Knowledge, attitude and practice of Lebanese community pharmacists with regard to self-management of low back pain

Purpose: To determine the knowledge, attitude and reported practice of Lebanese community pharmacists who advise persons who present with low back pain.Methods: This was a multi-center cross-sectional study conducted in over 300 community pharmacies across Lebanon from December 2017 to May 2018. Pharmacists working at a community pharmacy were considered eligible, and those who volunteered to participate completed the questionnaire. The questionnaire was designed for self-completion by the pharmacist and included demographic questions about the respondent, questions that assessed knowledge and attitude toward low back pain, and questions about treatment to reflect and characterize the nature of practice. The primary outcome was to determine the knowledge, attitude and reported practice of the Lebanese pharmacists advising people who presented with low back pain. The secondary outcome was to assess factors that affect knowledge, attitude, and practice.Results: The response of 320 community pharmacists was analysed. The proportion of pharmacists with good knowledge about low back pain (51. 7 %) was slightly higher than those with poor knowledge (48. 3 %). Oral therapy was the most prescribed dosage form for back pain compared to local patch and cream. Among oral dosage forms, non-steroidal anti-inflammatory drugs were the most prescribed medications (42 %). Of the patients’ referral to the physician if necessary, 73.1 % of the referrals were by pharmacists.Conclusion: Community pharmacists in Lebanon demonstrate an acceptable level of knowledge of back pain, yet major gaps still exist, particularly in terms of the quality of advice. Hence, more education is needed to provide better quality of advice. Keywords: Attitude, Knowledge, Low back pain, Reported practice, Quality of advic

Air quality and urban sustainable development: the application of machine learning tools

