Twin Status Research Articles

Bayesian Accelerated Failure Time Model With Spatial Dependency: Application To Under Five Mortality Rate

Nigeria is one of the top five in the world with the highest under-five mortality (U5M) rate. The risk of U5M in Nigeria is assumed to vary from one state to another due to diversity in socio-economic and even environmental factors. Thus, this study aimed to quantified the hazard of U5M using Bayesian Accelerated Failure Time (AFT) with spatial dependency. The data for the study were obtained from 2018 Nigerian Demographic and Health Survey (NDHS). The study utilized Bayesian technique based on Markov Chain Monte Carlo (MCMC) technique to obtained the posterior estimates of the parameters. The Loglogistic, Weibull and Lognormal AFT models with and without spatial dependency were considered in this study. Out of these models used, the log-logistic AFT model with Intrinsic Conditional Autoregressive (ICAR) spatial prior performed better than the other models considered in the study. The findings revealed that the survival of under-five children (U5C) was not homogeneous across the states (95% CI: 2.6330, 11.4630). The subject-specific factors such as maternal age at birth, duration of breast feeding, preceding birth intervals, maternal educational qualification, wealth index, region, number of antenatal visits, duration of pregnancy, gender of child, twin status, contraceptive used and toilet facility were the significant risk factors of U5M. Based on these findings, it was recommended among others that the disparities observed across states should be taken into account at the policy level in order to meet the Sustainable Development Goal (SDG) 2030 targets.

Polygenic Risk Scores and Twin Concordance for Schizophrenia and Bipolar Disorder

Schizophrenia and bipolar disorder are highly heritable psychiatric disorders with strong genetic and phenotypic overlap. Twin and molecular methods can be leveraged to predict the shared genetic liability to these disorders. To investigate whether twin concordance for psychosis depends on the level of polygenic risk score (PRS) for psychosis and zygosity and compare PRS from cases and controls from several large samples and estimate the twin heritability of psychosis. In this case-control study, psychosis PRS were generated from a genome-wide association study (GWAS) combining schizophrenia and bipolar disorder into a single psychosis phenotype and compared between cases and controls from the Schizophrenia and Bipolar Twin Study in Sweden (STAR) project. Further tests were conducted to ascertain if twin concordance for psychosis depended on the mean PRS for psychosis. Structural equation modeling was used to estimate heritability. This study constituted an analysis of existing clinical and population datasets with genotype and/or twin data. Included were twins from the STAR cohort and from the Swedish Twin Registry. Data were collected during the 2006 to 2013 period and analyzed from March 2023 to June 2024. PRS for psychosis based on the most recent GWAS of combined schizophrenia/bipolar disorder. Psychosis case status was assessed by clinical interviews and/or Swedish National Register data. The final cohort comprised 87 pairs of twins with 1 or both affected and 59 unaffected pairs from the STAR project (for a total of 292 twins) as well as 443 pairs with 1 or both affected and 20 913 unaffected pairs from the Swedish Twin Registry. Among the 292 twins (mean [SD] birth year, 1960 [10.8] years; 158 female [54.1%]; 134 male [45.9%]), 134 were monozygotic twins, and 158 were dyzygotic twins. PRS for psychosis was higher in cases than in controls and associated with twin concordance for psychosis (1-SD increase in PRS, odds ratio [OR], 2.12; 95% CI, 1.23-3.87 on case status in monozygotic twins and OR, 2.74; 95% CI, 1.56-5.30 in dizygotic twins). The association between PRS for psychosis and concordance was not modified by zygosity. The twin heritability was estimated at 0.73 (95% CI, 0.30-1.00), which overlapped with the estimate in the full Swedish Twin Registry (0.69; 95% CI, 0.43-0.85). In this case-control study, using the natural experiment of twins, results suggest that twins with greater inherited liability for psychosis were more likely to have an affected co-twin. Results from twin and molecular designs largely aligned. Even as illness vulnerability is not solely genetic, PRS carried predictive power for psychosis even in a modest sample size.

Risk factors of children's low birth weight and infant mortality in Bangladesh: Evidence from binary logistic regression and Cox PH models.

