DrugExBERT for Pharmacovigilance – A Novel Approach for Detecting Drug Experiences from User-Generated Content

Pharmaceutical companies have to maintain drug safety through pharmacovigilance systems by monitoring various sources of information about adverse drug experiences. Recently, user-generated content (UGC) has emerged as a valuable source of real-world drug experiences, posing new challenges due to its high volume and variety. We present DrugExBERT, a novel approach to extract adverse drug experiences (adverse reaction, lack of effect) and supportive drug experiences (effectiveness, intervention, indication, and off-label use) from UGC. To be able to verify the extracted drug experiences, DrugExBERT additionally provides explications in the form of UGC phrases that were critical for the extraction. In our evaluation, we demonstrate that DrugExBERT outperforms state-of-the-art pharmacovigilance approaches as well as ChatGPT on several performance measures and that DrugExBERT is data- and drug-agnostic. Thus, our novel approach can help pharmaceutical companies meet their legal obligations and ethical responsibility while ensuring patient safety and monitoring drug effectiveness

Tell Me Why (I Want It That Way) – Effects of Explanations and Online Customer Reviews on Trust in Recommender Systems

Review-based recommender systems (RS) have shown great potential in helping users manage information overload and find suitable items. However, a lack of trust still impedes the widespread acceptance of RS. To increase users’ trust, research proposes various methods to generate justifications or explanations. Furthermore, online customer reviews (OCRs) are found to be a trustworthy and reliable source of information. However, it is still unclear how justifications compare to explanations in their influence on users’ trust and whether basing them on OCRs additionally adds trust. Hence, we conduct an online experiment with 531 participants and find that explanations exceed justifications in increasing users’ trust, while basing them on OCRs directly increases users’ intentions to use the system and adopt recommendations without increasing trust in the RS themselves. Unifying different research streams from review-based RS and Explainable Artificial Intelligence, we provide an overarching, holistic view on the conception of justifications and explanations

Dynamic Pricing on Two-Sided Platforms: Consequences on Customers’ Fairness Perceptions and Purchase Intentions

Technological advancements simplify the application of dynamic pricing, i.e., the flexible and rapid adjustment of prices to changes in demand. Consequently, companies increasingly use dynamic pricing in their business models, although research reports negative consequences on customer fairness perceptions. This holds not only for one-sided businesses, but also for popular two-sided platforms. However, these platforms differ from one-sided businesses in that the total prices paid by customers consist of product prices and platform fees – and both price components can be dynamically adjusted. In an online experiment, we examine customers’ fairness perceptions and purchase intentions when product price and platform fee change dynamically. We find that dynamic price increases reduce fairness perceptions and purchase intentions, while the cause of the price increases is irrelevant to customers. These results indicate an imbalance in the risks and benefits of dynamic pricing between the pricing strategies of the platform and the provider

Homeostatic model assessment of beta cell function predicting abnormal oral glucose tolerance testing in pregnancy:a systematic review and meta-analysis

Background: Gestational diabetes mellitus (GDM) complicates 1-14% of pregnancies and relates to increased risk of adverse obstetric outcomes. Currently GDM is diagnosed using an oral glucose tolerance test (OGTT), which is burdensome and time intensive.Objective: To compare current literature on whether the homeostatic model assessment beta cell function (HOMA-) is an accurate predictor of an abnormal OGTT in pregnant women.Methods: Pubmed, Cochrane and Embase were searched. Included studies evaluated pregnant women at risk for GDM using the homeostatic model assessment of beta cell function (HOMA-) for the assessment of beta cell function and the OGTT. Studies with animals, non-pregnant women, women with type 2 diabetes and post-partum diabetes were excluded. The QUADAS-2 criteria were used to assess the methodological quality of studies.Results: A total of 12 studies were included, reporting on 7292 women. Seven studies showed a difference in beta cell function between women with impaired glucose tolerance compared to healthy pregnant women. HOMA- is significantly lower in impaired glucose tolerance (

High-Fidelity Emergency Department Thoracotomy Simulator With Beating-Heart Technology and OSATS Tool Improves Trainee Confidence and Distinguishes Level of Skill

