Read Codes Research Articles

Development of algorithms for determining heart failure with reduced and preserved ejection fraction using nationwide electronic healthcare records in the UK

BackgroundDetermining heart failure (HF) phenotypes in routine electronic health records (EHR) is challenging. We aimed to develop and validate EHR algorithms for identification of specific HF phenotypes, using Read codes...

Association between childhood maltreatment and atopy in the UK: A population based retrospective cohort study.

Childhood maltreatment affects over one in three children worldwide and is associated with a substantial disease burden. This study explores the association between childhood maltreatment and the development of atopic disease. We did a population-based retrospective matched open cohort study using participating general practices between 1st January 1995 and 30th September 2019. Read codes were utilised to identify patients exposed to childhood maltreatment (either suspected or confirmed) who were matched to up to four unexposed patients by age, sex, general practice, and Townsend deprivation quintile. Cox regression analysis was used to calculate adjusted (age, sex, Townsend deprivation quintile) hazard ratios (aHR) for development of atopy (asthma, atopic dermatitis, or allergic rhino conjunctivitis) during follow up in those without atopy at study entry. 183,897 exposed patients were matched to 621,699 unexposed patients. During the follow up period, 18,555 patients (incidence rate (IR) 28.18 per 1000 person-years) in the exposed group developed atopic disease compared to the 68,368 (IR 23.58 per 1000 person-years) in the unexposed group, translating to an adjusted HR of 1.14 (95% CI 1.12-1.15). Notably, the risk of developing asthma was aHR 1.42 (95% CI 1.37-1.46). Associations were more pronounced in analyses restricted to females and confirmed cases of childhood maltreatment only. Considering the substantial health burden associated with childhood maltreatment, it is important to implement public health policies aimed at enhancing: 1) detection and primary prevention of childhood maltreatment, 2) secondary and tertiary prevention interventions to reduce the burden of ill health associated with exposure to maltreatment and 3) clinical awareness of such associations and subsequent knowledge of management. None.

Persistent Orofacial Pain Attendances at General Medical Practitioners

Patients with persistent orofacial pain (POFP) can go through complex care pathways to receive a diagnosis and management, which can negatively affect their pain. This study aimed to describe 44-y trends in attendances at Welsh medical practices for POFP and establish the number of attendances per patient and referrals associated with orofacial pain and factors that may predict whether a patient is referred. A retrospective observational study was completed using the nationwide Secure Anonymised Information Linkage Databank of visits to general medical practices in Wales (UK). Data were extracted using diagnostic codes (“Read codes”). Orofacial and migraine Read codes were extracted between 1974 and 2017. Data were analyzed using descriptive statistics and univariate and multivariable logistic regression. Over the 44-y period, there were 468,827 POFP and migraine diagnostic codes, accounting for 468,137 patient attendances, or 301,832 patients. The overall attendance rate was 4.22 attendances per 1,000 patient-years (95% confidence interval [CI], 4.21–4.23). The attendance rate increased over the study period. Almost one-third of patients (n = 92,192, 30.54%) attended more than once over the study period, and 15.83% attended more than once within a 12-mo period. There were 20,103 referral codes that were associated with 8,183 patients, with over half these patients being referred more than once. Odds of receiving a referral were highest in females (odds ratio [OR], 1.23; 95% CI, 1.17–1.29), in those living in rural locations (OR, 1.17; 95% CI, 1.12–1.22), and in the least deprived quintile (OR, 1.39; 95% CI, 1.29–1.48). Odds also increased with increasing age (OR, 1.03; 95% CI, 1.03–1.03). The increasing attendance may be explained by the increasing incidence of POFP within the population. These patients can attend on a repeated basis, and very few are referred, but when they are, this may occur multiple times; therefore, current care pathways could be improved.

Angiotensin receptor blockade is associated with increased risk of giant cell arteritis.

