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Abstract Introduction: Evidence suggests that herbivores, such as peccaries, shape vegetation structure and diversity through predation, trampling, dispersal, and rooting behavior. Objective: To evaluate the impact of peccaries (Dycotiles tajacu) on the understory vegetation of the tropical rainforest in the Nogal-La Selva Local Biological Corridor, Costa Rica, comparing a site with the absence of peccaries to another with the presence of these animals. Methodology: From June to November 2021, 20 experimental exclusions and 20 free access plots, each measuring 2 m2 were used to quantify herbivory, the number of leaf blades, damaged leaves, healthy leaves, sapling height, and fallen biomass at both sites. Results: A higher sapling density was found in the Nogal Reserve, but a lower sapling diversity, while in La Selva there was a higher sapling diversity, but a lower density of seedlings. Herbivory and sapling height in La Selva exceeded those in Nogal. The exclusion of peccaries reduced seedling damage but did not affect the dynamics of fallen biomass. Conclusion: For the design, implementation, and evaluation of the effectiveness of biological corridors, it is crucial to consider plant-animal interactions to enhance the flow of ecological processes through functional and structural connectivity, analyzed from interactions such as those presented in this paper.
Resumen Introducción: Existe evidencia que herbívoros, como los saínos, dan forma a la estructura y diversidad de la vegetación a través del comportamiento de depredación, pisoteo, dispersión y enraizamiento. Objetivo: Evaluar el impacto de los saínos (Dycotiles tajacu) en la vegetación del sotobosque del bosque tropical húmedo en el Corredor Biológico Local Nogal-La Selva, Costa Rica, en un sitio con ausencia y en otro con presencia de saínos. Métodos: De junio a noviembre de 2021 se utilizaron 20 exclusiones experimentales y 20 parcelas de acceso libre de 2 m2, se cuantifico la herbivoría, número de láminas foliares, hojas dañadas, hojas sanas, altura de brinzales y biomasa caída en ambos sitios. Resultados: Se encontró una mayor densidad de brinzales en Reserva Nogal pero una menor diversidad, contrario en La Selva donde se encontró una mayor diversidad de brinzales, pero una menor densidad de plántulas. La herbivoría y la altura de brinzales en La Selva fue mayor que en Nogal. La exclusión de los saínos disminuyó el daño a las plántulas, pero no afectó la dinámica de la biomasa caída. Conclusión: Es necesario contemplar para el diseño, implementación y evaluación de la efectividad de corredores biológicos, las interacciones planta-animal, para potencializar el flujo de procesos ecológicos mediante la conectividad funcional y estructural, analizada a partir de interacciones como las presentadas en este trabajo.
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Animais , Artiodáctilos , Florestas , Distribuição Animal , Ecossistema Tropical , Costa RicaRESUMO
Introduction: In this work we explore a potential approach to improve human-robot collaboration experience by adapting cobot behavior based on natural cues from the operator. Methods: Inspired by the literature on human-human interactions, we conducted a wizard-of-oz study to examine whether a gaze towards the cobot can serve as a trigger for initiating joint activities in collaborative sessions. In this study, 37 participants engaged in an assembly task while their gaze behavior was analyzed. We employed a gaze-based attention recognition model to identify when the participants look at the cobot. Results: Our results indicate that in most cases (83.74%), the joint activity is preceded by a gaze towards the cobot. Furthermore, during the entire assembly cycle, the participants tend to look at the cobot mostly around the time of the joint activity. Given the above results, a fully integrated system triggering joint action only when the gaze is directed towards the cobot was piloted with 10 volunteers, of which one characterized by high-functioning Autism Spectrum Disorder. Even though they had never interacted with the robot and did not know about the gaze-based triggering system, most of them successfully collaborated with the cobot and reported a smooth and natural interaction experience. Discussion: To the best of our knowledge, this is the first study to analyze the natural gaze behavior of participants working on a joint activity with a robot during a collaborative assembly task and to attempt the full integration of an automated gaze-based triggering system.
