Generalization challenges in electrocardiogram deep learning: insights from dataset characteristics and attention mechanism.

Deep learning's widespread use prompts heightened scrutiny, particularly in the biomedical fields, with a specific focus on model generalizability. This study delves into the influence of training data characteristics on the generalization performance of models, specifically in cardiac abnormality detection. Leveraging diverse electrocardiogram datasets, models are trained on subsets with varying characteristics and subsequently compared for performance.

A retrospective longitudinal cohort study of the clinical burden in myasthenia gravis.

Background: Patients with generalized myasthenia gravis (MG) often experience debilitating exacerbations, with the possibility of life-threatening respiratory crises requiring hospitalization. Long-term longitudinal studies are needed to understand the burden of MG, including in patients whose disease is refractory to conventional treatment.

Methods: A retrospective, longitudinal, cohort study was conducted of patients in England aged ≥ 18 years with treatment-refractory or non-refractory MG, using data recorded during 1997-2016 in the Clinical Practice Research Datalink and the Hospital Episode Statistics databases.

Structural Landscapes in Geometrically Frustrated Smectics.

A phenomenological free energy model is proposed to describe the behavior of smectic liquid crystals, an intermediate phase that exhibits orientational order and layering at the molecular scale. Advantageous properties render the functional amenable to numerical simulation. The model is applied to a number of scenarios involving geometric frustration, leading to emergent structures such as focal conic domains and oily streaks and enabling detailed elucidation of the very rich energy landscapes that arise in these problems.

Increasing cancer risk over calendar year in people with multiple sclerosis: a case-control study.

Background: Data on cancer prevalence and incidence in multiple sclerosis (MS) patients are controversial. This study is aimed at estimating cancer risk in MS patients.

Methods: Nested case-control study using data collected between 01/01/1987 and 28/02/2016 from the United Kingdom Clinical Practice Research Datalink.

Incidence of urinary tract infection following initiation of intermittent catheterization among patients with recent spinal cord injury in Germany and the Netherlands.

To assess incidence of urinary tract infection (UTI) among patients with recent spinal cord injury (SCI) who initiated intermittent catheterization (IC). Retrospective chart review. Two European SCI rehabilitation centers.

Oral Corticosteroid Treatment Patterns of Patients in the United States with Persistent Asthma.

Background: Patients with poor asthma control may receive oral corticosteroid (OCS) therapy despite the risk for adverse effects.

Objective: We assessed OCS use frequency and treatment patterns in patients with persistent asthma in the United States (US).

Methods: We used the IBM MarketScan Commercial Claims and Encounters, Medicare Supplemental, and Medicaid Multistate Claims research databases to identify patients from January 1, 2012, to December 31, 2017, who were ≥12 years old, met the 2-year Healthcare Effectiveness Data and Information Set criteria for persistent asthma, and were continuously enrolled ≥6 months before (baseline) and ≥24 months after (follow-up) the persistent asthma index date.

Influence of later exposure to perches and nests on flock level distribution of hens in an aviary system during lay.

Aviaries provide hens with many resources, but birds must develop motor and cognitive skills to use them properly. Introducing birds to aviaries at older ages has been reported to result in less use of perches, nests, and vertical space, which can reduce productivity and hen welfare. The objectives of this study were to examine (1) how enrichment influenced distribution of hens in the aviary during the day and (2) how enrichment influenced the distribution and roosting substrate of birds at night.

Impact of Cardio-Renal-Metabolic Comorbidities on Cardiovascular Outcomes and Mortality in Type 2 Diabetes Mellitus.

Background: We evaluated the incremental contribution of chronic kidney disease (CKD) to the risk of major adverse cardiovascular (CV) events (MACE), heart failure (HF), and all-cause mortality (ACM) in type 2 diabetes mellitus (T2DM) patients and its importance relative to the presence of other cardio-renal-metabolic (CaReMe) comorbidities.

Methods: Patients (≥40 years) were identified at the time of T2DM diagnosis from US (Humedica/Optum) and UK (Clinical Practice Research Datalink) databases. Patients were monitored post-diagnosis for modified MACE (myocardial infarction, stroke, ACM), HF, and ACM.

Epidemiology and health outcomes associated with hyperkalemia in a primary care setting in England.

Background: Real-world incidence, clinical consequences, and healthcare resource utilization (HRU) of hyperkalemia (HK) remain poorly characterized, particularly in patients with specific comorbidities.

Methods: Data from the Clinical Practice Research Datalink and Hospital Episode Statistics databases were analyzed to determine incidence of an index HK event, subsequent clinical outcomes, and HRU in the English population. Factors associated with index HK in a primary care setting were also identified for those with an index HK event during the study period (2009-2013) and matched controls.

Healthcare resource utilization by patients with treatment-refractory myasthenia gravis in England.

To examine healthcare resource utilization associated with refractory myasthenia gravis (MG) in England. This was a retrospective cohort study of linked data from the Clinical Practice Research Datalink and the Hospital Episode Statistics database collected between 1997 and 2016. Included patients were ≥18 years of age at the index MG diagnosis.

