bluuebunny/crossref_metadata_2025 huggingface dataset:
Research on multi-objective flow shop scheduling optimization in supply chain environment based on Fuzzy Relevance Entropy Method
Authors: Luo Zhe , Tan Yonghong , Zhu Guangyu , Xia Yuping , Wang Xinyu
Published: December 2023

For the multi-objective flow shop scheduling problem in the supply chain environment, this paper proposes the Fuzzy Relevance Entropy method (FREM) to solve the adaptive value assignment problem in the multi-objective optimization process of the supply chain environment by combining Fuzzy Information Entropy Theory (FIET) and Degree of Membership Function (DMF). Firstly, the uncertainty of each sub-objective of the ideal solution and Pareto solution of the objective is extracted using the Degree of Membership Function. Secondly, each solution is mapped into an affiliation degree fuzzy set and the information contained in the fuzzy set is reprocessed using Fuzzy Information Entropy Theory. Finally, the amount of information contained in the ideal solution solved by the Pareto method is used to guide the evolution of the Particle Swarm Optimization (PSO) algorithm, thus avoiding the traditional multi-objective optimization process of assigning weights to solve the fitness link. This paper combines both the Fuzzy Relevance Entropy method and the Stochastic Weight method with Particle Swarm Optimization (PSO) and Differential Evolution (DE) algorithms to address the five-objective flow shop scheduling problem in the supply chain environment. Experimental results demonstrate that the proposed Fuzzy Relevance Entropy method effectively solves the multi-objective flow shop scheduling problem in the supply chain environment and achieves better optimization results compared to the Stochastic Weight method.
Judicial bypass for minors post-Dobbs
Authors: Horvath Sarah , Frietsche Susan
Published: December 2023

State laws that require minors seeking abortion care to notify or obtain consent from a parent or other legal guardian are broadly referred to as parental involvement laws. Judicial bypass allows a minor to petition the court to bypass parental involvement. Even before the Dobbs v Jackson Women’s Health Organization decision overturned Roe v Wade on 24 June 2022, 36 states had at least one parental involvement law, making minor access to abortion care even more complex than adult access. Since the Dobbs decision, at least 15 states have completely banned abortion, adding further complexity, geographic barriers, and inequities to the pursuit of reproductive healthcare. In this narrative review and commentary, we explain parental involvement laws and judicial bypass from both a legal and medical perspective, exploring the evolving challenges created by this system in the year post- Dobbs.
Impact of the COVID-19 pandemic on adherence to positive airway pressure treatment in patients with obstructive sleep apnea: systematic review and meta-analysis
Authors: Jo Soomin , Cho Jaeyoung
Published: December 2023

Background:

The adverse effects of the COVID-19 pandemic on sleep have been well studied. However, whether the COVID-19 pandemic impacted positive airway pressure (PAP) adherence in patients with obstructive sleep apnea (OSA) remains unclear.

Objectives:

To evaluate the impact of the COVID-19 pandemic on adherence to PAP therapy in patients with OSA.

Design:

A retrospective cohort study, systematic review, and meta-analysis.

Data sources and methods:

The retrospective study included adults with OSA who received PAP prescriptions within the year before and the year after the start date of COVID-19 social distancing (22 March 2020) in South Korea. The threshold of clinical significance for PAP adherence was defined as 0.5 h/day. We also searched for relevant studies published up to 15 January 2023 using the MEDLINE and Embase databases. We performed a random-effects meta-analysis of our findings with the identified studies regarding the standardized mean change (SMC) with a 95% CI of PAP adherence.

Results:

Our study included a total of 306 patients (mean age, 59.7 years; men, 73.5%). The average daily PAP usage was 5.10 ± 1.63 h before the COVID-19 pandemic and 4.79 ± 1.96 h during the pandemic (mean difference, −0.31 h/day; 95% CI, −0.46 to −0.15 h/day; p < 0.001 using paired t-test). After identifying 10 observational before-and-after studies through a systematic review, we conducted a meta-analysis that included our original data and showed that adherence to PAP treatment was not different before and during the COVID-19 pandemic (SMC, 0.01; 95% CI, −0.18 to 0.19; p = 0.952).

Conclusion:

Although the COVID-19 pandemic had a statistically negative impact on adherence to PAP treatment in South Korea, the effect was not clinically relevant in patients with OSA. According to our meta-analysis, adherence to PAP treatment was not different before and during the COVID-19 pandemic in patients with OSA.

Trial registration:

PROSPERO database; No.: CRD42023414268; URL: https://www.crd.york.ac.uk/PROSPERO .
Disease burden of COPD in the Chinese population: a systematic review
Authors: Xu Jiaxin , Ji Zile , Zhang Peng , Chen Tao , Xie Yang , Li Jiansheng
Published: December 2023

Background:

Chronic obstructive pulmonary disease (COPD) is one of the main contributors to the global burden of disease.

Objectives:

This systematic review aimed to evaluate the disease burden of COPD in the Chinese population and to determine the factors influencing the economic burden of the disease.

Design:

This is a systematic review study.

Data sources and methods:

We searched PubMed, Web of Science, Embase, Chinese National Knowledge Infrastructure, WANGFANG Data, and VIP databases for studies regarding the disease burden of COPD in mainland China published before 31 December 2022. The Agency for Healthcare Research and Quality’s recommendation rating tool assessed the cross-sectional studies’ risk of bias.

