Sequencing of Cabazitaxel and Abiraterone Acetate After Docetaxel in Metastatic Castration-Resistant Prostate Cancer: Treatment Patterns and Clinical Outcomes in Multicenter Community-Based US Oncology Practices

AbstractBackgroundOptimal sequencing of cabazitaxel (C) and abiraterone acetate (A) after docetaxel (D) for metastatic castration-resistant prostate cancer (mCRPC) is unclear. We assessed treatment patterns and outcomes in patients with mCRPC receiving different sequences of A or C, or both, after administration of D.MethodsRetrospective analysis was conducted of US Oncology Network iKnowMed (iKM) electronic health record (EHR) data to assess patients with mCRPC who received treatment with D and were subsequently treated with C or A, or both, between April 2011 and May 2012. Patients received 2 or 3 drugs: DA, DC, DAC, or DCA. Overall survival (OS) and time to treatment failure (TTF) were analyzed by the Kaplan-Meier method from the start to the end of second-line therapy after administration of D (TTF1) and to the end of combined second- and third-line therapy (TTF2) for 3-drug sequences. Multivariable Cox proportional hazard models evaluated the impact of baseline clinical prognostic factors and treatment sequence on OS and TTF.ResultsOf 350 patients who were treated with D and subsequent therapies, 183 (52.3%) received DA, 54 (15.4%) received DC, 77 (22.0%) received DCA, and 36 (10.3%) received DAC. In a multivariable analysis, adjusted comparisons suggested that 3-drug sequences were associated with improved OS versus 2-drug sequences (hazard ratio [HR], 0.21; 95% confidence interval [CI], 0.092-0.476; P = .0002). There were no statistically significant differences in OS and TTF for DC versus DA, and OS was significantly greater for DCA versus DAC (HR, 0.13; 95% CI, 0.022-0.733; P = .0210). More cycles of C were administered in DCA than in DAC (median 6 vs. 4; t test P < .0001), whereas the duration of A treatment was similar.ConclusionAdministration of 3 agents in the DCA sequence was more optimal for treating mCRPC in this hypothesis-generating study

Aspect-based Sentiment Analysis Model for Evaluating Teachers' Performance from Students' Feedback

Evaluating teachers' performance is a fundamental pillar of educational enhancement, guiding the evolution of pedagogical practices and fostering enriched learning environments. This study pioneers an innovative approach by harnessing sentiment analysis within an aspect-based framework to decipher the intricate emotional nuances embedded within students' feedback. By categorizing sentiments as positive, negative, and neutral, we delve into the diverse perceptions of teaching aspects, offering a multifaceted portrait of educators' contributions. Through meticulous data collection, preprocessing, and a deep learning sentiment analysis model, we dissected student comments into distinct teaching aspects. The subsequent sentiment analysis unearthed positive, negative, and neutral sentiments. Positive sentiments highlighted strengths and effective communication, while negative sentiments illuminated areas for growth. Neutral sentiments provided contextual equilibrium, forming a holistic tapestry of teachers' performance. The proposed model achieved 86\% F1 score for classifying sentiments into three classes

Evaluating Teachers’ Performance through Aspect-Based Sentiment Analysis

This research demonstrates a novel approach for evaluating teacher performance by conducting aspect-based sentiment analysis (ABSA) on student feedback. A large dataset of over 2 million student comments about teachers is analyzed using cutting-edge natural language processing and customized deep learning techniques. The methodology involves identifying positive, negative and neutral aspects of teaching using a BiLSTM model. Rigorous preprocessing, domain adaptation, and performance metrics ensure a robust and objective evaluation. The granular, nuanced insights obtained through this aspect-level sentiment analysis enable educational institutions to provide targeted and unbiased feedback to teachers on their strengths and areas needing improvement. Moreover, this work lays the foundation for detecting potentially fraudulent reviews in academic settings – a crucial capability for safeguarding assessment integrity. The detailed aspect-based analysis methodology presented here significantly advances subjective and holistic evaluation practices. This research has far-reaching implications for enriching teacher development while upholding the credibility of performance assessments through sentiment analysis innovations

