Exploring patient medication adherence and data mining methods in clinical big data: A contemporary review.

BACKGROUND: Increasingly, patient medication adherence data are being consolidated from claims databases and electronic health records (EHRs). Such databases offer an indirect avenue to gauge medication adherence in our data-rich healthcare milieu. The surge in data accessibility, coupled with the pressing need for its conversion to actionable insights, has spotlighted data mining, with machine learning (ML) emerging as a pivotal technique. Nonadherence poses heightened health risks and escalates medical costs. This paper elucidates the synergistic interaction between medical database mining for medication adherence and the role of ML in fostering knowledge discovery. METHODS: We conducted a comprehensive review of EHR applications in the realm of medication adherence, leveraging ML techniques. We expounded on the evolution and structure of medical databases pertinent to medication adherence and harnessed both supervised and unsupervised ML paradigms to delve into adherence and its ramifications. RESULTS: Our study underscores the applications of medical databases and ML, encompassing both supervised and unsupervised learning, for medication adherence in clinical big data. Databases like SEER and NHANES, often underutilized due to their intricacies, have gained prominence. Employing ML to excavate patient medication logs from these databases facilitates adherence analysis. Such findings are pivotal for clinical decision-making, risk stratification, and scholarly pursuits, aiming to elevate healthcare quality. CONCLUSION: Advanced data mining in the era of big data has revolutionized medication adherence research, thereby enhancing patient care. Emphasizing bespoke interventions and research could herald transformative shifts in therapeutic modalities.

Atherosclerosis-related biomarker PABPC1 predicts pan-cancer events.

BACKGROUND: Atherosclerosis (AS) and tumours are the leading causes of death worldwide and share common risk factors, detection methods and molecular markers. Therefore, searching for serum markers shared by AS and tumours is beneficial to the early diagnosis of patients. METHODS: The sera of 23 patients with AS-related transient ischaemic attack were screened by serological identification of antigens through recombinant cDNA expression cloning (SEREX), and cDNA clones were identified. Pathway function enrichment analysis was performed on cDNA clones to identify their biological pathways and determine whether they were related to AS or tumours. Subsequently, gene-gene and protein-protein interactions were performed and AS-associated markers would be discovered. The expression of AS biomarkers in human normal organs and pan-cancer tumour tissues were explored. Then, immune infiltration level and tumour mutation burden of various immune cells were evaluated. Survival curves analysis could show the expression of AS markers in pan-cancer. RESULTS: AS-related sera were screened by SEREX, and 83 cDNA clones with high homology were obtained. Through functional enrichment analysis, it was found that their functions were closely related to AS and tumour functions. After multiple biological information interaction screening and the external cohort validating, poly(A) binding protein cytoplasmic 1 (PABPC1) was found to be a potential AS biomarker. To assess whether PABPC1 was related to pan-cancer, its expression in different tumour pathological stages and ages was screened. Since AS-associated proteins were closely related to cancer immune infiltration, we investigated and found that PABPC1 had the same role in pan-cancer. Finally, analysis of Kaplan-Meier survival curves revealed that high PABPC1 expression in pan-cancer was associated with high risk of death. CONCLUSIONS: Through the findings of SEREX and bioinformatics pan-cancer analysis, we concluded that PABPC1 might serve as a potential biomarker for the prediction and diagnosis of AS and pan-cancer.

The antioxidant capacity and nutrient composition characteristics of lotus (Nelumbo nucifera Gaertn.) seed juice and their relationship with color at different storage temperatures.

The effects of different storage temperatures on the nutritional quality, color, and antioxidant capacity of lotus seed juice and the correlations between various physicochemical indices and antioxidant capacity during storage were investigated in this study. The results showed that the overall retention rate of various nutrients and antioxidant activity in lotus seed juice under low-temperature storage was better than that under 37 °C storage. Meanwhile, temperature had a significant effect on increasing the browning of lotus seed juice and the change in L*. The results of Pearson correlation and redundancy analysis (RDA) showed that the reduction in antioxidant activity in lotus seed juice aggravated the browning index of the system at high temperatures. The color changes in the system were closely related to the clarity of lotus seed juice and aging of starch at low temperatures.

Southern Tibetan rifting since late Miocene enabled by basal shear of the underthrusting Indian lithosphere.