Results:

A total of 45 studies were included. The disability-adjusted life years (DALYs) for COPD have generally decreased in the Chinese population over the past 30 years. The total number of DALYs due to COPD in China decreased from 26.12 million person-years to 19.92 million person-years, with an annual decline rate of 0.9%. Subjects aged 40 years and older make up the majority of those with COPD in the Chinese population, and the condition is more prevalent among males than females, in rural areas than urban places, and in the West than the East. The median direct medical cost of COPD ranges from 150 to 2014 USD per capita per year. Among 23 influencing factors, age, hospitalization days, hospital type, gender, and career were the most significant variables that had an impact on the economic burden of COPD patients.

Conclusion:

The overall burden of COPD in China has been decreasing over the past 30 years. But there is a lack of standardized indicators for the economic burden of COPD patients in China, and it is recommended to establish a unified standard.

Registration:

The systematic review protocol was prospectively registered with PROSPERO (No. CRD42023393429).
Risk factors for super-refractory and mortality in generalized convulsive status epilepticus: a 10-year retrospective cohort study
Authors: Wang Dongmei , Li Meirong , Pan Yue , Lin Zhenzhou , Ji Zhong , Zhang Xiaomei , Tan Miaoqin , Pan Suyue , Wu Yongming , Wang Shengnan
Published: December 2023

Background:

Generalized convulsive status epilepticus (GCSE) is one of the most challenging life-threatening neurological emergencies. If GCSE becomes super-refractory, it is associated with significant mortality. Although aggressive management of prolonged status epilepticus was conducted, the mortality has not decreased since the late 1990s.

Objectives:

The present study aimed to explore the risk factors for progression to super-refractory in patients with generalized convulsive status epilepticus (GCSE). Moreover, we illustrated the risk factors for mortality in GCSE patients.

Design:

An observational retrospective cohort study.

Methods:

We conducted a retrospective study of patients with GCSE admitted to our neurocritical unit, in Guangzhou, China, from October 2010 to February 2021. The data of sociodemographic information, etiology, laboratory results, treatment, and prognosis were collected and analyzed.

Results:

A total of 106 patients were enrolled; 51 (48%) of them developed super-refractory status epilepticus (SRSE). Multivariate logistic regression analysis demonstrated that patients with autoimmune encephalitis ( p = 0.015) and intracranial infection ( p = 0.019) are likely to progress to SRSE. The in-hospital mortality was 11.8% and 9.1% for patients in the SRSE and non-SRSE groups, respectively ( p = 0.652). Multivariate logistic regression analysis showed that neutrophil-to-lymphocyte ratios (NLR) at admission were independently associated with in-hospital mortality. Up to 31.4% of SRSE patients and 29.1% of non-SRSE patients died within 6 months after discharge ( p = 0.798). Multivariate logistic regression analysis showed that plasma exchange (PE) was a protective factor for 6-month mortality. A high NLR at discharge was a risk factor for 6-month mortality.

Conclusion:

In the current study, about 48% of GCSE patients progressed to SRSE. Regarding etiology, autoimmune encephalitis or intracranial infection was prone to SRSE. No significant differences were observed in the in-hospital and 6-month mortality between SRSE and non-SRSE groups. Multivariate logistic regression analysis showed that NLR at admission and discharge was an independent predictor of in-hospital and 6-month mortality, respectively. Moreover, PE significantly reduced the 6-month mortality.
Phase Ib study of HSP90 inhibitor, onalespib (AT13387), in combination with paclitaxel in patients with advanced triple-negative breast cancer
Authors: Williams Nicole O. , Quiroga Dionisia , Johnson Courtney , Brufsky Adam , Chambers Mara , Bhattacharya Saveri , Patterson Maria , Sardesai Sagar D. , Stover Daniel , Lustberg Maryam , Noonan Anne M. , Cherian Mathew , Bystry Darlene M. , Hill Kasey L. , Chen Min , Phelps Mitch A. , Grever Michael , Stephens Julie A. , Ramaswamy Bhuvaneswari , Carson William E. , Wesolowski Robert
Published: December 2023

Background:

Heat shock protein 90 (HSP90) is a molecular chaperone required for stabilization of client proteins over-activated in triple-negative breast cancer (TNBC). Over-expression of HSP90 client proteins has been implicated in paclitaxel resistance. Onalespib (AT13387) is a potent inhibitor of HSP90 that could improve paclitaxel efficacy when administered in combination.

Design:

This phase Ib trial administered onalespib with paclitaxel in patients with advanced TNBC to assess safety and establish a recommended phase II dose (RP2D).

Objectives:

The primary objectives were determining the dose-limiting toxicities and maximum tolerated dose of combination therapy. Secondary objectives included pharmacokinetic (PK) analysis and determination of overall response rate (ORR), duration of response (DOR), and progression-free survival (PFS).

Methods:

Patients with advanced TNBC were treated with standard dose intravenous paclitaxel in combination with intravenous onalespib at doses ranging from 120 to 260 mg/m2 administered on days 1, 8, and 15 of a 28-day cycle using a standard 3 + 3 design. A total of 15 patients were enrolled to dose expansion cohort at RP2D to confirm safety profile.