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Background: Pancreatic cancer and colon cancer pose significant challenges in treatment, with poor prognoses. Natural products have long been explored for their potential as anticancer agents. Iso-mukaadial acetate has shown promise in inducing apoptosis in breast and ovarian cancer cells. The objective of this study was to investigate the effect of Iso-mukaadial acetate on pancreatic (MIA-PACA2) and colon (HT29) cancer cell lines. Methods: Pancreatic (MIA-PACA2) cancer cells, colon (HT29) cancer cells, normal embryonic kidney cells (HEK 293), and normal lung cells (MRC5) were cultured and treated with Iso-mukaadial acetate (IMA) for 24 hours. The viability assays were conducted using Alamarblue reagent and a real-time cell viability monitoring system, xCELLigence. The IC50 values were determined, followed by assessments of ATP production, caspase 3/7 activation, mitochondrial function, morphological changes using a light microscope, and gene expression changes via RT-PCR. Results: This study indicates that Iso-mukaadial acetate exhibited concentration-dependent cytotoxic effects, slowing cellular proliferation in both cancer cell lines. Activation of the mitochondrial apoptotic pathway and caspase 3/7 suggests induction of apoptosis. Reduced ATP production and altered gene expression further support its anticancer properties. Morphological changes after treatment with Iso-mukaadial acetate showed apoptotic characteristics which may suggest that apoptosis was induced. Conclusions: According to the results obtained, Iso-mukaadial acetate shows potential as an anticancer agent, evidenced by its effects on cellular viability, mitochondrial function, ATP production, caspase activation, and gene expression in pancreatic and colon cancer cells. These findings highlight its promise for further investigation and potential in the development of therapeutic agents.
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PURPOSE: To determine the frequency and severity of further visual loss experienced by patients within ten weeks from diagnosis of acute non-arteritic anterior ischemic optic neuropathy. (NAION). DESIGN: Retrospective case series. METHODS: Electronic medical records (EMR) at an academic neuro-ophthalmology practice were searched for diagnosis of "NAION" and all identified charts were reviewed to determine eligibility. Patients diagnosed with acute NAION between February 2014 and December 2023 who presented within four weeks of symptom onset and were seen in follow-up within ten weeks were included. Clinically significant decline in best corrected visual acuity (BCVA) and peripheral VF were defined as decline of BCVA ≥2 Snellen lines and decrease of ≥2 decibels (dB) in mean deviation (MD) on perimetric testing. RESULTS: Forty-nine eyes met inclusion and exclusion criteria. Sixty-seven percent of patients were male and average age at presentation was 66 years. Twenty-two percent of eyes demonstrated worsening of BCVA by ≥2 lines. Of these, 55% worsened by ≥4 lines and 27% by ≥8 lines. In 27% of eyes MD on perimetry worsened by ≥2 dB and in 18% by ≥4 dB. In total, 41% of eyes demonstrated clinically significant worsening of BCVA or VF. CONCLUSIONS: Subacute deterioration of BCVA and/or VF following acute NAION is not uncommon while optic disc edema is present, with sizeable proportion of patients experiencing dramatic visual decline. Deterioration in visual function within the first 10 weeks of presentation does not exclude the diagnosis of NAION and further investigations should only be performed if additional clinical features are discordant with this diagnosis.