A comprehensive dataset for aspect-based sentiment analysis in evaluating teacher performance

Teacher performance evaluation is an essential task in the field of education. In recent years, aspect-based sentiment analysis (ABSA) has emerged as a promising technique for evaluating teaching performance by providing a more nuanced analysis of student evaluations. This article presents a novel approach for creating a large-scale dataset for ABSA of teacher performance evaluation. The dataset was constructed by collecting student feedback from American International University-Bangladesh and then labeled by undergraduate-level students into three sentiment classes: positive, negative, and neutral. The dataset was carefully cleaned and preprocessed to ensure data quality and consistency. The final dataset contains over 2,000,000 student feedback instances related to teacher performance, making it one of the largest datasets for ABSA of teacher performance evaluation. This dataset can be used to develop and evaluate ABSA models for teacher performance evaluation, ultimately leading to better feedback and improvement for educators. The results of this study demonstrate the usefulness and effectiveness of ABSA in evaluating teacher performance and highlight the importance of creating high-quality datasets for this task

Safety and Effectiveness of Antidepressants in Medicaid-Enrolled Pediatric Bipolar Depression

Pediatric bipolar disorder (I and II) patients suffer from recurrent episodes of depression and mania or hypomania (American Psychiatric Association, 1994), or mixed episodes with rapid cycling (Findling et al., 2001; Geller et al., 2002). Worldwide prevalence of bipolar disorder was 5% (Tondo et al., 2003), and in the USA was 2.6% in adults and 0-3% in adolescents (Bipolar Disorder). Early-onset bipolar disorder in childhood was associated with a higher number of lifetime episodes of manic and depressive phases, more comorbidities such as anxiety and substance abuse, rapid cycling between different phases, and higher incidence of suicide attempts compared to adulthood onset of bipolar disorder (Potter et al., 2009; Leverich et al., 2007; Perlis et al., 2004). Lifetime prevalence of the depressive phase among bipolar disorder patients is 3-fold higher than the mania phase (Post et al., 2003). Untreated bipolar depression among all the phases of bipolar disorder, particularly in children and adolescents, is associated with a high risk of suicidality (Tondo et al., 1998), substance abuse, functional disability, and poor academic and social performance among children and adolescents (Baldessarini et al., 2008; Angst et al., 2002; Frye et al., 2006; Thase, 2006; Dutta et al., 2007; Huxley and Baldessarini, 2007; Tondo and Baldessarini, 2007). Despite a higher prevalence of the depressive phase and associated risk of morbidity and mortality among bipolar disorder patients, research on the bipolar depressive phase is limited (Bhangoo et al., 2003). Although medication regimens includingmood stabilizers, antidepressants, and antipsychotics for treating bipolar depression in adults is well established (Lin et al., 2006), similar treatment guidelines for bipolar depression in younger populations are unavailable. Efficacy of different classes of medications in treating pediatric bipolar depression has been examined in several randomized trials or observational studies and documented (Kowatch et al., 2005), but psychiatric practice for children and adolescents in this regard is mostly extrapolated from adult guideline, expert consensus, or clinicians’ experience. Accordingly, mood stabilizers and second-generation antipsychotics (SGA) are considered to be the 1st line therapy for pediatric bipolar depression, while antidepressants selective serotonin reuptake inhibitors (SSRI) and bupropion are recommended only as adjunct therapy when 1st line treatment is ineffective (Kowatch et al., 2005). However, the utilization pattern of medications in treating bipolar depression in pediatric population is mostly unexplored. Subsequently, real-world safety and effectiveness of psychotropic medications in pediatric bipolar depression is also limited. Controversy prevails over the safety of using antidepressants in bipolar depression patients due to the concerns about possible manic or hypomanic switching, rapid cycling, and long-term mood destabilization. Although a potential risk of mood destabilization with the use of antidepressants has been suggested historically, critical evaluation of those clinical