[EN] Air quality has an efect on a population¿s quality of life. As a dimension of sustainable urban development, governments have been concerned about this indicator. This is refected in the references consulted that have demonstrated progress in forecasting pollution events to issue early warnings using conventional tools which, as a result of the new era of big data, are becoming obsolete. There are a limited number of studies with applications of machine learning tools to characterize and forecast behavior of the environmental, social and economic dimensions of sustainable development as they pertain to air quality. This article presents an analysis of studies that developed machine learning models to forecast sustainable development and air quality. Additionally, this paper sets out to present research that studied the relationship between air quality and urban sustainable development to identify the reliability and possible applications in diferent urban contexts of these machine learning tools. To that end, a systematic review was carried out, revealing that machine learning tools have been primarily used for clustering and classifying variables and indicators according to the problem analyzed, while tools such as artifcial neural networks and support vector machines are the most widely used to predict diferent types of events. The nonlinear nature and synergy of the dimensions of sustainable development are of great interest for the application of machine learning tools.Molina-Gómez, NI.; Díaz-Arévalo, JL.; López Jiménez, PA. (2021). Air quality and urban sustainable development: the application of machine learning tools. International Journal of Environmental Science and Technology. 18(4):1-18. https://doi.org/10.1007/s13762-020-02896-6S118184Al-Dabbous A, Kumar P, Khan A (2017) Prediction of airborne nanoparticles at roadside location using a feed–forward artificial neural network. Atmos Pollut Res 8:446–454. https://doi.org/10.1016/j.apr.2016.11.004Antanasijević D, Pocajt V, Povrenović D, Ristić M, Perić-Grujić A (2013) PM10 emission forecasting using artificial neural networks and genetic algorithm input variable optimization. Sci Total Environ 443:511–519. https://doi.org/10.1016/j.scitotenv.2012.10.110Brink H, Richards JW, Fetherolf M (2016) Real-world machine learning. Richards JW, Fetherolf M (eds) Manning Publications Co. Berkeley, CA. https://www.manning.com/books/real-world-machine-learning. Accessed 26 Apr 2020Cervone G, Franzese P, Ezber Y, Boybeyi Z (2008) Risk assessment of atmospheric emissions using machine learning. Nat Hazard Earth Syst 8:991–1000. https://doi.org/10.5194/nhess-8-991-2008Chen S, Kan G, Li J, Liang K, Hong Y (2018) Investigating China’s urban air quality using big data, information theory, and machine learning. Pol J Environ Stud 27:565–578. https://doi.org/10.15244/pjoes/75159Corani (2005) Air quality prediction in Milan: feed-forward neural networks, pruned neural networks and lazy learning. Ecol Model 185:513–529. https://doi.org/10.1016/j.ecolmodel.2005.01.008Cruz C, Gómez A, Ramírez L, Villalva A, Monge O, Varela J, Quiroz J, Duarte H (2017) Calidad del aire respecto de metales (Pb, Cd, Ni, Cu, Cr) y relación con salud respiratoria: caso Sonora, México. Rev Int Contam Ambient 33:23–34. https://doi.org/10.20937/RICA.2017.33.esp02.02de Hoogh K, Héritier H, Stafoggia M, Künzli N, Kloog I (2018) Modelling daily PM2.5 concentrations at high spatio-temporal resolution across Switzerland. Environ Pollut 233:1147–1154. https://doi.org/10.1016/j.envpol.2017.10.025Franceschi F, Cobo M, Figueredo M (2018) Discovering relationships and forecasting PM10 and PM2.5 concentrations in Bogotá, Colombia, using Artificial Neural Networks, Principal Component Analysis, and k-means clustering. Atmos Pollut Res 9:912–922. https://doi.org/10.1016/j.apr.2018.02.006García N, Combarro E, del Coz J, Montañes E (2013) A SVM-based regression model to study the air quality at local scale in Oviedo urban area (Northern Spain): a case study. Appl Math Comput 219:8923–8937. https://doi.org/10.1016/j.amc.2013.03.018Gibert K, Sànchez-Màrre M, Sevilla B (2012) Tools for environmental data mining and intelligent decision support. In iEMSs. Leipzig, Germany. http://www.iemss.org/society/index.php/iemss-2012-proceedings. Accessed 26 Nov 2018Gibert K, Sànchez-Marrè M, Izquierdo J (2016) A survey on pre-processing techniques: relevant issues in the context of environmental data mining. Ai Commun 29:627–663. https://doi.org/10.3233/AIC-160710Gounaridis D, Chorianopoulos I, Koukoulas S (2018) Exploring prospective urban growth trends under different economic outlooks and land-use planning scenarios: the case of Athens. Appl Geogr 90:134–144. https://doi.org/10.1016/j.apgeog.2017.12.001Holloway J, Mengersen K (2018) Statistical machine learning methods and remote sensing for sustainable development goals: a review. Remote Sens 10:1–21. https://doi.org/10.3390/rs10091365Ifaei P, Karbassi A, Lee S, Yoo Ch (2017) A renewable energies-assisted sustainable development plan for Iran using techno-econo-socio-environmental multivariate analysis and big data. Energy Convers Manag 153:257–277. https://doi.org/10.1016/j.enconman.2017.10.014Kadiyala A, Kumar A (2017a) Applications of R to evaluate environmental data science problems. Environ Prog Sustain 36:1358–1364. https://doi.org/10.1002/ep.12676Kadiyala A, Kumar A (2017b) Vector time series-based radial basis function neural network modeling of air quality inside a public transportation bus using available software. Environ Prog Sustain 36:4–10. https://doi.org/10.1002/ep.12523Karimian H, Li Q, Wu Ch, Qi Y, Mo Y, Chen G, Zhang X, Sachdeva S (2019) Evaluation of different machine learning approaches to forecasting PM2.5 mass concentrations. Aerosol Air Qual Res 19:1400–1410. https://doi.org/10.4209/aaqr.2018.12.0450Krzyzanowski M, Apte J, Bonjour S, Brauer M, Cohen A, Prüss-Ustun A (2014) Air pollution in the mega-cities. Curr Environ Health Rep 1:185–191. https://doi.org/10.1007/s40572-014-0019-7Lässig K, Morik (2016) Computat sustainability. Springer, Berlin. https://doi.org/10.1007/978-3-319-31858-5Li Y, Wu Y-X, Zeng Z-X, Guo L (2006) Research on forecast model for sustainable development of economy-environment system based on PCA and SVM. In: Proceedings of the 2006 international conference on machine learning and cybernetics, vol 2006. IEEE, Dalian, China, pp 3590–3593. https://doi.org/10.1109/ICMLC.2006.258576Liu B-Ch, Binaykia A, Chang P-Ch, Tiwari M, Tsao Ch-Ch (2017) Urban air quality forecasting based on multi- dimensional collaborative support vector regression (SVR): a case study of Beijing-Tianjin-Shijiazhuang. PLoS ONE 12:1–17. https://doi.org/10.1371/journal.pone.0179763Lubell M, Feiock R, Handy S (2009) City adoption of environmentally sustainable policies in California’s Central Valley. J Am Plan Assoc 75:293–308. https://doi.org/10.1080/01944360902952295Ma D, Zhang Z (2016) Contaminant dispersion prediction and source estimation with integrated Gaussian-machine learning network model for point source