Inconsistent Values Research Articles

Circulating levels of micronutrients and the risk of benign paroxysmal positional vertigo: A Mendelian randomization study

BackgroundBenign paroxysmal positional vertigo (BPPV) is a typical vestibular disease characterized by recurrent episodes of vertigo. The role of micronutrients in BPPV pathogenesis has not been extensively studied, prompting this investigation into the relationship between circulating micronutrients and BPPV risk. This research aimed to explore the relationship between blood micronutrient levels and BPPV risk via Mendelian randomization (MR) analysis, a robust method for inferring causality from observational data. MethodsA total of 15 circulating micronutrients were assessed for their association with BPPV risk. MR analysis was conducted via the following methods: MR‒Egger, weighted median, simple model, inverse variance weighting (IVW), and weighted mode. Sensitivity analyses were performed to assess heterogeneity and pleiotropy. A multivariate MR analysis was also conducted, incorporating potential confounders such as trauma, chronic otitis media, hearing loss, peripheral atherosclerosis, ageing, and osteoporosis. ResultsMR analysis revealed an obvious association between selenium and BPPV risk (OR 1.074, 95 % CI 1.005 to 1.148; P = 0.035). Folate was negatively related (OR 0.694, 95 % CI 0.501 to 0.962, P = 0.028) but was excluded because of inconsistent OR values across methods. Sensitivity analysis supported the IVW results, and there was no evidence of significant heterogeneity among the selenium-related instrumental variables included in the study, nor was horizontal pleiotropy detected among the instrumental variables. Multivariate MR analysis confirmed that selenium was an independent risk factor for BPPV (OR 1.22, 95 % CI 1.059 to 1.406, P = 0.006), with no significant associations observed for other micronutrients or exposure factors. ConclusionThis study provides evidence that blood selenium levels are positively associated with the risk of BPPV, suggesting a potential role for selenium in the pathogenesis of this disorder. These findings are robust to various sensitivity analyses and support the use of MR analysis to identify novel risk factors for BPPV. The identification of selenium as an independent risk factor for BPPV has implications for the development of preventive strategies and targeted interventions. It is necessary to analyse the biological mechanisms of this association and determine the therapeutic value of limiting selenium intake for BPPV to provide support for the treatment of such patients.

Hemodynamic Evaluation of Coronary Artery Lesions after Kawasaki Disease: Comparison of Fractional Flow Reserve during Cardiac Catheterization with Myocardial Flow Reserve during 13N-Ammonia PET.

Coronary artery lesions (CALs) after Kawasaki disease present complex coronary hemodynamics. We investigated the relationship between coronary fractional flow reserve (FFR), myocardial flow reserve (MFR), and myocardial blood flow volume fraction (MBF) and their clinical usefulness in CALs after Kawasaki disease. Nineteen patients (18 men, 1 woman) who underwent cardiac catheterization and 13N-ammonia positron emission tomography, with 24 coronary artery branches, were included. Five branches had inconsistent FFR and MFR values, two had normal FFR but abnormal MFR, and three had abnormal FFR and normal MFR. The abnormal MFR group had significantly higher MBF at rest than the normal group (0.86 ± 0.13 vs. 1.08 ± 0.09, p = 0.001). The abnormal FFR group had significantly lower MBF at adenosine loading than the normal group (2.23 ± 0.23 vs. 1.88 ± 0.29, p = 0.021). The three branches with abnormal FFR only had stenotic lesions, but the MFR may have been normal because blood was supplied by collateral vessels. Combining FFR, MFR, and MBF will enable a more accurate assessment of peripheral coronary circulation and stenotic lesions in CALs and help determine treatment strategy and timing of intervention.

Delineating leachate-groundwater interaction at Gyadi-Gyadi dumpsite, Kano, using natural electromagnetic (EM) field detector and Vertical Electrical Sounding (VES)