Results:

Thirty-one patients were enrolled in the study, of which over 90% had received prior taxane therapy. Paclitaxel was given for metastatic disease in 23% of patients. Adverse events (AEs) included anemia (grade 3: 20%), lymphopenia (grade 3: 17%), and neutropenia (grade 3: 33%, grade 4: 4%). The most frequent grade ⩾3 non-hematologic AE was diarrhea (7%). The established RP2D was 260 mg/m2 onalespib when given with paclitaxel at 80 mg/m2. PK analysis revealed a modest drug interaction profile for onalespib in the combination regimen. ORR was 20%. Three patients achieved complete responses, all of whom had received prior taxane therapy. Median DOR was 5.6 months; median PFS was 2.9 months.

Conclusion:

Combination treatment with onalespib and paclitaxel had an acceptable toxicity profile and RP2D was determined to be 260 mg/m2 of onalespib. Combination therapy showed antitumor activity in patients with advanced TNBC.

Trial registration:

Onalespib and paclitaxel in treating patients with advanced TNBC https://clinicaltrials.gov/ct2/show/NCT02474173 .
Essential Oils From the Trunks and Leaves of Paramignya scandens (Griff.) Craib From Vietnam: Phytochemical Composition, In Vitro α-Amylase and Tyrosinase Inhibitory Activities and In Silico Molecular Docking Studies
Authors: Tran-Trung Hieu , Thang Tran Dinh , Nguyen Trang H.D. , Vu Danh C. , Tuan Nguyen Hoang , Ha Nguyen Xuan , Chen Tran Van , Oanh Ha Thuy , Giang Ngu Thi Tra , Thuy Phan Thi
Published: December 2023

Objective/Background: This work aims to evaluate the chemical composition of Paramignya scandens essential oils (EOs), their in vitro α-amylase, tyrosinase inhibitory activities, and in silico molecular docking study. Methods: The EOs of P scandens trunks and leaves were extracted by hydrodistillation process and the chemical compositions were determined by gas chromatography-mass spectrometry. These EOs were also tested for in vitro α-amylase and tyrosinase inhibitory activities. Additionally, in silico molecular docking simulations on the main components of the EOs were performed. Results: The EO profiles of P scandens trunks and leaves included 21 (98.8%) and 34 (89.7%) components, respectively. The main compounds in the trunk EO were ( E)- β-caryophyllene (60.8%), α-humulene (13.0%), and germacrene D (7.4%). The predominant compounds of the leaf EO were caryophyllene oxide (16.7%), ( E) -β-caryophyllene (14.6%), spathulenol (12.2%), germacrene D (6.5%), and α-humulene (5.0%). Moreover, their α-amylase and tyrosinase inhibitory effects were demonstrated for the first time. In molecular docking results, ( E)- β-caryophyllene was the potential compound in EOs with the best binding affinity against the α-amylase enzyme, whereas spathulenol revealed the strongest binding ability with the tyrosinase enzyme. Furthermore, the assessment of potential interactions between the main components of the EOs and the selected proteins was elucidated. Conclusions: The results of this work revealed that EOs of P scandens trunks and leaves had α-amylase and tyrosinase inhibition properties and potential applications in nutraceuticals, medicine, and cosmetics.
Increases in Intellectual Humility From Guided Conversations Are Greater When People Perceive Affiliation With Conversation Partners
Authors: Thorson Katherine R. , Beck Lindsey A. , Ketay Sarah , Welker Keith M.
Published: December 2023

Intellectual humility involves awareness that one’s knowledge has limitations and that one’s beliefs might be incorrect. Despite documented benefits of intellectual humility, few studies have examined factors associated with long-term changes in intellectual humility. This study investigated whether an intervention focused on guided conversations was associated with increases in intellectual humility and whether these changes were stronger when people perceived greater affiliation with their conversation partner. Participants ( N = 937) completed an intervention with four guided conversations and reported on their relationship with their partner after each conversation. Intellectual humility was measured before the first conversation, immediately after the last conversation, and 1 month following the last conversation. As hypothesized, intellectual humility increased over time, especially when people perceived greater affiliation with their conversation partner. These findings suggest that intellectual humility interventions with social components may have stronger effects when people perceive greater affiliation with their partners.
Safety and efficacy of Surpass Evolve Flow diverter for intracranial aneurysms: A study of 116 patients
Authors: Bibi Richard , Bankole Nourou Dine Adeniran , Donnard Baptiste , Giubbolini Francesca , Boucherit Julien , Barrot Valère , Herbreteau Denis , Ifergan Héloïse , Janot Kevin , Boulouis Grégoire , Bala Fouzi
Published: December 2023

Background and purpose

Flow diverter embolization is a recognized method for treating intracranial aneurysms. This study evaluates the safety and efficacy of the Surpass Evolve flow diverter in treating intracranial aneurysm.

Material and methods

From May 2019 to June 2022, our center prospectively enrolled patients presenting with both ruptured and unruptured intracranial aneurysms. We assessed aneurysm occlusion, along with the occurrence of ischemic and hemorrhagic complications, and mortality at 6-months. The 3-month occlusion rate was determined using MR angiography, while the 6-month occlusion rate employed the O’Kelly–Marotta (OKM) grading scale on DSA.

Results

A total of 116 patients with 120 aneurysms received treatment with the Surpass Evolve device. The average aneurysm size was 6.6 mm (range: 2-30 mm). All patients were administered two loading doses of ticagrelor (180 mg) one day before the procedure and 2 h pre-embolization. A procedural complication occurred in one case, involving wire-related perforation of an M3 branch distant from the giant aneurysm; however, this evolved favorably. There were no reported deaths linked to the treatment. Permanent neurological deficits were observed in 3 (2.5%) patients, primarily due to early in-stent thrombosis. MR angiography results at 3 months indicated complete occlusion for 87 out of 115 (75.6%) monitored aneurysms. The 6-month DSA showed neck remnant or complete occlusion (OKM grade C or D) in 86 out of the 107 (80.4%) patients who underwent follow-up.

