar"/left blank questions related to tumor characteristics, years of symptoms, and liver-directed therapies. In addition, 69.5% of the patients did not feel sufficient information about NETs was provided at diagnosis. Overall, 67.8% of the patients felt that NET VITALS provides topics to discuss with providers and 76.3% would recommend NET VITALS to others. CONCLUSIONS: NET VITALS is a feasible and acceptable self-assessment tool to potentially help patients improve communication about their NET diagnosis/treatment with their physician. Further studies will examine NET VITALS' generalizability and discuss its incorporation into clinical care.

Trace Metal Lead Exposure in Typical Lip Cosmetics From Electronic Commercial Platform: Investigation, Health Risk Assessment and Blood Lead Level Analysis.

Lead (Pb) in lipstick products has become an increasing concern, which can cause safety problems to human body directly with diet. To investigate the Pb exposure and potential health risk level of typical popular lip cosmetics in Chinese e-commerce market, Python crawler was introduced to identify and select 34 typical popular lip cosmetics, including 12 lipsticks, 13 lip glosses, and 9 lip balms. And then this study used ICP-MS to determine the content of Pb. Furthermore, the ingestion health risk assessment method issued by United States Environmental Protection Agency (USEPA) and Monte Carlo simulation algorithm were applied to assess the probabilistic health risks of adults exposure. Finally, taking the possible exposure of children contacting with lip products, the health risk assessment of children blood Pb was carried out. The results showed that the concentration of Pb in lip products ranged from 0 to 0.5237 mg/kg, which was far lower than the limit set by various countries. The probabilistic non-carcinogenic risks and carcinogenic risks were 4.93 ×10-7~2.82 ×10-3 and 1.68 ×10-12~9.59 ×10-9, respectively, which were in an acceptable level. The results of blood Pb assessment suggested that the Pb content of lip cosmetics had no obvious influence on blood Pb concentration of children, and background Pb exposure is the main factor affecting children's blood Pb level (BLL). Overall, the samples of lip products are selected by Python crawler in this study, which are more objective and representative. This study focuses on deeper study of Pb, especially for the health risk assessment of blood Pb in children exposed to lip products. These results perhaps could provide useful information for the safety cosmetics usage for people in China and even the global world.

Comparing the downstream costs and healthcare utilization associated with the use of low-dose computed tomography (LDCT) in lung cancer screening in patients with and without alzheimer's disease and related dementias (ADRD).

OBJECTIVE: This study aims to compare the downstream costs and healthcare utilization associated with using low-dose computed tomography (LDCT) for lung cancer screening in patients with and without Alzheimer's disease and related dementias (ADRD). METHODS: Based on data from IBM MarketScan Commercial Claims Databases (2014-2018), we have identified four study cohorts: ADRD and non-ADRD patients who went through LDCT screening; ADRD and non-ADRD patients without LDCT screening. Annually healthcare utilization and cost were grouped into outpatient, inpatient, and pharmacy. We used difference-in-differences (DID) models to estimate the downstream healthcare utilization and cost associated with LDCT screening in both ADRD and non-ADRD population. We used a difference-in-difference-in-differences (DDD) model to explore whether LDCT screening was associated with higher downstream cost and healthcare utilization in ADRD population than non-ADRD population. RESULT: Compared to individuals without LDCT screening, LDCT screening was associated with increased outpatient visits (2.1, 95% CI 0.7, 3.4) and outpatient cost ($2301.0, 95% CI 296.2, 4305.8) in the ADRD population and increased outpatient visits (0.6, 95% CI 0.1, 1.1) in the non-ADRD population within 1 year after screening. Compared with the non-ADRD population, LDCT screening was found to be associated with an additional 1.5 (95% CI 0.2, 2.8) outpatient visits, 0.7 (95% CI 0.1, 1.3) days of inpatient stays, and $4,960.4 (95% CI 532.7, 9388.0) in overall healthcare costs within 1-year after LDCT in the ADRD population (all p < .5). CONCLUSION: The downstream cost and healthcare utilization associated with LDCT screening were found to be higher in the ADRD population compared to the average population.

Investigation and probabilistic health risk assessment of trace elements in good sale lip cosmetics crawled by Python from Chinese e-commerce market.

A growing body of evidence suggests that the lip products are polluted by heavy metals, which would inevitably cause safety problems with long-term exposure, but few studies have focused on their deeper health risk assessments. This study sets out to identify the lip cosmetics in good sale from Chinese e-commerce market utilizing Python crawler and then explore the probabilistic health risks caused by 6 trace elements in 34 most popular lip cosmetics with Monte Carlo simulation. The results found that there was no obvious non-carcinogenic risk to humans. As for high users, the carcinogenic risk levels of Cr exceeded the acceptable risk recommended by USEPA, approximately 10% and 25% for lipsticks and lip glosses, respectively. Cr was regarded as the priority metal for risk control in the present study. Finally, it was recommended that the minimum use period limit for using up one lip product ranged from 0.54 months to 5.74 months. Overall, this study appears to be the first to conduct a probabilistic health risk assessment of trace elements in lip products, which would be of significance for policy makers to take effective strategies to minimize exposure health risk and contamination.