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We present a financial justification for an outpatient infectious diseases pharmacist, based on cost savings from decreases in length of stay for patients with Staphylococcus aureus infections and additional revenue generated by physicians and pharmacists while following patients discharged on outpatient parenteral antimicrobial therapy.
Background: The complement component C5 inhibitor, ravulizumab, is approved in Canada for the treatment of adults with AQP4-Ab+ NMOSD. Updated efficacy and safety results from the ongoing CHAMPION-NMOSD (NCT04201262) trial are reported. Methods: Participants received IV-administered, weight-based dosing of ravulizumab, with loading on day 1 and maintenance doses on day 15 and every 8 weeks thereafter. Following a primary treatment period (PTP; up to 2.5 years), patients could enter a long-term extension (LTE). Outcome measures included safety, time to first adjudicated on-trial relapse (OTR), risk reduction, and disability scores. Results: 56/41 patients entered/completed the LTE as of June 14, 2024. Median follow-up was 170.3 weeks (186.6 patient-years). No patients experienced an OTR. 94.8% (55/58 patients) had stable or improved Hauser Ambulation Index scores. 89.7% (52/58 patients) had no clinically important worsening in Expanded Disability Status Scale scores. Treatment-emergent adverse events (98.4%) were predominantly mild and unrelated to ravulizumab. Serious adverse events occurred in 25.9% of patients. Two cases of meningococcal infection occurred during the PTP, and none in the LTE. One unrelated death (cardiovascular) occurred during the LTE. Conclusions: Ravulizumab demonstrated long-term clinical benefit in AQP4-Ab+ NMOSD relapse prevention while maintaining or improving disability measures, with no new safety concerns.
Depression is a complex mental health disorder with highly heterogeneous symptoms that vary significantly across individuals, influenced by various factors, including sex and regional contexts. Network analysis is an analytical method that provides a robust framework for evaluating the heterogeneity of depressive symptoms and identifying their potential clinical implications.
Objective:
To investigate sex-specific differences in the network structures of depressive symptoms in Asian patients diagnosed with depressive disorders, using data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants, Phase 3, which was conducted in 2023.
Methods:
A network analysis of 10 depressive symptoms defined according to the National Institute for Health and Care Excellence guidelines was performed. The sex-specific differences in the network structures of the depressive symptoms were examined using the Network Comparison Test. Subgroup analysis of the sex-specific differences in the network structures was performed according to geographical region classifications, including East Asia, Southeast Asia, and South or West Asia.
Results:
A total of 998 men and 1,915 women with depression were analysed in this study. The analyses showed that all 10 depressive symptoms were grouped into a single cluster. Low self-confidence and loss of interest emerged as the most central nodes for men and women, respectively. In addition, a significant difference in global strength invariance was observed between the networks. In the regional subgroup analysis, only East Asian men showed two distinct clustering patterns. In addition, significant differences in global strength and network structure were observed only between East Asian men and women.
Conclusion:
The study highlights the sex-specific differences in depressive symptom networks across Asian countries. The results revealed that low self-confidence and loss of interest are the main symptoms of depression in Asian men and women, respectively. The network connections were more localised in men, whereas women showed a more diverse network. Among the Asian subgroups analysed, only East Asians exhibited significant differences in network structure. The considerable effects of neurovegetative symptoms in men may indicate potential neurobiological underpinnings of depression in the East Asian population.
Older adults with treatment-resistant depression (TRD) benefit more from treatment augmentation than switching. It is useful to identify moderators that influence these treatment strategies for personalised medicine.
Aims
Our objective was to test whether age, executive dysfunction, comorbid medical burden, comorbid anxiety or the number of previous adequate antidepressant trials could moderate the superiority of augmentation over switching. A significant moderator would influence the differential effect of augmentation versus switching on treatment outcomes.
Method
We performed a preplanned moderation analysis of data from the Optimizing Outcomes of Treatment-Resistant Depression in Older Adults (OPTIMUM) randomised controlled trial (N = 742). Participants were 60 years old or older with TRD. Participants were either (a) randomised to antidepressant augmentation with aripiprazole (2.5–15 mg), bupropion (150–450 mg) or lithium (target serum drug level 0.6 mmol/L) or (b) switched to bupropion (150–450 mg) or nortriptyline (target serum drug level 80–120 ng/mL). Treatment duration was 10 weeks. The two main outcomes of this analysis were (a) symptom improvement, defined as change in Montgomery–Asberg Depression Rating Scale (MADRS) scores from baseline to week 10 and (b) remission, defined as MADRS score of 10 or less at week 10.
