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The emergence of precision oncology approaches has begun to inform clinical decision-making in diagnostic, prognostic, and treatment contexts. High-throughput technology has enabled machine learning algorithms to use the molecular characteristics of tumors to generate personalized therapies. However, precision oncology studies have yet to develop a predictive biomarker incorporating pan-cancer gene expression profiles to stratify tumors into similar drug sensitivity profiles. Here we show that a neural network with ten hidden layers accurately classifies pancancer cell lines into two distinct chemotherapeutic response groups based on a pan-drug dataset with 89.0% accuracy (AUC = 0.904). Using unsupervised clustering algorithms, we found a cohort of cell line gene expression data from the Genomics of Drug Sensitivity in Cancer could be clustered into two response groups with significant differences in pan-drug chemotherapeutic sensitivity. After applying the Boruta feature selection algorithm to this dataset, a deep learning model was developed to predict chemotherapeutic response groups. The model’s high classification efficacy validates our hypothesis that cell lines with similar gene expression profiles present similar pan-drug chemotherapeutic sensitivity. This finding provides evidence for the potential use of similar combinatorial biomarkers to select potent candidate drugs that maximize therapeutic response and minimize the cytotoxic burden. Future investigations should aim to recursively subcluster cell lines within the response clusters defined in this study to provide a higher resolution of potential patient response to chemotherapeutics.

Objectives To test if two e-learning modules – one on cognitive impairment, and one on continence and mobility – in older people would improve the knowledge of nurse members from the Canadian Gerontological Nurses Association and College of Licensed Practical Nurses of Alberta. Methods A pre-post-test design was used to test 88 nurses’ knowledge of cognitive impairment and 105 nurses’ knowledge of continence and mobility and their perceptions of how the modules contributed to their learning. Results There was a statistically significant increase in practicing nurses’ knowledge about cognitive impairment (0.68 increase), continence (2.30 increase), and its relationship to mobility. Nurses’ self-report on the feedback survey demonstrated increases in knowledge, confidence, and perceptions about older people. Conclusion These results suggest the modules have strong potential to enhance practicing nurses’ knowledge about cognitive impairment, continence, and mobility.

Background The Canadian province of Alberta released the ABTraceTogether smartphone app in May 2020 to assist in contact tracing during the SARS-CoV-2 pandemic. Public engagement with this public health tool has been low, limiting the effectiveness of the intervention. This study examines physician knowledge of the app and practice patterns in relation to the app. Methods We conducted a cross-sectional self-administered online English language survey of physicians and medical students in Alberta, Canada. The survey link was sent to all registered members of the College of Physicians and Surgeons of Alberta and was distributed by other provincial physician organizations and health zone leaders. Results The survey received 317 responses. 96% of participants were aware of the app but only 27% had recommended the app to patients. The most common reason provided for not downloading or recommending the app was that participants had security concerns about the app. 23% of participants indicated they did not believe they had a responsibility to recommend the app to others. Conclusions Our study provides insights into participants’ knowledge and beliefs about the ABTraceTogether app. This information may be valuable to public health officials who wish to engage physicians in future public health campaigns.

In this paper, we discuss a family of robust, high-dimensional regression models for quantile and composite quantile regression, both with and without an adaptive lasso penalty for variable selection. We reformulate these quantile regression problems and obtain estimators by applying the alternating direction method of multipliers (ADMM), majorize-minimization (MM), and coordinate descent (CD) algorithms. Our new approaches address the lack of publicly available methods for (composite) quantile regression, especially for high-dimensional data, both with and without regularization. Through simulation studies, we demonstrate the need for different algorithms applicable to a variety of data settings, which we implement in the cqrReg package for R. For comparison, we also introduce the widely used interior point (IP) formulation and test our methods against the IP algorithms in the existing quantreg package. Our simulation studies show that each of our methods, particularly MM and CD, excel in different settings such as with large or high-dimensional data sets, respectively, and outperform the methods currently implemented in quantreg. The ADMM approach offers specific promise for future developments in its amenability to parallelization and scalability., Comment: 24 pages (including 2 appendices), 4 tables

