Factors Affecting the Performance of Automated Speaker Verification in Alzheimer's Disease Clinical Trials

Detecting duplicate patient participation in clinical trials is a major challenge because repeated patients can undermine the credibility and accuracy of the trial's findings and result in significant health and financial risks. Developing accurate automated speaker verification (ASV) models is crucial to verify the identity of enrolled individuals and remove duplicates, but the size and quality of data influence ASV performance. However, there has been limited investigation into the factors that can affect ASV capabilities in clinical environments. In this paper, we bridge the gap by conducting analysis of how participant demographic characteristics, audio quality criteria, and severity level of Alzheimer's disease (AD) impact the performance of ASV utilizing a dataset of speech recordings from 659 participants with varying levels of AD, obtained through multiple speech tasks. Our results indicate that ASV performance: 1) is slightly better on male speakers than on female speakers; 2) degrades for individuals who are above 70 years old; 3) is comparatively better for non-native English speakers than for native English speakers; 4) is negatively affected by clinician interference, noisy background, and unclear participant speech; 5) tends to decrease with an increase in the severity level of AD. Our study finds that voice biometrics raise fairness concerns as certain subgroups exhibit different ASV performances owing to their inherent voice characteristics. Moreover, the performance of ASV is influenced by the quality of speech recordings, which underscores the importance of improving the data collection settings in clinical trials.Comment: Accepted to the 5th Clinical Natural Language Processing Workshop (ClinicalNLP) at ACL 202

Influence of secondary hyperparathyroidism in management of anemia in patients on regular hemodialysis

© 2020 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved. Background/Aim. Anemia is a common complication in hemodialysis patients. Treatment of anemia is affected by iron deficiency, insufficient dose of erythropoietin, microinflammation, vitamin D deficiency, increased intact parathyroid hormone concentration and inadequate hemodialysis. The aim of the study was to determine the prevalence of vitamin D deficiency and its impact on hemoglobin con-centration, iron status, microinflammation, malnutrition, dialysis adequacy and erythropoietin dose in patients on regular hemodialysis. Methods. The study involved 120 patients divided into three groups: severely deficient of vitamin D: 25- hydroxyvitamin D [25(OH)D] 20 ng/mL. For statistical analysis Kolmogorov- Smirnov test, the single-factor parametric analysis of variance - ANOVA and Kruskal-Wallis test were used. Results. The prevalence of vitamin D deficiency in patients on regular hemodialysis was 75.83%, while the prevalence of severe vitamin D deficiency was 24.7%. Patients with severe vitamin D deficiency had lower blood concentration of hemoglobin, hematocrit, serum concentration of total proteins and albumin, and dialysis indices were also lower compared to the other two groups of patients. The level of C-reactive protein was significantly higher in the group of patients with severe vitamin D deficiency than in the two rest groups. Conclusion. Hemodialysis patients with severe vitamin D deficiency have lower hemoglobin, lower dialysis adequacy, significant microinflammation, malnutrition, bone meta-bolism disorders and need higher dose of erythropoietin than patients whose vitamin D was higher than 10 ng/mL. Vitamin D is important risk factor for development of anemia in hemodialysis patients and important factor that can affect treatment of anemia in these patients

High frequency of the R75Q CFTR variation in patients with chronic obstructive pulmonary disease

AbstractWe performed the complete screening of the CFTR gene in a group of 31 patients with COPD in order to investigate the impact of mutations and polymorphisms in the CFTR gene. The cumulative frequency of CFTR mutations (17.74%) was significantly higher than in our general population (P<0.0001). The R75Q was significantly overrepresented in COPD patients (8.06%; P=0.002). In all patients carrying the R75Q chronic bronchitis was a dominant symptom of COPD, and all were homozygous for the V470 allele. These findings suggest that R75Q mutation could be characteristic CFTR variant for COPD patients

Accumulation of 17 organochlorine pesticides in muscle of pikeperch (Sander lucioperca) from Garaši reservoir (Serbia)

Samples of pikeperch (20 in total) were caught at Garaši reservoir during the summer of 2017. The objectives of this research was to analyse the concentrations of 17 organochlorine pesticides (aldrin, α-HCH, β-HCH, γ-HCH, δ-HCH, 4,4’-DDD, 4,4’-DDE, 4,4’-DDT, dieldrin, endosulfan I, endosulfan II, endosulfan sulfate, endrin, endrin aldehyde, heptachlor, heptachlor epoxide, and metoxychlor) in fish muscle by gas chromatography with mass spectrometric (GC-MS) detection. QuEChERS method was used for extraction and clean-up of pesticide residues from muscle tissue. Three phenyl phosphate (TPP) was used as an internal standard. Concentrations of 4,4’-DDD, 4,4’-DDE, 4,4’-DDT, heptachlor and heptachlor epoxide in fish muscle were compared with the maximum allowed concentrations (MAC) in fish meat set by the national legislation of Serbia. This reservoir is used as a drinking water source. Therefore, the hypothesis was that it was exposed to low organic pollution. The concentrations of all analyzed pesticides were below the detection limits. In conclusion, there is no health risk for consumption of pikeperch from Garaši reservoir