Geophysical investigations are mostly used for hydrogeological studies, mining, geotechnical investigation and environmental surveys. Geophysical investigation of groundwater within the dumpsite is highly critical because the extent of interaction between leachate plume/contaminated zone and aquifer zones could significantly reduce groundwater quality. The textural complexity and clay content of soils could change their electrical properties, thus reflecting inconsistent resistivity values using the resistivity method. This research investigates the extent of leachate infiltration from waste dumpsite into groundwater at Gyadi-Gyadi Kano State, using natural Electromagnetic (EM) field and Vertical Electrical Sounding (VES) methods. Six natural EM profiles were obtained in various locations within the study area using PQWT-TC 150 model. Six VES data points were occupied along the EM profile lines using SAS 1000 ABEM resistivity meter. The two techniques employed revealed some intercalations of low resistivity (conductive) as well as very low electrical potential differences in the study area. The low resistivity media are mixtures of leachates into groundwater units, thereby creating formations from the surface to a depth of about 40 m. The first and second layers have experience leachate-aquifer interaction in the northern, southern and eastern parts of the study area to about 40 m depth, and the leachate-aquifer interaction has extended to the deep aquifer of about 70 m depth at the western part. Shallow aquifer has not been infiltrated by leachate at about >100 m away from the waste dumpsite. Therefore, for potable groundwater exploitation in this area, it is advised that boreholes should be sited >100 m away from the dumpsite, where leachate-aquifer interaction has attenuated. The natural EM field detector is evidently constrained by issues of over-generalization and summation of potential values, probably due to its relatively low resolution. Hence it might not be capable of precisely delineating varying geological units. In contrast, the resistivity method is able to delineate and discretize the subsurface into sub-units of different resistive zones. This implies that VES is better suited for accurately defining the true subsurface geology, while the NEF detector is effective for determining the extent of a leachate plume.

Intricacies of high temperature thermal characterization of Silicaf/Silica composites

In this paper, we discuss the unique challenges posed by Silicaf/Silica composite while measuring their thermal conductivity by using Transient Plane Source (TPS) method and specific heat by Differential Scanning Calorimeter (DSC). The measured thermal conductivity values were found reaching a plateau followed by a reduction at temperatures 800 °C and above. Thermal expansion characteristics as measured in Thermomechanical Analyzer (TMA) exhibited strong dependency on static force applied during experiments. Keeping in view the real life application of the developed Silicaf/Silica composite, a novel method of sample preparation was implemented which restricted the sample compression at elevated temperatures during TPS experiments. Experiments utilizing DSC under linear and step heating with sample placement in alumina crucible yielded inconsistent values of specific heat (Cp). With further experimentation, the combination of step heating and direct placement of sample in platinum crucible was found most appropriate for accurate measurement of specific heat of Silicaf/Silica.

Index-based Approach in Relation to Built-up and LST Dynamics; A Study of Lahore, Pakistan

In 21st century, cities outpaced in size and also in density due to development of economic sector.Consequently, the wide spread expansion of urban areas is resulting in the loss of productive green cover and waterbodies. Therefore, realizing this alarming situation, the present study is aimed to investigate and evaluate the pattern ofurban expansion by considering two major land cover types (i) built-up area (ii) other classes (vegetation, waterbody,soil etc.) during the last six years (2015-2020). For this study Sentinel imagery was acquired from USGS EarthExplorer, while Modis Terra images were acquired from World View NASA. New built-up area index (NBUI),normalized difference vegetation index (NDVI), worldview water index (WV-WI) and land surface temperature (LST)were calculated in order to analyze variations in Lahore’s major land cover types and its varying temperature patterns.Spatial analysis presented the obvious impacts of land development on Lahore. NBUI indicated that the built-up areahas increased drastically from 34.0% in 2015 to 84.2% in 2020; NDVI analysis depicted a decline from 0.76% to0.73%, in the green spaces of Lahore during the study period; WV-WI portrayed inconsistent values of water bodies, agift of massive rise in the built-up area in Lahore. LST results presented that the temperature was 42.21°C in 2015,which simultaneously increased and recorded at 49.51°C in 2020. The increase in LST exhibited the alarming situationfor urban environment and can become threat to increase the air pollution level in Lahore. Therefore, this study willserve as a snapshot for policy makers to control the menace of unplanned urbanization by formulating stringent policiesto protect environment.