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INTRODUCTION: The natural history of rotator cuff tears often involves progressive pain development, tear enlargement, and advancing muscle fatty degeneration. Both surgery and conservative management have proven to be effective treatments. Our study purpose was to compare the short to mid-term effects of rotator cuff repair on shoulder function, progression of tear size, and muscle degeneration compared to controls with asymptomatic tears that developed pain and were managed nonoperatively. METHODS: This comparative study consists of two separate longitudinal study arms. The control group consisted of asymptomatic degenerative cuff tears followed until pain development and then managed nonoperatively with continued surveillance. The surgical group consisted of subjects with degenerative tears that failed nonoperative treatment and underwent surgical intervention with a minimum of 2 years follow-up. Outcomes included VAS pain, ASES, AROM, strength, and ultrasonography. RESULTS: There were 83 controls and 65 surgical shoulders. The surgical group was younger at enrollment (58.9±5.3 yr vs. 61.2±7.8 yr, p=0.04). The median follow-up for control subjects after pain development was 5.1 years (IQR 3.6) and the median postoperative follow-up for the surgical group was 3.0 years (IQR 0.2). Baseline tear widths (median 14 mm, IQR 9 vs. 13 mm, IQR 8; p=0.45) and tear lengths (median 14 mm, IQR 13 vs. median 11 mm, IQR 8; p=0.06) were similar between the surgical group and controls. There were no differences in the baseline prevalence of fatty degeneration of the supraspinatus or infraspinatus muscles between groups (p=0.43 and p=0.58, respectively). At final follow-up, the surgical group demonstrated significantly lower VAS pain (0 [IQR 2] vs. 3.5 [IQR 4], p=0.0002), higher composite ASES (95 [IQR 13] vs. 65.8 [IQR 32], p=0.0002) and ADL scores (29 [IQR 4] vs. 22 [IQR 8], p=0.0002), greater abduction strength (69.6 N [SD 29] vs. 35.9 N [SD 29], p=0.0002), greater active forward elevation (155Ë [SD 8] vs. 142Ë [SD 28], p=0.002), greater active external rotation in abduction (mean 98.5Ë, SD 12 vs. mean 78.2Ë, SD 20; p=0.0002) compared to controls. Additionally, the prevalence of fatty muscle degeneration was lower in the surgical group for the supraspinatus and infraspinatus (25% vs. 41%, p=0.05; 17% vs. 34%, p=0.03; respectively). CONCLUSION: This prospective longitudinal study comparing a surgical cohort undergoing rotator cuff repair with a control group treated nonoperatively supports the notion that surgical intervention has the potential to alter the early natural history of degenerative rotator cuff disease. Patients in the surgical group demonstrated clinically relevant differences in pain and functional outcomes. Surgical intervention was protective against progressive muscle degeneration compared to nonoperative treatment.
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Non-communicable diseases (NCDs) are defined as a kind of diseases closely related to bad behaviors and lifestyles, e.g., cardiovascular diseases, cancer, and diabetes. Driven by population growth and aging, NCDs have become the biggest disease burden in the world, and it is urgent to prevent and control these chronic diseases. Autophagy is an evolutionarily conserved process that degrade cellular senescent or malfunctioning organelles in lysosomes. Mounting evidence has demonstrated a major role of autophagy in the pathogenesis of cardiovascular diseases, cancer, and other major human diseases, suggesting that autophagy could be a candidate therapeutic target for NCDs. Natural products/phytochemicals are important resources for drugs against a wide variety of diseases. Recently, compounds from natural plants, such as resveratrol, curcumin, and ursolic acid, have been recognized as promising autophagy modulators. In this review, we address recent advances and the current status of the development of natural autophagy modulators in NCDs and provide an update of the latest in vitro and in vivo experiments that pave the way to clinical studies. Specifically, we focus on the relationship between natural autophagy modulators and NCDs, with an intent to identify natural autophagy modulators with therapeutic potential.
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Semi-natural grasslands (SNGLs) in Estonia are threatened by abandonment. This threat is leading to concerns about the degradation of biodiversity within grassland communities. Despite the high relevance of economic incentives in this context, how such incentives influence land managers' decision-making regarding the agricultural use of SNGLs has not been investigated. To obtain its socio-ecological implications for policy-making, we developed regionally specific agricultural scenarios (compensation payments, livestock capacity, hey export, and bioenergy production) and an interdisciplinary modelling approach that made it possible to simulate agricultural land use changes through land managers' responses to varied economic conditions. Through this approach, we found that some economic factors hampered the use of SNGLs: the moderate profitability of beef production, labour shortages, and the relatively high profitability of mulching. We observed a positive relationship between SNGLs and habitat suitability for breeding and feeding birds. However, due to the high maintenance costs of SNGLs, the modelling results indicated that increasing the use of SNGLs through public budgets caused crowding-out effects, i.e., the deteriorating market integration of regional agriculture. This study emphasises the need for policy measures aimed at cost-effective, labour-efficient management practices for SNGLs.