Conclusion

The Surpass Evolve stands out as a reliable and effective flow diverter for the management of intracranial aneurysms.
Direct pseudomeningocele contrast injection for spinal CSF leak localization
Authors: Mark Ian T , Madhavan Ajay A , Delone David R , Oien Michael P , Messina Steven A
Published: December 2023

CT myelography has been traditionally used to evaluate post-operative paraspinal fluid collections to discern CSF leaking into a pseudomeningocele versus a contained seroma. Rather than performing a lumbar puncture and injecting intrathecal contrast for myelography, we present the first report of direct contrast injection into a post-operative paraspinal pseudomeningocele for CSF leak confirmation and localization. This is a simple procedure that has several advantages over a conventional CT myelogram for the evaluation of post-operative paraspinal fluid collections.
The split apparent diffusion coefficient sign: A novel magnetic resonance imaging biomarker for cortical pathology with possible implications in autoimmune encephalitis
Authors: Ludovichetti Riccardo , Nierobisch Nathalie , Achangwa Ngwe Rawlings , De Vere-Tyndall Anthony , Fierstra Jorn , Reimann Regina , Togni Claudio , Terziev Robert , Galovic Marian , Kulcsar Zsolt , Hainc Nicolin
Published: December 2023

Introduction

MRI is the imaging modality of choice for assessing patients with encephalopathy. In this context, we discuss a novel biomarker, the “split ADC sign,” where the cerebral cortex demonstrates restricted diffusion (high DWI signal and low ADC) and the underlying white matter demonstrates facilitated diffusion (high or low DWI signal and high ADC). We hypothesize that this sign can be used as a biomarker to suggest either acute encephalitis onset or to raise the possibility of an autoimmune etiology.

Materials and Methods

A full-text radiological information system search of radiological reports was performed for all entities known to produce restricted diffusion in the cortex excluding stroke between January 2012 and June 2022. Initial MRI studies performed upon onset of clinical symptoms were screened for the split ADC sign.

Results

25 subjects were encountered with a positive split ADC sign (15 female; median age = 57 years, range 18–82). Diagnosis included six herpes simplex encephalitis, three peri-ictal MRI changes, eight PRES, two MELAS, and six autoimmune (3 anti-GABAAR, two seronegative, and one anti-Ma2/Ta). Subjects were imaged at a mean 1.8 days after the onset of symptoms (range 0–8).

Discussion

We present a novel visual MRI biomarker, the split ADC sign, and highlight its potential usefulness in subjects with encephalopathy to suggest acute disease onset or to raise the possibility of an autoimmune etiology when location-based criteria are applied. When positive, the sign was present on the initial MRI and can therefore be used to help focus further clinical and laboratory workup.
Middle meningeal artery embolization for chronic subdural hematoma: A single-center experience and predictive modeling of outcomes
Authors: Cohen-Cohen Salomon , Jabal Mohamed Sobhi , Rinaldo Lorenzo , Savastano Luis E , Lanzino Giuseppe , Cloft Harry , Brinjikji Waleed
Published: December 2023

Background

Remarkable interest is rising around middle meningeal artery embolization (MMAE) as an emerging alternative therapy for chronic subdural hematoma (cSDH). The study aims to highlight a large center experience and the variables associated with treatment failure and build experimental machine learning (ML) models for outcome prediction.

Material and Methods

A 2-year experience in MMAE for managing patients with chronic subdural hematoma was analyzed. Descriptive statistical analysis was conducted using imaging and clinical features of the patients and cSDH, which were subsequently used to build predictive models for the procedure outcome. The modeling evaluation metrics were the area under the ROC curve and F1-score.

Results

A total of 100 cSDH of 76 patients who underwent MMAE were included with an average follow-up of 6 months. The intervention had a per procedure success rate of 92%. Thrombocytopenia had a highly significant association with treatment failure. Two patients suffered a complication related to the procedure. The best performing machine learning models in predicting MMAE failure achieved an ROC-AUC of 70%, and an F1-score of 67%, including all patients with or without surgical intervention prior to embolization, and an ROC-AUC of 82% and an F1-score of 69% when only patients who underwent upfront MMAE were included.

Conclusion

MMAE is a safe and minimally invasive procedure with great potential in transforming the management of cSDH and reducing the risk of surgical complications in selected patients. An ML approach with larger sample size might help better predict outcomes and highlight important predictors following MMAE in patients with cSDH.
Assessing the prediction of type 2 diabetes risk using polygenic and clinical risk scores in South Asian study populations
Authors: Rout Madhusmita , Wander Gurpreet S. , Ralhan Sarju , Singh Jai Rup , Aston Christopher E. , Blackett Piers R. , Chernausek Steven , Sanghera Dharambir K.
Published: December 2023

Background:

Genome-wide polygenic risk scores (PRS) have shown high specificity and sensitivity in predicting type 2 diabetes (T2D) risk in Europeans. However, the PRS-driven information and its clinical significance in non-Europeans are underrepresented. We examined the predictive efficacy and transferability of PRS models using variant information derived from genome-wide studies of Asian Indians (AIs) (PRSAI) and Europeans (PRSEU) using 13,974 AI individuals.