trials suggested presence of bias and a lack of control groups to accurately address the issue. Quantitative real-world data on comparative safety of antidepressants, antipsychotics, and mood stabilizers, in terms of risk of short-term manic switch among pediatric bipolar depression patients, is limited as well. Effectiveness of psychotropic pharmacotherapy in bipolar disorder is examined for outcomes such as response, remission, recovery, and relapse of the depressive phase. Such outcomes are measured using mania and depression rating scales, such as Young’s mania rating scale, Montgomery-Asberg depression rating scale, etc. Unavailability of such severity scales in administrative data hinders direct assessment of comparative effectiveness of psychotropic medications in real-world patients. Overall, numerical data on comparative effectiveness of antidepressants, antipsychotics, and mood stabilizers in pediatric bipolar depression is limited. Considering the prevalence of bipolar depression among children and adolescents and the associated risk of morbidity and mortality, and paucity of knowledge regarding drug utilization pattern, and comparative safety and effectiveness of antidepressant pharmacotherapy in this patient population, the specific aims of this study will be- Aim I: To assess adherence to psycho-pharmacotherapeutic regimens during 6 months after the initial bipolar depression diagnosis among Medicaid-enrolled children and adolescents, in terms of- (1) Continuation of antidepressant monotherapy, antipsychotic monotherapy, mood stabilizer monotherapy, antidepressant polytherapy (with antipsychotic or mood stabilizer), antipsychotic-mood stabilizer polytherapy, and 3-class polytherapy regimens during 6 months after initial bipolar depression diagnosis, (2) Augmentation pattern with a new class of medications among antidepressant, antipsychotic, and mood stabilizer monotherapy; and antidepressant, and antipsychotic-mood stabilizer polytherapy regimens during the 6 months of follow up after initial bipolar depression diagnosis, (3) Switch from initial treatment regimen including antidepressant, antipsychotic, and mood stabilizer monotherapy; and antidepressant, antipsychotic-mood stabilizer, and 3-class polytherapy to regimens inclusive of other therapeutic classes, during the 6 months of follow up after initial bipolar depression diagnosis, (4) All medication class discontinuation patterns in antidepressant, antipsychotic, and mood stabilizer monotherapy; and antidepressant, antipsychotic-mood stabilizer, and 3-class polytherapy regimens, during 6 the months of follow up after initial bipolar depression diagnosis. Aim II: To examine the risk of manic switch with the use of antidepressant in Medicaid-enrolled pediatric bipolar depression patients – (1) To assess comparative safety of antidepressant monotherapy against antipsychotic monotherapy, in terms of risk of manic switch in pediatric bipolar depression population, (2) To assess comparative safety of antidepressant monotherapy against mood stabilizer monotherapy, in terms of risk of manic switch in pediatric bipolar depression population, (3) To assess comparative safety of antidepressant polytherapy against antipsychotic-mood stabilizer polytherapy, in terms of risk of manic switch in pediatric bipolar depression population. Aim III: To evaluate the effectiveness of antidepressant pharmacotherapy among Medicaid enrolled children and adolescents with bipolar depression - (1) To assess risk of treatment augmentation in pediatric bipolar depression patients, comparing (i) Antidepressant monotherapy vs. antipsychotic monotherapy, (ii) Antidepressant monotherapy vs. mood stabilizer monotherapy, (iii) Antidepressant polytherapy vs. antipsychotic-mood stabilizer polytherapy. (2) To assess risk of mental-health related hospitalization in pediatric bipolar depression patients, comparing (i) Antidepressant monotherapy vs. antipsychotic monotherapy, (ii) Antidepressant monotherapy vs. mood stabilizer monotherapy, (iii) Antidepressant polytehrapy vs. antipsychotic-mood stabilizer polytherapyPharmacy, College o

Supplemental material for Healthcare resource use and costs associated with chronic kidney disease in US private insurance patients with multiple myeloma

<p>Supplemental material for Healthcare resource use and costs associated with chronic kidney disease in US private insurance patients with multiple myeloma by Debajyoti Bhowmik, Xue Song, Michele Intorcia, Shia T Kent and Nianwen Shi in Journal of Oncology Pharmacy Practice</p