Angiotensin II is implicated in GCA pathology. We examined whether the use of angiotensin receptor blockers (ARBs) is associated with GCA risk compared with angiotensin-converting enzyme inhibitors (ACEis) or other antihypertensives. We performed a matched cohort study including adults who were initiators of antihypertensives in UK primary care data between 1995 and 2019. Treatment-naïve individuals without prior GCA or PMR were categorized into three groups-ARB initiators, ACEi initiators, or other antihypertensive initiators (beta-blockers, calcium channel blockers, diuretics or alpha-adrenoceptor blockers)-and followed for up to 5 years. Incident GCA was defined using validated Read codes, with age of onset ≥50 years and two or more glucocorticoid prescriptions. Inverse probability-weighted Cox models were used to model outcome risk, adjusting for lifestyle parameters, comorbidities and comedications. Among >1 million new starters of antihypertensives (81 780 ARBs, 422 940 ACEis and 873 066 other antihypertensives), the incidence rate of GCA per 10 000 patient-years was 2.73 (95% CI 2.12, 3.50) in the ARB group, 1.76 (95% CI 1.25, 2.39) in the ACEi group and 1.90 (95% CI 1.37, 2.56) in the other antihypertensives group. The hazard of GCA was higher in ARB initiators [hazard ratio (HR) 1.55; 95% CI 1.16, 2.06] than initiators of ACEis, but similar between initiators of other antihypertensives and ACEis (HR 1.08; 95% CI 0.87, 1.35). Initiation of ARBs is associated with a higher risk of GCA compared with ACEis or other antihypertensives. Mechanistic studies of angiotensin receptor biology will provide further clarity for our findings.

Rheumatoid arthritis, psoriatic arthritis, and axial spondyloarthritis epidemiology in England from 2004 to 2020: An observational study using primary care electronic health record data.

SummaryBackgroundContemporary data on rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritits (SpA) epidemiology in England are lacking. This knowledge is crucial to planning healthcare services. We updated algorithms defining patients with diagnoses of RA, PsA, and axial SpA in primary care and applied them to describe their incidence and prevalence in the Clinical Practice Research Datalink Aurum, an electronic health record (EHR) database covering ∼20% of England.MethodsAlgorithms for ascertaining patients with RA, axial SpA, and PsA diagnoses validated in primary care EHR databases using Read codes were updated (to account for the English NHS change to SNOMED CT diagnosis coding) and applied. Updated diagnosis and synthetic disease-modifying anti-rheumatic drug code lists were devised by rheumatologists and general practitioners. Annual incidence/point-prevalence of RA, PsA, and axial SpA diagnoses were calculated from 2004 to 2020 and stratified by age/sex.FindingsPoint-prevalence of RA/PsA diagnoses increased annually, peaking in 2019 (RA 0·779% [95% confidence interval (CI) 0·773, 0·784]; PsA 0·287% [95% CI 0·284, 0·291]) then falling slightly. Point-prevalence of axial SpA diagnoses increased annually (except in 2018/2019), peaking in 2020 (0·113% [95% CI 0·111, 0·115]). RA diagnosis annual incidence was higher between 2013-2019 (after inclusion in the Quality and Outcomes Framework, range 49·1 [95% CI 47·7, 50·5] to 52·1 [95% CI 50·6, 53·6]/100,000 person-years) than 2004-2012 (range 34·5 [95% CI 33·2, 35·7] to 40·0 [95% CI 38·6, 41·4]/100,000 person-years). Increases in the annual incidence of PsA/axial SpA diagnosis occurred following new classification criteria publication. Annual incidence of RA, PsA and axial SpA diagnoses fell by 40·1%, 67·4%, and 38·1%, respectively between 2019 and 2020, likely reflecting the COVID-19 pandemic's impact on their diagnosis.InterpretationRecorded RA, PsA, and axial SpA diagnoses are increasingly prevalent in England, underlining the importance of organising healthcare services to provide timely, treat-to-target care to optimise the health of >1% of adults in England.FundingNational Institute for Health and Care Research (NIHR300826).

