Paliperidone ER and oral risperidone in patients with schizophrenia: a comparative database analysis

<p>Abstract</p> <p>Background</p> <p>To compare the efficacy and tolerability of paliperidone extended-release (ER) with risperidone immediate-release using propensity score methodology.</p> <p>Methods</p> <p>Six double-blind, randomized, placebo-controlled, short-term clinical trials for acute schizophrenia with availability of individual patient-level data were identified (3 per compound). Propensity score pairwise matching was used to balance observed covariates between the paliperidone ER and risperidone patient populations. Scores were generated using logistic regression models, with age, body mass index, race, sex, baseline Positive and Negative Syndrome Scale (PANSS) total score and baseline Clinical Global Impressions–Severity (CGI-S) score as factors. The dosage range of paliperidone ER (6-12 mg/day) was compared with 2 risperidone dosage ranges: 2-4 and 4-6 mg/day. The primary efficacy measure was change in PANSS total score at week 6 end point. Tolerability end points included adverse event (AE) reports and weight. AEs with rates ≥5% and with a ≥2% difference between paliperidone ER and risperidone were identified.</p> <p>Results</p> <p>Completion rates for placebo-treated subjects in paliperidone ER trials (n = 95) and risperidone trials (n = 122) groups were 36.8% and 51.6%, respectively; end point changes on PANSS total scores were similar (p = 0.768). Completion rates for subjects receiving paliperidone ER 6-12 mg/day (n = 179), risperidone 2-4 mg/day (n = 113) or risperidone 4-6 mg/day (n = 129) were 64.8%, 54.0% and 66.7%, respectively (placebo-adjusted rates: paliperidone ER vs risperidone 2-4 mg/day, p = 0.005; paliperidone ER vs risperidone 4-6 mg/day, p = 0.159). PANSS total score improvement with paliperidone ER was greater than with risperidone 2-4 mg/day (difference in mean change score, -6.7; p < 0.05) and similar to risperidone 4-6 mg/day (0.2; p = 0.927). Placebo-adjusted AEs more common with paliperidone ER were insomnia, sinus tachycardia and tachycardia; more common with risperidone were somnolence, restlessness, nausea, anxiety, salivary hypersecretion, akathisia, dizziness and nasal congestion. Weight changes with paliperidone ER and risperidone were similar (paliperidone ER vs risperidone 2-4 mg/day, p = 0.489; paliperidone ER vs risperidone 4-6 mg/day, p = 0.236).</p> <p>Conclusions</p> <p>This indirect database analysis suggested that paliperidone ER 6-12 mg/day may be more efficacious than risperidone 2-4 mg/day and as efficacious as risperidone 4-6 mg/day. The AE-adjusted incidence rates suggest differences between treatments that may be relevant for individual patients. Additional randomized, direct, head-to-head clinical trials are needed to confirm these findings.</p

A Mutliple Stakeholders' Software Requirements Prioritization Approach based on Intuitionistic Fuzzy Sets

Prioritization of requirements in a software project is a crucial activity for the project success. Taking into account the time and budget constraints imposed by the available project resources, it is often not possible to implement all candidate requirements in a single software release. Thus, software requirements should be evaluated by the involved stakeholders based on multiple value/cost criteria. Stakeholders' evaluations are often characterized by indecision, hesitation and lack of knowledge which can be expressed by evaluating some requirements with the same ratings or leaving some requirements unrated. This paper suggests a multiple stakeholders' requirements prioritization approach based on Intuitionistic Fuzzy Sets (IFSs). Tied or unrated requirements are represented mathematically by utilizing IFSs which are an extension to Fuzzy Sets capable of expressing stakeholders' positive, negative as well as "neutral/don't know"assessments. The proposed approach is supported by a consensus reaching technique which aggregates multiple stakeholders' ratings on the candidate requirements with the aim to improve the level of stakeholders' agreement on the final prioritization results. The validation of the proposed approach was performed by considering the requirements dataset of a real software development project. © 2022 IEEE

A Recommender System based on Intuitionistic Fuzzy Sets for Software Requirements Prioritization

