A Computational Framework for Identifying Age Risks in Drug-Adverse Event Pairs

The identification of associations between drugs and adverse drug events (ADEs) is crucial for drug safety surveillance. An increasing number of studies have revealed that children and seniors are susceptible to ADEs at the population level. However, the comprehensive explorations of age risks in drug-ADE pairs are still limited. The FDA Adverse Event Reporting System (FAERS) provides individual case reports, which can be used for quantifying different age risks. In this study, we developed a statistical computational framework to detect age group of patients who are susceptible to some ADEs after taking specific drugs. We adopted different Chi-squared tests and conducted disproportionality analysis to detect drug-ADE pairs with age differences. We analyzed 4,580,113 drug-ADE pairs in FAERS (2004 to 2018Q3) and identified 2,523 pairs with the highest age risk. Furthermore, we conducted a case study on statin-induced ADE in children and youth. The code and results are available at https://github.com/Zhizhen-Zhao/Age-Risk-Identification

Challenges in the Intraoperative Consultation of Low-Grade Epilepsy-Associated Neuroepithelial Tumors by Cytomorphology in Squash Preparations

<b><i>Introduction:</i></b> Low-grade epilepsy-associated neuroepithelial tumors (LEATs) create a diagnostic challenge in daily practice and intraoperative pathological consultation (IC) in particular. Squash smears are extremely useful in IC for accurate diagnosis; however, the knowledge on cytopathologic features of LEATs is based on individual case reports. Here, we discuss the 3 most common and well-established entities of LEATs: ganglioglioma (GG), dysembryoplastic neuroepithelial tumor (DNT), and papillary glioneuronal tumor (PGNT). <b><i>Methods:</i></b> Thirty patients who underwent surgery for GG, DNT, and PGNT between 2001 and 2021 were collected. Squash smears prepared during intraoperative consultation were reviewed by 1 cytopathologist and an experienced neuropathologist. <b><i>Results:</i></b> Among the 30 tumors, 16 (53.3%) were GG, 11 (36.6%) DNT, and 3 (10%) PGNT. Cytomorphologically, all of the 3 tumor types share 2 common features such as dual cell population and vasculocentric pattern. GG smears were characteristically composed of dysplastic ganglion cells and piloid-like astrocytes on a complex architectural background of thin- to thick-walled vessels. DNT, on the other hand, showed oligodendroglial-like cells in a myxoid thin fibrillary background associated with a delicate capillary network. Common cytological features of PGNT were hyperchromatic cells with narrow cytoplasm surrounding hyalinized vessels forming a pseudopapillary pattern and bland cells with neuroendocrine nuclei dispersed in a neuropil background. <b><i>Conclusion:</i></b> A higher diagnostic accuracy can be obtained when squash smears are applied with frozen sections. However, it is important to integrate clinical and radiologic features of the patient as well as to know the cytopathologic features of the LEAT spectrum in the context of differential diagnosis to prevent misinterpretation in the IC.

Additional opportunities for using computer technologies in expert analysis of laboratory data

The presented work reflects the author’s algorithm of mathematical processing and possible interpretations of the results obtained when creating expert analytical systems using computer technology. As initial parameters for the construction of neural networks of the second level, it is proposed to use individual results of calculations of the ratios of a number of laboratory indicators capable of forming a single functional cluster (leukogram, indicators of water-electrolyte balance, protein fractions, etc.). Further, using the proposed calculation algorithm and the archive database, structural features in the ′deformation′ of the ratio panel were compared against the background of the growth of each indicator, a matrix table was built reflecting the degree (correlation coefficients, KCr) of the coincidence of the features of the formation of the structure of the obtained panels of the parameters determined in individual observations. At high values of KCr, a conclusion is made about their (determined parameters) unified participation in the mechanism of emerging disorders. Thus, the system allows you to establish a leading complex of associated relationships by changes in the structure of ratios in the selected panel, corresponding to the dynamics of deviation of the target (analyzed) indicator, thereby differentiating the different mechanisms of formation of pathological deviations in this patient, the manifestation and balance of their values in the system-wide response, to evaluate the specific value of the absolute indicator as the final result of such interaction at the time of examination of the patient. The approach used, proposed by the authors, allows us to evaluate not only quantitative relationships, but also the features of the manifestation of the functional properties of the evaluated indicators. All of the above significantly expands the informativeness of the obtained laboratory data, allowing us to build a reasonable paradigm of the connections of the emerging complex of pathological disorders in each individual case. In the list of references, the authors cite publications as concrete examples of the use of the proposed approach in assessing a complex of disorders with different pathological processes using different panels in calculations.

