Medication Expenditure and Resource Utilization Among Patients with Musculoskeletal Disorders: Analysis of 2007 Medical Expenditure Panel Survey Data

Objective: To estimate the national prevalence and direct incremental expenditures of musculoskeletal disorders (MSD\u27s) using the 2007 Medical Expenditure Panel Survey data. Methods: A retrospective database analysis was conducted and individuals with MSD\u27s (ICD-9-CM codes 274.00; 710.00-738.00) were identified. Dependent variables were total health care and other service category expenditures. The study utilized descriptive and regression analyses. Results: In 2007, the national prevalence of MSD\u27s was 33 million with incremental costs of $886.49 per person. The inpatient expenditures ($33,461.85) were the highest cost component in MSD\u27s and the predictors of total health care expenditures were age, marital status, and presence of the disease condition. Conclusion: The systematic assessment of MSD\u27s and their associated incremental costs to the society is essential in increasing the awareness of decision makers to implement intervention strategies that are effective in lowering the disease incidence and in reducing the overall cost of disease management

"HOT" ChatGPT: The promise of ChatGPT in detecting and discriminating hateful, offensive, and toxic comments on social media

Harmful content is pervasive on social media, poisoning online communities and negatively impacting participation. A common approach to address this issue is to develop detection models that rely on human annotations. However, the tasks required to build such models expose annotators to harmful and offensive content and may require significant time and cost to complete. Generative AI models have the potential to understand and detect harmful content. To investigate this potential, we used ChatGPT and compared its performance with MTurker annotations for three frequently discussed concepts related to harmful content: Hateful, Offensive, and Toxic (HOT). We designed five prompts to interact with ChatGPT and conducted four experiments eliciting HOT classifications. Our results show that ChatGPT can achieve an accuracy of approximately 80% when compared to MTurker annotations. Specifically, the model displays a more consistent classification for non-HOT comments than HOT comments compared to human annotations. Our findings also suggest that ChatGPT classifications align with provided HOT definitions, but ChatGPT classifies "hateful" and "offensive" as subsets of "toxic." Moreover, the choice of prompts used to interact with ChatGPT impacts its performance. Based on these in-sights, our study provides several meaningful implications for employing ChatGPT to detect HOT content, particularly regarding the reliability and consistency of its performance, its understand-ing and reasoning of the HOT concept, and the impact of prompts on its performance. Overall, our study provides guidance about the potential of using generative AI models to moderate large volumes of user-generated content on social media

The Impact of Long Term Opioid Medication on Oral Antihyperglycmic Medication Adherence and Subsequent Type 2 Diabetes Mellitus Related Hospitalization Risk among Individuals with Type 2 Diabetes Mellitus: A Retrospective Database Analysis

Prescription opioids are a highly prescribed class of medication, which when administered over long durations can lead to negative effects (e.g., addiction, non-medical use). Prescription opioids are often prescribed concomitantly with antihyperglycemic medication among patients with T2DM. Due to known associated negative effects of prescription opioids, it is imperative to study the impact of long term opioid use of antihyperglycemic medication when prescribed concomitantly. Therefore, the primary aim of this study was to examine if there is any effect of long-term opioid use on antihyperglycemic medication adherence when the two medication classes are prescribed concomitantly among patients with T2DM. Additionally, this study also examined whether the duration of opioid use and antihyperglycemic adherence has any potential impact on subsequent diabetes related hospitalizations.Pharmaceutical Health Outcomes and Policy, Department o

Understanding Organisational Factors and Models to Support Corporate Entrepreneurship in Business Organisation – Some Case Studies

Purpose of business is business - to make money. World today offers very dynamic and challenging environment. There have been periods of economic recession which have slowed down growth but have also given rise to various new entrepreneurial start-ups whose daring entrepreneur, visionary leader took advantage and changed those challenges into opportunities, when no one else dared. They proved their acumen and with the passage of time took/grew their small start-up into giants like Cargill, Siemens, General Mills etc. At this stage the small start-up is said to have undergone and completed its metamorphosis as it evolved into bureaucratic, multi hierarchy, and rigid structure, which tend to slow down the very essence of its existence - its entrepreneurial and innovative spirit, which took it from nowhere to somewhere. This report delves into subject of Corporate Entrepreneurship which is about corporations keeping the flame of entrepreneurship and innovation kindled. This report studies various types, essential dimensions, and various organisational factors associated with CE and are indicated to promote CE within an organisation. Also various models which ategorise/define such deliberate efforts practiced by organisations to breathe life into its organisations entrepreneurial spirit and to achieve growth and competitive advantage. In order to evaluate CE this research adopts qualitative based approach to decipher the norms and practices of nine large established multinational corporations. It gleans out crucial organisational factors and CE models prominent within these corporations. Findings revealed that there are various ways in which organisations fund and drive entrepreneurial and innovation initiatives within the organisation and the ownership of new business creation (here the newness was reflected through different forms of outcomes) was either diffused i.e., dispersed teams or focused i.e., dedicated team/units. All these organisations indicated to have been promoting CE through one or more of the factors which the existing literature had highlighted. Based on these findings and utilising the concepts discussed in literature a framework was created to provide a holistic view of CE. The significance of this research is that it will be precursor to the future research in this area and will augment business organisation's strategy

Low Body Mass Index Can Identify Majority of Osteoporotic Inflammatory Bowel Disease Patients Missed by Current Guidelines