Population estimates of obstructive and non-obstructive hypertrophic cardiomyopathy in the UK and Germany

Abstract Background While numerous publications have estimated the prevalence of diagnosed hypertrophic cardiomyopathy (HCM), none have quantified the real-world proportion of obstructive and non-obstructive HCM using nationally representative data sources in any European countries. Purpose To estimate the prevalence of diagnosed HCM and its subtypes in the UK and Germany. Methods Patients with HCM were identified in the UK from 01 Apr 2009 to 30 Oct 2020 and Germany from 2011 to 2019. UK patients with HCM were identified using electronic health records from the Clinical Practice Research Datalink (CPRD) primary care data linked with Hospital Episode Statistics (HES) secondary care data using ICD-10 (I42.1, I42.2), Read, Medcode, SNOMED, and OPCS codes. German patients with HCM were identified using a nationally representative administrative claims data pool (WIG2 Benchmark database) from several German Statutory Health Insurance (SHI)-insurances using ICD-10 and OPS codes. Obstructive HCM was identified as any obstructive HCM diagnosis, any HCM diagnosis with septal reduction therapy, and any HCM diagnosis and left ventricular outflow tract obstruction (LVOTO; not in German claims data). Non-obstructive HCM was any non-obstructive or unspecified HCM diagnosis without evidence of any obstructive HCM. Annual prevalence was calculated for each year in the respective study periods and average annual prevalence across the study period. Results The average annual prevalence rate of HCM was 4.15/10,000 in the UK and 8.61/10,000 in Germany, while the average annual prevalence rate of obstructive HCM was 2.84/10,000 in the UK and 4.18/10,000 in Germany (Table). The proportion of HCM that was obstructive HCM was 68% in the UK and 49% in Germany. The prevalence rates of diagnosed HCM and obstructive HCM tended to increase over time (Figure). Conclusion The prevalence of HCM, obstructive HCM and the proportion of HCM that is obstructive varied between the UK and Germany. The prevalence of HCM was generally consistent with previously published estimates. Although there are limitations with coding in administrative data, it is important to differentiate obstructive HCM from non-obstructive HCM given their unique treatments and disease progression and management, especially since at least 49–68% of HCM is obstructive. Funding Acknowledgement Type of funding sources: Private company. Main funding source(s): Bristol Myers-Squibb

OA35 Continuing specialist care into adulthood in young people with juvenile idiopathic arthritis: a retrospective cohort study using electronic health records in England