Consistency of the Troposphere Wet Delay From Water Vapor Radiometer and Co‐Located GPS Station

AbstractThe tropospheric delay acquired by the Global Navigation Position System (GPS) Precise Point Positioning (PPP) is continuous and steady, less affected by rainfall. The Water Vapor Radiometer (WVR) can provide real‐time meteorological parameters but is more sensitive to high‐frequency information in troposphere. To explore the use of WVR‐retrieved tropospheric delay and assist other geodetic techniques for atmospheric correction, the tropospheric delay from WVR and co‐located GPS at Shanghai, Beijing, Kunming, and Urumqi stations in China are compared. For the inconsistent values of WVR‐PPP zenith wet delay, the variations of the tropospheric delay from WVR and GPS before and after the rainfall were statistically analyzed. The results suggest that, for the rain rate ranging from 0.1 to 50 mm/hr, the impact of rainfall on WVR could last from 10 min before to 30 min after the rainfall. With filtering WVR data based on meteorological parameters and rain rate, the zenith wet delay between WVR and PPP at Shanghai shows good consistency, the root mean square (RMS) is 6.11 mm, correlation is 0.997, and the RMS in the other three stations ranges from 16.35 to 25.16 mm (correlation ranges in 0.794–0.951). The analysis indicates that the tropospheric delay of WVR is reliable to be applied to space geodetic techniques correction in real‐time with filtering to reduce the effect of rainfall, water vapor, and liquid water variability.

Sensitivity and specificity of the ICDAS II system and bitewing radiographs for detecting occlusal caries using the Spectra™ caries detection system as the reference test in children

BackgroundMost studies assessing the sensitivity and specificity of caries detection methods have been performed in vitro using the histological method as the gold standard showing inconsistent values. The aim of this study was to compare the sensitivity and specificity in detecting occlusal caries using the International Caries Detection and Assessment System (ICDAS II) with the radiographic method (RM), while using the Spectra™ Caries Detection System (SCDS) as the reference test.MethodsOne hundred sixty children, ages 7–12 years, participated in the study. Five zones in the occlusal surfaces of 859 primary and 632 first permanent molars were examined visually using ICDAS-II, the RM using bitewing radiographs and SCDS. The descriptive statistics of sensitivity and specificity were calculated and compared.ResultsFor all molars combined and for primary molars only, the sensitivity of ICDAS II was higher for detecting total caries (p < 0.001), caries in enamel (p < 0.001), and caries in dentin (p = 0.016), but it was not different for detecting caries in the dentin of permanent first molars (p = 0.214), and primary second molars (p = 0.761). The specificity of RM was higher for detecting total caries, caries in enamel for all molars combined and for permanent first molars (p < 0.001). For caries in dentin, the specificity of ICDAS II was higher for all molars combined and for primary molars only (p < 0.001). For total caries in primary molars only, and caries in dentin of permanent first molars only, the specificity was not different (p = 0.156 and p = 0.181 respectively).ConclusionsThe sensitivity and specificity of ICDAS II and RM changes depending on whether the carious lesion compromises the enamel or dentin, and if the caries detection is performed in the primary molars or permanent first molars.

CrowdDA: Difficulty-aware crowdsourcing task optimization for cleaning web tables

Web tables are rich sources of structured data for collecting and analyzing data, but there exist various data quality problems such as missing or inconsistent values. Crowdsourcing provides a new solution that leverages the human cognitive ability to clean tables, but existing crowdsourcing-based solutions suffer from cleaning quality. For most crowd are not experts, the difficulty degree of cleaning tasks will seriously affect the cleaning result. To help people clean web tables effectively and efficiently, it is important to reduce the overall difficulty of tasks. In this paper, we introduce a difficulty-aware crowdsourcing task optimization system CrowdDA, which aims to recommend the best task execution order from easy to difficult for crowd and support various kinds of cleaning tasks for web tables. CrowdDA takes both latency and space constraints into account for task optimization and generates the task execution order that minimizes the overall difficulty of tasks under two constraints. Furthermore, CrowdDA adopts partition strategies for large tables to improve system efficiency, and introduces independent task sequence to tolerate crowd’s inconsistent answers for system robustness. The experiments based on the real-world datasets demonstrate the performance superiority of CrowdDA for improving the cleaning quality of web tables.