Requirements Prioritization (RP) is an important activity in requirements engineering aiming to give priority and order to requirements for implementation in the next version of a software project. RP is applied iteratively, according to various prioritization criteria, by multiple project stakeholders who may have different roles, needs and knowledge. In large-scale software projects, where the set of candidate requirements is large, stakeholders may not be interested in evaluating all requirements and they may not have the expertise, the time or the willingness to consider all candidate requirements. Recommender Systems (RS) can be a useful solution to information overload when stakeholders have to evaluate a large number of alternatives. During evaluation of requirements, it is often practically impossible to ensure that all stakeholders have complete knowledge on all requirements. Thus, stakeholders may show some degree of uncertainty and hesitation, as it is difficult to precisely evaluate each requirement according to each prioritization criterion. The intuitionistic Fuzzy Sets (IFSs) are an extension of fuzzy sets which can deal with stakeholders' uncertainty and hesitation regarding the prioritization criteria importance and requirements ratings. The aim of this paper is to present an RS approach based on the collaborative filtering technique to effectively provide suggestions to stakeholders while prioritizing requirements. The proposed RS approach is tested using a publicly available large dataset of software requirements and the results show an improved performance. © 2021 ACM

Effectors of Pregorexia and Emesis among Pregnant Women: A Pilot Study

During pregnancy, women tend to improve their lifestyle habits and refine their dietary intake. Quite often, however, these dietary improvements take an unhealthy turn, with orthorexia nervosa (ON) practices being apparent. The aim of the present pilot cross-sectional study was to assess the prevalence of ON tendencies and the incidence of pica and record diet practices in a sample of pregnant women. A total of 157 pregnant women were recruited through private practice gynecologists during the first months of 2021. Nutrition-related practices were recorded, orthorexic tendencies were assessed using the translated and culturally adapted Greek version of the ORTO-15 questionnaire, pica practices were evaluated with a binary question and nausea and emesis during pregnancy (NVP) was evaluated using the translated modified Pregnancy—Unique Quantification of Emesis and Nausea (mPUQE). Only two women reported pica tendencies, with ice and snow being the consumed items. The majority (61.1%) of women reported improving their diet since conception was achieved. Folic acid and iron oral nutrient supplements (ONS) were reportedly consumed by the majority of participants (87.9% and 72.6%, respectively) and 9.6% reported using herbal medicine products. The ORTO-15 score was reduced with tertiary education attainment, ART conception, being in the third trimester of pregnancy, consumption of folic acid and MV supplements and was only increased among women who were at their first pregnancy. The majority of participants experienced severe NVP and the remaining experienced moderate NVP. NVP was associated with lower hemoglobin levels, lack of supplementary iron intake, avoidance of gluten-containing foods, as well as with increased gestational weight gain. The results highlight the need to screen pregnant women for disturbed eating behaviors and nutrition-related problems, in order to ensure a healthy pregnancy outcome. © 2022 by the authors

A novel approach combining particle swarm optimization and deep learning for flash flood detection from satellite images

Flood is one of the deadliest natural hazards worldwide, with the population affected being more than 2 billion between 1998–2017 with a lack of warning systems according to WHO. Especially, flash floods have the potential to generate fatal damages due to their rapid evolution and the limited warning and response time. An effective Early Warning Systems (EWS) could support detection and recognition of flash floods. Information about a flash flood can be mainly provided from observations of hydrology and from satellite images taken before the flash flood happens. Then, predictions from satellite images can be integrated with predictions based on sensors’ information to improve the accuracy of a forecasting system and subsequently trigger warning systems. The existing Deep Learning models such as UNET has been effectively used to segment the flash flood with high performance, but there are no ways to determine the most suitable model architecture with the proper number of layers showing the best performance in the task. In this paper, we propose a novel Deep Learning architecture, namely PSO-UNET, which combines Particle Swarm Optimization (PSO) with UNET to seek the best number of layers and the parameters of layers in the UNET based architecture; thereby improving the performance of flash flood segmentation from satellite images. Since the original UNET has a symmetrical architecture, the evolutionary computation is performed by paying attention to the contracting path and the expanding path is synchronized with the following layers in the contracting path. The UNET convolutional process is performed four times. Indeed, we consider each process as a block of the convolution having two convolutional layers in the original architecture. Training of inputs and hyper-parameters is performed by executing the PSO algorithm. In practice, the value of Dice Coefficient of our proposed model exceeds 79.75% (8.59% higher than that of the original UNET model). Experimental results on various satellite images prove the advantages and superiority of the PSO-UNET approach. © 2021 by the authors. Licensee MDPI, Basel, Switzerland

