External Validation of a Predictive Model for Acute Pancreatitis Risk in Patients With Severe Hypertriglyceridemia

Objective: We previously developed a predictive model to assess the risk of developing acute pancreatitis (AP) in patients with severe hypertriglyceridemia (HTG). In this study, we aimed to externally validate this model. Methods: The validation cohort included cross-sectional data between 2013 and 2017. Adult patients (≥18 years old) with triglyceride levels ≥1,000 mg/dL were identified. Based on our previous 4-factor predictive model (age, triglyceride [TG], excessive alcohol use, and gallstone disease), we estimated the probability of developing AP. Model performance was assessed using area under receiver operating characteristic curve (AUROC). Results: In comparison to the original cohort, patients in the validation cohort had more prevalent acute pancreatitis (16.2% versus 9.2%; P<.001) and gallstone disease (7.5% versus 2.1%; P<.001). Other characteristics were comparable and not statistically significant. The AUROCs were almost identical: 0.8337 versus 0.8336 in the validation and the original cohorts, respectively. In univariable analyses, the highest increase in odds of AP was associated with HTG, followed by gallstones, excessive alcohol use, and younger age. Conclusion: This study externally validates the 4-factor predictive model to estimate the risk of AP in adult patients with severe HTG (TG ≥1,000 mg/dL). Younger age was confirmed to place patients at high risk of AP. The clinical risk categories suggested in this study may be useful to guide treatment options

Critical mass and discontinued use of social media

Using simulation, this study compares a critical mass of adopters with a critical mass of those who discontinue their adoption of social media. A network of reflex agents is simulated where each agent has an unchanging threshold and will adopt social media if the number of their friends who have adopted is greater than it. In the first study, the size of the critical mass that adopts is varied, and in the second, the size of the critical mass that discontinues use is varied. The studies show that a critical mass of leavers can cause a community to fail and that this mass can potentially be as small as that needed to influence a community to succeed; although given a certain critical mass, their leaving is less likely to cause failure than their adoption is success. This influence of the critical mass is facilitated by network structure

Mode of administration of dulaglutide: implications for treatment adherence

Ambika Amblee1,2 1Department of Internal Medicine, Division of Endocrinology, John Stroger Hospital of Cook County, 2Rush University Medical Center, Chicago, IL, USA Background: Medication complexity/burden can be associated with nonadherence in patients with type 2 diabetes mellitus (T2DM). Patients&rsquo; satisfaction with their treatment is an important consideration for physicians. Strategies like using longer acting efficacious agents with less frequent dosing may help adherence. Objective: To explore the mode of administration of dulaglutide and its implications for treatment adherence in T2DM. Methods: PubMed search using the term &ldquo;Dulaglutide&rdquo; through October 31, 2015 was conducted. Published articles, press releases, and abstracts presented at national/international meetings were considered. Results/conclusion: Dulaglutide is a once-weekly glucagon like peptide-1 analog with a low intraindividual variability. Phase III trials demonstrated significant improvements in glycemia and weight, with a low hypoglycemia risk similar to liraglutide/exenatide, but with substantially fewer injections. A significant improvement was observed in the total Diabetes Treatment Satisfaction Questionnaire score, Impact of Weight on Self-Perception, and perceived frequency of hyperglycemia with dulaglutide when compared with placebo, exenatide, liraglutide, or metformin. Treatment satisfaction scores showed an improvement with dulaglutide (34%&ndash;39%) when compared with exenatide (31%). A positive experience with a high initial (97.2%) and final (99.1%) injection success rate along with a significant reduction in patients&rsquo; fear of self-injecting, as measured by the modified self-injecting subscale of the Diabetes Fear of Injecting and Self-Testing Questionnaire and Medication Delivery Device Assessment Battery, was found. Its acceptance was high (&gt;96%) among a variety of patients including patients who fear injections and injection-na&iuml;ve users. Dulaglutide is available as a single-dose automatic self-injecting device, which has a low volume, does not need reconstitution, and avoids patient handling of the needle. Dose adjustment based on weight, sex, age, race, ethnicity, or injection-site is not necessary. In chronic diseases like diabetes where patients need lifelong medications, the efficacy, safety, and convenience of a once-weekly, easy-to-use, self-injecting device should encourage patient adherence to dulaglutide therapy. Keywords: type 2 diabetes, weekly GLP1, treatment satisfaction, quality of life, patient treatment satisfactio

Three empirical studies on the impact of electronic word-of-mouth on digital microproducts

