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In this work we combine sentiment analysis with graph theory to analyze user posts, likes/dislikes on a variety of social media to provide recommendations for YouTube videos. We focus on the topic of climate change/global warming, which has caused much alarm and controversy over recent years. Our intention is to recommend informative YouTube videos to those seeking a balanced viewpoint of this area and the key arguments/issues. To this end we analyze Twitter data; Reddit comments and posts; user comments, view statistics and likes/dislikes of YouTube videos. The combination of sentiment analysis with raw statistics and linking users with their posts gives deeper insights into their needs and quest for quality information. Sentiment analysis provides the insights into user likes and dislikes, graph theory provides the linkage patterns and relationships between users, posts, and sentiment.

It is a well-known fact that the data mining process can generate many hundreds and often thousands of patterns from data. The task for the data miner then becomes one of determining the most useful patterns from those that are trivial or are already well known to the organization. It is therefore necessary to filter out those patterns through the use of some measure of the patterns actual worth. This article presents a review of the available literature on the various measures devised for evaluating and ranking the discovered patterns produced by the data mining process. These so-called interestingness measures are generally divided into two categories: objective measures based on the statistical strengths or properties of the discovered patterns and subjective measures that are derived from the user's beliefs or expectations of their particular problem domain. We evaluate the strengths and weaknesses of the various interestingness measures with respect to the level of user integration within the discovery process.

Background Pharmacy service is an essential part of a healthcare system. The profession of pharmacy is well recognized and is practiced to its full potential in developed countries however, it is underutilized in developing countries such as Pakistan. The recognition of pharmacist’s role as healthcare professional is limited. This study aimed to document pharmacists’ attitude towards their role in Pakistan’s healthcare system, their experience with doctors and their perceptions towards involvement in medicines management. Methods A 4-month cross-sectional survey (Jan – Apr 18) was conducted targeting pharmacists practising in 26 tertiary care hospitals across Pakistan using a developed and validated questionnaire in both Urdu/English languages. Chi square (χ 2 ) test was used to report any associations between independent variables, i.e., education, type of hospital and work experience and, dependent variables, i.e., pharmacists’ attitudes, experience, and perception. A p -value of ≤0.01 with value of Cramer’s V ≥ 0.3 was considered cut-off for establishing statistical significance. The study was approved by ethical committee and local hospital committees. Results Three hundred ninety-six questionnaires were returned out of 500, i.e., response rate = 87.9%. Most participants (92.2%) interacted with doctors at least once daily. Most interactions were related to drug availability inquiry (72.5%). Most pharmacists (91.4%) mentioned that pharmacy duties are mostly clinical in nature. 93.4% of the respondents indicated that pharmacists are reliable source of information regarding general medicines. Furthermore, 87.4% reasoned inadequate training for not being able to discuss issues of clinical nature with doctors. Conclusion Pharmacists were willing to perform their duties and provide healthcare benefits to patients however, they seemed sceptical of advanced clinical pharmacy roles such as intervening in prescriptions and medication therapy, consultations and prescribing. There is a need to increase awareness regarding pharmacist’s role. Therefore, it would be helpful if trainings and seminars are conducted on the importance of clinical pharmacy to improve the pharmacy services in Pakistan’s healthcare system.

Background The inclusion of pharmacist in health care system is essential to ensure optimal patient care. However, with the passage of time, pharmacist’s role has transcended from dispensing, compounding and counting of pills, to more sophisticated clinical duties. Objective To evaluate doctors’ experience, perceptions and expectations regarding pharmacists’ role in Pakistani healthcare settings. Setting All tertiary care hospitals across 26 cities of Pakistan. Method A cross-sectional study using a self-administered questionnaire was carried out targeting doctors practising in Pakistan. The survey was conducted from January to April 2018. Chi square (χ2) test was used to analyse responses of doctors regarding pharmacist’s role in the healthcare system of Pakistan. The associations were considered significant at p value less than 0.05. The study was approved by concerned ethical committee. Main outcome measure Doctors’ experience, perceptions and expectations regarding pharmacists’ role. Results A total of 483 questionnaires were received and analysed (response rate; 87.9%). Most participants (67.5%) reported interaction with pharmacists at least once daily, and that was mostly related to drug availability inquiry (73.7%). 86.7% of doctors expected pharmacists to ensure safe and appropriate use of medicines to patients. 87.6% of doctors expected pharmacists to monitor patient’s response to drug therapy (p < 0.05) and 66.5% expected pharmacists to review patient’s medicines as well as discuss possible amendments to therapy (p < 0.05). Besides, most doctors (84.9%) disagreed with the notion of pharmacists prescribing medicine for patients (p < 0.05). Most participants (81.6%) did not want pharmacists to prescribe independently. Conclusion The study highlights that doctors considered pharmacists as drug information specialists, dispensers, educators and counsellors; however, their expectation of pharmacists performing the clinical role and being involved in direct patient care was limited. They negated the idea of prescription intervention and direct involvement of pharmacists in pharmacotherapy plan for patients. It is imparative to increase doctors’ awareness regarding the role pharmacists could play in Pakistan’s healthcare system. Currently, the clinical role of pharmacists in Pakistan’s healthcare system seems minimal and is seen with scepticism within the community of doctors.