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Glioblastoma (GB) is the most common and fatal type of primary malignant brain tumor for which effective therapeutics are still lacking. GB stem cells, with tumor-initiating and self-renewal capacity, are mostly responsible for GB malignancy, representing a crucial target for therapies. The TP73 gene, which is highly expressed in GB, gives rise to the TAp73 isoform, a pleiotropic protein that regulates neural stem cell biology; however, its role in cancer has been highly controversial. We inactivated TP73 in human GB stem cells and revealed that TAp73 is required for their stemness potential, acting as a regulator of the transcriptional stemness signatures, highlighting TAp73 as a possible therapeutic target. As proof of concept, we identified a novel natural compound with TAp73-inhibitory capacity, which was highly effective against GB stem cells. The treatment reduced GB stem cell-invasion capacity and stem features, at least in part by TAp73 repression. Our data are consistent with a novel paradigm in which hijacking of p73-regulated neurodevelopmental programs, including neural stemness, might sustain tumor progression, pointing out TAp73 as a therapeutic strategy for GB.
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Isoflavones are phenolic natural compounds with a C6C3C6 framework. They possess a plethora of biological activities that are associated with putative benefits to human health. In particular, the cancer chemopreventive and chemotherapeutic potential of isoflavones has attracted the interest of researchers. Several isoflavone derivatives have been synthesised and probed for their anticancer activities. The isoflavone analogues are mainly synthesised by molecular hybridisation and other strategies that enable diversification through early or late-stage functionalisation of A-, B- and C-rings of the isoflavones. This has resulted in the discovery of isoflavone analogues with improved antiproliferative activities against several cancer cells and different mechanisms of action. In this review, the synthesis of isoflavone derivatives and their anticancer activity studies are discussed.
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Aim: Cancer constitutes the second leading cause of death worldwide, with conventional therapies limited by significant side effects. Melatonin (MEL), a natural compound with antitumoral properties, suffers from instability and low solubility. To overcome these issues, MEL was encapsulated into nanostructured lipid carriers (MEL-NLC) containing rosehip oil to enhance stability and boost its antitumoral activity. Methods: MEL-NLC were optimized by a design of experiments approach and characterized for their physicochemical properties. Stability and biopharmaceutical behavior were assessed, along with interaction studies and in vitro antitumoral efficacy against various cancer cell lines. Results: Optimized MEL-NLC exhibited desirable physicochemical characteristics, including small particle size and sustained MEL release, along with long-term stability. In vitro studies demonstrated that MEL-NLC selectively induced cytotoxicity in several cancer cell lines while sparing healthy cells. Conclusion: MEL-NLC represent a promising alternative for cancer, combining enhanced stability and targeted antitumoral activity, potentially overcoming the limitations of conventional treatments.
Despite current advances, cancer is the second cause of death worldwide, but conventional therapies have side effects and limited efficacy. Natural therapies are emerging as suitable alternatives and, among them, Melatonin is a well-known compound with antitumoral properties. However, it is degraded by light, decreasing its therapeutical activity. In order to effectively deliver Melatonin into cancer cells, it has been encapsulated into biodegradable nanoparticles containing rosehip oil, which may boost the antitumoral properties. These nanoparticles have been optimized, showing a small size and a high Melatonin encapsulation, sustained drug release and good stability. Furthermore, in vitro studies demonstrated antitumoral activity against several cancer cell lines, also showing a high internalization inside them. Moreover, studies conducted using chicken embryonated eggs, showed that nanoparticles were non-toxic, thus confirming its promising therapeutical applications.
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The genus Nocardia are gram-positive bacteria, many of which possess pathogenicity and infect human lungs, skin, brain, and other organs. Since research on the genus Nocardia has not progressed as rapidly as that on the genus Streptomyces, the genus Nocardia is considered a useful undeveloped resource for exploring natural products. On the other hand, when the genus Nocardia infects the human body, the strains are attacked by immune cells such as macrophages. Therefore, we suggested a new method for screening natural products by culturing the genus Nocardia in the presence of animal cells. In this review, we describe our recent results in searching for natural products from the genus Nocardia.