Low birth weight is recognized as a pivotal risk factor affecting child survival and growth. Although Bangladesh has made commendable progress in public health, an infant mortality rate of 38 per 1000 live births and a 16% prevalence of low birth weight remain significant concerns compared to other developing countries. This situation poses a significant challenge for the formulation of future health policies in Bangladesh. As a result, this study aims to identify potential risk factors contributing to low birth weight and infant mortality among children in Bangladesh. The data is extracted from the 2014 Bangladesh Demographic and Health Survey. The response variables are infant mortality and low birth weight. In the bivariate analysis, Log-rank tests and Chi-square tests of independence were conducted. Cox proportional hazards and binary logistic regression models were utilized to determine the impact of risk factors on infant mortality and low birth weight. This study identified several significant factors associated with children's low birth weight, including wealth index, parental education, birth order, twin births, mother's body mass index, and child sex. Additionally, wealth index, parental education, twin status, media exposure, birth order, antenatal care visits, prenatal care assistance, and low birth weight were identified as potential risk factors for infant mortality in Bangladesh. This study revealed that maternal and child characteristics, along with knowledge about child health care during pregnancy, can potentially reduce the risk of low birth weight and infant mortality among children in Bangladesh. To improve child health and survival, policymakers should prioritize community-based health education programs, and encourage parents to seek healthcare information from institutional medical facilities during pregnancy and after birth.

Exploring Machine Learning Algorithms to Predict Diarrhea Disease and Identify its Determinants among Under-Five Years Children in East Africa

BackgroundThe second most common cause of death for children under five is diarrhea. Early Predicting diarrhea disease and identify its determinants (factors) using an advanced machine learning model is the most effective way to save the lives of children. Hence, this study aimed to predict diarrheal diseases, identify their determinants, and generate some rules using machine learning models.MethodsThe study used secondary data from the 12 east African countries for DHS dataset analysis using Python. Machine learning techniques such as Random Forest, Decision Tree (DT), K-Nearest Neighbor, Logistic Regression (LR), wrapper feature selection and SHAP values are used for identify determinants.ResultThe final experimentation results indicated the random forest model performed the best to predict diarrhea disease with an accuracy of 86.5%, precision of 89%, F-measure of 86%, AUC curve of 92%, and recall of 82%. Important predictors’ identified age, countries, wealth status, mother’s educational status, mother’s age, source of drinking water, number of under-five children immunization status, media exposure, timing of breast feeding, mother’s working status, types of toilet, and twin status were associated with a higher predicted probability of diarrhea disease.ConclusionAccording to this study, child caregivers are fully aware of sanitation and feeding their children, and moms are educated, which can reduce child mortality by diarrhea in children in east Africa. This leads to a recommendation for policy direction to reduce infant mortality in East Africa.

Association between twin status with cognitive, behavioral development and brain structure in early adolescence: a retrospective cohort analysis based on the Adolescent Brain Cognitive Development Study.

Twin births are related with maternal and fetal adverse outcomes. Little was known about the comparability of the cognitive, behavioral development and brain structure between twins and singletons in early adolescence. This retrospective cohort study was based on data from the United States population-based, prospective, longitudinal observational Adolescent Brain Cognitive Development study. Children with complete twin status information were enrolled, and the exposure variable was twin status. Primary outcomes were cognitive, behavioral development and brain structure in early adolescence. Cognitive and behavioral outcomes were assessed by using the NIH Toolbox and Child Behavioral Checklist, respectively. Brain structure was evaluated by the cortical thickness, area, and volume extracted from the magnetic resonance imaging (MRI) data. Subgroup analyses were conducted by prematurity, birth weight, with sibling, genetic profiles, and twin types (zygosity). From 1st September 2016 to 15th November 2018, 11545 children (9477 singletons and 2068 twins) aged 9-10years were enrolled. Twins showed mildly lower cognitive performance (|t|> 5.104, P-values < 0.001, False Discovery Rate [FDR] < 0.001), better behavioral outcome (|t|> 2.441, P-values < 0.015, FDR < 0.042), such as lower scores for multiple psychiatric disorders and behavioral issues, and smaller cortical volume (t = - 3.854, P-values < 0.001, FDR < 0.001) and cortical area (t = - 3.872, P-values < 0.001, FDR < 0.001). The observed differences still held when stratified for prematurity, birth weight, presence of siblings, genetic profiles, and twin types (zygosity). Furthermore, analyses on the two-year follow-up data showed consistent results with baseline data. Twin status is associated with lower cognitive and better behavioral development in early adolescence accompanied by altered brain structure. Clinicians should be aware of the possible difference when generalizing results from adolescent twin samples to singletons.