European Network on Optimising Treatment with Therapeutic Antibodies in chronic inflammatory diseases (ENOTTA)

Although treatment of chronic inflammatory diseases has been revolutionised with the introduction of targeted therapies with therapeutic antibodies, a large portion of patients do not respond to treatment or they lose response over time. This is mainly attributed to suboptimal dosing, immunogenicity and interpatient variability in pharmacokinetics. To overcome the problems of suboptimal treatment, researchers have started to focus on individualised treatment optimisation strategies based on development of patient stratification tools and therapeutic drug monitoring (TDM)-guided dose adaptations based on serum drug concentrations. A substantial improvement in patient care will be realised by implementing individualised (TDM-guided) dosing schemes of therapeutic antibodies in daily clinical practice for treatment of chronic inflammatory diseases, which will ultimately result in a more cost-effective use of these expensive drugs (“the right drug at the right dose for the right patient”). However, expertise on individualised (TDM-guided) treatment optimisation is highly fragmented in Europe, and largely limited to a few pioneering centres. Transferring knowledge and techniques to other (peripheral) centres is challenging, especially due to the need for inhouse expertise and a lack of standardisation in TDM assays. Therefore, this Action will create an interdisciplinary, pan-European Network in order to defragment and structure the scientific research in this field and to facilitate the implementation of individualised (TDM-guided) cost-effective dose optimisation of therapeutic antibodies in daily clinical practice for treatment of chronic inflammatory diseases

Pharmacotherapy literacy level and predictors of low literacy among diabetes mellitus type 2 patients in Serbia

Abstract Background Pharmacotherapy literacy (PTHL) is a specific ability to safely access, appraise and understand the available information concerning medication and to calculate and act accordingly. The concept of PTHL is mostly unknown for the majority of diabetes mellitus type 2 (DMT2) patients in Serbia. With diabetes being one of the major public health problems in Serbia with a prevalence of 9.1%, this two-study research aims at constructing performance-based instrument and estimating the prevalence of PTHL levels and identification of predictors of low PTHL scores in patients with DMT2. Methods Multistage study was performed to adapt the existing performance–based instrument (PTHL-SR) into specific questionnaire for DMT2 population (PTHL-DM instrument). PTHL levels were assessed through cross-sectional study categorising patients into groups of low, medium, and high PTHL levels. We considered 19 predictors for low PTHL scores, from sociodemographic characteristics, health behaviours and health characteristics, access to health-related information and empowerment-related indicators. Univariate and multivariate logistic regression analyses were used to determine independent predictors of low PTHL. Results The final 15-item PTHL-DM instrument proved to have satisfactory reliability (KR20 = 0.475) and internal reliability [ICC for the whole instrument was 0.97 with 95% confidence intervals (0.95–0.99)]. Positive correlation (rho = 0.69) between PTHL-DM score (15 questions) and the total PTHL-SR score (14 questions) was also observed. It was demonstrated that the majority of 350 patients had low PTHL (62%), and only 5% high PTHL level. Mean score on PTHL-DM was 7.8 ± 2.3. Probability of low PTHL increased among smokers, patients with low interest in health and those who estimated their health as bad. Patients who used pharmacists as sourse of information were less likely to be pharmacotherapy illiterate. Combined therapy with insulin and Oral Hypoglycemic Agents was associated with higher PTHL. Conclusions Our data indicate that specific PTHL-DM tool is objective, valid, and reliable. It was found that low level of PTHL prevailed among DMT2 patients. Medication literacy is influenced by age, residence, education, and family status. Patients with better health literacy also reported better health behaviours. Different patient empowerment programs and approaches aimed at raising PTHL would be essential to improve self-management and control of this widespread chronic disease in Serbia

The neurotoxic effects of hydrogen peroxide and copper in Retzius nerve cells of the leech Haemopis sanguisuga