Background. Patients with inflammatory bowel disease (IBD) are at high risk of developing osteoporosis. Our objective was to determine the usefulness of IBD guidelines in identifying patients at risk for developing osteoporosis. Methods. We utilized institutional repository to identify patients seen in IBD center and extracted data on demographics, disease history, conventional, and nonconventional risk factors for osteoporosis and Dual Energy X-ray Absorptiometry (DXA) findings. Results. 59% of patients (1004/1703) in our IBD cohort had at least one risk factor for osteoporosis screening. DXA was documented in 263 patients with indication of screening (provider adherence, 26.2%), and of these, 196 patients had DXA completed (“at-risk” group). Ninety-five patients not meeting guidelines-based risk factors also had DXA completed (“not at-risk” group). 139 (70.9%) patients in “at-risk” group had low BMD, while 51 (53.7%) of “not-at-risk” patients had low BMD. Majority of the patients with osteoporosis (83.3%) missed by the current guidelines had low BMI. Multivariate logistic regression analysis showed that low BMI was the strongest risk factor for osteoporosis (OR 3.07; 95% CI, 1.47–6.42; P = 0.003). Conclusions. Provider adherence to current guidelines is suboptimal. Low BMI can identify majority of the patients with osteoporosis that are missed by current guidelines

The diagnostic role of saliva: a review

As a diagnostic fluid, saliva offers distinctive advantages over serum because it can be collected non-invasively by individuals, even by patient. Does not require special equipment for collection and storage as unlike blood saliva does not clot. Advantageous for person in whom blood drawing is difficult as in obese and haemophilic patient. Whole saliva used for diagnosis of systemic diseases, because it contains serum constituents. These constituents are derived from the local vasculature of the salivary glands and gingival cervicular fluid.This review examines the diagnostic application of saliva for hereditary disorders, autoimmune diseases, malignant and infectious diseases, and endocrine disorders, as well as in the assessment of therapeutic levels of drugs and the monitoring of illicit drug use, and also for forensic evidence and others. . In future we are likely to see the increased utilization of saliva as a diagnostic fluid. As we enter the era of genomic medicine, sialochemistry will play an increasingly important role in the early detection, the monitoring and progression of the systemic and oral diseases

Factors associated with good adherence to self-care behaviours amongst adolescents with food allergy

Background: Our understanding of factors which affect adherence to health sustaining self-care behaviours in adolescents with food allergy is limited. This study used the Health Belief Model to explore the relationship between food allergic adolescents’ health beliefs, demographic, structural and social psychological factors with adherence to self-care behaviours, including allergen avoidance and carrying emergency medication. Methods: A cross-sectional study of 188 13- to 19- olds identified from hospital prescribed auto-injectable epinephrine for food allergy. Data were collected on demographics, structural factors, social psychological factors, health beliefs and current adherence behaviour using a postal questionnaire. Results: Full adherence was reported by 16% of participants. Multivariate analysis indicated that adherence was more likely to be reported if the adolescents belonged to a support group (OR = 2.54, (1.04, 6.20) 95% CI), had an anaphylaxis management plan (OR = 3.22, (1.18, 8.81) 95% CI), perceived their food allergy to be more severe (OR = 1.24, (1.01, 1.52) 95% CI) and perceived fewer barriers to disease management (OR = 0.87, (0.79, 0.96) 95% CI). Conclusions: Membership of a patient support group and having an anaphylaxis management plan were associated with good adherence to self-care behaviours in adolescents with food allergy. Our results suggest that interventions to improve provision and utilisation of management plans, address adolescents’ perceptions of the severity of anaphylaxis and reduce barriers to disease management may facilitate good adherence behaviours than focussing on knowledge-based interventions

Therapeutic hypothermia initiated within 6 hours of birth is associated with reduced brain injury on MR biomarkers in mild hypoxic ischemic encephalopathy: a non-randomised cohort study

Objective To examine the effect of therapeutic hypothermia on MR biomarkers and neurodevelopmental outcomes in babies with mild hypoxic-ischaemic encephalopathy (HIE). Design Non-randomised cohort study. Setting Eight tertiary neonatal units in the UK and the USA. Patients 47 babies with mild HIE on NICHD neurological examination performed within 6 hours after birth. Interventions Whole-body cooling for 72 hours (n=32) or usual care (n=15; of these 5 were cooled for <12 hours). Main outcome measures MRI and MR spectroscopy (MRS) within 2 weeks after birth, and a neurodevelopmental outcome assessment at 2 years. Results The baseline characteristics in both groups were similar except for lower 10 min Apgar scores (p=0.02) in the cooled babies. Despite this, the mean (SD) thalamic NAA/Cr (1.4 (0.1) vs 1.6 (0.2); p<0.001) and NAA/Cho (0.67 (0.08) vs 0.89 (0.11); p<0.001) ratios from MRS were significantly higher in the cooled group. Cooled babies had lower white matter injury scores than non-cooled babies (p=0.02). Four (27%) non-cooled babies with mild HIE developed seizures after 6 hours of age, while none of the cooled babies developed seizures (p=0.008). Neurodevelopmental outcomes at 2 years were available in 40 (85%) of the babies. Adverse outcomes were seen in 2 (14.3%) non-cooled babies, and none of the cooled babies (p=0.09). Conclusions Therapeutic hypothermia may have a neuroprotective effect in babies with mild HIE, as demonstrated by improved MRS biomarkers and reduced white matter injury on MRI. This may warrant further evaluation in adequately powered randomised controlled trials