Introduction/BackgroundIt is estimated that juvenile idiopathic arthritis (JIA) persists into adulthood in at least one-third of patients, but it is unclear how frequently hospital services are used as young people move from paediatric to adult specialist services. This study aimed to describe characteristics related to continued specialist care in young people (YP) with JIA using electronic health records (EHR) in England.Description/MethodYP with JIA were identified from primary care EHR (Clinical Practice Research Datalink GOLD and Aurum databases combined) between 2003 and 2018. JIA was identified if they had a Read code for JIA and either > =3 Hospital Episode Statistics (HES) outpatient specialist care (rheumatology/ophthalmology) appointments or a HES inpatient admission coded with JIA, prior to age 16. Further, cases needed to have linkage to HES data, registration at the same GP for >1 year beyond age 18. Cases were followed from the earliest of first Read code or first HES outpatient appointment until leaving their GP or end of 2018. Continuity of specialist care was categorised into 3 groups by age of last specialist care appointment: prior to 16 years, 16 to 17 years, and 18 years and beyond. YP were considered discharged from specialist care (a proxy for disease remission) if they had > =1 year between the last appointment and end of study follow-up. Multinomial logistic regression model assessed if any demographic or comorbidity variables were associated with continuing specialist care category. Discussion/ResultsOf 666 YP eligible, 427 (64%) received specialist care beyond age 18, 90 (13%) had their last recorded contact between 16-17 years and 149 (22%) did not continue after 16 years. Patients characteristics are described in Table 1. Of those continuing beyond 18, 35% (n = 153) were subsequently discharged by study end date. Of all those discharged, 32% had a missed appointment recorded after the last visit attended suggesting failure to attend. In the regression model, female gender and a childhood diagnosis of uveitis were associated with continuing specialist care beyond age 18 compared to those discharged before age 16; respective adjusted odds ratio (95% confidence intervals) 1.84 (1.25, 2.72) and 2.23 (1.14, 4.35).OA35 Table 1Characteristics by continuing specialist care categorySpecialist care until <16 years (n = 149)Specialist care until 16-17 years (n = 90)Specialist care ≥ 18 years (n = 427)Age at first JIA code (%) 0 - 3 years 22 (14.8) 6 (6.7) 62 (14.5) 4 – 8 years 43 (28.9) 18 (20.0) 106 (24.8) 9 - 15 years 84 (56.4) 66 (73.3) 259 (60.7) Gender (%) Male 76 (51.0)39 (43.3)159 (37.2) Female 73 (49.0)51 (56.7)268 (62.8)Discharged (%) 149 (100.0) 90 (100.0) 153 (35.8) Age at last outpatient appointment attended if discharged (median [IQR]) 14.0 [12.8, 15.2]16.9 [16.5, 17.4]20.2 [18.7, 22.5]Key learning points/ConclusionOver two-third of patients with JIA continue to have hospital visits beyond age 18. Of those, however, approximately one-third were subsequently discharged or lost to follow up from adult specialist care. These data provide important information for YP with JIA and their families, as well as clinicians running, developing and planning young adult services in paediatric and adult rheumatology.

Quantum simulation with just-in-time compilation

Quantum technologies are moving towards the development of novel hardware devices based on quantum bits (qubits). In parallel to the development of quantum devices, efficient simulation tools are needed in order to design and benchmark quantum algorithms and applications before deployment on quantum hardware. In this context, we present a first attempt to perform circuit-based quantum simulation using the just-in-time (JIT) compilation technique on multiple hardware architectures and configurations based on single-node central processing units (CPUs) and graphics processing units (GPUs). One of the major challenges in scientific code development is to balance the level of complexity between algorithms and programming techniques without losing performance or degrading code readability. In this context, we have developed qibojit: a new module for the Qibo quantum computing framework, which uses a just-in-time compilation approach through Python. We perform systematic performance benchmarks between our JIT approach and a subset of relevant publicly available libraries for quantum computing. We show that our novel approach simplifies the complex aspects of the implementation without deteriorating performance.

FindICI: Using machine learning to detect linguistic inconsistencies between code and natural language descriptions in infrastructure-as-code

Linguistic anti-patterns are recurring poor practices concerning inconsistencies in the naming, documentation, and implementation of an entity. They impede the readability, understandability, and maintainability of source code. This paper attempts to detect linguistic anti-patterns in Infrastructure-as-Code (IaC) scripts used to provision and manage computing environments. In particular, we consider inconsistencies between the logic/body of IaC code units and their short text names. To this end, we propose FindICI a novel automated approach that employs word embedding and classification algorithms. We build and use the abstract syntax tree of IaC code units to create code embeddings used by machine learning techniques to detect inconsistent IaC code units. We evaluated our approach with two experiments on Ansible tasks systematically extracted from open source repositories for various word embedding models and classification algorithms. Classical machine learning models and novel deep learning models with different word embedding methods showed comparable and satisfactory results in detecting inconsistent Ansible tasks related to the top-10 used Ansible modules.

Phantom Study on the Robustness of MR Radiomics Features: Comparing the Applicability of 3D Printed and Biological Phantoms.