Systematic analysis of drug-associated myocarditis reported in the World Health Organization pharmacovigilance database

While multiple pharmacological drugs have been associated with myocarditis, temporal trends and overall mortality have not been reported. Here we report the spectrum and main features of 5108 reports of drug-induced myocarditis, in a worldwide pharmacovigilance analysis, comprising more than 21 million individual-case-safety reports from 1967 to 2020. Significant association between myocarditis and a suspected drug is assessed using disproportionality analyses, which use Bayesian information component estimates. Overall, we identify 62 drugs associated with myocarditis, 41 of which are categorized into 5 main pharmacological classes: antipsychotics (n = 3108 reports), salicylates (n = 340), antineoplastic-cytotoxics (n = 190), antineoplastic-immunotherapies (n = 538), and vaccines (n = 790). Thirty-eight (61.3%) drugs were not previously reported associated with myocarditis. Antipsychotic was the first (1979) and most reported class (n = 3018). In 2019, the two most reported classes were antipsychotics (54.7%) and immunotherapies (29.5%). Time-to-onset between treatment start and myocarditis is 15 [interquartile range: 10; 23] days. Subsequent mortality is 10.3% and differs between drug classes with immunotherapies the highest, 32.5% and salicylates the lowest, 2.6%. These elements highlight the diversity of presentations of myocarditis depending on drug class, and show the emerging role of antineoplastic drugs in the field of drug-induced myocarditis.

Diagnosis and Management of Infected or Suspected Patients with Covid-19 a Study of 48 Cases in the UK

Covid-19 is a pandemic infective disease, which has been erupting throughout the whole world from 2020 to 2021. There have been at the time of reviewing more than a hundred million cases (102,399,513) of infection, and more than 2 million deaths (2,217,005) in more than 200 countries; this information is taken from the Covid-19 daily situation report issued on 1st Feb 2021 by WHO. The pandemic was also declared as an outbreak of Public Health Emergency of International Concern on 30th Jan 2020 by WHO. No effective treatment model has yet been confirmed by conventional western medicine, but some herbal treatments used in China can be recognized as having positive results in Covid-19 cases. This pandemic disaster has been severely damaging to quality of life, disturbing social communication, economic development and the progress of humanity. Successful results were first reported from temporary hospitals (Fangcang Hospitals set up in arenas and exhibition spaces) in Wuhan, China, where more than 90% of patients treated with Chinese herbal medicine were prevented by transferring from the minor or milder stages of the disease to the severe or critical stage. In all of them the positive PCR became negative; herbs were involved in the rescue and treatment of severe and critical cases in ICU’s in hospitals as well. It was an important factor in how Covid-19 was controlled so quickly in China. The author recruited both confirmed and suspected Covid-19 patients through social media (WeChat, WhatsApp, Internet, message etc.) as a volunteer TCM consultant from March 2020, during the first Lockdown phase in UK. It was quickly realized that the appearance of the tongue provides special and significant information for identifying whether Covid-19 is present and shows its severity, from a TCM perspective, as the degree and type of dampness accumulated within the body. Herbal prescriptions were sent by post for patients’ treatment according to their clinical findings, virus exposure history and tongue information (from photos). Similar positive effects were found as in China, and treatment reports and results are summarized here. The author believes there are many herbal medicines that can be effective in controlling the Sars-Cov-2 virus, and that prescribing the appropriate formula to match each individual case is the key point for TCM control of Covid-19. Chinese herbal medicine is the most effective current treatment method that can prevent cases in the minor and ordinary stages from progressing to the severe or critical stage, and so can play a significant role in the decrease and cure of Covid-19.