Methods:

Weighted PRS models were constructed and analyzed on 4602 individuals from the Asian Indian Diabetes Heart Study/Sikh Diabetes Study (AIDHS/SDS) as discovery/training and test/validation datasets. The results were further replicated in 9372 South Asian individuals from UK Biobank (UKBB). We also assessed the performance of each PRS model by combining data of the clinical risk score (CRS).

Results:

Both genetic models (PRSAI and PRSEU) successfully predicted the T2D risk. However, the PRSAI revealed 13.2% odds ratio (OR) 1.80 [95% confidence interval (CI) 1.63–1.97; p = 1.6 × 10−152] and 12.2% OR 1.38 (95% CI 1.30–1.46; p = 7.1 × 10−237) superior performance in AIDHS/SDS and UKBB validation sets, respectively. Comparing individuals of extreme PRS (ninth decile) with the average PRS (fifth decile), PRSAI showed about two-fold OR 20.73 (95% CI 10.27–41.83; p = 2.7 × 10−17) and 1.4-fold OR 3.19 (95% CI 2.51–4.06; p = 4.8 × 10−21) higher predictability to identify subgroups with higher genetic risk than the PRSEU. Combining PRS and CRS improved the area under the curve from 0.74 to 0.79 in PRSAI and 0.72 to 0.75 in PRSEU.

Conclusion:

Our data suggest the need for extending genetic and clinical studies in varied ethnic groups to exploit the full clinical potential of PRS as a risk prediction tool in diverse study populations.
Dual-basal-insulin regimen for the management of dawn phenomenon in children with type 1 diabetes: a retrospective cohort study
Authors: Celik Nur Berna , Canoruc Emet Dicle , Canturk Merve , Ozon Z. Alev , Gonc E. Nazli
Published: December 2023

Background:

Handling of the dawn phenomenon (DP) with multiple daily insulin injection (MDII) regimen is a real challenge.

Objective:

We aimed to demonstrate the effectiveness of a dual-basal-insulin (a long-acting glargine and an intermediate-acting neutral protamine Hagedorn (NPH)) regimen for the management of DP in children with type 1 diabetes mellitus (T1DM). The primary efficacy outcome was to overcome morning hyperglycemia without causing hypoglycemia during the non-DP period of the night.

Design:

Retrospective cohort study.

Method:

Charts of 28 children with T1DM (12 female; 42.8%, mean age 13.7 ± 2.1 years) treated with MDII were retrospectively reviewed. The median duration of diabetes was 4.5 years (range 2–13.5 years). DP was diagnosed using a threshold difference of 20 mg/dL (0.1 mmol/L) between fasting capillary blood glucose at 3 a.m. and prebreakfast. NPH was administered at midnight in addition to daily bedtime (08.00–09.00 p.m.) glargine (dual-basal-insulin regimen). Midnight, 03:00 a.m., prebreakfast and postprandial capillary blood glucose readings, insulin–carbohydrate ratios, and basal-bolus insulin doses were recorded the day before the dual-basal-insulin regimen was started and the day after the titration of the insulin doses was complete. Body mass index standard deviation scores (BMI SDS) at the onset–3rd–12th month of treatment were noted.

Results:

Before using dual basal insulin, prebreakfast capillary blood glucose levels were greater than those at midnight and at 03:00 a.m. ( F = 64.985, p < 0.01). After titration of the dual-basal-insulin doses, there were significant improvements such that there were no statistically significant differences in the capillary blood glucose measurements at the three crucial time points (midnight, 03.00 a.m., and prebreakfast; F = 1.827, p = 0.172). No instances of hypoglycemia were reported, and the total daily insulin per kilogram of body weight did not change. The BMI SDS remained steady over the course of the 1-year follow-up.

Conclusion:

In this retrospective cohort study, the dual-basal-insulin regimen, using a long-acting glargine and an intermediate-acting NPH, was effective in overcoming early morning hyperglycemia due to insulin resistance in the DP. However, the effectiveness of the dual-basal-insulin regimen needs to be verified by prospective controlled studies using continuous glucose monitoring metrics or frequent blood glucose monitoring.
Evaluation of four machine learning models for signal detection
Authors: Dauner Daniel G. , Leal Eleazar , Adam Terrence J. , Zhang Rui , Farley Joel F.
Published: December 2023

Background:

Logistic regression-based signal detection algorithms have benefits over disproportionality analysis due to their ability to handle potential confounders and masking factors. Feature exploration and developing alternative machine learning algorithms can further strengthen signal detection.

Objectives:

Our objective was to compare the signal detection performance of logistic regression, gradient-boosted trees, random forest and support vector machine models utilizing Food and Drug Administration adverse event reporting system data.

Design:

Cross-sectional study.

Methods:

The quarterly data extract files from 1 October 2017 through 31 December 2020 were downloaded. Due to an imbalanced outcome, two training sets were used: one stratified on the outcome variable and another using Synthetic Minority Oversampling Technique (SMOTE). A crude model and a model with tuned hyperparameters were developed for each algorithm. Model performance was compared against a reference set using accuracy, precision, F1 score, recall, the receiver operating characteristic area under the curve (ROCAUC), and the precision-recall curve area under the curve (PRCAUC).

Results:

Models trained on the balanced training set had higher accuracy, F1 score and recall compared to models trained on the SMOTE training set. When using the balanced training set, logistic regression, gradient-boosted trees, random forest and support vector machine models obtained similar performance evaluation metrics. The gradient-boosted trees hyperparameter tuned model had the highest ROCAUC (0.646) and the random forest crude model had the highest PRCAUC (0.839) when using the balanced training set.