Deep Learning based Densenet Convolution Neural Network for Community Detection in Online Social Networks

Online Social Networks (OSNs) have become increasingly popular, with hundreds of millions of users in recent years. A community in a social network is a virtual group with shared interests and activities that they want to communicate. OSN and the growing number of users have also increased the need for communities. Community structure is an important topological property of OSN and plays an essential role in various dynamic processes, including the diffusion of information within the network. All networks have a community format, and one of the most continually addressed research issues is the finding of communities. However, traditional techniques didn't do a better community of discovering user interests. As a result, these methods cannot detect active communities. To tackle this issues, in this paper presents Densenet Convolution Neural Network (DnetCNN) approach for community detection. Initially, we gather dataset from Kaggle repository. Then preprocessing the dataset to remove inconsistent and missing values. In addition to User Behavior Impact Rate (UBIR) technique to identify the user URL access, key term and page access. After that, Web Crawling Prone Factor Rate (WCPFR) technique is used find the malicious activity random forest and decision method. Furthermore, Spider Web Cluster Community based Feature Selection (SWC2FS) algorithm is used to choose finest attributes in the dataset. Based on the attributes, to find the community group using Densenet Convolution Neural Network (DnetCNN) approach. Thus, the experimental result produce better performance than other methods.

An ontology-based approach for harmonization and cross-cohort query of Alzheimer’s disease data resources

BackgroundIn the United States, the National Alzheimer’s Coordinating Center (NACC) and the Alzheimer’s Disease Neuroimaging Initiative (ADNI) are two major data sharing resources for Alzheimer’s Disease (AD) research. NACC and ADNI strive to make their data more FAIR (findable, interoperable, accessible and reusable) for the broader research community. However, there is limited work harmonizing and supporting cross-cohort interoperability of the two resources.MethodIn this paper, we leverage an ontology-based approach to harmonize data elements in the two resources and develop a web-based query system to search patient cohorts across the two resources. We first mapped data elements across NACC and ADNI, and performed value harmonization for the mapped data elements with inconsistent permissible values. Then we built an Alzheimer’s Disease Data Element Ontology (ADEO) to model the mapped data elements in NACC and ADNI. We further developed a prototype cross-cohort query system to search patient cohorts across NACC and ADNI.ResultsAfter manual review, we found 172 mappings between NACC and ADNI. These 172 mappings were further used to construct common concepts in ADEO. Our data element mapping and harmonization resulted in five files storing common concepts, variables in NACC and ADNI, mappings between variables and common concepts, permissible values of categorical type data elements, and coding inconsistency harmonization, respectively. Our cross-cohort query system consists of three core architectural elements: a web-based interface, an advanced query engine, and a backend MongoDB database.ConclusionsIn this work, ADEO has been specifically designed to facilitate data harmonization and cross-cohort query of NACC and ADNI data resources. Although our prototype cross-cohort query system was developed for exploring NACC and ADNI, its backend and frontend framework has been designed and implemented to be generally applicable to other domains for querying patient cohorts from multiple heterogeneous data sources.

Discrete q-Exponential Limit Order Cancellation Time Distribution

Modeling financial markets based on empirical data poses challenges in selecting the most appropriate models. Despite the abundance of empirical data available, researchers often face difficulties in identifying the best fitting model. Long-range memory and self-similarity estimators, commonly used for this purpose, can yield inconsistent parameter values, as they are tailored to specific time series models. In our previous work, we explored order disbalance time series from the broader perspective of fractional L’evy stable motion, revealing a stable anti-correlation in the financial market order flow. However, a more detailed analysis of empirical data indicates the need for a more specific order flow model that incorporates the power-law distribution of limit order cancellation times. When considering a series in event time, the limit order cancellation times follow a discrete probability mass function derived from the Tsallis q-exponential distribution. The combination of power-law distributions for limit order volumes and cancellation times introduces a novel approach to modeling order disbalance in the financial markets. Moreover, this proposed model has the potential to serve as an example for modeling opinion dynamics in social systems. By tailoring the model to incorporate the unique statistical properties of financial market data, we can improve the accuracy of our predictions and gain deeper insights into the dynamics of these complex systems.

Estimating formation and fracturing water production using simple diagnostic plots