Prodromal symptoms of multiple sclerosis in primary care.

Objective: Early diagnosis and treatment initiation significantly influence long-term disability outcome in multiple sclerosis (MS). We aimed at identifying prodromal symptoms of MS in primary care settings.

Methods: This was a nested case-control study comparing the occurrence of various symptoms in MS patients versus controls at 0 to 2, 2 to 5, and 5 to 10 years before index date (first MS record).

Lions, hyenas and mobs (oh my!).

Understanding the factors that facilitate the emergence of cooperation among organisms is central to the study of social evolution. Spotted hyenas frequently cooperate to mob lions , approaching the lions as a tightknit group while vocalizing loudly in an attempt to overwhelm them and drive them away. Whereas cooperative mobbing behavior has been well documented in birds and some mammals, to our knowledge it has never been described during interactions between 2 apex predators.

A retrospective study to assess resource utilization and costs in patients with post-stroke spasticity in the United Kingdom.

Objective: Post-stroke spasticity (PSS) is a common complication following stroke. This study describes the differences in healthcare resource utilization between patients who do and do not develop PSS in the UK.

Methods: Adults registered in The Health Improvement Network database with a recorded stroke between 2007 and 2011 were included.

Real-world utilization of darbepoetin alfa in cancer chemotherapy patients.

Objectives: To provide an understanding of darbepoetin alfa dose patterns in cancer patients undergoing myelosuppressive chemotherapy starting from 2011.

Study Design: This is a retrospective cohort study using a proprietary outpatient oncology database.

Methods: Metastatic, solid tumor cancer patients receiving concomitant myelosuppressive chemotherapy and darbepoetin alfa with an associated hemoglobin <10 g/dL during 2011-2015 were identified.

Understanding the ballistic event: methodology and initial observations.

The purpose of the study is to accelerate the development of ceramic materials for armour applications by substantially increasing the information obtained from a high-energy projectile impact event. This has been achieved by modifying an existing test configuration to incorporate a block of ballistic gel, attached to the strike face of a ceramic armour system, to capture fragments generated during the ballistic event such that their final positions are maintained. Three different materials, representative of the major classes of ceramics for armour applications, alumina, silicon carbide, and boron carbide, have been tested using this system.

Basal-bolus Therapy in Patients with Type 2 Diabetes Mellitus in the UK: Patient Characteristics, Treatment Patterns and the Effect of Switching to Premixed Insulin.

Introduction: Increasing emphasis is being placed on insulin use among patients with type 2 diabetes mellitus (T2DM). Basal-bolus (BB) therapy is regarded as the gold standard, but a high frequency of injections and the general complexity of this therapy are seen as barriers in real-world practice. Here we describe the characteristics and treatment patterns of patients with T2DM receiving BB in the UK, with specific focus on those switching to a simplified regimen of premixed insulin.

COPD exacerbations by disease severity in England.

Objectives: Exacerbations of chronic obstructive pulmonary disease (COPD) are associated with accelerated disease progression and are important drivers of health care resource utilization. The study aimed to quantify the rates of COPD exacerbations in England and assess health care resource utilization by severity categories according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2013.

Methods: Data from the Clinical Practice Research Datalink linked to Hospital Episode Statistics were used to identify patients with a COPD diagnosis aged ≥40 years.

Epidemiology, severity, and treatment of chronic obstructive pulmonary disease in the United Kingdom by GOLD 2013.

Objectives: In 2013, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) updated the management strategy on COPD based on severity using a combined assessment of symptoms, degree of airflow limitation, and number of exacerbations. This study quantified prevalence and incidence of COPD in the United Kingdom and estimated disease severity by GOLD 2013 categories A/B (low risk) and C/D (high risk).

Methods: The Clinical Practice Research Datalink was used to identify COPD patients ≥40 years.

Effect of ketotifen premedication on adverse reactions during peanut oral immunotherapy.

Background: Oral immunotherapy (OIT) has shown promise in inducing desensitization for food allergy. However, there are safety concerns regarding the frequency and severity of adverse events during food OIT.

Objective: To evaluate the effect of Ketotifen premedication on adverse reactions during peanut OIT.

Octreotide infusion for malignant duodenal obstruction in a 12-year-old girl with metastatic peripheral nerve sheath tumor.

Malignant bowel obstruction is a common complication of some adult malignancies. In childhood cancer, malignant bowel obstruction is relatively rare. Octreotide, an analogue of the hormone somatostatin, has been shown to be an effective treatment for this condition in adults.

Synthesis-secretion coupling of insulin: effect of aging.

Synthesis-secretion coupling of insulin was measured in four age groups of perfused pancreases taken from Sprague-Dawley rats ranging in age from 2-12 months. The effect of long term (6 h) near-maximal glucose stimulation (300 mg/dl) on both insulin secretion and net insulinogenesis demonstrated an age-related increase in both parameters. Net insulinogenesis as well as total insulin secretion increased linearly as a function of aging.