emission in atmosphere. J Hazard Mater 311:237–245. https://doi.org/10.1016/j.jhazmat.2016.03.022Madu C, Kuei N, Lee P (2017) Urban sustainability management: a deep learning perspective. Sustain Cities Soc 30:1–17. https://doi.org/10.1016/j.scs.2016.12.012Mellos K (1988) Theory of eco-development. In: Perspectives on ecology. Palgrave Macmillan, London. https://doi.org/10.1007/978-1-349-19598-5_4Ni XY, Huang H, Du WP (2017) Relevance analysis and short-term prediction of PM2.5 concentrations in Beijing based on multi-source data. Atmos Environ 150:146–161. https://doi.org/10.1016/j.atmosenv.2016.11.054Oprea M, Dragomir E, Popescu M, Mihalache S (2016) Particulate matter air pollutants forecasting using inductive learning approach. Rev Chim 67:2075–2081Paas B, Stienen J, Vorländer M, Schneider Ch (2017) Modelling of urban near-road atmospheric PM concentrations using an artificial neural network approach with acoustic data input. Environments 4:1–25. https://doi.org/10.3390/environments4020026Pandey G, Zhang B, Jian L (2013) Predicting submicron air pollution indicators: a machine learning approach. Environ Sci Proc Impacts 15:996–1005. https://doi.org/10.1039/c3em30890aPeng H, Lima A, Teakles A, Jin J, Cannon A, Hsieh W (2017) Evaluating hourly air quality forecasting in Canada with nonlinear updatable machine learning methods. Air Qual Atmos Health 10:195–211. https://doi.org/10.1007/s11869-016-0414-3Pérez-Ortíz M, de La Paz-Marín M, Gutiérrez PA, Hervás-Martínez C (2014) Classification of EU countries’ progress towards sustainable development based on ordinal regression techniques. Knowl Based Syst 66:178–189. https://doi.org/10.1016/j.knosys.2014.04.041Phillis Y, Kouikoglou V, Verdugo C (2017) Urban sustainability assessment and ranking of cities. Comput Environ Urban 64:254–265. https://doi.org/10.1016/j.compenvurbsys.2017.03.002Saeed S, Hussain L, Awan I, Idris A (2017) Comparative analysis of different statistical methods for prediction of PM2.5 and PM10 concentrations in advance for several hours. Int J Comput Sci Netw Secur 17:45–52Sayegh A, Munir S, Habeebullah T (2014) Comparing the performance of statistical models for predicting PM10 concentrations. Aerosol Air Qual Res 14:653–665. https://doi.org/10.4209/aaqr.2013.07.0259Shaban K, Kadri A, Rezk E (2016) Urban air pollution monitoring system with forecasting models. IEEE Sens J 16:2598–2606. https://doi.org/10.1109/JSEN.2016.2514378Sierra B (2006) Aprendizaje automático conceptos básicos y avanzados Aspectos prácticos utilizando el software Weka. Madrid Pearson Prentice Hall, MadridSingh K, Gupta S, Rai P (2013) Identifying pollution sources and predicting urban air quality using ensemble learning methods. Atmos Environ 80:426–437. https://doi.org/10.1016/j.atmosenv.2013.08.023Song L, Pang S, Longley I, Olivares G, Sarrafzadeh A (2014) Spatio-temporal PM2.5 prediction by spatial data aided incremental support vector regression. In: International joint conference on neural networks. IEEE, Beijing, pp 623–630. https://doi.org/10.1109/IJCNN.2014.6889521Souza R, Coelho G, da Silva A, Pozza S (2015) Using ensembles of artificial neural networks to improve PM10 forecasts. Chem Eng Trans 43:2161–2166. https://doi.org/10.3303/CET1543361Suárez A, García PJ, Riesgo P, del Coz JJ, Iglesias-Rodríguez FJ (2011) Application of an SVM-based regression model to the air quality study at local scale in the Avilés urban area (Spain). Math Comput Model 54:453–1466. https://doi.org/10.1016/j.mcm.2011.04.017Tamas W, Notton G, Paoli C, Nivet M, Voyant C (2016) Hybridization of air quality forecasting models using machine learning and clustering: an original approach to detect pollutant peaks. Aerosol Air Qual Res 16:405–416. https://doi.org/10.4209/aaqr.2015.03.0193Toumi O, Le Gallo J, Ben Rejeb J (2017) Assessment of Latin American sustainability. Renew Sustain Energy Rev 78:878–885. https://doi.org/10.1016/j.rser.2017.05.013Tzima F, Mitkas P, Voukantsis D, Karatzas K (2011) Sparse episode identification in environmental datasets: the case of air quality assessment. Expert Syst Appl 38:5019–5027. https://doi.org/10.1016/j.eswa.2010.09.148United Nations, Department of Economic and Social Affairs (2019) World urbanization prospects The 2018 Revision. New York. https://doi.org/10.18356/b9e995fe-enWang B (2019) Applying machine-learning methods based on causality analysis to determine air quality in China. Pol J Environ Stud 28:3877–3885. https://doi.org/10.15244/pjoes/99639Wang X, Xiao Z (2017) Regional eco-efficiency prediction with support vector spatial dynamic MIDAS. J Clean Prod 161:165–177. https://doi.org/10.1016/j.jclepro.2017.05.077Wang W, Men C, Lu W (2008) Online prediction model based on support vector machine. Neurocomputing 71:550–558. https://doi.org/10.1016/j.neucom.2007.07.020WCED (1987) Report of the world commission on environment and development: our common future: report of the world commission on environment and development. WCED, Oslo. https://doi.org/10.1080/07488008808408783Weizhen H, Zhengqiang L, Yuhuan Z, Hua X, Ying Z, Kaitao L, Donghui L, Peng W, Yan M (2014) Using support vector regression to predict PM10 and PM2.5. In: IOP conference series: earth and environmental science, vol 17. IOP. https://doi.org/10.1088/1755-1315/17/1/012268WHO (2016) OMS | La OMS publica estimaciones nacionales sobre la exposición a la contaminación del aire y sus repercusiones para la salud. WHO. http://www.who.int/mediacentre/news/releases/2016/air-pollution-estimates/es/. Accesed 26 Nov 2018Yeganeh N, Shafie MP, Rashidi Y, Kamalan H (2012) Prediction of CO concentrations based on a hybrid partial least square and support vector machine model. Atmos Environ 55:357–365. https://doi.org/10.1016/j.atmosenv.2012.02.092Zalakeviciute R, Bastidas M, Buenaño A, Rybarczyk Y (2020) A traffic-based method to predict and map urban air quality. Appl Sci. https://doi.org/10.3390/app10062035Zeng L, Guo J, Wang B, Lv J, Wang Q (2019) Analyzing sustainability of Chinese coal cities using a decision tree modeling approach. Resour Policy 64:101501. https://doi.org/10.1016/j.resourpol.2019.101501Zhan Y, Luo Y, Deng X, Grieneisen M, Zhang M, Di B (2018) Spatiotemporal prediction of daily ambient ozone levels across China using random forest for human exposure assessment. Environ Pollut 233:464–473. https://doi.org/10.1016/j.envpol.2017.10.029Zhang Y, Huan Q (2006) Research on the evaluation of sustainable development in Cangzhou city based on neural-network-AHP. In: Proceedings of the fifth international conference on machine learning and cybernetics, vol 2006. pp 3144–3147. https://doi.org/10.1109/ICMLC.2006.258407Zhang Y, Shang W, Wu Y (2009) Research on sustainable development based on neural network. In: 2009 Chinese control and decision conference. IEEE, pp 3273–3276. https://doi.org/10.1109/CCDC.2009.5192476Zhou Y, Chang F-J, Chang L-Ch, Kao I-F, Wang YS (2019) Explore a deep learning multi-output neural network for regional multi-step-ahead air quality forecasts. J Clean Prod 209:134–145. https://doi.org/10.1016/j.jclepro.2018.10.24