Objectives To examine discrepancy rates over multiple annual cycles in reporting by consultant radiologists for the interpretation of acute Computerized Tomography (CT) examinations. Methods A prospective audit with peer review and second reading of acute CT scans was implemented in one radiology department in the UK. A longitudinal audit over 5 years was performed to determine the discrepancy rate of acute and emergency CT scans conducted on weekends. The examinations comprised CT head, thorax, abdomen and pelvis, CT Kidneys, Ureters, and Bladder (CT KUB), and CT angiography scans. Discrepancies were scored as no discrepancy (zero), minor discrepancy (one), moderate discrepancy (two), or significant discrepancy (three). Seventeen consultants took part in the audit as primary reporters and second readers. All consultants were on‐call radiologists, and the allocation of cases was randomized depending on the on‐call rota. Results were reported annually to one consultant radiologist. Results A significant discrepancy rate of 1.2% (p = 0.026) was found for consultant radiologists, interpreting acute CT examinations based on 2951 s read CT scans. Conclusions To the best of our knowledge, this is the first study to establish significant discrepancy rates among consultant radiologists, interpreting acute CT examinations over time. Analysis of discrepancies over time.

Purpose The purpose of this paper is to review the efficacy of atypical antipsychotics in combination with clozapine. Previous meta-analyses have assessed the use of both typical and atypical antipsychotics in combination with clozapine, combination treatment being withheld only for those patients deemed treatment resistant. Design/methodology/approach Outcomes assessed included: positive, negative and overall symptom score. The total numbers of participants (n=588) were scored using the Positive and Negative Symptom Scale/the Brief Psychiatric Rating Scale and effect sizes were used to judge the efficacy of the combination treatments. Data gained from the ten randomized, double blind, placebo controlled trials were analysed using the R statistical software. Findings The effect sizes gained from analysis showed a small benefit of combination therapy over clozapine monotherapy. Therefore, it is the recommendation of this analysis that alternative avenues be sought in order to treat patients who have a sub-optimal response to clozapine with a combination other than two second generation antipsychotics. Research limitations/implications The initial trials search unveiled 1,412 studies. After the inclusion and exclusion criteria were applied, ten trials were used in this meta-analysis. Practical implications The recommendation of this analysis that alternative medications be sought in order to treat patients who have a sub-optimal response to clozapine with a combination other than two second generation antipsychotics. This route should only be used once all other treatment options have been exhausted. Originality/value This meta-analytical study looks specifically at the combination of atypical antipsychotics with clozapine in comparison to clozapine monotherapy. This work extends existing meta-analysis by incorporating data from more recent trials.

Diseases are often caused by defective proteins; these proteins rarely operate in isolation and may have several roles in the cell. Thus over time a defective protein may be involved in several disorders, either directly or indirectly. The multiple roles lead to the concept of a disease module or cluster. This work describes how we generate overlapping clusters from complex networks to explore the dynamic nature of diseases, the genes implicated with them and the drugs used to treat them. Link clustering is vital for community detection as it enables the integration of disparate sources of data and provides a better understanding of community hierarchy and community dynamics than non-link methods. Furthermore, we view not just the genes directly shared between diseases but also indirectly connected genes in the network neighborhood. We use data and information from the STITCH protein and drug interaction databases, OMIM disease database, lists of diseases categorized by MeSH and the DrugBank repository. The gene ontology, disease ontology and KEGG provide biological validity for the disease communities. We demonstrate how the detection of overlapping clusters enables the identification of biologically plausible communities consisting of cooperating proteins. We verify their role in disease with respect to targeting drugs more effectively with expert opinion. We have been able to identify various modules that make sense from a biological and medical perspective and validate drug repositioning candidates with clinicaltrials.gov.