The objectives of our study were to (a) evaluate the feasibility of using 3D printed phantoms in magnetic resonance imaging (MR) in assessing the robustness and repeatability of radiomic parameters and (b) to compare the results obtained from the 3D printed phantoms to metrics obtained in biological phantoms. To this end, three different 3D phantoms were printed: a Hilbert cube (5 × 5 × 5 cm3) and two cubic quick response (QR) code phantoms (a large phantom (large QR) (5 × 5 × 4 cm3) and a small phantom (small QR) (4 × 4 × 3 cm3)). All 3D printed and biological phantoms (kiwis, tomatoes, and onions) were scanned thrice on clinical 1.5 T and 3 T MR with 1 mm and 2 mm isotropic resolution. Subsequent analyses included analyses of several radiomics indices (RI), their repeatability and reliability were calculated using the coefficient of variation (CV), the relative percentage difference (RPD), and the interclass coefficient (ICC) parameters. Additionally, the readability of QR codes obtained from the MR images was examined with several mobile phones and algorithms. The best repeatability (CV ≤ 10%) is reported for the acquisition protocols with the highest spatial resolution. In general, the repeatability and reliability of RI were better in data obtained at 1.5 T (CV = 1.9) than at 3 T (CV = 2.11). Furthermore, we report good agreements between results obtained for the 3D phantoms and biological phantoms. Finally, analyses of the read-out rate of the QR code revealed better texture analyses for images with a spatial resolution of 1 mm than 2 mm. In conclusion, 3D printing techniques offer a unique solution to create textures for analyzing the reliability of radiomic data from MR scans.

Exploring gender differences, medical history, and treatments used in patients with fibromyalgia in the UK using primary-care data: a retrospective, population-based, cohort study

<h2>Abstract</h2><h3>Background</h3> Fibromyalgia mainly affects women (80–90% of cases), but some contradictory studies have shown lower estimates (59% of cases affecting women). Psychosocial impacts of fibromyalgia are similar in men and women, but men delay seeking medical help. Subsequent revisions of the 1990 American College of Rheumatology fibromyalgia classification criteria removed the requirement for at least 11 of 18 tender point sites, which led to various prevalence estimates and women to men ratios in the general population. We aimed to measure new cases of fibromyalgia to determine whether the sex ratio has changed after criteria revisions and to explore the symptoms and treatment. <h3>Methods</h3> This retrospective, population-based, cohort study was done in the UK (Wales) using primary-care electronic health data from the Secure Anonymised Information Linkage. Individuals aged 18 years or older with a first mention of fibromyalgia using READ codes (N239 and N248) were included and stratified by gender, which was coded as men or women. Cases of fibromyalgia were calculated at three 5-year periods (period 1 defined as 2004–08, period 2 defined as 2009–13, and period 3 defined as 2014–18). Descriptive analyses were performed on variables according to gender. <h3>Findings</h3> Between Jan 1, 2004, and Dec 31, 2018, data on 22 568 individuals with fibromyalgia were extracted. The mean age of participants was 48 years (SD 13) and 20 040 (88·8%) were women. In period 1, among 5296 new cases of fibromyalgia, 784 (14·8%) were men and 4512 (85·2%) were women. In period 2, 642 (10·8%) of 5958 new cases were men and 5316 (89·2%) were women, and in period 3, 1102 (9·7%) of 11 314 new cases were men and 10 212 (90·3%) were women. Women had a significantly higher BMI than men (difference 1·6%, 95% CI 1·5–1·7; p<0·01) and more widespread pain based on READ code (2·9%, 95% CI 1·8–4·0; p<0·05). Men had significantly more comorbidities; however, women had more gastrointestinal disorders (difference of 10·0%, 95% CI 8·4–11·4; p<0·01). A significantly higher number of women received steroids (difference of 8·3%, 6·3–10·3; p<0·01), antidepressants (5·4%, 4·2–6·6; p<0·01), and anxiolytics and barbiturates (7·2%, 5·2–9·2; p<0·01), whereas more men received gabapentin (9%, 7·0–11·0; p<0·01). <h3>Interpretation</h3> Routine health data does not show an increase of fibromyalgia in men compared with women, despite revisions to classification criteria. Men had significantly more comorbidities, except for gastrointestinal disorders. The sex differences in fibromyalgia treatment might represent clinician or patient choice and are worth exploring in future studies. <h3>Funding</h3> None