Use of platelet glycoprotein IIb/IIIa inhibitors in diabetics undergoing PCI for non-ST-segment elevation acute coronary syndromes: impact of clinical status and procedural characteristics

Background: The most recent ESC guidelines for percutaneous coronary intervention (PCI) recommend the use of glycoprotein IIb/IIIa inhibitors (GPI) in high risk patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS), particularly in diabetics. Little is known about the adherence to these guidelines within Europe. Methods and results: Between May 2005 and April 2008 a total of 47,407 consecutive patients undergoing PCI were prospectively enrolled into the PCI-Registry of the Euro Heart Survey Programme. In the present analysis we examined the use of GPI in 2,922 diabetics who underwent PCI for NSTE-ACS. In this high risk population only 22.2% received a GPI; 8.9% upstream and 13.4% during PCI. The strategy of the individual institution had a major impact on the usage of GPI. In the multiple regression analysis clinical instability and complex lesion characteristics were strong independent determinants for the use of GPI, whereas renal insufficiency was negatively associated with its use. After adjustment for confounding variables no significant differences in hospital mortality could be observed between the cohorts, but a significantly higher rate of non-fatal postprocedural myocardial infarction was observed among patients receiving GPI upstream. Conclusions: Despite the recommendation for its use in the current ESC guidelines, only a minority of the diabetics in Europe undergoing PCI for NSTE-ACS received a GPI. The use of GPI was mainly triggered by high-risk interventional scenarios