Thesis (Ph.D.)--University of Hawaii at Manoa, 2007.Digital microproducts---such as Apple's 99-cents I-tunes songs or Amazon.com's 49-cents short books, or Disney's $4.99 short videos---are products in digital forms that can be delivered anywhere, at any time, at a low acquisition cost and no delivery costs. Since the selling price is small, fixed and identical to all products, it no longer plays an important role in the purchasing decision. As traditional micro-economic theory does not fully apply to these types of microproducts, an increasing body of research suggests that word-of-mouth has taken over price as the key demand factor. The purpose of this dissertation is to measure the impacts of electronic word-of-mouth (eWOM), as a signal of product reputation, brand reputation and reputation of complementary goods, on the microproduct buying decision. This dissertation consists of three empirical studies using digital short stores (Shorts) from Amazon.com and freeware downloads from Download.com. Shorts are condensed versions of books in PDF format sold for a fixed price of 49 cents. In this research, eWOM consists of product reviews and ratings posted on the Amazon.com e-book marketplace and the Download.com software marketplace. The first essay studies the impact of eWOM on sales performance of Amazon Shorts, and also maps the change in the predictive power of eWOM over time. The second study focuses on the impact of brand and complementary goods reputations, signaled by eWOM, on the likelihood of first and additional product eWOM being posted, as well as the likelihood of those additional eWOM significantly impacting sales. The third study looks at the impact of expert and amateur user reviews on demand for digital microproducts with zero cost, using freeware from Download.com. This dissertation makes several unique contributions to the growing body of research on eWOM, including a comprehensive and integrated study on the impact of eWOM as a signal of product reputation, brand reputation and complementary goods reputation. eWOM-based demand models for digital microproducts are also developed, and two longitudinal studies contribute to an understanding of the dynamic impact of eWOM over time. It also sheds new evidence on the interplay between reviews by critics and amateurs.Includes bibliographical references (leaves 117-125).Also available by subscription via World Wide Web124 leaves, bound 29 cmDigital microproducts - such as Apple's 99-cents I-tunes songs or Amazon.com's 49- cents short books, or Disney's$4.99 short videos - are products in digital forms that can be delivered anywhere, at any time, at a low acquisition cost and no delivery costs. Since the selling price is small, fixed and identical to all products, it no longer plays an important role in the purchasing decision. As traditional micro-economic theory does not fully apply to these types of microproducts, an increasing body of research suggests that word-of-mouth has taken over price as the key demand factor. The purpose of this dissertation is to measure the impacts of electronic word-of-mouth (eWOM), as a signal of product reputation, brand reputation and reputation of complementary goods, on the microproduct buying decision. This dissertation consists of three empirical studies using digital short stores (Shorts) from Amazon.com and freeware downloads from Download.com. Shorts are condensed versions of books in PDF format sold for a fixed price of 49 cents. In this research, eWOM consists of product reviews and ratings posted on the Amazon.com e-book marketplace and the Download.com software marketplace. The first essay studies the impact of eWOM on sales performance of Amazon Shorts, and also maps the change in the predictive power of eWOM over time. The second study focuses on the impact of brand and complementary goods reputations, signaled by eWOM, on the likelihood of first and additional product eWOM being posted, as well as the likelihood of those additional eWOM significantly impacting sales. The third study looks at the impact of expert and amateur user reviews on demand for digital microproducts with zero cost, using freeware from Download.com. This dissertation makes several unique contributions to the growing body of research on eWOM, including a comprehensive and integrated study on the impact of eWOM as a signal of product reputation, brand reputation and complementary goods reputation. eWOM-based demand models for digital microproducts are also developed, and two longitudinal studies contribute to an understanding of the dynamic impact of eWOM over time. It also sheds new evidence on the interplay between reviews by critics and amateurs

Physical Features of Intracellular Proteins that Moonlight on the Cell Surface

Moonlighting proteins comprise a subset of multifunctional proteins that perform two or more biochemical functions that are not due to gene fusions, multiple splice variants, proteolytic fragments, or promiscuous enzyme activities. The project described herein focuses on a sub-set of moonlighting proteins that have a canonical biochemical function inside the cell and perform a second biochemical function on the cell surface in at least one species. The goal of this project is to consider the biophysical features of these moonlighting proteins to determine whether they have shared characteristics or defining features that might suggest why these particular proteins were adopted for a second function on the cell surface, or if these proteins resemble typical intracellular proteins. The latter might suggest that many other normally intracellular proteins found on the cell surface might also be moonlighting in this fashion. We have identified 30 types of proteins that have different functions inside the cell and on the cell surface. Some of these proteins are found to moonlight on the surface of multiple species, sometimes with different extracellular functions in different species, so there are a total of 98 proteins in the study set. Although a variety of intracellular proteins (enzymes, chaperones, etc.) are observed to be re-used on the cell surface, for the most part, these proteins were found to have physical characteristics typical of intracellular proteins. Many other intracellular proteins have also been found on the surface of bacterial pathogens and other organisms in proteomics experiments. It is quite possible that many of those proteins also have a moonlighting function on the cell surface. The increasing number and variety of known moonlighting proteins suggest that there may be more moonlighting proteins than previously thought, and moonlighting might be a common feature of many more proteins