A comprehensive survey on digital twin for future networks and emerging Internet of Things industry

The rapid growth of industrial digitalization in the Industry 4.0 era is fundamentally transforming the industrial sector by connecting products, machines, and people, offering real-time digital models to allow self-diagnosis, self-optimization and self-configuration. However, this uptake in such a digital transformation faces numerous obstacles. For example, the lack of real-time data feeds to perform custom closed-loop control and realize common, powerful industrial systems, the complexity of traditional tools and their inability in finding effective solutions to industry problems, lack of capabilities to experiment rapidly on innovative ideas, and the absence of continuous real-time interactions between physical objects and their simulation representations along with reliable two-way communications, are key barriers towards the adoption of such a digital transformation. Digital twins hold the promise of improving maintainability and deployability, enabling flexibility, auditability, and responsiveness to changing conditions, allowing continuous learning, monitoring and actuation, and allowing easy integration of new technologies in order to deploy open, scalable and reliable Industrial Internet of Things (IIoT).A critical understanding of this emerging paradigm is necessary to address the multiple dimensions of challenges in realizing digital twins at scale and create new means to generate knowledge in the industrial IoT. To address these requirements, this paper surveys existing digital twin along software technologies, standardization efforts and the wide range of recent and state-of-the-art digital twin-based projects; presents diverse use cases that can benefit from this emerging technology; followed by an in-depth discussion of the major challenges in this area drawing upon the research status and key trends in Digital Twins.

Attitude and concerns of healthy individuals regarding post-mortem brain donation. A qualitative study on a nation-wide sample in Italy

BackgroundCollecting post-mortem brain tissue is essential, especially from healthy “control” individuals, to advance knowledge on increasingly common neurological and mental disorders. Yet, healthy individuals, on which this study is focused, are still understudied. The aim of the study was to explore, among healthy potential brain donors and/or donors’ relatives, attitude, concerns and opinion about post-mortem brain donation (PMBD).MethodsA convenience sampling of the general population (twins and their non-twin contacts) was adopted. From June 2018 to February 2019, 12 focus groups were conducted in four Italian cities: Milan, Turin, Rome and Naples, stratified according to twin and non-twin status. A qualitative content analysis was performed with both deductive and inductive approaches. Emotional interactions analysis corroborated results.ResultsOne hundred and three individuals (49–91 yrs of age) participated. Female were 60%. Participants had scarse knowledge regarding PMBD. Factors affecting attitude towards donation were: concerns, emotions, and misconceptions about donation and research. Religion, spirituality and secular attitude were implied, as well as trust towards research and medical institutions and a high degree of uncertainty about brain death ascertainment. Family had a very multifaceted central role in decision making. A previous experience with neurodegenerative diseases seems among factors able to favour brain donation.ConclusionsThe study sheds light on healthy individuals’ attitudes about PMBD. Brain had a special significance for participants, and the ascertainment of brain death was a source of debate and doubt. Our findings emphasise the importance of targeted communication and thorough information to promote this kind of donation, within an ethical framework of conduct. Trust in research and health professionals emerged as an essential factor for a collaborative attitude towards donation and informed decision making in PMBD.

