ABSTRACT
BACKGROUND: Topic modeling of patient medication reviews of erectile dysfunction (ED) drugs can help identify patient preferences regarding ED treatment options. The identification of a set of topics important to the patient from social network service drug reviews would inform the design of patient-centered medication counseling. OBJECTIVE: This study aimed to (1) identify the distinctive topics from patient medication reviews unique to tadalafil versus sildenafil; (2) determine if the primary topics are distributed differently for each drug and for each patient characteristic (age and time on ED drug therapy); and (3) test if the primary topics affect satisfaction with ED drug therapy controlling for patient characteristics. METHODS: Data were collected from the patient medication reviews of sildenafil and tadalafil posted on WebMD and Ask a Patient. The latent Dirichlet allocation method of natural language processing was used to identify 5 distinctive topics from the patient medication reviews on each drug. Analysis of variance and a 2-sample t test were conducted to compare the topic distribution and assess whether patient satisfaction varies with the primary topics, age, and time on medication for each ED drug. Statistical significance was tested at an alpha of .05. RESULTS: The patient medication reviews of sildenafil (N=463) had 2 topics on treatment benefit and 1 each on medication safety, marketing claim, and treatment comparison, while the patient medication reviews of tadalafil (N=919) had 2 topics on medication safety and 1 each on the remaining subjects. Sildenafil's reviewers quite frequently (94/463, 20.4%) mentioned erection sustainability as their primary topic, whereas tadalafil's reviewers were more concerned about severe medication safety. Those who mentioned erection sustainability as their primary topic were quite satisfied with their treatment as opposed to those who mentioned severe medication safety as their primary topic (score 3.85 vs 2.44). The discovered topics reflected the marketing claims of blue magic and amber romance for sildenafil and tadalafil, respectively. The topic of blue magic was preferred among younger patients, while the topic of amber romance was preferred among older patients. The topic alternative choices, which appeared for both the ED drugs, reflected patient interest in the comparative effectiveness and price outside the drug labeling information. CONCLUSIONS: The patient medication reviews of ED drugs reflect patient preferences regarding drug labeling information, marketing claims, and alternative treatment choices. The patient preferences concerning ED treatment attributes inform the design of patient-centered communication for improved ED drug therapy.
ABSTRACT
In roller pumps used for cardiopulmonary bypass (CPB), the degree of blockage within the tube resulting from compression of the tube by the rollers, or the degree of occlusion, is closely related to hemolysis, with both tight occlusive and non-occlusive degrees promoting hemolysis. There are as yet no international standards regarding methods of adjusting occlusiveness, and the amount of mechanical stress exerted upon blood remains unknown. To prevent hemolysis during CPB using roller pumps, there is a need to clarify and quantitatively assess the mechanical stress of the occlusiveness of the roller pump. In this study, we have developed a degree of occlusion quantification system which constructs the flow channel shape within an occluded tube from red optical density images, and we have verified the validity of this system. Utilizing a linear actuator, an acrylic roller and raceway, a solution colored with simulated blood powder, and a 3/8-inch vinyl chloride tube, this system uses a camera to capture red optical density images within an occluded tube and constructs the tube flow channel shape using a formula manipulation system. To verify the accuracy of this system, we compared the thickness of a cross-section of the flow channel constructed with the degree of occlusion quantification system with the thickness of a cross-section of silicone cured under the same occlusion conditions. Our experiments indicated that for areas with a small tube gap, this system can construct highly accurate three-dimensional shapes and obtain quantitative indicators assessing the degree of occlusion.
Subject(s)
Cardiopulmonary Bypass/instrumentation , Optical Devices , Hemolysis , Humans , Stress, MechanicalABSTRACT
A miniature dachshund aged 9 years and 7 months with a history of polyuria/polydipsia and depression was referred. General physical and neurological examinations revealed no obvious abnormalities. MRI of the brain revealed a large space-occupying lesion in the left frontal lobe. This was surgically removed and pathologically diagnosed as a primitive neuroectodermal tumor (PNET). Although the clinical signs had been improved, follow-up MRI revealed recurrence of the tumor. Lomustine was administered, but 1 year after surgery, the dog exhibited cluster seizures and died. This is the first reported case of a dog with PNET confined to the forebrain region treated by surgical resection in combination with chemotherapy, as observed by repeated follow-up MRI.