Conclusion:

All models trained on the balanced training set performed similarly. Logistic regression models had higher accuracy, precision and recall. Logistic regression, random forest and gradient-boosted trees hyperparameter tuned models had a PRCAUC ⩾ 0.8. All models had an ROCAUC ⩾ 0.5. Including both disproportionality analysis results and additional case report information in models resulted in higher performance evaluation metrics than disproportionality analysis alone.
Physiologically based pharmacokinetic modeling of candesartan to predict the exposure in hepatic and renal impairment and elderly populations
Authors: Guo Lingfeng , Zhu Xinyu , Zhang Lei , Xu Yichao
Published: December 2023

Background:

Candesartan cilexetil is a widely used angiotensin II receptor blocker with minimal adverse effects and high tolerability for the treatment of hypertension. Candesartan is administered orally as the prodrug candesartan cilexetil, which is wholly and swiftly converted to the active metabolite candesartan by carboxylesterase during absorption in the intestinal tract. In populations with renal or hepatic impairment, candesartan’s pharmacokinetic (PK) behavior may be altered, necessitating dosage adjustments.

Objectives:

This study was conducted to examine how the physiologically based PK (PBPK) model characterizes the PKs of candesartan in adult and geriatric populations and to predict the PKs of candesartan in elderly populations with renal and hepatic impairment.

Design:

After developing PBPK models using the reported physicochemical properties of candesartan and clinical data, these models were validated using data from clinical investigations involving various dose ranges.

Methods:

Comparing predicted and observed blood concentration data and PK parameters was used to assess the fit performance of the models.

Results:

Doses should be reduced to approximately 94% of Chinese healthy adults for the Chinese healthy elderly population; approximately 92%, 68%, and 64% of that of the Chinese healthy adult dose in elderly populations with mild, moderate, and severe renal impairment, respectively; and approximately 72%, 71%, and 52% of that of the Chinese healthy adult dose in elderly populations with Child–Pugh-A, Child–Pugh-B, and Child–Pugh-C hepatic impairment, respectively.

Conclusion:

The results suggest that the PBPK model of candesartan can be utilized to optimize dosage regimens for special populations.
Deconstructing informality: Will the informal/formal dialectic ever end?
Authors: Nchito Wilma S.
Published: December 2023

The article by Brandon Finn titled ‘The structure of informality: The Zambian Copperbelt and the informal/formal dialectic' presents a discussion that, for me, needs to be had. I have always argued that some of these universally applied nomenclatures that have been used to label certain phenomena in the global South need revisiting. This is because they have been devised with a global North contextualization and do not adequately define the phenomena. Those seeking to define African informality most likely approach it from a Western context within which urbanization has evolved and developed to a level where systems and infrastructure work efficiently. My thinking on this issue is that ‘ what would happen if we stopped trying to force development of the Global South to fit into western stereotypes?’ There seems to be an expectation of global South urban development to follow in the footsteps of the West. Meanwhile the development of cities on the continent have taken a totally different trajectory from the textbook cases that we find ourselves trying to superimpose on the global South cities.
Preliminary data from a 4-year mirror-image and multicentre study of patients initiating paliperidone palmitate 6-monthly long-acting injectable antipsychotic: the Paliperidone 2 per Year study
Authors: García-Carmona Juan Antonio , García-Pérez Alba , Isidro García Guillermo , Forcen-Muñoz Luis Alberto , Ovejero García Santiago , Sáez Povedano Rocío , González-Galdámez Ana Luisa , Mata Iturralde Laura , Hernández-Sánchez Fernando , Ramirez Bonilla Mariluz , Fuentes-Pérez Paloma , Ovejas-Catalán Claudia , Suárez-Pinilla Paula , Valdivia-Muñoz Francisco , Fernández Abascal Blanca , Omaña Colmenares Miguel , de Lourdes Martín-Pérez Ángela , Campos-Navarro María Pilar , Baca-García Enrique , Benavente-López Sergio , Raya Platero Alberto , Barberán Navalón Miguel , Sánchez-Alonso Sergio , Vázquez-Bourgon Javier , Pappa Sofia
Published: December 2023

Background:

Paliperidone palmitate 6-monthly (PP6M) is the first long-acting antipsychotic injectable (LAI) to allow for only two medication administrations per year, though there is presently limited insight into its effectiveness and potential added value in real clinical practice conditions.

Objectives:

To present our ongoing study and draw its preliminary data on patient characteristics initiating PP6M and adherence during the first year of treatment.

Methods:

The paliperidone 2 per year (P2Y) study is a 4-year, multicentre, prospective mirror-image pragmatic study taking place at over 20 different sites in Europe. The mirror period covers 2 years either side of the PP6M LAI initiation. Retrospective data for the previous 2 years are collected for each patient from the electronic health records. Prospective data are recorded at baseline, 6, 12, 18 and 24 months of drug administration and also cover information on concomitant psychiatric medication, relapses, hospital admissions, side effects, discontinuation and its reasons. Meanwhile, here we present preliminary data from the P2Y study at basal and 6-month period (first and second PP6M administration).