Middle-out from Bottom-up: Engineering and Close Reading Code in HBO’s Silicon Valley

Middle-out from Bottom-up: Engineering and Close Reading Code in HBO’s Silicon Valley

Rise of the Androids: The Reflection of Developers’ Characteristics in Computerized Systems

AbstractDue to their speed and accuracy, computerized decision‐making and data‐analysis systems are often perceived to be close to the ideal of unbounded rationality. Challenging this perception, this study explores the possibility that computerized systems reflect the individual characteristics of the developers who have designed and realized them. Through the analysis of interviews with high‐frequency trading system developers and a survey of software developers working in diverse industries, it shows that developers’ characteristics, which have been related to bounded rationality (e.g. experience and expertise), influence their codes’ performance and errors. Computer codes also reflect the personal circumstances of the developers (e.g. deadlines and stress), and their values. However, whereas some developers value code characteristics that are congruent with the ideal of unbounded rationality, including speed and accuracy, others aim to achieve characteristics that could be incongruent with it (e.g. code readability and modularity). Developers’ roles and organizational practices, such as testing procedures and code reviews, limit the expression of their characteristics in their codes. Nevertheless, developers can be often identified by reading the codes. Highlighting that developers transfer some of their characteristics to their codes, this study identifies elements of bounded rationality in decision‐making systems and extends organizational decision‐making research.

To what extent are the mental health needs of children and young people (aged 11-18) in care being supported?

ObjectivesThe objective of this research is to provide updated data regarding the prevalence of mental health disorders within the population of care-experienced young people (aged 11-18) in Wales. Furthermore, pathways to referrals to specialist mental health services will be investigated, as well as subsequent engagement with these services. ApproachTen years of population-level routinely collected data that is available within an anonymised, information linkage databank will be used. Eight datasets will be examined; one that will provide information on the population of interest, three comparison groups, and four that contain clinical data. Statistical analyses will be conducted to investigate the prevalence of mental health disorders among care-experienced young people. Read codes, which are used to record clinical summary information, will be used to identify poor mental health. Free-text searches will also be conducted on all health-related datasets to improve identification of outcomes. ResultsExpected results include revised data of the mental health needs of care-experienced young people, with prevalence in this group compared to children and young people receiving professional support in the general population. Prevalence will be looked at in relation to changes across time, as well as across demographic characteristics, including gender, age, ethnicity, local authority, placement type, and number of moves within care. Outcomes after diagnosis of a mental health disorder will be analysed and, if an onward referral is made, the time from referral to service access will be shown, both at a national level and for local authorities. Number of referrals made at each local authority will also be shown. Lastly, young people’s engagement with mental health services will be studied. ConclusionIt is anticipated that findings will highlight the specific mental health needs of this group including contextual information about and in response to these needs. Findings are likely to have policy relevance by informing mental health inequality targets and strategic planning for improving outcomes for care-experienced young people.

Implementing the Calculations and Characterization of Underground Coal Gasification using Data Analytic Method

Indonesian coal production nowadays has reached 63% of total production, which means this high demand will also produce a lot of data. This high demand needs to be innovated as a new alternative energy based on coal production, Underground Coal Gasification (UCG). The coal in this alternative energy source is used to turn the solid coal into gas. Coal mining data has a lot of variables that might be difficult to process manually. Our automatic system will help the users, especially the geologists, identify which coal seams have the potential to be developed as the UCG. We developed the system using a python-based coding system and required data standardization to ease the built-in code reading and process all the required steps to identify the UCG. We implemented the calculation and characterization regarding the calorific value (ADB), proximate, and ultimate analysis from the provided data to find the needed variables for the UCG analytics system. The automatic system will allow the user to choose the interesting borehole that they want to identify. Our system then shows the initial UCG recommendation layer for the next analysis. From our experiment, our system finally found that at the depth of 260 meters, Borehole MJ02 has the potential as the initial guest of the recommendation layer of the UCG development. Doi: 10.28991/CEJ-SP2021-07-012 Full Text: PDF