Coverage with Evidence Development Schemes for Medical Devices in Europe : Characteristics and Challenges

Objectives. Medical devices are potentially good candidates for coverage with evidence development (CED) schemes, as clinical data at market entry are often sparse and (cost-)effectiveness depends on real-world use. The objective of this research was to explore the diffusion of CED schemes for devices in Europe, and the factors that favour or hamper their utilization.Methods: We conducted structured interviews with 25 decision-makers from 22 European countries to explore the characteristics of existing CED programmes for devices, and how decision-makers perceived 13 pre-identified challenges associated with initiating and operating CED schemes for devices. We also collected data on individual schemes that were either initiated or still ongoing in the last 5 years.Results: We identified 7 countries with CED programmes for devices and 78 ongoing schemes. The characteristics of CED programmes varied across countries, including eligibility criteria, roles and responsibilities of stakeholders, funding arrangements, and type of decisions being contemplated at the outset of each scheme. We observed a high variability in how decision-makers perceived CED related challenges possibly reflecting country-specific arrangements and different experiences with CED. One general finding across all countries was that relatively little attention was paid to the evaluation of schemes, both during and at their completion.Conclusions: CED programmes for devices with different characteristics exist in Europe. Decision-makers’ perceptions differ on the challenges associated with these schemes. More exchange of knowledge and experience will help decision-makers anticipate the likely challenges in CED schemes for devices, and to learn from good practices existing elsewhere

The phocein homologue SmMOB3 is essential for vegetative cell fusion and sexual development in the filamentous ascomycete Sordaria macrospora

Members of the striatin family and their highly conserved interacting protein phocein/Mob3 are key components in the regulation of cell differentiation in multicellular eukaryotes. The striatin homologue PRO11 of the filamentous ascomycete Sordaria macrospora has a crucial role in fruiting body development. Here, we functionally characterized the phocein/Mob3 orthologue SmMOB3 of S. macrospora. We isolated the gene and showed that both, pro11 and Smmob3 are expressed during early and late developmental stages. Deletion of Smmob3 resulted in a sexually sterile strain, similar to the previously characterized pro11 mutant. Fusion assays revealed that ∆Smmob3 was unable to undergo self-fusion and fusion with the pro11 strain. The essential function of the SmMOB3 N-terminus containing the conserved mob domain was demonstrated by complementation analysis of the sterile S. macrospora ∆Smmob3 strain. Downregulation of either pro11 in ∆Smmob3, or Smmob3 in pro11 mutants by means of RNA interference (RNAi) resulted in synthetic sexual defects, demonstrating for the first time the importance of a putative PRO11/SmMOB3 complex in fruiting body development