Results:

At the point of PP6M initiation, the most frequent diagnosis was schizophrenia (69%), the clinical global impression scale mean score was 3.5 (moderately markedly ill) and the rate of previous hospital admissions per patient and year was 0.21. PP6M was initiated after a median of 3–4 years on previous treatment: 146 (73%) from paliperidone palmitate 3-monthly, 37 (19%) from paliperidone palmitate 1-monthly and 17 (9%) from other antipsychotics. The mean dose of the first PP6M was 1098.9 mg. The retention rate at 6 months and 1 year of treatment on PP6M in our cohort was 94%.

Conclusion:

Patient and clinician preference for LAIs with longer dosing intervals was the main reason for PP6M initiation/switching resulting in high treatment persistence. Future data are needed to evaluate the full impact of PP6M in clinical practice.
Spotivey: A web application for simplified use of the Spotify application programming interface in online questionnaire studies
Authors: Radke Markus , Lepa Steffen , Ladleif Matthias
Published: December 2023

Everyday music listening has become an important research topic during the last decades. However, self-reporting through questionnaire surveys, the received approach for studying individual music consumption, presents methodological challenges. The rise of mobile music streaming and open application programming interfaces introduces new opportunities to address these productively. Spotivey is a free research software that integrates music streaming provider API functionalities into online surveys and in this way allows to connect digital behavioral traces with self-reported questionnaire data. The current version effortlessly retrieves comprehensive information about respondents’ past music listening on Spotify while they fill an online survey. Through an informed consent procedure, General Date Protection Regulation compliance for this new form of digital data donation is ensured. Methodical challenges include participant dropout and the need for robust statistical analysis methods. Planned future enhancements encompass expanding application programming interfaces support, enriching retrieved data with information from other music databases, and compatibility with diverse online survey design systems.
Diabetic peripheral neuropathy and their associations with overweight/obesity and impaired blood glucose among diabetic patients in Eastern Ethiopia: Institutional-based study
Authors: Fentie Dilnessa , Solomon Yonatan , Abebe Fitsum , Derese Tariku , Tigstu Feven , Hailemariam Tekleberhan
Published: December 2023

Objective:

This study aimed to determine the burden of diabetic peripheral neuropathy and its associations with overweight/obesity and impaired blood glucose among diabetic patients in Eastern Ethiopia.

Method:

A total of 644 diabetic individuals were included in the study through systematic random sampling techniques. The Michigan neuropathy screening instrument was used to evaluate the presence of diabetic neuropathy. Data were presented using narrative, figures, and tables from the results of statistical analysis. The descriptive result was reported using frequency (percentage) for categorical variables and mean ± SD for continuous measures, respectively. Multivariable logistic regression was performed to identify factors associated with diabetic peripheral neuropathy.

Results:

The overall prevalence of diabetic peripheral neuropathy was 47.8% (95% CI: 43.9%–51.7%). Low monthly income (AOR: 2.02, 95% CI: 1.09, 3.73), history of khat chewing (AOR: 2.32, 95% CI: 1.04, 4.907), impaired blood glucose (AOR: 1.52, 95% CI: 1.63, 1.94), physical inactivity (AOR: 2.76, 95% CI: 1.74, 4.36), and raised body mass index (AOR: 2.45, 95% CI: 1.01, 4.99) were factors significantly associated with diabetic peripheral neuropathy.

Conclusion:

The study emphasizes the value of early diabetic peripheral neuropathy detection and the widespread presence of diabetic peripheral neuropathy risk factors in diabetes patients. Any initiative intended to lessen the burden of diabetic peripheral neuropathy-related morbidity and high health care costs must be implemented as a strategy.
Development of H51Y and E157Q mutations for integrase inhibitor resistance in a patient undergoing treatment for pulmonary tuberculosis: A case report
Authors: Farias Luís Arthur Brasil Gadelha , Saboya Melissa Fiuza , Ponte Fernandes Natália , Perdigão Neto Lauro Vieira , de Arruda Erico Antonio Gomes
Published: December 2023

Background:

Failure of first-line regimens with dolutegravir, a high genetic barrier antiretroviral of the integrase inhibitor class, although uncommon, tends to increase in prevalence due to broader use.

Objective:

To describe the clinical case of an HIV/Tuberculosis coinfected patient who developed Human Immunodeficieny Virus (HIV) treatment failure during dolutegravir therapy.

Case report:

Male, 29 years old, presented with a right cervical mass, dry cough, and hyporexia, which lasted 2 weeks. Diagnostic tests were positive for tuberculosis and HIV. The viral load was 437,927 cp/mL (Log = 5.64). Antiretroviral therapy was initiated with Tenofovir/Lamivudine and Dolutegravir (TDF/3TC and DTG), the latter at a dose of 50 mg/day, as was a regimen for tuberculosis. After 8 months, therapeutic failure was verified. Genotyping was requested, with detection of the H51Y and E157Q mutations in the integrase.

