Birth anthropometry among three Asian racial groups in Singapore: proposed new growth charts.

OBJECTIVE: We analysed birth anthropometry of babies of Chinese, Malay and Indian ancestry living in Singapore with an aim to develop gestational age (GA) and gender-specific birth anthropometry charts and compare these with the widely used Fenton charts. DESIGN: Retrospective observational study. SETTING: Department of Neonatology, National University Hospital, Singapore. POPULATION: We report data from 52 220 infants, born between 1991-1997 and 2010-2017 in Singapore. METHODS: Anthropometry charts were built using smoothened centile curves and compared with Fenton's using binomial test. Birth weight (BW), crown-heel length and head circumference (HC) were each modelled with maternal exposures using general additive model. MAIN OUTCOME MEASURES: BW, crown-heel length and HC. RESULTS: There were 22 248 Chinese (43%), 16 006 Malay (31%) and 8543 Indian (16%) babies. Mean BW was 3103 g (95% CI 3096 to 3109), 3075 g (95% CI 3067 to 3083) and 3052 g (95% CI 3041 to 3062) for Chinese, Malays and Indians, respectively. When exposed to a uniform socioeconomic environment, intrauterine growth and birth anthropometry of studied races were almost identical. From our GA-specific anthropometric charts until about late prematurity, Asian growth curves mirrored that of Fenton's; thereafter, Asian babies showed a reduction in growth velocity. CONCLUSIONS: These findings suggest that Asian babies living in relatively uniform socioeconomic strata exhibit similar growth patterns. There is a slowing of growth among Asian babies towards term, prompting review of existing birth anthropometry charts. The proposed charts will increase accuracy of identification of true fetal growth restriction as well as true postnatal growth failure in preterm infants when applied to the appropriate population.

The efficacy of acupuncture combined with Bailemian capsule in the treatment of cervical spondylosis accompanied by headache, anxiety, and depression.

OBJECTIVE: The present study aimed to investigate the efficacy of using acupuncture combined with Bailemian capsule to treat cervical spondylosis by observing the improvement in the degree of headache, anxiety, and depression suffered by patients. METHODS: A total of 100 patients with cervical spondylosis of the cervical type were equally divided into a combination group and a control group using the random number table method. The patients in the combination group were treated with acupuncture combined with the oral administration of Bailemian capsule, while those in the control group were only treated with acupuncture. Patient self-assessment was conducted, comprising the visual analogue scale, the self-assessment scale for anxiety, and the self-assessment scale for depression. Before treatment and on the14th and 28th days of treatment, the therapeutic effects of the two treatment modalities on the cervical spondylosis and accompanying headache, anxiety, and depression were analyzed using the Hamilton anxiety scale, the Hamilton depression scale, the Pittsburgh sleep quality inventory, and the Neck Disability Index (%). RESULTS: There were statistically significant differences between the two groups in all seven indicators at the different treatment time points (p < 0.01). The seven indicators were significantly reduced in both groups on the 14th and 28th days of treatment compared with before the treatment. Moreover, except for the Neck Disability Index results at 14 days, which did not differ between the groups (p = 0.37), all the other indicators were significantly lower in the combination group than in the control group on the 14th and 28th days of treatment (p < 0.01), and at the end of the treatment, the therapeutic effect was significantly better in the combination group than in the control group (p = 0.006). CONCLUSION: Both acupuncture combined with Bailemian Capsule and acupuncture alone were effective in the treatment of cervical spondylosis, but the combination therapy was better than the acupuncture alone in improving the accompanying negative symptoms of headache, anxiety, and depression.

Stratification of Patients with Diabetes Using Continuous Glucose Monitoring Profiles and Machine Learning.

Background. Continuous glucose monitoring (CGM) offers an opportunity for patients with diabetes to modify their lifestyle to better manage their condition and for clinicians to provide personalized healthcare and lifestyle advice. However, analytic tools are needed to standardize and analyze the rich data that emerge from CGM devices. This would allow glucotypes of patients to be identified to aid clinical decision-making.Methods. In this paper, we develop an analysis pipeline for CGM data and apply it to 148 diabetic patients with a total of 8632 days of follow up. The pipeline projects CGM data to a lower-dimensional space of features representing centrality, spread, size, and duration of glycemic excursions and the circadian cycle. We then use principal components analysis and k-means to cluster patients' records into one of four glucotypes and analyze cluster membership using multinomial logistic regression.Results. Glucotypes differ in the degree of control, amount of time spent in range, and on the presence and timing of hyper- and hypoglycemia. Patients on the program had statistically significant improvements in their glucose levels.Conclusions. This pipeline provides a fast automatic function to label raw CGM data without manual input.