150 Repeatability of Rangeland Behavioral and Social Traits Derived from Gps Collars

Abstract The ability of an individual to cope with stressors in their environment is going to be paramount in the face of climate change. Rangeland livestock experience harsh conditions including heat and/or cold stress, water and feed restrictions and risk of predation. In extensive management systems, the ability to capture the capacity to cope with stressors of an individual in its environment is encumbered by remote locations with difficult terrain and no access to power or the internet. GPS collars can provide insights into individual land-use behavior, e.g., their impact on the environment or ability to cope with stressors, and social interactions, e.g., mothering ability. GPS collars (n = 112) developed at the University of Idaho were deployed on 57 ewes and 55 lambs (45 ewe-lamb pairs) in an extensive rangeland environment at the Great Basin Research and Extension Center in Eureka, NV. The collars recorded location data every 10 minutes from July 27th to August 18, 2022. Coordinate fixes were successfully recorded 67.11 ± 27.12% of the time and resulted in a kept record occurring every 60 ± 202 minutes. Of the ewe-lamb pair devices, 43 pairs contributed 801 ± 703 paired records (i.e., records that occurred within 5 minutes of each other). GPS coordinate locations, and their respective capture times, allow for the analysis of distance traveled, water usage, dispersion, and ewe-lamb distance. Distance traveled was analyzed on a daily basis with a weighted median distance imputed for all travel times that lasted more than 900 seconds. Dispersion was defined as the distance of an individual from the centroid of the flock in meters, and was transformed to a Z-score based on the position of individuals with GPS coordinates captured within 10 minutes of the measurement of the individual. Ewe-lamb pair distances were cube root transformed. Twin status, dam line, age, and day were fitted as fixed classes to estimate the repeatability of records for mature ewes. Repeatability estimates of daily distance traveled, daily water usage, and daily dispersion were 0.22 ± 0.05, 0.30 ± 0.06 and 0.10 ± 0.03, respectively. Daily ewe-lamb distances had a repeatability estimate of 0.45 ± 0.08. Day of recording was significant for daily distance traveled (P-value = 2.72×10-4) and water usage (P-value = 1.06×10-3). No other effects were significant in any of the models. In conclusion, PLF tools are an enabling technology that allow for passive data capture in remote locations. Our findings suggest that GPS collars can elucidate a variety of land use and social behavior traits that could serve as meaningful criteria for selection in extensive livestock production settings. Selection on these indicators of resilience may increase livestock productivity and welfare by increasing heat stress tolerance via the analysis of novel behavioral traits seen on extensive rangelands.

A Shared Frailty Model for Left-Truncated and Right-Censored Under-Five Child Mortality Data in South Africa

Many African nations continue to grapple with persistently high under-five child mortality rates, particularly those situated in the Sub-Saharan region, including South Africa. A multitude of socio-economic factors are identified as key contributors to the elevated under-five child mortality in numerous African nations. This research endeavors to investigate various factors believed to be associated with child mortality by employing advanced statistical models. This study utilizes child-level survival data from South Africa, characterized by left truncation and right censoring, to fit a Cox proportional hazards model under the assumption of working independence. Additionally, a shared frailty model is applied, clustering children based on their mothers. Comparative analysis is performed between the results obtained from the shared frailty model and the Cox proportional hazards model under the assumption of working independence. Within the scope of this analysis, several factors stand out as significant contributors to under-five child mortality in the study area, including gender, birth province, birth year, birth order, and twin status. Notably, the shared frailty model demonstrates superior performance in modeling the dataset, as evidenced by a lower likelihood cross-validation score compared to the Cox proportional hazards model assuming independence. This improvement can be attributed to the shared frailty model’s ability to account for heterogeneity among mothers and the inherent association between siblings born to the same mother, ultimately enhancing the quality of the study’s conclusions.

Polygenic risk scores and the prediction of onset of mood and psychotic disorders in adolescents and young adults.