Orthorexia nervosa: replication and validation of the ORTO questionnaires translated into Greek in a survey of 848 Greek individuals

Purpose: The present study aimed to validate the ORTO-15 questionnaire for orthorexia nervosa (ON), translated by our group into the Greek language, and replicate the findings of the recently proposed 6-item ORTO-R. Methods: The tool was translated into the Greek language (ORTO-15-GR) using the forward–backward–forward method. A total of 848 adults participated in the validation study by filling in the questionnaires and providing general characteristics (age, gender, educational level, body weight, and height). The internal consistency of the tool was assessed by the omega (ω) coefficient, and confirmatory factor analyses (CFA) examined its factorial structure. Using the original six items of the ORTO-15 tool, a separate CFA model examined the factorial structure of the proposed ORTO-R tool. Furthermore, regression models tested the association of ORTO-R with study variables. Results: For ORTO-15-GR, the omega coefficient was 0.70 and for the ORTO-R 0.65. For the latter, the CFA revealed acceptable goodness-of-fit (standardized factor loadings from 0.36 to 0.64); however, all ORTO-15 models were characterized by a poor fit. In addition, there was a negative association between ORTO-R score and female gender, body mass index (BMI), and having a nutrition-related health problem. Conclusion: The replication of ORTO-R indicates that it is a reliable tool in the field of ON. Therefore, the use of a 6-item questionnaire for ON assessment appears promising in research and clinical settings. © 2022, Hellenic Endocrine Society

Moderators of Food Insecurity and Diet Quality in Pairs of Mothers and Their Children

Research has suggested that maternal diet and characteristics may influence the diet of offspring during childhood. The present cross-sectional study aimed to assess the influence of distinct maternal characteristics and the diet quality of mothers on the prevalence of household food insecurity (FI) and the diet quality of children. A total of 179 mother–child pairs were recruited from two primary schools in the metropolitan area of Thessaloniki. The children were aged between 10 and 12 years old. Diet quality was assessed as the level of adherence to the Mediterranean diet (MD), with the use of the KIDMED for the children and the MedDietScore for the mothers. The household FI and the social and demographic characteristics of the mothers were also recorded, and anthropometric measures of both the mothers and their children were collected. Approximately14 (26.3%) of the pairs reported some degree of FI, with a greater prevalence (64.7%) within single-mother families. Moreover, FI affected the level of maternal MD adherence (p = 0.011). On the other hand, FI was decreased in households with a greater maternal educational level (OR: 0.25; 95% CI: 0.10–0.63) and conjugal family status (OR: 0.15; 95% CI: 0.87–0.52). Maternal adherence to the MD was inversely related to the respective adherence of their offspring (OR: 0.93; 95% CI: 0.86–0.997), suggesting that during periods of financial constraints, maternal diet quality is compromised at the expense of affording a better diet for the minors in the family. © 2022 by the authors. Licensee MDPI, Basel, Switzerland

Orthorexia nervosa: replication and validation of the ORTO questionnaires translated into Greek in a survey of 848 Greek individuals

Purpose: The present study aimed to validate the ORTO-15 questionnaire for orthorexia nervosa (ON), translated by our group into the Greek language, and replicate the findings of the recently proposed 6-item ORTO-R. Methods: The tool was translated into the Greek language (ORTO-15-GR) using the forward–backward–forward method. A total of 848 adults participated in the validation study by filling in the questionnaires and providing general characteristics (age, gender, educational level, body weight, and height). The internal consistency of the tool was assessed by the omega (ω) coefficient, and confirmatory factor analyses (CFA) examined its factorial structure. Using the original six items of the ORTO-15 tool, a separate CFA model examined the factorial structure of the proposed ORTO-R tool. Furthermore, regression models tested the association of ORTO-R with study variables. Results: For ORTO-15-GR, the omega coefficient was 0.70 and for the ORTO-R 0.65. For the latter, the CFA revealed acceptable goodness-of-fit (standardized factor loadings from 0.36 to 0.64); however, all ORTO-15 models were characterized by a poor fit. In addition, there was a negative association between ORTO-R score and female gender, body mass index (BMI), and having a nutrition-related health problem. Conclusion: The replication of ORTO-R indicates that it is a reliable tool in the field of ON. Therefore, the use of a 6-item questionnaire for ON assessment appears promising in research and clinical settings