Conclusion:

Attention when determining the antiretroviral therapy treatment regimen of HIV/TB coinfected patients is paramount. Poor adherence to antiretroviral therapy and follow-up may have contributed to treatment failure and resistance.
Dimensionalizing privacy to advance the study of digital disempowerment
Authors: Quinn Kelly , Epstein Dmitry
Published: December 2023

In this essay, we call attention to privacy as the foundational construct that underpins digital disempowerment. We argue that to better understand the processes of disempowerment, scholars must critically engage with the dimensionality of privacy conceptualizations and privacy-dependent constructs such as privacy concerns and privacy-protecting behavior, and the way in which these are measured. We focus on privacy's horizontal and vertical dimensions as a way to offer a more nuanced understanding of power in computationally mediated environments and potentially enable a more refined and meaningful understanding of privacy resignation and disengagement.
Increasing trends in online information-seeking and decreasing trends of funded research for polycystic ovary syndrome: An 18-year joinpoint analysis of Google Trends data from 2004 to 2022
Authors: Malhotra Kashish , Kempegowda Punith
Published: December 2023

Background

The internet has become the primary source of health-related information, and online health information-seeking behaviour has been used as a reliable surrogate of public awareness. We studied the trends of search interest in polycystic ovary syndrome over time and whether funding for polycystic ovary syndrome research corresponded with the changes in search interest. We also studied the geographic reach of polycystic ovary syndrome interest and whether polycystic ovary syndrome awareness month is an effective strategy to increase polycystic ovary syndrome interest.

Methods

We performed joinpoint regression on relative search volume data for polycystic ovary syndrome using Google Trends from 2004 to 2022, comparing weekly, monthly and yearly trends. We retrieved the total polycystic ovary syndrome-related articles from 1980 to 2022 to study funded and unfunded literature trends. We did a Mann-Whitney U-test analysis comparing the mean relative search volume during the polycystic ovary syndrome awareness month versus the rest of the weeks yearly.

Results

Three joinpoints were seen at months 70, 196, and 199 months which were statistically significant when compared to the null hypothesis of zero joinpoints ( p = .0002), one joinpoint ( p = .0002), and two joinpoints ( p = .0395), respectively. The search interest of ‘Polycystic ovary syndrome’ was seen in 195 regions globally. The mean relative search volume in September corresponding to polycystic ovary syndrome awareness month was higher than other months from 2013 to 2022. Of the 41,292 journal articles analysed, there was a positive trend in funded polycystic ovary syndrome research from the 2000s until the onset of the COVID-19 pandemic.

Conclusions

An increasing polycystic ovary syndrome search interest is probably driven by major legislative and scientific events suggesting the importance of such events. Polycystic ovary syndrome Awareness Month is an effective international awareness initiative to increase online polycystic ovary syndrome information-seeking behaviour. The declining trend in funding is a concern as it mismatches with the continued increase in information-seeking behaviour globally.
Enhancing equitable engagement for digital health promotion: Lessons from evaluating a childrearing app in Indonesia
Authors: Loblay Victoria , Ekambareshwar Mahalakshmi , Naderbagi Aila , Song Yun JC , Ford Michele , Zahed Iqthyer , Yoon Adam , Hickie Ian B , LaMonica Haley M
Published: December 2023

Part of the appeal of digital health interventions, including mHealth, is the potential for greater reach in places where conventional health promotion is hampered by geographical, financial or social barriers. Yet, ‘engagement’ – typically understood as user experience and interactions with technology - remains a persistent challenge, particularly in places where technology access or familiarity with technology is limited. We undertook an evaluation of a childrearing app to promote socioemotional and cognitive development in early childhood across the world. In this article, we present findings from qualitative research on app rollout in Indonesia, the first of numerous low- and middle-income countries targeted by the app. We draw on systems theory and complexity thinking to broaden the lens of ‘engagement’ beyond individual users to encompass collective systems (families and communities), exploring how the intervention was harnessed to meet local contextual needs. The qualitative research involved semi-structured interviews, workshops and audio diaries with 57 diverse stakeholders, including Indonesian parents, caregivers, and collaborators involved in funding, development, and dissemination of the app. We observed the importance of social connection, sense-making, and interactive learning for enhancing engagement with the app and its messages. Enthusiastic users, strongly linked across community networks (e.g. kindergarten teachers), improvised dissemination strategies to facilitate uptake. Interactive learning that tapped into familiar social structures (e.g. intergenerational hierarchies) was crucial for engagement. Understanding ways the app failed to tap into structures of social connection served to highlight the need to embed strategies to support collective engagement.
The portrayal of organ donation on TikTok: A content analysis of popular English-language TikTok videos
Authors: Marcon Alessandro R , Zenone Marco , Caulfield Timothy
Published: December 2023

Objective

TikTok is one of the most popular social media platforms and plays a role in shaping public perceptions. This research examined how organ donation was portrayed on the platform.

Methods

We built a dataset of the most popular English-language TikTok videos that used the hashtags #organdonor or #organdonation. We then performed content analysis on the 400 most viewed videos after limiting data set inclusion to one video per user account.

Results

The finalized videos ( N = 313) had generated nearly 80 million views and 10 million likes. Featuring both donors (56.2%) and recipients (44.1%), videos shared experiences that celebrated and lamented lost donor lives (41.8%) while also celebrating transplantation successes (31.3%). Very few videos included public solicitation (2.9%). Common video traits included detailing medical procedures (45.4%), presenting honor walks (10.9%), and displaying donors and recipients connecting or wanting to connect (16.9%). Videos mostly had a positive (74.1%) versus negative (10.2%) leaning tone.

Conclusion

Far from superficially glamorizing organ donation/transplantation processes and procedures, popular English-language TikTok videos depicted what we perceived as highly emotional and expository experiences. While the videos likely offered learning and cathartic opportunities for individuals and communities, they also highlight some tensions between personal anecdotes and data/research. Findings from this research can inform public outreach efforts as well as policies related to protecting anonymity and celebrating donors with honor walks. Indeed, given TikTok's increasing popularity and influence, it could be a valuable tool to meaningfully learn from, and engage with, patient and donor communities.