To examine whether polygenic risk scores (PRS) for neuroticism, depression, bipolar disorder and schizophrenia are higher in individuals manifesting trans-diagnostic risk factors for the development of major mental disorders and whether PRS enhance prediction of early onset full-threshold disorders. Using data from the Brisbane Longitudinal Twin Study, we examined individual PRS for neuroticism, depression, bipolar disorder and schizophrenia, recorded evidence of subthreshold syndromes and family history of mood and/or psychotic disorders and noted progression to trans-diagnostic clinical caseness (onset of major mental disorders) at follow-up. We undertook multivariate, receiver operating curve and logistic regression analyses that were adjusted for known variables of influence (age, twin status, and so on). Of 1473 eligible participants (female = 866, 59%; mean age 26.3 years), 28% (n = 409) met caseness criteria for a mood and/or psychotic disorder. All PRS were higher in cases versus non-cases but associations with different levels of risk were inconsistent. The prediction of caseness (reported as area under the curve with 95% confidence intervals [CI]) improved from 0.68 (95% CI: 0.65, 0.71) when estimated using clinical risk factors alone up to 0.71 (95% CI: 0.69, 0.73) when PRS were added to the model. Logistic regression identified five variables that optimally classified individuals according to caseness: age, sex, individual risk characteristics, PRS for depression and mental health case status of cotwins or siblings. The findings need replication. However, this exploratory study suggests that combining PRS with other risk factors has the potential to improve outcome prediction in youth.

57 Butterflies and Ribbons: The Positive Impact of Educational Strategies to Optimize Communication with Parents after the Perinatal Loss of a Co-twin

Abstract Background In neonatology, multiples pregnancies are common: 50% of twins and 95% of triplets are admitted to the NICU. Unfortunately, it is not rare for one baby to die. When this happens, parents are in a unique situation: they need to mourn their baby, while continuing to visit their other baby(ies) in the NICU. Communication with parents in these circumstances has been demonstrated to be sub-optimal, sometimes because clinicians are unaware and ask harmful questions (e.g., “Do you have any other kids?”) or because their education on how to deal with such issues was limited (despite available evidence). These gaps often lead to parental distress. Objectives To assess the impact of two different teaching strategies for clinicians dealing with the perinatal loss of a co-twin or triplet. Design/Methods Two different programs aimed at educating clinicians dealing with perinatal loss of co-twins or triplets were evaluated in 2022: 1) an open online 4-hour course with theory and practical points (the Butterfly project); and 2) a one hour in-person (workshop) or online course offered to NICU clinicians (free of charge) in a large academic NICU. The second course became the “Ribbon project” because bereaved parent partners had recommended the symbol of a ribbon rather than the butterfly as better reflecting perinatal loss. In both courses, essential topics were covered. For example: identifying the status of a surviving twin (including name of the deceased one); moving the surviving baby to another room after the death, knowing when and how to speak with bereaved parents, and identifying the surviving twin status at discharge. Participants in both groups were surveyed to ask whether they were satisfied with the course, their knowledge of care for perinatal loss was evaluated pre- and -post course, as well as when and how they used their training. Clinical impacts of the Ribbon project were also evaluated. Results In the butterfly project, all participants (n=734) reported that training exceeded or met their expectations, while 97% reported they learned new skills, and 48% reported already applying them. Many participants were grateful for the course, answering positively to open-ended questions: e.g., “I found this course incredibly useful for my future practice,” and “I feel a lot more confident in supporting parents.” For the ribbon project (n= 174), 97% were satisfied or very satisfied with the training, and 97% reported feeling more comfortable talking to bereaved parents. Knowledge improved with training. In clinical audits that occurred between 2020 and 2022, 100% of cases were identified (28/28; 23 twins and 5 triplets surviving; 8 antenatal deaths) on the incubator and the baby(ies)’ admission card. Also, 100% of the surviving twins or triplets kept their identification (#1, 2, or 3) after speaking with parents, all changed rooms after the death of their co-twin or triplet, and all had the name of their co-twin or triplet on the discharge summary. All clinicians (55) knew what the ribbon symbol meant when asked during surprise audits at the bedside; 38/55 (71%) felt comfortable dealing with parents in this situation and for those who did not, they knew who to ask for help. Conclusion Different educational strategies to optimize communication with families after the perinatal loss of a co-twin/triplet are appreciated and have a positive impact. One hour of teaching specifically for NICU personnel is enough to make a difference.

