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Background: The medication regimen for critically ill patients is complex and dynamic, leading to a high incidence of drug-related problems. This study aimed to assess the effectiveness and economic efficiency of pharmaceutical care for these patients. Methods: In this prospective cohort study conducted in a tertiary hospital, adult patients were assigned either to a clinical pharmaceutical care group or a control group based on existing clinical grouping rules. Health outcomes and economic indicators were collected, followed by a cost-effectiveness analysis. Results: The acceptance rate for clinical pharmacist interventions was 89.31%. The pharmaceutical care group exhibited significant reductions in the rate of medication errors (40.65% vs. 61.69%, P < 0.001) and adverse drug events (44.52% vs. 56.45%, P = 0.020). The usage rates for special-grade antibiotics (85.16% vs. 91.13%, P = 0.009) and proton pump inhibitors (77.42% vs. 88.71%, P = 0.002) were also lower in the pharmaceutical care group. Secondary outcomes did not show significant differences in total hospital stay (21 days vs. 22 days, P = 0.092). However, ICU stay was significantly shorter (9 days vs. 11 days, P = 0.003) in the pharmaceutical care group. Cost-effectiveness analysis demonstrated that each 1% reduction in adverse drug events associated with ICU pharmaceutical care saved $226.75 in ICU hospitalization costs and $203.42 in total ICU drug costs. A 1% reduction in the medication error rate saved $128.57 in ICU hospitalization costs and $115.34 in total ICU drug costs. Conclusions: Pharmaceutical care significantly reduces adverse drug events and medication errors, promotes rational use of medications, decreases the length of ICU stay, and lowers treatment costs in critically ill patients, establishing a definitive advantage in terms of cost-effectiveness.

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BACKGROUND: This study aimed to establish a precise preoperative high-risk factor scoring system and algorithm for antibiotic prophylaxis decision-making, provide guidance for the judicious use of AMP, refine interventions, and ensure the appropriate application of AMP for class I incisions in neurosurgery. METHODS: According to PRISMA guidelines, literature searches, study selection, methodology development, and quality appraisal were performed. The quality of evidence across the study population was assessed using the Newcastle-Ottawa Scale. A two-round Delphi expert consultation method involved 15 experts from leading tertiary hospitals in China. Establishing an algorithm of SOPs for perioperative antimicrobial prophylaxis in Class I neurosurgical incisions. RESULTS: Thirteen studies, encompassing 11,936 patients undergoing clean neurosurgical procedures, were included. 791 patients experienced SSI, resulting in an average incidence of 6.62%. Identified risk factors significantly associated with an increased incidence of postoperative SSI (P < 0.05) included emergency surgery, preoperative hospitalization ≥7 days, intraoperative blood loss ≥300 mL, operation time ≥4 hours, diabetes mellitus, cerebrospinal fluid leakage, and repeat surgery. Sensitivity analysis demonstrated robust results for emergency surgery, intraoperative blood loss ≥300 mL, operation time ≥4 hours, cerebrospinal fluid leakage, and repeat surgery. Established a risk assessment system for Class I neurosurgical incisions by the Delphi method. Additionally, we have formulated an algorithm of SOPs for perioperative antimicrobial prophylaxis in Class I neurosurgical incisions. CONCLUSIONS: The established index for AMP utilization and SOPs in the preoperative period of class I neurosurgical incisions proves valuable, contributing to improved patient outcomes in neurosurgical procedures.