The main goal of this paper is to evaluate the possibility of distinguishing between formation and fracturing water based on the water-flowback response without analyzing water chemical data. We analyze flowback production data of 100 multi-fractured horizontal oil wells completed in the Montney Formation and 89 oil and gas wells completed in the Duvernay and Horn River formations. We hypothesize that 1) the slope of water-flowback harmonic decline (HD) profiles (mHD) is proportional to the slope of rate-normalized pressure (RNP) plots (mRNP), and 2) both mRNP and mHD are inversely proportional to the amount of water influx from matrix into fractures. To verify our hypothesis, we 1) extend the previous HD and single-phase flowing material balance models by considering the water influx from matrix into fractures, 2) classify the studied wells based on observed trends, 3) construct RNP diagnostic plots of the studied wells, 4) investigate the relationship between mHD and mRNP, 5) analyze log data and estimate average initial water saturation (Swi) for the studied wells, and 6) investigate the relationship between of mHD and Swi. The results show that mHD for all the studied wells ranges from 0.00001 to 0.036 1/ m3 with a mean value of 0.0056 1/ m3. Wells with higher mHD have relatively higher mRNP values. In contrast, wells with very low mHD show no significant decline in water rate through the entire flowback process and relatively low or inconsistent mRNP values on the corresponding plots of RNP versus material balance time (MBT). We also observe a negative correlation between mHD and Swi obtained by analysis of wireline log data. This correlation and the positive correlation between mHD and mRNP indicate that as Swi increases, water influx from matrix to fracture increases, and thus, both mHD and mRNP decrease. Based on our modified models and the observed correlations, we develop a method to approximately differentiate between formation and fracturing water. The applications of our heuristic method on field data shows that 1) fracturing water production dominates the total water recovery for wells with higher mRNP, and 2) formation water production dominates the total water recovery for wells with lower mRNP.

Optical emission spectroscopy of an industrial thermal atmospheric pressure plasma jet: Parametric study of electron temperature

The plasma parameters of an industrial atmospheric pressure plasma jet (APPJ) are measured as a function of the electric power of the plasma generator, the gas flow, and the distance from the jet nozzle exit. The APPJ device operates an electric discharge under Argon gas flow resulting into a continuous Argon plasma jet in the kW power range expanding into ambient air. The plasma temperature Te and electron number density Ne are determined by optical emission spectroscopy (OES) analyzing up to 17 emission lines of neutral Ar (I) and singly-ionized Ar (II) species using the Saha-Boltzmann plot (SBP) method. For the accurate determination of plasma parameters a methodology is developed to overcome fundamental limitations in OES of Argon plasma that is due to the strongly different intensities of Ar (I) and Ar (II) emission lines. The most significant step is the use of spectral bandpass filters in the optical collection system. The experimental parameters of the jet device are playing a crucial role for APPJ applications (e.g. thermal load to the workpiece, plasma chemistry interaction etc.). We measure Te and Ne in dependence of the experimental parameters and obtain consistent and accurate values of Te = 9000 ± 150 K and Ne = 5 × 1015 cm−3 (typ.). For comparison, plasma characterization using only the neutral Ar lines gives inaccurate and inconsistent Te values. This highlights the importance of using also the ionic Ar lines. The developed methodology may be diversified and applied also for OES of other rare gas plasma.

Neutrosophic Autocratic Multi-Attribute Decision-Making Strategies for Building Material Supplier Selection

Because of the intricate nature of real-world scenarios, experts could encounter many ambiguities throughout the decision-making (DM) process. Adopting a DM strategy in conditions of indeterminacy so that the decision makers are limited to a small number of experts is always helpful in real life. Neutrosophic conception is a convenient technique for handling inconsistent, ambiguous, and uncertain values. This research presents an autocratic DM strategy based on Neutrosophic Sets (NSs) to address these ambiguities. The essential component of the suggested technique is the conversion of diverse management decision and weight matrices into a unified evaluation matrix. Supplier Selection (SS) is a multi-criteria decision-making problem where a limited number of alternative suppliers are evaluated using a limited set of criteria. The suggested methodology based on different score functions is applied to SS issues involving construction materials. The numerical illustrations indicate the success of the introduced method in selecting the best supplier with the least computational complexity. The important point obtained in this research is that adopting a suitable score function appropriate to the characteristics of the data plays an important role in the decision-making process.

The cost of aiming for the best answers: Inconsistent perception.

The laws of physics and mathematics describe the world we live in as internally consistent. As these rules provide a very effective description, and our interaction with the world is also very effective, it seems self-evident that our perception follows these laws. As a result, when trying to explain imperfections in perception, we tend to impose consistency and introduce concepts such as deformations of visual space. In this review, we provide numerous examples that show that in many situations we perceive related attributes to have inconsistent values. We discuss how our tendency to assume consistency leads to erroneous conclusions on how we process sensory information. We propose that perception is not about creating a consistent internal representation of the outside world, but about answering specific questions about the outside world. As the information used to answer a question is specific for that question, this naturally leads to inconsistencies in perception and to an apparent dissociation between some perceptual judgments and related actions.