Background Over 80 % of bariatric surgical patients are women with obesity in their reproductive years. Obesity adversely affects fertility; the rapid weight loss following bariatric surgery can increase fecundity. Current guidelines recommend avoiding pregnancy for up to 24 months following surgery, but little is known about current contraceptive care of women who undergo bariatric surgery. Two surveys were undertaken with bariatric surgical and contraceptive practitioners in England to establish current contraceptive practices in both groups. Methods Two anonymous on-line surveys were sent to all 382 members of the British Obesity and Metabolic Surgery Society (BOMSS) and an estimated 300 contraceptive practitioners in the North East of England. Results The BOMSS survey elicited a response rate of 17 % ( n  = 65), mainly from bariatric surgeons ( n  = 24 (36 %)). Most respondents (97 %) acknowledged the need to educate patients, but contraceptive information was only provided by 7 % ( n  = 4) of respondents in bariatric surgical clinics. Less than half of respondents were confident discussing contraception, and the majority requested further training, guidance and communication with contraceptive practitioners. The majority of respondents to the contraceptive practitioner survey were general practitioners (28 %, n  = 20). Three quarters of respondents reported little knowledge of bariatric surgery, and many reported not seeing women with obesity requiring contraception before (66 %, n  = 45) or after surgery (71 %, n  = 49). Conclusions There is a need to increase knowledge levels of contraception within bariatric surgical teams and to understand why, despite increasing levels of bariatric surgery, women do not seem to be appearing for advice in contraceptive settings.

Daniel Edward Robert Beck,1 Karim El-Assal,1 Ken McGarry,2 Nicholas Kloster Wride1 1Sunderland Eye Infirmary, 2Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UKWe read with interest the article by Negrete et al.1 A recent study performed at our unit found similar results on conducting a review of tolerance to preservative-free latanoprost (Monopost) in patients who were unable to tolerate preserved formulae, and we would like to take the opportunity to share the results with you.View the original paper by Negrete and colleagues.

Introduction: Pakistan is the 6th most populous country in the world and has an enormous potential for an ever increasing drug market. The health care system is highly prone to unethical drug prescribing practices. In addition, there is a huge tendency of pharmaceutical firms to indulge in unethical drug promotional practices by means of inducements and other benefits through their medical sales representatives (MSRs). On the other hand, the prescribers are also reported to be demanding inducements from these companies in return to write higher number of prescription. This study investigated the ground realities of drug promotion and prescribing practices in Pakistan. Materials and Methods: A cross sectional study was conducted for a period of 6 months in which 472 physicians and 609 medical sales representatives of Pakistan selected through prospective sampling were interviewed on a validated, structured questionnaire. The responses of the target groups were then analyzed for association between variables by Chi-square test (p<0.05) and cross tabulation through SPSS, version 20. Results: Majority of practitioners (83.2%) expected both, good communication skills and knowledge from MSRs and at the same time nearly 53% of prescribers demanded CME and almost 36% demanded gifts, incentives and inducements from MSRs. Replying to same question, MSRs disagreed with prescribers and believed that ~70 % of prescribers ask for inducements with a whopping ~64 % among them demanding unethical inducements like excessive free samples, gifts, leisure trips and even cars. Majority of physicians have consensus that the multinational pharmaceutical firms (92 %) have defined promotional practices while the national pharmaceutical companies (~73 %) are mainly involved in unethical practices of drug marketing. Conclusion: Majority of national pharmaceuticals as well as prescribers were involved in unethical drug promotion and prescribing respectively. There is a need of curbing the unethical drug promotion and prescribing and formidable policies governing this issue are required to be implemented by the concerned regulatory authorities to avoid unnecessary harm to the patient's life and pocket. Strength and weakness of study: The study explored the drug promotion and prescribing practices for the first time in a developing country however, due to sensitivity of the topic a number of respondents hesitated to participate.