Syncontractional extension is prominent in present-day Tibet, but its origin remains vigorously debated. Several deep-seated geodynamic processes (e.g., Indian underthrusting, horizontal flow, and mantle upwelling) have been linked to Tibetan rifting. Indian underthrusting is a good candidate because it can well explain why surface rifts are more prominent south of the Bangong-Nujiang suture; however, how Indian underthrusting causes extension is not well understood and lacks observational constraints. Seismic anisotropy, measured by exploiting the birefringence effect of shear waves, can be indicative of the deformation styles within the crust. Here, we unveil the dominant convergence-parallel alignment of anisotropic fabrics in the deep crust of the southern Tibetan rifts using seismic recordings collected from our recently deployed and existing seismic stations. This finding suggests that the strong north-directed shearing exerted by the underthrusting Indian plate is key to enabling present-day extension in southern Tibet.

Single-Actuator Soft Robot for In-Pipe Crawling.

Pipe inspection and maintenance are necessary to prevent economic and casualty losses due to leakage of fluids from damaged pipes. In-pipe soft robots made of highly deformable materials have been proposed to meet the needs, yet most of those comprise multiple segments and require multiple actuators controlled independently, resulting in less compact structures and more demanding control schemes. In this study, we harness the highly nonlinear buckling of elastic ribbons and bioinspired artificial muscles to significantly enhance the crawling capability of a single-actuator soft robot. Our prototype robot consists of a McKibben pneumatic actuator surrounded by three longitudinally arranged elastic ribbons. These tailored ribbons are three-dimensional (3D) printed and can be buckled into highly deformed 3D shapes upon inflation of the actuator. First, we show that the robot exhibits strong anisotropic friction when fully buckled. Then, we demonstrate that by simple open-loop on/off control, our robot achieves robust crawling in horizontal, vertical, bent pipes and even wet pipes partially or filled with water. It can also adapt to pipes with some variations in diameter. Using only one actuator lowers the complexity of robot structure and pneumatic system, offering high potential for new applications at different scales.

Using Restricted Cubic Splines to Study the Duration of Antibiotic Use in the Prognosis of Ventilator-Associated Pneumonia.

Background: Ventilator-associated pneumonia (VAP) is the most widespread and life-threatening nosocomial infection in intensive care units (ICUs). The duration of antibiotic use is a good predictor of prognosis in patients with VAP, but the ideal duration of antibiotic therapy for VAP in critically ill patients has not been confirmed. Research is therefore needed into the optimal duration of antibiotic use and its impact on VAP. Methods: The Medical Information Mart for Intensive Care database included 1,609 patients with VAP. Chi-square or Student's t-tests were used to compare groups, and Cox regression analysis was used to investigate the factors influencing the prognoses of patients with VAP. Nonlinear tests were performed on antibiotic use lasting <7, 7-10, and >10 days. Significant factors were included in the model for sensitivity analysis. For the subgroup analyses, the body mass indexes (BMIs) of patients were separated into BMI <30 kg/m2 and BMI ≥30 kg/m2, with the criterion of statistical significance set at p < 0.05. Restricted cubic splines were used to analyze the relationship between antibiotic use duration and mortality risk in patients with VAP. Results: In patients with VAP, the effects of antibiotic use duration on the outcomes were nonlinear. Antibiotic use for 7-10 days in models 1-3 increased the risk of antibiotic use by 2.6020-, 2.1642-, and 2.3263-fold relative to for >10 days, respectively. The risks in models 1-3 for <7 days were 2.6510-, 1.9933-, and 2.5151-fold higher than those in models with >10 days of antibiotic use, respectively. These results were robust across the analyses. Conclusions: The duration of antibiotic treatment had a nonlinear effect on the prognosis of patients with VAP. Antibiotic use durations of <7 days and 7-10 days both presented risks, and the appropriate duration of antibiotic use can ensure the good prognosis of patients with VAP.

Predicting ICU Mortality in Rheumatic Heart Disease: Comparison of XGBoost and Logistic Regression.

Background: Rheumatic heart disease (RHD) accounts for a large proportion of Intensive Care Unit (ICU) deaths. Early prediction of RHD can help with timely and appropriate treatment to improve survival outcomes, and the XGBoost machine learning technology can be used to identify predictive factors; however, its use has been limited in the past. We compared the performance of logistic regression and XGBoost in predicting hospital mortality among patients with RHD from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Methods: The patients with RHD in the MIMIC-IV database were divided into two groups retrospectively according to the availability of data and its clinical significance based on whether they survived or died. Backward stepwise regression was used to analyze the independent factors influencing patients with RHD, and to compare the differences between the two groups. The XGBoost algorithm and logistic regression were used to establish two prediction models, and the areas under the receiver operating characteristic curves (AUCs) and decision-curve analysis (DCA) were used to test and compare the models. Finally, DCA and the clinical impact curve (CIC) were used to validate the model. Results: Data on 1,634 patients with RHD were analyzed, comprising 207 who died during hospitalization and 1,427 survived. According to estimated results for the two models using AUCs [0.838 (95% confidence interval = 0.786-0.891) and 0.815 (95% confidence interval = 0.765-0.865)] and DCA, the logistic regression model performed better. DCA and CIC verified that the logistic regression model had convincing predictive value. Conclusions: We used logistic regression analysis to establish a more meaningful prediction model for the final outcome of patients with RHD. This model might be clinically useful for patients with RHD and help clinicians to provide detailed treatments and precise management.