State Inference and Evaluation Technology of Relay Protection Based on Digital Twinning

The problems of relay protection equipment in such aspects as the insufficient depth of data mining, not timely grasp of equipment status, and poor timeliness of fault warning restrict the development of the operation and maintenance mode of relay protection, which aims at “autonomous and controllable, safe and reliable, advanced and applicable, intensive and efficient”. This article studies the comprehensive state evaluation and action simulation deduction technology of intelligent substation relay protection equipment based on digital twins. It uses multi-source state monitoring data of relay protection equipment for state quantity correlation analysis. It constructs a key state feature index library and uses digital twin technology to model the relay protection function and software and hardware states. Through the collaborative linkage between physical devices and digital twin models, the twin can dynamically track the operational status of devices and automatically update the twin status. Finally, based on the established high-precision digital twin model, relay protection action deduction and status evaluation are carried out. Then the effectiveness of the scheme is demonstrated through example testing of the relay protection twin system.

Ear anomalies and hearing loss in patients with VACTERL association and the effect of maternal diabetes.

VACTERL association is typically defined as the presence of three components among these birth defects: vertebral anomalies, anal atresia, cardiac anomalies, esophageal atresia/tracheoesophageal fistula (EA/TEF), renal anomalies, and limb defects. There is increasing recognition that VACTERL and other recurrent constellations of embryonic development often overlap clinically and might share pathogenesis. We conducted a comprehensive chart review of a large patient population with VACTERL association from two tertiary care centers in California. We included patients with incomplete VACTERL expression, which we denoted as "partial VACTERL" (pVACTERL). We assessed the occurrence of craniofacial (CF) findings in these two groups and the combined cohort. We collected data on potential risk factors and demographic information such as sex, Hispanic ancestry, pregnancy complications, and maternal age. The study included 409 participants, of whom 263 had VACTERL and 146 pVACTERL. CF abnormalities were found in 17.3% of VACTERL patients and 9.4% of pVACTERL patients. In the VACTERL group, ear anomalies were found in 10.2%, microtia in 5.9%, hearing loss (HL) in 13.90%, and orofacial clefts in 3.1%. In the pVACTERL group, ear anomalies were found in 7.2%, microtia in 5.0%, HL in 9.3%, and orofacial cleft in 2.2%. Maternal diabetes significantly increased the risk for HL in VACTERL (odds ratio [OR]: 3.71, 95% confidence interval [CI]: 1.5-7.3) and pVACTERL patients (OR: 6.7, 95% CI: 1.70-23.4). Poorly controlled maternal diabetes significantly increased the risk for all the outcomes in VACTERL patients including CF anomalies (OR: 4.2, 95% CI: 1.9-9.6), ear anomalies (OR: 4.7, 95% CI: 1.8-11.8), microtia (OR: 5.4, 95% CI: 1.7-16.6), and HL (OR: 8.1, 95% CI: 3.4-19.4). Twin status was significantly associated with the occurrence of microtia (p = 0.038) in VACTERL patients. Occurrence of CF features, particularly ear anomalies, microtia, and HL, might be considered as part of phenotypic diversity of VACTERL association. Diabetes and twinning might appear to play a role in increasing the risk for this phenotype in VACTERL association.

Birthweight of the subsequent singleton pregnancy following a first twin or singleton pregnancy.

Birthweight is an important pregnancy indicator strongly associated with infant, child, and later adult life health. Previous studies have found that second-born babies are, on average, heavier than first-born babies, indicating an independent effect of parity on birthweight. Existing data are mostly based on singleton pregnancies and do not consider higher order pregnancies. We aimed to compare birthweight in singleton pregnancies following a first twin pregnancy relative to a first singleton pregnancy. This was a prospective registry-based cohort study using maternally linked offspring with first and subsequent pregnancies registered in the Medical Birth Registry of Norway between 1967 and 2020. We studied offspring birthweights of 778 975 women, of which 4849 had twins and 774 126 had singletons in their first pregnancy. Associations between twin or singleton status of the first pregnancy and birthweight (grams) in subsequent singleton pregnancies were evaluated by linear regression adjusted for maternal age at first delivery, year of first pregnancy, maternal education, and country of birth. We used plots to visualize the distribution of birthweight in the first and subsequent pregnancies. Mean combined birthweight of first-born twins was more than 1000 g larger than mean birthweight of first-born singletons. When comparing mean birthweight of a subsequent singleton baby following first-born twins with those following first-born singletons, the adjusted difference was just 21 g (95% confidence interval 5-37 g). Birthweights of the subsequent singleton baby were similar for women with a first twin or a first singleton pregnancy. Although first twin pregnancies contribute a greater combined total offspring birthweight including more extensive uterine expansion, this does not explain the general parity effect seen in birthweight. The physiological reasons for increased birthweight with parity remain to be established.