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Background: We tested the hypothesis that intravenous (IV) lidocaine reduces propofol requirements in painless bronchoscopy in patients with chronic obstructive pulmonary disease (COPD). Methods: A total of 93 patients who underwent bronchoscopy were included in this randomized placebo-controlled study. The patients were randomly divided into two groups. After the IV doses of nalbuphine, patients were given a bolus of propofol, which was titrated if necessary until loss of consciousness. Then patients were given IV lidocaine (2 mg/kg then 4 mg/kg/h) or the same volume of saline. The primary endpoint was the propofol requirements. Secondary endpoints were the incidence of hypoxemia, the incidence of cough during glottis examination, the systolic blood pressure (SBP) and heart rate (HR) during bronchoscopy procedures, the bronchoscopist's comforts, and the time for wakefulness before recovery. Results: Lidocaine infusion resulted in a significant reduction in propofol requirements (p < .0001), and the incidence of hypoxemia (p = .001) and cough (p = .003) during examination decreased significantly in the lidocaine group. During the examination, the fluctuation of SBP and HR was significantly lower than that in the control group, and the difference was statistically significant (p < .05). Bronchoscopist's comforts were higher in the lidocaine group (p < .001), and time for wakefulness (p < .001) were significantly lower in the lidocaine group. Conclusion: In painless bronchoscopy in patients with COPD, IV infusion of lidocaine resulted in a reduction in propofol dose requirements and reduce the incidence of adverse events.

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Objectives: To evaluate the implementation effect of hepatitis C medical insurance reimbursement policy in China from the view of medical institutions. Methods: The electronic medical record of a top tertiary hospital in Chengdu from January 2014 to December 2020 were extracted, and the interrupted time series model was used to analyze the changes in diagnosis and treatment behavior and disease burden of hepatitis C patients after the implementation of HCV insurance reimbursement policy. Results: In terms of diagnosis and treatment, the number of visits (ß2 = 19.290, P < 0.001) and treatments (ß2 = 14.291, P < 0.01) increased instantaneously after the implementation of the outpatient reimbursement policy in Chengdu in 2018, and there was no significant change after the implementation of the single line payment policy for oral direct antiviral (DAA) drugs in 2019 (P > 0.05); in terms of medical expenses, the total treatment cost (ß2 = 21439.3, P < 0.001), out-of-pocket expenses (ß2 = 6109.44, P < 0.001) and drug expenses (ß2 = 21889.8, P < 0.001) of hepatitis C patients have been significantly reduced after the implementation of the single-line payment policy. Conclusion: Hepatitis C medical insurance reimbursement policy can promote hepatitis C patients to actively seek medical treatment, promote the widespread use of DAA scheme, reduce the burden of patients, and improve the treatment efficiency of hepatitis C.

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Objectives: To survey, analyze, and ascertain the preferences for specialty pharmacy services among patients requiring complex care and to provide evidence to support specialty pharmacy service decision-making in China. Methods: To identify essential service attributes and levels, a review of the literature, discussions with specialty pharmacy managers and a pilot questionnaire were conducted. A D-efficient fractional factorial design was used to generate the discrete-choice experiment (DCE) questionnaire. A face-to-face survey of patients with chronic illness and their families or friends was conducted at three specialty pharmacies in Chengdu and Qingdao, China. A mixed logit model was used for estimation. Results: Six relevant attributes were identified and incorporated into the DCE questionnaire. A total of 417 participants completed the survey (mean age 43 years, 45.1% males), and 32.1% had lung cancer. The conditional relative importance showed that the most critical attribute was "frequency of telephone follow-up to monitor adverse drug reactions (ADRs), "followed by "mode of drug delivery," "provider of medication guidance services," and "availability of medical insurance consultation"; the least important attribute was "business hours." A 1 min increase in time spent led to a 0.73% decrease in the probability that a service profile would be chosen. Negative preferences were noted for ADR monitoring by telephone follow-up once a year (ß = -0.23, p < 0.001) and business hours [8:30-20:00 (Monday to Friday), 8:30-17:30 (weekend)] (ß = -0.12, p < 0.001). Compared with women, men had a higher preference for service monitoring ADRs once every 3 months. Conclusions: Preference measurements showed that "frequency of telephone follow-up to monitor ADRs" had the most critical impact on decisions, followed by "mode of drug delivery." Specialty pharmacies in China need to take these findings into account to improve their design to increase uptake and patient loyalty.