An Automated Tool for Upgrading Fortran Codes

With archaic coding techniques, there will be a time when it will be necessary to modernize vulnerable software. However, redeveloping out-of-date code can be a time-consuming task when dealing with a multitude of files. To reduce the amount of reassembly for Fortran-based projects, in this paper, we develop a prototype for automating the manual labor of refactoring individual files. ForDADT (Fortran Dynamic Autonomous Diagnostic Tool) project is a Python program designed to reduce the amount of refactoring necessary when compiling Fortran files. In this paper, we demonstrate how ForDADT is used to automate the process of upgrading Fortran codes, process the files, and automate the cleaning of compilation errors. The developed tool automatically updates thousands of files and builds the software to find and fix the errors using pattern matching and data masking algorithms. These modifications address the concerns of code readability, type safety, portability, and adherence to modern programming practices.

A matched cohort study investigating premature, accentuated, and accelerated aging in people living with HIV.

The impact of HIV infection on the aging process is disputed and largely unknown. We aimed to identify whether people living with HIV experience premature, accelerated, and/or accentuated aging by investigating the development of four age-related non-communicable diseases in people living with versus without HIV. This population-based matched cohort study design used UK-based primary care electronic health records from the IQVIA Medical Research Database. Between January 2000 and January 2020, all people living with and without HIV aged ≥18 years were eligible. Outcomes included cardiovascular disease (CVD), hypertension, type 2 diabetes mellitus (T2DM), and chronic kidney disease (CKD), which were identified by Read codes. We used age at diagnosis to investigate premature aging and age at exit date to investigate accentuation and acceleration. For each outcome, people with and without HIV were excluded if they had the outcome of interest at baseline. Participants were matched based on propensity scores (1:1 ratio). Linear regression was used to report any difference in age at diagnosis between the two groups and to report the prevalence trends for age at exit date. In total, 8880 people living with HIV were matched with 8880 people without HIV and were found to have an earlier onset of CVD (54.5 vs. 56.8; p = 0.002). Similarly, people living with HIV had an earlier onset of hypertension (49.7 vs. 51.4; p = 0.002). No difference was found for T2DM or CKD (53.4 vs. 52.6; p = 0.368 and 57.6 vs. 58.1; p = 0.483, respectively). The burden of CKD increased over time, whereas no difference in the burden was found for the other conditions. The earlier development of CVD and hypertension in people living with HIV than in those without HIV indicates premature aging, whereas the increased burden of CKD indicates accelerated aging.

Preparing First-Year Engineering Students to Think About Code: A Guided Inquiry Approach

In the wake of the so-called fourth industrial revolution, computer programming has become a foundational competency across engineering disciplines. Yet engineering students often resist the notion that computer programming is a skill relevant to their future profession. Here are presented two activities aimed at supporting the early development of engineering students’ attitudes and abilities regarding programming in a first-year engineering course. Both activities offer students insights into the way programs are constructed, which have been identified as a source of confusion that may negatively affect acceptance. In the first activity, a structured, language-independent way to approach programming problems through guided questions was introduced, which has previously been used successfully in introductory computer science courses. The team hypothesized that guiding students through a structured reflection on how they construct programs for their class assignments might help reveal an understandable structure to them. Results showed that students in the intervention group scored nearly a full letter grade higher on the unit’s final programming assessment than those in the control condition. The second activity aimed to help students recognize how their experience with MATLAB might help them interpret code in other programming languages. In the intervention group, students were asked to review and provide comments for code written in a variety of programming languages. A qualitative analysis of their reflections examined what skills students reported they used and, specifically, how prior MATLAB experience may have aided their ability to read and comment on the unfamiliar code. Overall, the ability to understand and recognize syntactic constructs was an essential skill in making sense of code written in unfamiliar programming languages. Syntactic constructs, lexical elements, and patterns were all recognized as essential landmarks used by students interpreting code they did not write, especially in new languages. Developing an understanding of the static structure and dynamic flow required of programs was also an essential skill which helped the students. Together, the results from the first activity and the insights gained from the second activity suggest that guided questions to build skills in reading code may help mitigate confusion about program construction, thereby better preparing engineering students for computing-intensive careers.