Oxidative stress and the generation of reactive oxygen species (ROS) play an important role in cellular damage. Electrophysiological analyses have shown that membrane transport proteins are susceptible to ROS. In the present study, oxidative stress was induced in Retzius nerve cells of the leech Haemopis sanguisuga by bath application of 1 mM of hydrogen peroxide (H2O2) and 0.02 mM of copper (Cu) for 20 min. The H2O2/Cu(II) produced considerable changes in the electrical properties of the Retzius nerve cells. Intracellular recording of the resting membrane potential revealed that the neuronal membrane was depolarized in the presence of H2O2/Cu(II). We found that the amplitude of action potentials decreased, while the duration augmented in a progressive way along the drug exposure time. The combined application of H2O2 and Cu(II) caused an initial excitation followed by depression of the spontaneous electrical activity. Voltage-clamp recordings revealed a second effect of the oxidant, a powerful inhibition of the outward potassium channels responsible for the repolarization of action potentials. The neurotoxic effect of H2O2/Cu(II) on the spontaneous spike electrogenesis and outward K+ current of Retzius nerve cells was reduced in the presence of hydroxyl radical scavengers, dimethylthiourea and dimethyl sulfoxide, but not mannitol. This study provides evidence for the oxidative modification of outward potassium channels in Retzius nerve cells. The oxidative mechanism of the H2O2/Cu(II) system action on the electrical properties of Retzius neurons proposed in this study might have a wider significance, referring not only to leeches but also to mammalian neurons

Intestinal Colonization of Preterm Neonates with Carbapenem Resistant Enterobacteria at Hospital Discharge

Our aim was to investigate gut colonization with carbapenem-resistant Enterobacterales (CRE) in the population of preterm neonates at discharge from a tertiary care center in Serbia. The study included 350 randomly selected neonates/infants discharged in the period April 2018–May 2019. CRE colonization was present in 88/350 (25.1%) of patients. Klebsiella pneumoniae producing KPC and OXA-48 carbapenemase were detected in 45 and 42 subjects, respectively, while NDM producing Escherichia coli was identified in one patient only. All OXA-48 strains harbored blaCTX-M-15, while both blaTEM and blaSHV were present in all but one KPC-producing strain. CRE isolates exhibited a multidrug resistance pattern with uniform fluoroquinolone resistance, universal susceptibility to colistin, and variable susceptibility to aminoglycosides. Administration of carbapenems was common (~50%) and it was strongly associated with colonization, as well as the combinational therapeutic regimens that included meropenem, contrary to ampicillin–sulbactam/colistin therapy and prolonged course of the initial therapy (ampicillin/amikacin ≥ 7 days). Other risk factors for CRE carriage were level of immaturity, admission to neonatal intensive care unit, prolonged hospitalization and invasive procedures. Although the rate of clinically and/or laboratory proven systemic infections was significantly higher among colonized patients, CRE infection was confirmed in one patient only (1.1%) that was colonized with NDM E. coli. Clonal relatedness of CRE isolates was high, with seven and eight clusters detected among KPC (N = 30) and OXA-48 (N = 37) producing strains, respectively. The follow up of the 31 KPC-colonized patients after discharge from hospital revealed common decolonization within one month (~68%). In conclusion, our results demonstrated a high rate of CRE colonization that is most likely related to carbapenem consumption and lack of screening as important infection prevention practice

Colonization with Multidrug-Resistant Bacteria in the First Week of Life among Hospitalized Preterm Neonates in Serbia: Risk Factors and Outcomes

The aim of this prospective cohort study was to determine the prevalence of gut colonization with multidrug-resistant (MDR) bacteria, risk factors for colonization, infection risk, and outcomes among preterm neonates hospitalized at a tertiary-care center in Serbia. During the period from December 2017 to April 2018, 103 neonates were screened for rectal carriage at admission and on the seventh day of life. Characterization of MDR strains was done by conventional microbiology and molecular methods. Out of 61 (59.2%) colonized neonates, 12 (11.6%) were found colonized at admission, while 49 (47.6%) became colonized at the study site. Among a total of 72 MDR isolates, extended-spectrum beta-lactamase (ESBL)-producing enterobacteria prevailed (56/72, 77%), followed by Acinetobacter baumannii (14/72, 19%). The majority of ESBL-producing strains carried multiple genes (blaTEM/blaCTX-M-15 or blaTEM/blaSHV). Longer previous hospitalization and delivery by cesarean section were associated with MDR colonization, while mechanical ventilation was a risk factor for colonization at the study site. Infections due to MDR bacteria were more frequent among colonized than non-colonized neonates, but not significantly, and mortality was low (1%) in the studied neonates. These results indicate that hospitalized preterm neonates in Serbia are rapidly colonized with a diversity of MDR species and resistance phenotypes/genotypes