Intraocular Pressure Spikes Following iStent Inject and the Relationship to Aqueous Outflow in Open Angle Glaucoma.

Adding trabecular bypass surgery (TBS) to phacoemulsification creates unpredictable short-term intraocular pressure (IOP) control that may be undesirable for patients with advanced glaucoma. Aqueous outflow (AO) responses after TBS are complex and probably multifactorial. To assess IOP spikes in patients with open angle glaucoma up to 1 month after iStent inject and their relationship to AO patterns measured by hemoglobin video imaging (HVI). We studied IOP for 4 weeks after TBS with iStent inject in 105 consecutive eyes with open angle glaucoma (6 TBS only and 99 combined with phacoemulsification). The change in IOP after surgery at each time point was compared with baseline measurements and the prior postoperative visit. IOP-lowering medications were stopped on the day of surgery in all patients. A smaller pilot study of 20 eyes (TBS only = 6 and combined = 14) underwent concurrent HVI to observe and quantify perioperative AO. Aqueous column cross-sectional area (AqCA) of one nasal and one temporal aqueous vein was calculated at each time point, and qualitative observations were documented. An additional 5 eyes were studied after phacoemulsification only. Mean IOP for the entire cohort (preoperative 17.3 ± 5.6 mm Hg) was lowest the day after TBS (13.1 ± 5.0 mm Hg) and peaked at 1 week (17.2 ± 8.0 mm Hg), before stabilizing by 4 weeks (15.2 ± 5.2 mm Hg; P < 0.00001). The same IOP pattern was seen when separating the group into a larger cohort without HVI (respectively 15.9 ± 3.2 mm Hg, 12.8 ± 4.9 mm Hg, 16.4 ± 7.4 mm Hg, and 14.1 ± 4.1 mm Hg; N = 85, P < 0.00001) and the smaller HVI pilot study (respectively 21.4 ± 9.9 mm Hg, 14.2 ± 4.9 mm Hg, 20.2 ± 9.7 mm Hg, and 18.9 ± 7.6 mm Hg; N = 20, P < 0.001). More than 30% IOP elevation above baseline occurred in 13.3% of the entire cohort at 1 week after surgery. This increased to 46.7% when IOP was compared with 1 day after surgery. Inconsistent AqCA values and patterns of aqueous flow were demonstrated after TBS. AqCA after phacoemulsification alone was maintained or increased within 1 week in all 5 eyes. After iStent inject surgery in patients with open angle glaucoma, intraocular spikes were most commonly seen at 1 week. AO patterns were variable and additional studies are needed to understand the pathophysiology underlying IOP responses after this procedure.

Diallel crosses in Picea abies III. Variation and inheritance patterns in nursery trials

Abstract The complete diallel cross is the only mating design that provides estimates of variance components of general combining (GCA), specific combining ability (SCA), maternal and reciprocal effects, in addition to heritabilities and genetic correlations. To obtain such estimates, complete diallels were made among 10 trees in each of three natural Norway spruce populations from altitude 300 and 500 m in Norway. Nursery trials were performed with the families from these crosses and families from seeds collected from open pollination. Traits measured and analysed are seed weight, germination rate, germination percentage, terminal bud set, and seedling heights the first and second years. The seedlings from the population at origin 500 m had lower seed weight, lower heights and earlier bud set than those from the two populations from lower altitude. A considerable variation was present among families within each diallel, and the GCA variance components had the highest values and were significant for most traits. Variance components for SCA and maternal effects were also significant for some traits, but with inconsistent values in the three diallels. A strong relationship was present between the weight of the seed lots from the maternal parent and mean family height after one and two growing seasons. The highest estimate of heritability was observed for bud set, with similar values in all three diallels.

Inconsistencies in the days supply values reported in pharmacy claims databases for biologics with long maintenance intervals.