Determinants of coexisting forms of undernutrition among under-five children: Evidence from the Bangladesh demographic and health surveys.

In many underdeveloped and developing countries, epidemiological and nutritional transitions are leading to an increase in malnutrition, resulting in pediatric diseases and eventually deaths. Therefore, this study intents to determine the important factors of the presence of coexisting forms of malnutrition (CFM), i.e., pediatric undernutrition. This study used the latest Bangladesh Demographic and Health Survey (BDHS)-2017/18 dataset consisting of 7127 under-five children. The logistic regression model has been utilized to gain explicit and in-depth knowledge of the relationship between the presence of pediatric undernutrition with socioeconomic and demographic factors. Findings revealed that about 31%, 22%, and 8% suffered from stunted, underweight, and wasted, respectively. The prevalence of stunted, underweighted, wasted, and CFM among children in the Sylhet division is higher than in any other region. A child of a secondary-level completed mother is 27.6% (OR: 0.724, 95% CI: 0.58-0.90) less likely to suffer from undernutrition than a child of an uneducated mother. The rate of undernutrition of children was less among children of highly educated parents. Age, birth order of the child, twin status, mother's age, body mass index (BMI), working status, parental educational qualification, cooking fuel, toilet facility, region, residence, and wealth index are important for determining the nutritional status of a child. The authors believe that the study findings will be helpful to the policymakers to take proper actions for achieving the sustainable development goal (SDGs) by reducing pediatric undernutrition in Bangladesh by 2030.

A spatiotemporal intelligent framework and experimental platform for urban digital twins

BackgroundsThis work emphasizes the current research status of the urban Digital Twins to establish an intelligent spatiotemporal framework. A Geospatial Artificial Intelligent (GeoAI) system is developed based on the Geographic Information System and Artificial Intelligence. It integrates multi-video technology and Virtual City in urban Digital Twins. MethodsBesides, an improved small object detection model is proposed: YOLOv5-Pyramid, and Siamese network video tracking models, namely MPSiam and FSSiamese, are established. Finally, an experimental platform is built to verify the georeferencing correction scheme of video images. ResultThe Multiply-Accumulate value of MPSiam is 0.5B, and that of ResNet50-Siam is 4.5B. Besides, the model is compressed by 4.8 times. The inference speed has increased by 3.3 times, reaching 83 Frames Per Second. 3% of the Average Expectation Overlap is lost. Therefore, the urban Digital Twins-oriented GeoAI framework established here has excellent performance for video georeferencing and target detection problems.

(049) Project SEXUS – Baseline Findings from a Nationwide Cohort Study on Sexual Behavior and Health in Denmark

Abstract Introduction Project SEXUS (www.projectsexus.dk) is a nationwide cohort study on sexual behavior and health in Denmark that was initiated in 2017 by two state research institutions. The aim of this presentation is to introduce the methodology of the study and to present key findings from its baseline data collection. Objective The objectives of the Project SEXUS study were 1) to provide a thorough insight into the sexual landscapes of the general Danish population, 2) to shed light on the sexual health of understudied groups such as elderly people, chronically ill individuals and LGBT+ persons and 3) to investigate the interplay between sex lives, lifestyles and general health. Methods The cohort was created using a probability-based sampling frame, and the questionnaire comprised more than 600 items, including brief versions of validated measurement instruments such as the International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI). Due to strategic filter questions, the median number of items addressed by respondents was 180. Between September 2017 and August 2018, 187,084 Danes aged 15-89 years were invited to participate in the study by filling out an online questionnaire. 64,706 individuals gave complete or almost-complete responses (AAPOR response rate 1: 34.6%). Individual weighting procedures ensured exact national representativeness regarding sex, birth year, region of residence, marital status, cultural background and twin status, and logistic regression analyses provided age-adjusted odds ratios as measures of relative risk at baseline. Results Based on complete and validated questionnaire data from 62,675 participants, key findings concerning sexual orientation, needs, experiences, satisfaction and current behaviors will be presented, and various dimensions of sexual health in the Danish population will be discussed. Moreover, topics such as relationship satisfaction, pornography consumption, risky sexual behavior, body contentment and childhood gender non-conformity will be addressed. Further, noteworthy associations between general and sexual lifestyles and health will be emphasized, and main findings regarding general and sexual wellbeing in strata of different sexual and gender identities will be shown. Conclusions The presented baseline findings from Project SEXUS provide a detailed account of the sex life situation in contemporary Denmark. Due to its huge size, national representativeness and ability to follow individual cohort members over time through identity-secure linkage with information in national health registers, the study offers internationally unique opportunities for detailed prospective assessments of the complex interplay between sex life, lifestyles and health. This is of obvious relevance to sexologists, sexual health promoters and general health-care providers around the world. Disclosure No