To identify and characterize the incidence and correlates of open-globe injuries documented at the Eye Institute of Alberta (EIA) at the Royal Alexandra Hospital in Edmonton.A 10-year single-centre retrospective chart review.All patients who underwent traumatic open-globe injury repair at EIA from January 2009-December 2018 were identified using key search terms. Charts were individually assessed for key demographic variables, including mechanism and location of injury. Patterns in open-globe injury incidence over the 10-year period and across demographics were assessed using Poisson regression. Associations between key demographic variables also were analyzed.In total, 551 traumatic open-globe injuries were treated at the EIA from January 2009-December 2018, resulting in an average of 4.63 injuries per month over the 10-year period. Mean patient age was 42 ± 21.56 years. The number of males (n = 442) presenting for open-globe injury repair was 3.9 times higher than that for females (n = 114). Among patients for whom use of eye protection was recorded (n = 186), only 11% reported using eye protection at the time of the trauma. The incidence rate of injuries with zone 3 involvement was significantly higher in males (41.4%) than in females (29.8%).Open-globe injuries remain a significant source of ocular morbidity at EIA, averaging just over 1 emergency case a week. Given the strong association with sex and the infrequent use of eye protection, targeted public health strategies are necessary to mitigate the risk of these sight-threatening injuries.

Background Despite older people being the largest demographic accessing health care, nurses often lack knowledge about how to work with them and may hold ageist perceptions towards them. Previous research has identified the gaps in their education program and offered suggestions on what and how to fill those gaps in education related to older people. E-learning activities to fill these gaps were developed. Objective The aim of this study was to determine if nursing students' perceptions about older people could be improved through an e-learning activity focused on communication and understanding older people. Methods A quasi-experimental pre-post design was used to test whether the understanding and communication with older people e-learning activity improved student nurses' perceptions about older people. A feedback survey was also analyzed using descriptive statistics to understand students' perceptions of the learning activity. Results There was a statistically significant decrease in participant's negative perceptions towards older people after completing the e-learning activity. Participants enjoyed the activity and believed that it improved their knowledge of older people, their confidence in working with older people, and their perceptions about older people. Conclusions The strength of the e-learning activity in this study is that the educator need not be an expert in order to use the activity in their course. In this way, knowledge about older people is facilitated despite the dearth of nurse educators with gerontological expertise. More research to test this activity in other universities is needed. Implications for practice Improved understanding and communicating with older people could improve person-centered-care. The flexible delivery of this learning activity could facilitate practicing nurses understanding and communication strategies if offered to them.

Navigating copyright issues can be frustrating to the point of causing anxiety, potentially discouraging or inhibiting legitimate uses of copyright-protected materials. A lack of data about the extent and impact of these phenomena, known as copyright anxiety and copyright chill, respectively, motivated the authors to create the Copyright Anxiety Scale (CAS). This article provides an overview of the CAS’s development and validity testing. Results of an initial survey deployment drawing from a broad cross-section of respondents living in Canada and the United States (n = 521) establishes that the phenomenon of copyright anxiety is prevalent and likely associated with copyright chill.

In attempt to provide a practical guide to handling missing birthdate information, this paper examines the strategy proposed by Hu and Rosychuk (2016) for estimating age-varying effects in a margin...

Summary Despite interest in the joint modeling of multiple functional responses such as diffusion properties in neuroimaging, robust statistical methods appropriate for this task are lacking. To address this need, we propose a varying coefficient quantile regression model able to handle bivariate functional responses. Our work supports innovative insights into biomedical data by modeling the joint distribution of functional variables over their domains and across clinical covariates. We propose an estimation procedure based on the alternating direction method of multipliers and propagation separation algorithms to estimate varying coefficients using a B-spline basis and an $L_2$ smoothness penalty that encourages interpretability. A simulation study and an application to a real-world neurodevelopmental data set demonstrates the performance of our model and the insights provided by modeling functional fractional anisotropy and mean diffusivity jointly and their association with gestational age and sex.

Stigma is commonly experienced by people living with HIV/AIDS and by those providing care to HIV/AIDS patients. Few intervention studies have explored the impact of workplace policies and/or quality improvement on stigma. We examine the contribution of health care workplace policies, procedures and quality assurance initiatives, and self- and peer-assessed individual nurse practices, to nurse-reported HIV/AIDS-stigma practices toward patients living with HIV/AIDS and nurses in health care settings. Our sample of survey respondents (n = 1157) included managers (n = 392) and registered/enrolled nurses (n = 765) from 29 facilities in 4 countries (South Africa, Uganda, Jamaica, Kenya). This is one of the first studies in LMIC countries to use hierarchical linear modeling to examine the contributions of organizational and individual factors to HIV/AIDS stigma. Based on our results, we argue that organizational interventions explicitly targeting HIV/AIDS stigma are required to reduce the incidence, prevalence and morbidity of HIV/AIDS.