BACKGROUND: Days supply values reported in large administrative claims databases are commonly used to estimate drug exposure and quantify adherence and persistence with prescribed therapy. In recent claims database studies assessing treatment patterns for biologic therapies, a high frequency of 28-31-days supply values has been observed for therapies with label-recommended maintenance dosing intervals longer than 4 weeks. Such inconsistencies suggest potential inaccuracy of days supply data. OBJECTIVE: To confirm the existence and describe the extent of inconsistencies in the reported days supply values and the documented fill intervals among prescription claims from administrative claims databases for 2 different biologics with label-recommended maintenance dosing intervals longer than 4 weeks and 2 biologics with intervals less than or equal to 4 weeks. METHODS: Using data from 2 large US administrative claims databases (IBM MarketScan Commercial Claims and Encounters and the Optum Clinformatics Data Mart Socio-economic Status [SES]), the reported days supply values and associated intervals between consecutive fills for 2 biologics with maintenance dosing intervals longer than 4 weeks (guselkumab and ustekinumab) and 2 with intervals less than or equal to 4 weeks (adalimumab and ixekizumab) were described. For all fill pairs with reported days supply values of 28-31 days, the percentage with inconsistent fill intervals (defined as >45 days or >60 days) was calculated. RESULTS: Across all datasets, the proportions of fill pairs with inconsistent days supply values and fill intervals (ie, days supply values of 28-31 days but fill intervals of >45 days) were 41.8%-73.4% for guselkumab, 33.4%-59.4% for ustekinumab, 8.5%-9.5% for adalimumab, and 7.3%-11.4% for ixekizumab. The same trend was observed across these biologics when using more than 60 days to define an inconsistent fill interval. Unlike adalimumab and ixekizumab, a wide distribution of fill intervals was observed among guselkumab and ustekinumab fill pairs with 28-31 days supply values, with peaks evident at approximately 28-31 days as well as around the label-recommended maintenance dosing intervals for these therapies (56 or 84 days). CONCLUSIONS: This study demonstrated a large discrepancy between days supply values and fill intervals reported in administrative claims data for biologics with label-recommended maintenance dosing intervals longer than 4 weeks (ie, guselkumab and ustekinumab), potentially suggesting widespread underestimation of days supply values for these therapies. Such inconsistencies in the reported days supply values may lead to underestimation of treatment adherence and persistence for these biologics, which could be mitigated by systematic data imputation. DISCLOSURES: This study was funded by Janssen Scientific Affairs, LLC. Ms Xu and Drs Ferrante, Fitzgerald, Pericone, and Wu are employees of Janssen Scientific Affairs, LLC, and shareholders of Johnson & Johnson, of which Janssen Scientific Affairs, LLC, is a wholly owned subsidiary. Funding for programming support and medical writing and editorial assistance was provided by Janssen.

Sperm DNA fragmentation testing in clinical management of reproductive medicine.

Approximately 8%-12% of couples worldwide face infertility, with infertility of individuals assigned male at birth (AMAB) contributing to at least 50% of cases. Conventional semen analysis commonly used to detect sperm abnormalities is insufficient, as 30% of AMAB patients experiencing infertility show normal results in this test. From a genetic perspective, the assessment of sperm DNA fragmentation (SDF) is important as a parameter of sperm quality. In this narrative study, we review and discuss pathophysiological causes, DNA repair mechanisms, and management of high SDF. We then summarize literature exploring the association between SDF and reproductive outcomes. Recent systematic reviews and meta-analyses have revealed a significant association between high SDF in AMAB individuals and adverse reproductive outcomes including embryo development, natural conception, intrauterine insemination, and invitro fertilization. However, the association with live birth rates and pregnancy rates following intracytoplasmic injection remains inconclusive. The disparities among quantitative assays, inconsistent reference range values, absent high-quality prospective clinical trials, and clinical heterogeneity in AMAB patients with elevated SDF represent the main limitations affecting SDF testing. The evaluation and management of SDF plays an important role in a subset of AMAB infertility, but widespread integration into clinical guidelines will require future high-quality clinical trials and assay standardization.

SAM: A Mechanism to Facilitate Smear-Aware Forensic Analysis of Volatile System Memory

Page smear is a phenomenon that occurs when a system’s volatile memory dump is obtained in a non-atomic manner; it’s more common in systems with a lot of RAM and different workloads. It has a considerable impact on the quality and reliability of the forensic artifacts obtained, as well as the analysis of such snapshots. We present SAM, a timeline-based page table state information collection mechanism that enables a reliable memory analysis. It facilitates visualizing inconsistencies in the page table data structure and provides the investigator with a reliable source of page table information to deal with the inconsistent values.