Measurement of Nonlinear Poisson's Ratio of Thermoplastic Polyurethanes under Cyclic Softening Using 2D Digital Image Correlation.

Thermoplastic polyurethanes (TPUs) and other elastomers are widely used in many applications for the advantages they provide in terms of high elasticity, lightness, resistance to breakage, and impact resistance. These materials exhibit strong hysteresis in the large strain stress-strain behavior, known as cyclic softening or the Mullins effect. Despite the extensive studies on this phenomenon and the importance of Poisson's ratio, how the Poisson's ratio of these materials changes during cyclic uniaxial tests is still unclear. Here, we measure the nonlinear Poisson's ratio of TPU and investigate its correlation with cyclic softening using two-dimensional digital image correlation (2D-DIC) combined with the reference sample compensation (RSC) method. This accuracy-enhanced method can effectively eliminate the measurement errors induced by the unavoidable out-of-plane displacements and lens distortion. We find that the Poisson's ratio of TPUs also exhibits large hysteresis in the first cycle and then approaches a steady state in subsequent cycles. Specifically, it starts from a relatively low value of 0.45 ± 0.005 in the first loading, then increases to 0.48 ± 0.005 in the first unloading, and remains largely constant afterward. Such a change in the Poisson's ratio results in a slight volume increase (≈1%) at a maximum strain of 17.5%. Our findings are useful for those who use finite element method to analyze the mechanical behavior of TPU, and shed new light on understanding the physical origin of cyclic softening.

Tomography of the source zone of the great 2011 Tohoku earthquake.

The mechanism and rupture process of the giant 2011 Tohoku-oki earthquake (Mw 9.0) are still poorly understood due to lack of permanent near-field observations. Using seismic arrival times recorded by dense seismograph networks on land and at ocean floor, we determine a detailed seismic tomography model of the megathrust zone beneath the Tohoku forearc. Our results show that the coseismic slip of the 2011 Tohoku-oki earthquake initiated at a boundary between a down-dip high-velocity anomaly and an up-dip low-velocity anomaly. The slow anomaly at shallow depths near the Japan trench may reflect low-rigidity materials that are close to the free surface, resulting in large slip and weak high-frequency radiation. Our new tomographic model can account for not only large slip near the trench but also weak high-frequency radiation from the shallow rupture areas.

Arc-arc collision caused the 2018 Eastern Iburi earthquake (M 6.7) in Hokkaido, Japan.

Inland crustal earthquakes usually occur in the brittle upper crust (0-20 km depths), but the 6 September 2018 Eastern Iburi earthquake (M 6.7) took place in southern Hokkaido with a focal depth of ~37 km, causing 41 fatalities and serious damage to the local infrastructure. The reason why this event was so deep and its causal mechanism are still unclear. In this work we study the three-dimensional P and S wave seismic attenuation (1/Q) structure in the source zone of the 2018 Iburi earthquake. Our results show that this event occurred at the boundary between the Sorachi-Yezo belt (low Q) and the dipping Northeastern (NE) Japan arc (high Q) that is descending beneath the Kuril arc. The collision between the NE Japan and Kuril arcs as well as fluids from dehydration of the subducting Pacific plate caused this big event and its unusual focal depth. Similar attenuation structures are revealed in source zones of the 1970 Hidaka earthquake (M 6.7) and the 1982 Urakawa-oki earthquake (M 7.1), suggesting that they were caused by similar processes. We think that large earthquakes will take place again on the active thrust faults in southern Hokkaido in the coming decades. Hence, we should pay much attention to the seismic risk and prepare for reduction of earthquake hazards there.

Bridging the connection between effective viscosity and electrical conductivity through water content in the upper mantle.

Upper mantle viscosity plays a key role in understanding plate tectonics and is usually extrapolated from laboratory-based creep measurements of upper mantle conditions or constrained by modeling geodetic and post-seismic observations. At present, an effective method to obtain a high-resolution viscosity structure is still lacking. Recently, a promising estimation of effective viscosity was obtained from a transform derived from the results of magnetotelluric imaging. Here, we build a relationship between effective viscosity and electrical conductivity in the upper mantle using water content. The contribution of water content to the effective viscosity is isolated in a flow law with reference to relatively dry conditions in the upper mantle. The proposed transform is robust and has been verified by application to data synthesized from an intraoceanic subduction zone model. We then apply the method to transform an electrical conductivity cross-section across the Yangtze block and the North China Craton. The results show that the effective viscosity structure coincides well with that estimated from other independent datasets at depths of 40 to 80 km but differs slightly at depths of 100 to 200 km. We briefly discussed the potentials and associated problems for application.

