Linking Symptom Inventories using Semantic Textual Similarity

An extensive library of symptom inventories has been developed over time to measure clinical symptoms, but this variety has led to several long standing issues. Most notably, results drawn from different settings and studies are not comparable, which limits reproducibility. Here, we present an artificial intelligence (AI) approach using semantic textual similarity (STS) to link symptoms and scores across previously incongruous symptom inventories. We tested the ability of four pre-trained STS models to screen thousands of symptom description pairs for related content - a challenging task typically requiring expert panels. Models were tasked to predict symptom severity across four different inventories for 6,607 participants drawn from 16 international data sources. The STS approach achieved 74.8% accuracy across five tasks, outperforming other models tested. This work suggests that incorporating contextual, semantic information can assist expert decision-making processes, yielding gains for both general and disease-specific clinical assessment

Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial

Background: Short-term treatment for people with type 2 diabetes using a low dose of the selective endothelin A receptor antagonist atrasentan reduces albuminuria without causing significant sodium retention. We report the long-term effects of treatment with atrasentan on major renal outcomes. Methods: We did this double-blind, randomised, placebo-controlled trial at 689 sites in 41 countries. We enrolled adults aged 18–85 years with type 2 diabetes, estimated glomerular filtration rate (eGFR)25–75 mL/min per 1·73 m 2 of body surface area, and a urine albumin-to-creatinine ratio (UACR)of 300–5000 mg/g who had received maximum labelled or tolerated renin–angiotensin system inhibition for at least 4 weeks. Participants were given atrasentan 0·75 mg orally daily during an enrichment period before random group assignment. Those with a UACR decrease of at least 30% with no substantial fluid retention during the enrichment period (responders)were included in the double-blind treatment period. Responders were randomly assigned to receive either atrasentan 0·75 mg orally daily or placebo. All patients and investigators were masked to treatment assignment. The primary endpoint was a composite of doubling of serum creatinine (sustained for ≥30 days)or end-stage kidney disease (eGFR <15 mL/min per 1·73 m 2 sustained for ≥90 days, chronic dialysis for ≥90 days, kidney transplantation, or death from kidney failure)in the intention-to-treat population of all responders. Safety was assessed in all patients who received at least one dose of their assigned study treatment. The study is registered with ClinicalTrials.gov, number NCT01858532. Findings: Between May 17, 2013, and July 13, 2017, 11 087 patients were screened; 5117 entered the enrichment period, and 4711 completed the enrichment period. Of these, 2648 patients were responders and were randomly assigned to the atrasentan group (n=1325)or placebo group (n=1323). Median follow-up was 2·2 years (IQR 1·4–2·9). 79 (6·0%)of 1325 patients in the atrasentan group and 105 (7·9%)of 1323 in the placebo group had a primary composite renal endpoint event (hazard ratio [HR]0·65 [95% CI 0·49–0·88]; p=0·0047). Fluid retention and anaemia adverse events, which have been previously attributed to endothelin receptor antagonists, were more frequent in the atrasentan group than in the placebo group. Hospital admission for heart failure occurred in 47 (3·5%)of 1325 patients in the atrasentan group and 34 (2·6%)of 1323 patients in the placebo group (HR 1·33 [95% CI 0·85–2·07]; p=0·208). 58 (4·4%)patients in the atrasentan group and 52 (3·9%)in the placebo group died (HR 1·09 [95% CI 0·75–1·59]; p=0·65). Interpretation: Atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease. Funding: AbbVie

Strategy as a response to organizational uncertainty: an alternative perspective on the strategy-performance relationship

Much of the literature suggests that strategies are formulated in light of perceived environmental conditions and internal capabilities. This study supports the notion that strategy is formulated in part as a response to management uncertainties about competitors, customers, and the environment. Responses from 137 wholesale grocers demonstrate that uncertainty varies by generic strategy, suggesting that businesses consider both the type and degree of uncertainty when crafting a competitive strategy. Specifically, the data suggest that viable strategic options may be limited more by the cognitive and perceptual abilities of an organization\u27s managers than by objective measures of factors such as organizational resources and industry competitiveness. The premise that strategy must “fit” with organizational or environmental factors to be effective may be incomplete. Rather, a strategy – to be successful – should also fit with the psychological characteristics and constraints of the managers responsible for its formulation and implementation. © 2000, MCB UP Limite

The impact of web-based technologies on business organisations: A review and thoughts on the future

Almost all of the published work in the academic and popular press on Web-Based Technologies (WBT) - most notably the internet - emphasises the merits. While WBT have had an extraordinary, and arguably positive net influence on business organisations, they have also created a number of significant challenges for managers. This paper proposes a framework for evaluating the positive and negative influences of WBT, outlining economic, organisational and customer factors that have influenced organisations in far-reaching ways. If organisations are to harness the full benefits of technology, they must become fully aware and minimise the negative \u27side effects\u27 of these advances. Copyright © 2007 Inderscience Enterprises Ltd

The Party’s Primary Preferences: Race, Gender, and Party Support of Congressional Primary Candidates

Party support has a strong influence on candidate success in the primary. What remains unexplored is whether party actions during the primary are biased along racial and gender lines. Using candidate demographic data at the congressional level and measures of party support for primary candidates, we test whether parties discriminate against women and minority candidates in congressional primaries and also whether parties are strategic in their support of minority candidates in certain primaries. Our findings show parties are not biased against minority candidates and also that white women candidates receive more support from the Democratic Party than do other types of candidates. Our findings also suggest that parties do not appear to strategically support minority candidates in districts with larger populations of minorities. Lastly, we also find no significant differences in the effects of party support on the likelihood of success in the primary by candidate race or gender