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Hops is an economically important species due to its diverse secondary metabolites and extensive use in the brewing and medicinal industries. Although hops is widely distributed in Kosovo, the chemical composition of its essential oils and genetic variability of wild populations remain understudied. Therefore, this study aimed to evaluate the chemical and genetic variability of Kosovo's wild hop population using essential oil constituents and microsatellite (simple sequence repeat - SSR) markers. Female hop inflorescences were collected from 21 wild populations in Kosovo. Essential oils were extracted from the dried plant material using a Clevenger apparatus. Chemical composition of the essential oils was analysed using GC-FID-MS. DNA was extracted from dried leaves, and 15 SSR markers were used for fragment analysis. The main constituents of the essential oil were myrcene, α-humulene, (E)-ß-farnesene, α-selinene, ß-selinene, and E-caryophyllene. Statistical analyses based on chemical composition of essential oils and SSR markers highlighted the low variability among populations and high variability within populations. These findings provide valuable insights for developing strategies for potential use and conservation of wild hop populations in Kosovo, laying the groundwork for future research and comparison with commercial cultivars to assess their breeding potential.
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The resource utilization of natural pyrite not only reduces secondary pollution but also brings certain environmental benefits. However, the green and efficient use of pyrite presents certain challenges. In this study, a novel electro-Fenton (EF) system was constructed utilizing copper modified graphite felt (GF/Cu) as cathode and natural pyrite (com-FeS2) as catalyst. The results demonstrated that the system exhibited a remarkable stability over an extensive pH range (3.0-10.0) and remained effective even under adverse environmental conditions, such as high salinity or elevated antibiotic concentration. After optimizing the reaction conditions, 0.2 mM sulfamerazine (SMZ) was almost completely degraded within 1.5 h. The results highlighted the catalytic role of Fe(II) on the com-FeS2 surface. Combined with quenching experiments and quantitative analysis of reactive oxygen species (ROS), the removal of SMZ was primarily attributed to the generation of â¢OH, ordered by 1O2 > â¢O2- > â¢OHads, a possible degradation pathway was proposed by HR-LC-MS. The biological toxicity after the reaction was detected, and the introduction of polyvinylpyrrolidone (PVP) was beneficial to reduce the biological toxicity of iron dissolution. This work provides new insights into the green and efficient resource utilization of natural pyrite and significantly expands the pH applicability range of the Fenton process, demonstrating the large-scale industrial application potential of pyrite.
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Mesenchymal stem cells (MSCs) therapy is a highly researched treatment that has the potential to promote immunomodulation and anti-inflammatory, anti-apoptotic, and antimicrobial activities. It is thought that it can enhance internal organ function, reverse tissue remodeling, and achieve significant organ repair and regeneration. However, the limited infusion, survival, and engraftment of transplanted MSCs diminish the effectiveness of MSCs-based therapy. Consequently, various preconditioning methods have emerged as strategies for enhancing the therapeutic effects of MSCs and achieving better clinical outcomes. In particular, the use of natural small molecule compounds (NSMs) as a pretreatment strategy is discussed in this narrative review, with a focus on their roles in regulating MSCs for injury repair in vital internal organs. Additionally, the discussion focuses on the future directions and challenges of transforming mesenchymal stem cell research into clinical applications.