Image analysis and error detection in source software code

Subject of study. We study cognitive mechanisms for the analysis of images of source software code and detection of errors in it by a human. Aim. The aim of this study is to determine the influence of the professional skill of visual error detection in a Python source code on the control over oculomotor processes to be used for the subsequent modeling of the identified principles in artificial intelligence systems. Method. The eye movement properties of a human during error detection in the images of software code were investigated using eye movement tracking technology by means of the Russian software–hardware suite “Neurobureau,” which enabled a complete set of psychophysiological studies to be conducted. The test subjects completed two tasks: explaining the software code and finding an error in it. Each task comprised 10 stimuli with software code in Python language normalized to length and complexity and with syntax highlighting. The task completion time was not limited. Eight programmers with different professional experience (from 1 to 13 years) participated in the study. Main results. With increasing professional skill in image analysis, humans develop eye movement strategies enabling more effective performance of tasks with minimum effort. These strategies entail division of an integral software code into individual units relevant for the analysis. We discovered that experienced programmers exhibited fewer fixations, shorter scanpath length, and larger saccade amplitudes than novice programmers. Notably, the speed of saccades, in particular the broad searching eye movements during the task of software code explanation, increases with professional experience. We demonstrated that visual error detection is mainly determined by recognition of the details in a text that can be found exclusively based on the semantics and grammar of the programming language. We established that reading of software code texts is different from both viewing visual scenes and reading texts written in a natural language. Professional experience minimizes the efforts in this work, similar to any other type of professional activity. Eye movement control during code reading is guided by the knowledge of the programming language, understanding of context, and knowledge of the semantics and grammar of the language, as well as the low-spatial-frequency description of the images of strings and words, which is used to develop the skill of reading and recognition of the general configuration of strings and words in a natural language. Practical significance. The conclusions obtained in this study can be used to describe the existing techniques and create new neuromorphic algorithms (based on the strategies developed during human evolution) for the generation and correction of software code.

The health economic impact of cow's milk allergy in childhood: A retrospective cohort study.

BackgroundCow's milk allergy (CMA) is one of the most common food allergies among children. Whilst avoidance of cow's milk protein is the cornerstone of management, further treatment of symptoms including those affecting the gastrointestinal, skin and respiratory systems plus other allergic comorbidities, maybe required. This study aimed to quantify the wider economic impact of CMA and its management in the United Kingdom (UK).MethodsWe conducted a retrospective matched cohort study on children with CMA (diagnosis read code and/or hypoallergenic formula prescription for ≥3 months) examining healthcare data (medication prescriptions and healthcare professional contacts) from case records within The Health Improvement Network (A Cegedim Proprietary Database) in the UK. A comparative cost analysis was calculated based on healthcare tariff and unit costs in the UK.Results6998 children (54% male; mean observation period 4.2 years) were included (n = 3499 with CMA, mean age at diagnosis 4.04 months; n = 3499 matched controls without CMA). Compared to those without CMA, medications were prescribed to significantly more children with CMA (p < 0.001) at a higher rate (p < 0.001). Children with CMA also required significantly more healthcare contacts (p < 0.001) at higher rate (p < 0.001) compared to those without CMA. CMA was associated with additional potential healthcare costs of £1381.53 per person per year.ConclusionThe findings of this large cohort study suggest that CMA and its associated co‐morbidities presents a significant additional healthcare burden with economic impact due to higher prescribing of additional medications. Further research into management approaches that may impact these clinical and economic outcomes of CMA is warranted.