BACKGROUND Nurses often lack the knowledge and expertise to work with older people with cognitive impairment, which includes dementia, delirium and depression. This is due in part to deficits in their basic nursing education related to older people and managing the care needs of people with cognitive impairment. We developed an e-learning activity to facilitate student nurses' knowledge of cognitive impairment. OBJECTIVES To test if the e-learning activity could improve student nurses' knowledge of cognitive impairment and whether they would find the style of learning beneficial. DESIGN A quasi-experimental pre-post-test design was used to test if the cognitive impairment e-learning activity could improve student nurses' knowledge about assessing and managing the needs of older people who are experiencing cognitive impairment. A 12-item true/false quiz was completed by participants. SETTINGS One large Western Canadian university. PARTICIPANTS Second year nursing students in the four-year baccalaureate degree program, second year nursing students in the bilingual four-year baccalaureate degree program, and first year nursing students in the two-year after-degree nursing program were invited to participate. Data from 166 students were included in the analysis (n = 166). RESULTS Based on the results of a paired t-test (p

BackgroundUse of interleukin-17 inhibitors (IL-17i) in psoriasis has been associated with an increased risk of inflammatory bowel disease (IBD). However, the clinical significance of this association is not understood.ObjectivesTo quantify the absolute risk of IBD in patients with psoriasis treated with IL-17i, stratified by known IBD risk factors.MethodsLiterature searches were performed to identify known IBD risk factors and the prevalences were quantified by a meta-analysis of proportions. The Bayesian model was used to estimate the probability of a new-onset or a flare of IBD in patients with psoriasis.ResultsThe prevalence of Crohn’s disease (CD) or ulcerative colitis (UC) in the general psoriasis population was 0.0010. Use of IL-17i increased the risk of CD to 0.0037 and UC to 0.0028, translating to a number needed to harm (NNH) of 373 for CD and 564 for UC. In patients who had concomitant hidradenitis suppurativa, the use of IL-17i was associated with a decrease in NNH for CD and UC to 18 and 76, respectively, whereas for patients with a family history of IBD, the NNH values were 6 (for CD) and 10 (for UC).ConclusionsIn patients with no risk factors, the probability of IBD flare or onset during IL-17i treatment is negligible and additional IBD screening procedures are not indicated. In contrast, the patients with psoriasis who have hidradenitis suppurativa or first-degree family history of IBD as risk factors should be monitored for signs and symptoms of CD and UC during IL-17i therapy.

While one-dimensional persistent homology can be an effective way to discriminate data, it has limitations. Multidimensional persistent homology is a technique amenable to data naturally described by more than a single parameter, and is able to encoding more robust information about the structure of the data. However, as indicated by Carlsson and Zomorodian (Discrete Comput Geom 42(1):71–271, 2009), no perfect higher-dimensional analogue of the one-dimensional persistence barcode exists for higher-dimensional filtrations. Xia and Wei (J Comput Chem 36:1502–1520, 2015) propose computing one-dimensional Betti number functions at various values of a second parameter and stacking these functions for each homological dimension. The aim of this visualization is to increase the discriminatory power of current one-dimensional persistence techniques, especially for datasets that have features more readily captured by a combination of two parameters. We apply this practical approach to three datasets, relating to (1) craniofacial shape and (2) Lissajous knots, both using parameters for scale and curvature; and (3) the Kuramoto–Sivashinsky partial differential equation, using parameters for both scale and time. This new approach is able to differentiate between topologically equivalent geometric objects and offers insight into the study of the Kuramoto–Sivashinsky partial differential equation and Lissajous knots. We were unable to obtain meaningful results, however, in our applications to the screening of anomalous facial structures, although our method seems sensitive enough to identify patients at severe risk of a sleep disorder associated closely with craniofacial structure. This approach, though still in its infancy, presents new insights and avenues for the analysis of data with complex structure.