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Transplante de Células-Tronco Mesenquimais , Células-Tronco Mesenquimais , Humanos , Células-Tronco Mesenquimais/metabolismo , Células-Tronco Mesenquimais/citologia , Células-Tronco Mesenquimais/efeitos dos fármacos , Transplante de Células-Tronco Mesenquimais/métodos , Animais , Produtos Biológicos/farmacologia , Produtos Biológicos/uso terapêutico , Cicatrização/efeitos dos fármacosRESUMO
Awassi is a fat-tailed sheep breed, and the best breed in Syria is famous. Awassi sheep are Syria's main source of red meat and milk production. In this study, we estimated the influence of various factors on sheep meat and milk production using time-series data from 1961 to 2020. This study employed the Cobb-Douglas production function to analyze the data. The results obtained indicate that Awassi meat production in Syria was positively and significantly influenced by carcass weight (p < 0.001) and quantity of slaughtered sheep (p < 0.001), with elasticity coefficients of 0.994 and 1.000, respectively. The model results show that raw milk yield and milk animals have a positive and significant inï¬uence on milk production at the 0.1 % significance level, with an elasticity coefficient of 0.998. However, climatic factors (precipitation and temperature) have a significant effect and negative inï¬uence on milk production at the 1 % and 5 % significance levels, respectively. This result sheds light on the policies and procedures the government should implement to develop sheep production in Syria. Therefore, it can be stated that policymakers should enhance the quality and productivity characterization of sheep through the implementation of breeding programs, improve grazing potential, and protect natural pastures. Furthermore, feed rations should be supported to help breeders overcome the effects of drought and high feed prices.
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INTRODUCTION: Endodontic retreatment is essential for periapical healing, involving the removal of inadequate fillings, thorough cleaning, and new filling application to prevent leakage. This study compares the dissolving abilities of Eucalyptus, Orange, and Castor oils in the re-treatment of resin-based endodontic fillings using conventional and rotary techniques. METHODOLOGY: Thirty single-rooted human teeth were prepared and filled with gutta-percha and AH Plus sealer. They were divided into three groups (n=10) based on the solvent used (Eucalyptus, Orange, or Castor oil) and further subdivided based on the techniques used (conventional and rotary). Standardised re-treatment procedures were performed, and the amount of residual material was measured. RESULTS: A significant difference (p<0.001) was found among the groups, indicating that both the type of solvent and the technique significantly affected the amount of residual material. The rotary technique generally left less residual material compared to the conventional technique for all solvents. Eucalyptus oil with the rotary technique showed the least residual material (mean = 5.8), while Castor oil with the conventional technique showed the most (mean = 10.2). CONCLUSION: Eucalyptus oil, especially when used with rotary techniques, is highly effective in removing resin-based endodontic fillings, providing a viable and safer alternative to traditional solvents. The study underscores the importance of selecting appropriate solvents and techniques for successful endodontic re-treatment.
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Sport faces many challenges in creating fair, interesting, and meaningful competitions that highlight and reward the qualities widely valued in sport, such as natural talents, dedication, and competitive savvy. The Paralympic Games illuminate both the challenge and a thoughtful way of responding by organizing events that group athletes with comparable levels of impairment so that raw physical discrepancies don't overwhelm differences in talent or dedication. It may be helpful to reflect on how gender is used in decisions about who competes against whom. Gender has long served as a rough proxy for differences in size and strength. For sports where size and strength matter, those are the dimensions along which competitors should be matched, not their gender identity. In that sense, gender is incidental to fair competition in sport. Because playing sports is good for people in so many ways, we should provide abundant opportunities that are widely available and enjoyable for all people.
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Esportes , Humanos , Feminino , Esportes/ética , Masculino , Comportamento Competitivo/ética , Identidade de Gênero , Fatores SexuaisRESUMO
Epoxomicin is an epoxyketone proteasome inhibitor with synthetic derivatives approved or under investigation for treatment of multiple myeloma. To leverage the advantages of Escherichia coli as a rapidly growing and readily engineered host for the production of epoxomicin and analogues, we expressed codon-optimized versions of the epoxomicin biosynthetic genes, epxD, epxE, and epxF. Epoxomicin was detected, but the major product was a ketone resulting from α,ß-keto acid precursor decarboxylation. Epoxomicin yield was improved by altering the copy numbers of each gene and creating a fusion of epxE and epxF. Our optimized system offers promise for efficient engineering and biosynthesis of improved epoxomicin analogues.
