Prevalence and types of inconsistencies in clinical pharmacogenetic recommendations among major U.S. sources

Clinical implementation of pharmacogenomics (PGx) is slow. Previous studies have identified some inconsistencies among clinical PGx recommendations, but the prevalence and types of inconsistencies have not been comprehensively analyzed among major PGx guidance sources in the U.S. PGx recommendations from the Clinical Pharmacogenetics Implementation Consortium, U.S. Food and Drug Administration drug labels, and major U.S. professional medical organizations were analyzed through May 24, 2019. Inconsistencies were analyzed within the following elements: recommendation category; whether routine screening was recommended; and the specific biomarkers, variants, and patient groups involved. We identified 606 total clinical PGx recommendations, which contained 267 unique drugs. Composite inconsistencies occurred in 48.1% of clinical PGx recommendations overall, and in 93.3% of recommendations from three sources. Inconsistencies occurred in the recommendation category (29.8%), the patient group (35.4%), and routine screening (15.2%). In conclusion, almost one-half of clinical PGx recommendations from prominent U.S. guidance sources contain inconsistencies, which can potentially slow clinical implementation

Artificial intelligence (AI): multidisciplinary perspectives on emerging challenges, opportunities, and agenda for research and practice

As far back as the industrial revolution, great leaps in technical innovation succeeded in transforming numerous manual tasks and processes that had been in existence for decades where humans had reached the limits of physical capacity. Artificial Intelligence (AI) offers this same transformative potential for the augmentation and potential replacement of human tasks and activities within a wide range of industrial, intellectual and social applications. The pace of change for this new AI technological age is staggering, with new breakthroughs in algorithmic machine learning and autonomous decision making engendering new opportunities for continued innovation. The impact of AI is significant, with industries ranging from: finance, retail, healthcare, manufacturing, supply chain and logistics all set to be disrupted by the onset of AI technologies. The study brings together the collective insight from a number of leading expert contributors to highlight the significant opportunities, challenges and potential research agenda posed by the rapid emergence of AI within a number of domains: technological, business and management, science and technology, government and public sector. The research offers significant and timely insight to AI technology and its impact on the future of industry and society in general

Comparison of harmonic blade versus traditional approach in canine patients undergoing spinal decompressive surgery for naturally occurring thoracolumbar disk extrusion

<div><p>Objectives</p><p>To assess feasibility of the harmonic Osteovue blade (HOB) for use in the soft tissue approach for dogs undergoing hemilaminectomy and to compare outcomes between dogs undergoing HOB or traditional approach (TRAD).</p><p>Methods</p><p>A prospective randomized clinical trial was performed using 20 client-owned dogs with thoracolumbar intervertebral disk extrusion requiring hemilaminectomy. Dogs were randomly assigned to HOB or TRAD. Neurologic function and pain scores were assessed pre-operatively. Intraoperative blood loss and surgical approach time as well as postoperative pain and wound healing scores were recorded. Additionally, neurologic recovery and owner perceived quality of life were recorded at day 10 and 30 postoperative.</p><p>Results</p><p>There was no significant difference in sex distribution, weight, age, preoperative neurological grade and pain score, and perioperative outcome measures between groups. Intraoperative total blood loss was minimal for HOB and TRAD (median: 0 ml (range 0–9) and 2.2 ml (range 0–6.8), respectively; p = 0.165) and approach times were similar (median: 7 min (range 5–12) and 8 min (range 5–13), respectively; p = 0.315). While changes in wound healing scores were similar, changes in postoperative pain scores and neurological function were significantly improved in the HOB compared to the TRAD group. Postoperative complications in the HOB group consisted of automutilation of part of the incision and development of a small soft, non-painful subcutaneous swelling in 1 dog each.</p><p>Conclusions</p><p>The HOB is a safe and effective tool for the soft tissue approach for routine spinal surgery in dogs and is associated with decreased pain and increased neurological function post-surgery.</p></div

Qualitative comparisons of various <i>postoperative</i> factors between dogs undergoing thoracolumbar spinal decompressive surgery for intervertebral disk extrusion using either Harmonic Osteovue Blade (HOB; n = 10) or traditional surgical approach (TRAD; n = 10).

<p>Qualitative comparisons of various <i>postoperative</i> factors between dogs undergoing thoracolumbar spinal decompressive surgery for intervertebral disk extrusion using either Harmonic Osteovue Blade (HOB; n = 10) or traditional surgical approach (TRAD; n = 10).</p

Comparison of various <i>preoperative</i> factors between dogs undergoing thoracolumbar spinal decompressive surgery for intervertebral disk extrusion selected for Harmonic Osteovue Blade (HOB; n = 10) versus traditional surgical approach (TRAD; n = 10).

<p>Comparison of various <i>preoperative</i> factors between dogs undergoing thoracolumbar spinal decompressive surgery for intervertebral disk extrusion selected for Harmonic Osteovue Blade (HOB; n = 10) versus traditional surgical approach (TRAD; n = 10).</p