Effects of ventricular conduction block patterns on mortality in hospitalized patients with dilated cardiomyopathy: a single-center cohort study.

BACKGROUND: Ventricular conduction blocks (VCBs) are associated with poor outcomes in patients with known cardiac diseases. However, the prognostic implications of VCB patterns in dilated cardiomyopathy (DCM) patients need to be evaluated. The purpose of this study was to determine all-cause mortality in patients with DCM and VCB. METHODS: This cohort study included 1119 DCM patients with a median follow-up of 34.3 (19.5-60.8) months, patients were then divided into left bundle branch block (LBBB), right bundle branch block (RBBB), intraventricular conduction delays (IVCD) and narrow QRS groups. The all-cause mortality was assessed using Kaplan-Meier survival curves and Cox regression. RESULTS: Of those 1119 patients, the all-cause mortality rates were highest in patients with IVCD (47.8, n = 32), intermediate in those with RBBB (32.9, n = 27) and LBBB (27.1 %, n = 60), and lowest in those with narrow QRS (19.9 %, n = 149). The all-cause mortality risk was significantly different between the VCB and narrow QRS group (log-rank χ2 = 51.564, P < 0.001). The presence of RBBB, IVCD, PASP ≥ 40 mmHg, left atrium diameter and NYHA functional class were independent predictors of all-cause mortality in DCM patients. CONCLUSIONS: Our findings indicate that RBBB and IVCD at admission,but not LBBB, were independent predictors of all-cause mortality in patients with DCM.

[Municipal biowaste thermal-hydrolysis and ASBR anaerobic digestion].

Thermal-hydrolysis can remarkably improve the solid organics dissolving efficiency of urban biomass waste, and anaerobic sequencing batch reactor (ASBR) was used to improve the efficiency of urban biomass waste anaerobic digestion. The optimum thermal-hydrolysis temperature and holding time was 175 degrees C and 60 min, the volatile suspended solid (VSS) dissolving ratio of kitchen waste, fruit-and-vegetable waste and sludge were 31.3%, 31.9% and 49.7%, respectively. Two ASBR and one continuous-flow stirred tank reactor (CSTR) were started at hydraulic retention time (HRT) = 20 d, COD organic loading rate (OLR) = 3.2-3.6 kg/(m3 x d). The biogas production volumes were 5656 mL/d(A1), 6335 mL/d(A2) and 3 103 mL/d(CSTR), respectively; VSS degradation ratios were 45.3% (A1), 50.87% (A2), 20.81% (CSTR), and the total COD (TCOD) removal rates were 88.1% (A1), 90% (A2), 72.6% (CSTR). In ASBR, organic solid and anaerobic microorganism were remained in the reactor during settling period. When HRT was 20 d, the solid retention time (SRT) was over 130 d, which made ASBR higher efficiency than CSTR.

[Characteristic of sludge thermal hydrolysis using microwave heating with alkali addition].

NaOH was added into sludge to improve thermal hydrolysis when heated with microwave irradiation. Volatile suspended solid (VSS) rapidly dissolved into aqueous phase when adding 0.1 g NaOH per gram into suspended solid (SS) of sludge. More than 60% of VSS solubilized at 170 degrees C, and VSS to SS ratio of treated sludge reduced to 25%. For 5 min treatment, soluble COD (SCOD) in treated sludge liquid phase was 9.8, 12.8, 15.1, and 14.5 g/L respectively at 80, 120, 150 and 170 degrees C. Accordingly, the SCOD to TCOD (total COD) ratio was 24.0%, 31.3%, 36.9% and 35.6%. The pH of the microwave heated sludge decreased with higher temperature and longer hydrolysis time, while the finale pH of different testes were still higher than 10.5. Alkali dose effect on organic matters dissolving was analyzed at the range of 0-0.2 g NaOH into per gram SS. Results showed that when alkali dose was above 0.05 g, the rapid dissolving trend became level for VSS and SS. BMP (biochemical methane potential) test was used to investigate treated sludge digestibility at NaOH dose of 0.05 g with 5 min microwave heating at set temperature and 0.1 g with 1 min heating. Results showed that adding 0.05 g NaOH improved sludge anaerobic digestion, the biogas production was 28.5% higher than control at 150 degrees 2, while adding 0.1 g NaOH would inhibit treated sludge digestion process.