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BACKGROUND: The COVID-19 pandemic impacted how people accessed health services and likely how they managed chronic conditions such as type 2 diabetes (T2D). Social media forums present a source of qualitative data to understand how adaptation might have occurred from the perspective of the patient. OBJECTIVE: Our objective is to understand how the care-seeking behaviors and attitudes of people living with T2D were impacted during the early part of the pandemic by conducting a scoping literature review. A secondary objective is to compare the findings of the scoping review to those presented on a popular social media platform Reddit. METHODS: A scoping review was conducted in 2021. Inclusion criteria were population with T2D, studies are patient-centered, and study objectives are centered around health behaviors, disease management, or mental health outcomes during the COVID-19 pandemic. Exclusion criteria were populations with other noncommunicable diseases, examining COVID-19 as a comorbidity to T2D, clinical treatments for COVID-19 among people living with T2D, genetic expressions of COVID-19 among people living with T2D, gray literature, or studies not published in English. Bias was mitigated by reviewing uncertainties with other authors. Data extracted from the studies were classified into thematic categories. These categories reflect the findings of this study as per our objective. Data from the Reddit forums related to T2D from March 2020 to early March 2021 were downloaded, and support vector machines were used to classify if a post was published in the context of the pandemic. Latent Dirichlet allocation topic modeling was performed to gather topics of discussion specific to the COVID-19 pandemic. RESULTS: A total of 26 studies conducted between February and September 2020, consisting of 13,673 participants, were included in this scoping literature review. The studies were qualitative and relied mostly on qualitative data from surveys or questionnaires. Themes found from the literature review were "poorer glycemic control," "increased consumption of unhealthy foods," "decreased physical activity," "inability to access medical appointments," and "increased stress and anxiety." Findings from latent Dirichlet allocation topic modeling of Reddit forums were "Coping With Poor Mental Health," "Accessing Doctor & Medications and Controlling Blood Glucose," "Changing Food Habits During Pandemic," "Impact of Stress on Blood Glucose Levels," "Changing Status of Employment & Insurance," and "Risk of COVID Complications." CONCLUSIONS: Topics of discussion gauged from the Reddit forums provide a holistic perspective of the impact of the pandemic on people living with T2D, which were found to be comparable to the findings of the literature review. The study was limited by only having 1 reviewer for the literature review, but biases were mitigated by consulting authors when there were uncertainties. Qualitative analysis of Reddit forms can supplement traditional qualitative studies of the behaviors of people living with T2D.
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BACKGROUND: Identification of pulmonary embolism (PE) across a cohort currently requires burdensome manual review. Previous approaches to automate capture of PE diagnosis have either been too complex for widespread use or have lacked external validation. We sought to develop and validate the Regular Expression Aided Determination of PE (READ-PE) algorithm, which uses a portable text-matching approach to identify PE in reports from computed tomography with angiography (CTA). METHODS: We identified derivation and validation cohorts of final radiology reports for CTAs obtained on adults (≥ 18 years) at two independent, quaternary academic emergency departments (EDs) in the United States. All reports were in the English language. We manually reviewed CTA reports for PE as a reference standard. In the derivation cohort, we developed the READ-PE algorithm by iteratively combining regular expressions to identify PE. We validated the READ-PE algorithm in an independent cohort, and compared performance against three prior algorithms with sensitivity, specificity, positive-predictive-value (PPV), negative-predictive-value (NPV), and the F1 score. RESULTS: Among 2948 CTAs in the derivation cohort 10.8 % had PE and the READ-PE algorithm reached 93 % sensitivity, 99 % specificity, 94 % PPV, 99 % NPV, and 0.93 F1 score, compared to F1 scores ranging from 0.50 to 0.85 for three prior algorithms. Among 1206 CTAs in the validation cohort 9.2 % had PE and the algorithm had 98 % sensitivity, 98 % specificity, 85 % PPV, 100 % NPV, and 0.91 F1 score. CONCLUSIONS: The externally validated READ-PE algorithm identifies PE in English-language reports from CTAs obtained in the ED with high accuracy. This algorithm may be used in the electronic health record to accurately identify PE for research or surveillance. If implemented at other EDs, it should first undergo local validation and may require maintenance over time.