COVID-19 Pandemic-Related Arguments in Polish Civil Litigation

The aim of this paper is to analyse the legal record on civil litigation from mid-March 2020 to mid-July 2021 and examine COVID-19 pandemic-related arguments in a sample of litigated cases heard in Polish courts, more precisely 41 cases. In an attempt to establish the number and types of court cases in which such arguments have been raised, the population of individual case records was accessed electronically from the Ordinary Courts Judgments Portal (Pol. Portal Orzeczeń Sądów Powszechnych). The analysed research material consists of texts of written justifications published along with rulings of courts of the first instance in the Portal, except for texts regarding criminal cases and widely understood labour cases. This paper refers to certain theoretical aspects of argument and argumentation. Then, it sheds light on the use of COVID-19 pandemic-related arguments by the parties involved in litigation—as reported by the courts in written justifications—considering, amongst others, whether those arguments were found convincing by the courts. Based on a survey of relevant cases, an attempt was made to identify categories of COVID-19 pandemic-related arguments of the parties involved in litigation, raised in their legal submissions. Also a look into the tendencies in this regard was taken to see whether any patterns emerge and it is possible (or not) to discern different trends in the analysed phenomena. The point of the analysis in this article is both descriptive and normative.

Subseasonal Meteorological Drought Development over the Central United States during Spring

Diagnosis of rapidly developing springtime droughts in the central U.S. has mostly been made via numerous individual case studies rather than in an aggregate sense. This study investigates common aspects of subseasonal “meteorological drought” evolution, here defined as persistent precipitation minus evapotranspiration (P-ET) deficits, revealed in early (April 1-May 15) and late (May 16-June 30) spring composites of 5-day running mean JRA-55 reanalysis data for three different central U.S. regions during 1958-2018. On average, these droughts are initiated by a quasi-stationary Rossby wave packet (RWP), propagating from the western North Pacific, which arises about a week prior to drought onset. The RWP is related to a persistent ridge west of the incipient drought region and strong subsidence over it. This subsidence is associated with low-level divergent flow that dries the atmosphere and suppresses precipitation for roughly 1-2 weeks, and generally has a greater impact on the moisture budget than does reduced poleward moisture transport. The resulting “dynamically driven” evaporative demand corresponds to a rapid drying of the root-zone soil moisture, which decreases ∼40 percentiles within ∼10 days. Anomalous near-surface warmth develops only after P-ET deficit onset, as does anomalously low soil moisture that then lingers a month or more, especially in late spring. The horizontal scale of the RWPs, and of the related drought anomalies, decreases from early to late spring, consistent with the climatological change in the Pacific Rossby waveguide. Finally, while this composite analysis is based upon strong, persistent P-ET deficits, it still appears to capture much of the springtime development of so-called “flash droughts” as well.

Mothers' perspective on the functioning of a family with a child with special communication needs – preliminary research

This article presents the results of preliminary research on the mothers’ perspective on the functioning of a family with a child with special communication needs. The goal was to gain an insight into the experiences of mothers of children with special communication needs in different areas of life and to understand the factors that influence their experiences. The following areas of the mothers’ experiences in the functioning of a family were identified: the doing everyday activities, spending free time, relationships between family members and mothers' ideas about the future of a family with a child with special communication needs. The research employed individual case studies and the in-depth interview technique.

Mortality rate comparison of enterotomy and resection and anastomosis (enterectomy) in dogs with foreign-body obstructions

PICO question In dogs with gastrointestinal foreign-body obstruction undergoing surgical correction, is the mortality rate in the perioperative period for those receiving resection and anastomosis higher, lower, or equivalent to those receiving an enterotomy? Clinical bottom line Category of research question Outcome The number and type of study designs reviewed Four retrospective studies were reviewed Strength of evidence Weak Outcomes reported It would appear that the mortality rate for resection and anastomosis for the purpose of foreign-body removal is higher than that of enterotomies performed for the same reason Conclusion There is insufficient evidence directly comparing enterotomies with resection and anastomoses in foreign-body obstructions to definitively state that the mortality rate is higher among resection and anastomosis procedures How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.

Co-creating rehabilitation: Findings from a pilot and implications for wider public service reform

As part of a large pan-European project on co-creating public services we supported the design of a programme in England that attempted to operationalise research on desistance, through a model of co-created, strengths-based working. We then evaluated its implementation and impact. The programme was implemented in a Community Rehabilitation Company. It was delivered in the context of rapid organisational change, often in response to rapidly changing external events and a turbulent policy environment. These factors impeded implementation. An impact evaluation did not identify a statistically significant difference in re-offending rates between the intervention group and a comparator group. However, in-depth qualitative evaluation identified positive examples of co-production and co-creation, with individual case managers and service users supportive and noting positive change. Taken as a whole our findings suggest that a co-created, strengths-based model of probation case management is promising but needs to be accompanied by wider systems change if it is to be embedded successfully.