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Spammers, who manipulate online reviews to promote or suppress products, are flooding in online commerce. To combat this trend, there has been a great deal of research focused on detecting review spammers, most of which design diversified features and thus develop various classifiers. The widespread growth of crowdsourcing platforms has created large-scale deceptive review writers who behave more like normal users, that the way they can more easily evade detection by the classifiers that are purely based on fixed characteristics. In this paper, we propose a hybrid semisupervised learning model titled hybrid PU-learning-based spammer detection (hPSD) for spammer detection to leverage both the users' characteristics and the user-product relations. Specifically, the hPSD model can iteratively detect multitype spammers by injecting different positive samples, and allows the construction of classifiers in a semisupervised hybrid learning framework. Comprehensive experiments on movie dataset with shilling injection confirm the superior performance of hPSD over existing baseline methods. The hPSD is then utilized to detect the hidden spammers from real-life Amazon data. A set of spammers and their underlying employers (e.g., book publishers) are successfully discovered and validated. These demonstrate that hPSD meets the real-world application scenarios and can thus effectively detect the potentially deceptive review writers.

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In this review, we provide a comprehensive overview on the registration of proprietary Chinese medicines (PCMs) in China over the past century by examining published literature and historical data. We will examine this evolving administrative practice for PCMs registration in China, which is divided to the following five stages: (1) initial measures (1915-1948); (2) early development (1949-1965); (3) provincial approval and trial implementation of the "approval number" system (1966-1984); (4) legislation and cleanup (1985-1999); and (5) centralized national approval (2000 until now), offering a panoramic view on the characteristics of PCMs registration management in China.

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Distributed and dynamic networks are ubiquitous in many real-world applications. Due to the huge-scale, decentralized, and dynamic characteristics, the global topological view is either too hard to obtain or even not available. So, most existing community detection methods working on the global view fail to handle such decentralized and dynamic large networks. In this paper, we propose a novel autonomy-oriented computing-based method for community mining (AOCCM) from the multiagent perspective in the distributed environment. In particular, AOCCM utilizes reactive agents to pick the neighborhood node with the largest structural similarity as the candidate node, and thus determine whether it should be added into local community based on the modularity gain. We further improve AOCCM to a more efficient incremental version named AOCCM-i for mining communities from dynamic networks. AOCCM and AOCCM-i can be easily expanded to detect both nonoverlapping and overlapping global community structures. Experimental results on real-life networks demonstrate that the proposed methods can reduce the computational cost by avoiding repeated structural similarity calculation and can still obtain the high-quality communities.

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A new cyathane diterpene, named as cyathin I (1), as well as two known cyathane diterpenes (12R)-11a,14a-epoxy-13a,14b,15-trihydroxycyath-3-ene (2) and erinacine I (3), were isolated from the liquid culture of Cyathus hookeri Berk. Their structures were elucidated on the basis of extensive spectroscopic analysis. Compounds 1-3 showed inhibition against nitric oxide production in macrophages with an IC50 value of 15.5, 52.3, and 16.8 µM, respectively.

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Information-theoretic clustering aims to exploit information-theoretic measures as the clustering criteria. A common practice on this topic is the so-called Info-Kmeans, which performs K-means clustering with KL-divergence as the proximity function. While expert efforts on Info-Kmeans have shown promising results, a remaining challenge is to deal with high-dimensional sparse data such as text corpora. Indeed, it is possible that the centroids contain many zero-value features for high-dimensional text vectors, which leads to infinite KL-divergence values and creates a dilemma in assigning objects to centroids during the iteration process of Info-Kmeans. To meet this challenge, in this paper, we propose a Summation-bAsed Incremental Learning (SAIL) algorithm for Info-Kmeans clustering. Specifically, by using an equivalent objective function, SAIL replaces the computation of KL-divergence by the incremental computation of Shannon entropy. This can avoid the zero-feature dilemma caused by the use of KL-divergence. To improve the clustering quality, we further introduce the variable neighborhood search scheme and propose the V-SAIL algorithm, which is then accelerated by a multithreaded scheme in PV-SAIL. Our experimental results on various real-world text collections have shown that, with SAIL as a booster, the clustering performance of Info-Kmeans can be significantly improved. Also, V-SAIL and PV-SAIL indeed help improve the clustering quality at a lower cost of computation.