Resuscitative Thoracotomy or Emergency Department Thoracotomy (EDT) is a time-sensitive and potentially life-saving procedure. Yet, trainee experience with this procedure is often limited in both clinical and simulation settings. We sought to develop a high-fidelity EDT simulation module and assessment tool to facilitate trainee education. Using the Kern model for curricular development, a group of expert trauma surgeons identified EDT as a high-stakes, low-frequency procedure. Task analysis identified 5 key steps of EDT: (1) opening chest/rib spreader utilization; (2) pericardiotomy/cardiac repair; (3) open cardiac massage; (4) clamping aorta; and (5) control of pulmonary hilum. A high-fidelity simulator with beating-heart technology was built. The previously validated Objective Structured Assessment of Technical Skills (OSATS) was adapted to create the “EDT-OSATS” which assessed performance along several domains: (1) Surgical technique (key steps); (2) general skills; and (3) global rating. A pilot test was performed to compare board-certified trauma surgeons (i.e., Experts) with categorical general surgery interns (i.e., Novices). Each subject received preparatory materials, completed a presimulation quiz, performed a videotaped procedure on the EDT simulator, and completed a postmodule survey. Two independent raters scored performances using the EDT-OSATS. Groups were compared in descriptive and unadjusted analyses. We hypothesized that our EDT simulation module would distinguish between expert vs novice performance and improve trainee confidence. Simulation laboratory at Massachusetts General Hospital in Boston, MA. Trauma surgeons (Experts, n = 6) and categorical general surgery interns (Novices, n = 8). Experts scored significantly higher than Novices on nearly all components of the EDT-OSATS, including: (1) surgical technique: pericardiotomy (4.2 vs 3.4, p = 0.040), cardiac massage (3.6 vs 2.4, p = 0.028), clamping aorta (4.1 vs 3.3, p = 0.035), control of pulmonary hilum (4.8 vs 3.4, p < 0.001); (2) general skills: time/motion (4.1 vs 2.9, p = 0.011), knowledge and handling of instruments (4.3 vs 3.1, p = 0.004), and (3) global rating (3.9 vs 2.9, p = 0.026). There was no statistical difference between groups on opening chest/rib spreader utilization (3.8 vs 3.3, p = 0.352) or procedure time (204sec vs 227sec, p = 0.401), though Experts scored numerically higher than Novices on every measure. Novices reported significantly increased confidence after the simulation (3.1 vs 1.4, p = 0.001). Ninety-three percent (13/14) of participants found the simulator realistic. Our novel high-fidelity beating-heart EDT simulator is realistic and improves trainee confidence in this low-frequency, high-stakes emergency procedure. The EDT-OSATS tool differentiates between performances of experienced surgeons vs novice trainees on the beating-heart simulator. This training module and accompanying assessment instrument hold promise as a learning tool for clinicians who may perform emergency department thoracotomy

Interrupted versus continuous fascial closure in patients undergoing emergent laparotomy: A randomized controlled trial

BACKGROUNDThe optimal method of fascial closure, interrupted fascial closure (IFC) versus continuous fascial closure (CFC) has never been studied exclusively in the setting of emergency surgery. We hypothesized that IFC decreases postoperative incisional hernia development following emergent laparotomies.METHODSBetween August 2008 and September 2015, patients undergoing emergent laparotomies were consented and randomly assigned to either IFC or CFC. Patients were followed up postoperatively for at least 3 months and assessed for incisional hernia, dehiscence, or wound infection. We excluded those with trauma, elective surgery, mesh in place, primary ventral hernia, previous abdominal surgery within 30 days, or those not expected to survive for more than 48 hours. Our primary endpoint was the incidence of postoperative incisional hernias.RESULTSOne hundred thirty-six patients were randomly assigned to IFC (n = 67) or CFC (n = 69). Baseline characteristics were similar between the groups. No difference was noted in the length of the abdominal incision, or the peak inspiratory pressure after the closure. The median time needed for closure was significantly longer in the IFC group (22 minutes vs. 13 minutes, p < 0.001). Thirty-seven (55.2%) IFC and 41 (59.4%) CFC patients completed their follow-up visits. There was no statistically significant difference in baseline and intraoperative characteristics between those who completed follow-ups and those who did not. The median time from the day of surgery to the day of the last follow-up was similar between IFC and CFC (233 days vs. 216 days, p = 0.67), as were the rates of incisional hernia (13.5% versus 22.0%, p = 0.25), dehiscence (2.7% vs. 2.4%, p = 1.0), and surgical site infection (16.2% vs. 12.2%, p = 0.75).CONCLUSIONThere was no statistically detectable difference in postoperative hernia development between those undergoing IFC versus CFC after emergent laparotomies. However, this may be due to the relatively low sample size.LEVEL OF EVIDENCETherapeutic/Care Management Study, level III

Targeting acetylcholinesterase to treat neurodegeneration

WOS: 000243579000006PubMed ID: 17227232Neurodegenerative disorders, such as Alzheimer's disease, are often characterised by the degeneration of the cholinergic system. Thus, the aim of many treatment regimens is to support this system either by means of muscarinic agonists or by inhibitors of acetylcholinesterase (AChE), the latter being able to increase the concentration of acetylcholine. However, both pharmacological groups of drugs can only help in the beginning of the progressive disease. The finding that the occupation of the peripheral anionic site of AChE is able to stop the formation of the amyloid plaque led to the development of bivalent ligands that occupy both the active and the peripheral site. This dual action might be more beneficial for treatment of Alzheimer's disease than simple inhibition of the acetylcholine hydrolysis. Thus, the new bivalent ligands are the focus of this review