On the Architecture and Key Technology for Digital Twin Oriented to Equipment Battle Damage Test Assessment

To overcome the technical bottleneck faced by the traditional equipment battle damage assessment method by analyzing the application status of digital twins in battle damage assessment, the application needs and the existing problems of current digital twin technology in damage assessment were summarized. Relying on battle damage tests, based on combing the current status of equipment battle damage test evaluation and digital twin technology research, the connotation and application features of digital twinning technology-oriented to equipment battle damage test assessment were explored. The architecture and implementation plan of the digital twin oriented to equipment battle damage test assessment were structured. The key technology and realization of digital twin oriented to battle damage test assessment were proposed. This study provided a theoretical reference and method guidance for the application of digital twins in battle damage assessment, which is of great reference significance for the development of digital twin battlefield construction and battle damage assessment.

Artificial intelligence in the digital twins: State of the art, challenges, and future research topics

Advanced computer technologies such as big data, Artificial Intelligence (AI), cloud computing, digital twins, and edge computing have been applied in various fields as digitalization has progressed. To study the status of the application of digital twins in the combination with AI, this paper classifies the applications and prospects of AI in digital twins by studying the research results of the current published literature. We discuss the application status of digital twins in the four areas of aerospace, intelligent manufacturing in production workshops, unmanned vehicles, and smart city transportation, and we review the current challenges and topics that need to be looked forward to in the future. It was found that the integration of digital twins and AI has significant effects in aerospace flight detection simulation, failure warning, aircraft assembly, and even unmanned flight. In the virtual simulation test of automobile autonomous driving, it can save 80% of the time and cost, and the same road conditions reduce the parameter scale of the actual vehicle dynamics model and greatly improve the test accuracy. In the intelligent manufacturing of production workshops, the establishment of a virtual workplace environment can provide timely fault warning, extend the service life of the equipment, and ensure the overall workshop operational safety. In smart city traffic, the real road environment is simulated, and traffic accidents are restored, so that the traffic situation is clear and efficient, and urban traffic management can be carried out quickly and accurately. Finally, we looked forward to the future of digital twins and AI, hoping to provide a reference for future research in related fields.

Speech processing performance of Hungarian-speaking twins and singletons

ABSTRACT Studying speech processing in twins versus their singleton peers provides opportunities to study both genetic and environmental effects on how children acquire these aspects of their speech and – by extension – their phonological systems. Our study focused on speech processing in typically developing Hungarian-speaking twins and their singleton peers between 5 and 9 years of age. Participants included 384 monolingual Hungarian-speaking children (192 twins, and 192 singletons). Data from four tasks – repetition of synthesised monosyllables, nonsense words, well-formed noisy sentences, and well-formed phonologically complex sentences – were analysed. There was a main effect for birth status, and singletons outperformed their twin peers on the majority of the speech processing tasks. Age and task also had effects on the performance of the participants, and there was a three-way task by age by twin versus singleton status indicating that the speech processing performance of twins versus singletons is interdependent with the type of task and age. Our results also indicate that monolingual Hungarian-speaking twins may be at higher risk for developmental speech delays relative to their singleton peers.