Identifying COVID-19 cases in outpatient settings.

Case identification is an ongoing issue for the COVID-19 epidemic, in particular for outpatient care where physicians must decide which patients to prioritise for further testing. This paper reports tools to classify patients based on symptom profiles based on 236 severe acute respiratory syndrome coronavirus 2 positive cases and 564 controls, accounting for the time course of illness using generalised multivariate logistic regression. Significant symptoms included abdominal pain, cough, diarrhoea, fever, headache, muscle ache, runny nose, sore throat, temperature between 37.5 and 37.9 °C and temperature above 38 °C, but their importance varied by day of illness at assessment. With a high percentile threshold for specificity at 0.95, the baseline model had reasonable sensitivity at 0.67. To further evaluate accuracy of model predictions, leave-one-out cross-validation confirmed high classification accuracy with an area under the receiver operating characteristic curve of 0.92. For the baseline model, sensitivity decreased to 0.56. External validation datasets reported similar result. Our study provides a tool to discern COVID-19 patients from controls using symptoms and day from illness onset with good predictive performance. It could be considered as a framework to complement laboratory testing in order to differentiate COVID-19 from other patients presenting with acute symptoms in outpatient care.

Beyond physical entrainment: competitive and cooperative mental stances during identical joint-action tasks differently affect inter-subjective neural synchrony and judgments of agency.

Little work has examined how mental stance alone, apart from physical entrainment, affects between-participant neural synchrony during joint social interaction. We report the first findings on how cooperative and competitive mental stances, even during identical visuomotor joint-action tasks, result in distinct neural oscillatory signatures in low beta and theta band between-participant phase synchrony. Two participants jointly controlled a cursor and were instructed to either compete or cooperate to move it to one of three targets. The visuomotor output was identical for both the compete and cooperate conditions because participants were privately given the same target for experimental trials. Cooperation enhanced theta band between-participant phase-locking value (PLV) midtrial at 1-2 seconds, reflecting activation of systems for social coordination to move the cursor in a shared direction. Competition enhanced low beta between-participant PLV, shifting from temporal to frontal regions, indicating that participants focused only on their target and later evaluated self-agency as winner or loser. This interpretation of the neural signature was corroborated by participants' greater post-trial ratings of the degree of control over the cursor during competition. Top-down cooperative and competitive mental stances shape perceptions of social context and affect interpersonal neural synchrony important for representation of self and others' actions.

Groups and Emotional Arousal Mediate Neural Synchrony and Perceived Ritual Efficacy.

We present the first neurophysiological signatures showing distinctive effects of group social context and emotional arousal on cultural perceptions, such as the efficacy of religious rituals. Using a novel protocol, EEG data were simultaneously recorded from ethnic Chinese religious believers in group and individual settings as they rated the perceived efficacy of low, medium, and high arousal spirit-medium rituals presented as video clips. Neural oscillatory patterns were then analyzed for these perceptual judgements, categorized as low, medium, and high efficacy. The results revealed distinct neural signatures and behavioral patterns between the experimental conditions. Arousal levels predicted ratings of ritual efficacy. Increased efficacy was marked by suppressed alpha and beta power, regardless of group or individual setting. In groups, efficacy ratings converged. Individual setting showed increased within-participant phase synchronization in alpha and beta bands, while group setting enhanced between-participant theta phase synchronization. This reflected group participants' orientation toward a common perspective and social coordination. These findings suggest that co-presence in groups leads to a social-tuning effect supported by between-participant theta phase synchrony. Together these neural synchrony patterns reveal how collective rituals have both individual and communal dimensions. The emotionality of spirit-medium rituals drives individual perceptions of efficacy, while co-presence in groups signals the significance of an event and socially tunes enhanced agreement in perceptual ratings. In other words, mass gatherings may foster social cohesion without necessarily requiring group-size scaling limitations of direct face-to-face interaction. This could have implications for the scaling computability of synchrony in large groups as well as for humanistic studies in areas such as symbolic interactionism.