Results
Of the 742 participants, 480 were randomised to augmentation and 262 to switching. The number of adequate previous antidepressant trials was a significant moderator of depression symptom improvement (b = −1.6, t = −2.1, P = 0.033, 95% CI [−3.0, −0.1], where b is the coefficient of the relationship (i.e. effect size), and t is the t-statistic for that coefficient associated with the P-value). The effect was similar across all augmentation strategies. No other putative moderators were significant.
Conclusions
Augmenting was superior to switching antidepressants only in older patients with fewer than three previous antidepressant trials. This suggests that other intervention strategies should be considered following three or more trials.
Artificial intelligence is dramatically reshaping scientific research and is coming to play an essential role in scientific and technological development by enhancing and accelerating discovery across multiple fields. This book dives into the interplay between artificial intelligence and the quantum sciences; the outcome of a collaborative effort from world-leading experts. After presenting the key concepts and foundations of machine learning, a subfield of artificial intelligence, its applications in quantum chemistry and physics are presented in an accessible way, enabling readers to engage with emerging literature on machine learning in science. By examining its state-of-the-art applications, readers will discover how machine learning is being applied within their own field and appreciate its broader impact on science and technology. This book is accessible to undergraduates and more advanced readers from physics, chemistry, engineering, and computer science. Online resources include Jupyter notebooks to expand and develop upon key topics introduced in the book.
The theory of kernels offers a rich mathematical framework for the archetypical tasks of classification and regression. Its core insight consists of the representer theorem that asserts that an unknown target function underlying a dataset can be represented by a finite sum of evaluations of a singular function, the so-called kernel function. Together with the infamous kernel trick that provides a practical way of incorporating such a kernel function into a machine learning method, a plethora of algorithms can be made more versatile. This chapter first introduces the mathematical foundations required for understanding the distinguished role of the kernel function and its consequence in terms of the representer theorem. Afterwards, we show how selected popular algorithms, including Gaussian processes, can be promoted to their kernel variant. In addition, several ideas on how to construct suitable kernel functions are provided, before demonstrating the power of kernel methods in the context of quantum (chemistry) problems.
In this chapter, we change our viewpoint and focus on how physics can influence machine learning research. In the first part, we review how tools of statistical physics can help to understand key concepts in machine learning such as capacity, generalization, and the dynamics of the learning process. In the second part, we explore yet another direction and try to understand how quantum mechanics and quantum technologies could be used to solve data-driven task. We provide an overview of the field going from quantum machine learning algorithms that can be run on ideal quantum computers to kernel-based and variational approaches that can be run on current noisy intermediate-scale quantum devices.
In this chapter, we introduce the field of reinforcement learning and some of its most prominent applications in quantum physics and computing. First, we provide an intuitive description of the main concepts, which we then formalize mathematically. We introduce some of the most widely used reinforcement learning algorithms. Starting with temporal-difference algorithms and Q-learning, followed by policy gradient methods and REINFORCE, and the interplay of both approaches in actor-critic algorithms. Furthermore, we introduce the projective simulation algorithm, which deviates from the aforementioned prototypical approaches and has multiple applications in the field of physics. Then, we showcase some prominent reinforcement learning applications, featuring some examples in games; quantum feedback control; quantum computing, error correction and information; and the design of quantum experiments. Finally, we discuss some potential applications and limitations of reinforcement learning in the field of quantum physics.
This chapter discusses more specialized examples on how machine learning can be used to solve problems in quantum sciences. We start by explaining the concept of differentiable programming and its use cases in quantum sciences. Next, we describe deep generative models, which have proven to be an extremely appealing tool for sampling from unknown target distributions in domains ranging from high-energy physics to quantum chemistry. Finally, we describe selected machine learning applications for experimental setups such as ultracold systems or quantum dots. In particular, we show how machine learning can help in tedious and repetitive experimental tasks in quantum devices or in validating quantum simulators with Hamiltonian learning.
In this chapter, we describe basic machine learning concepts connected to optimization and generalization. Moreover, we present a probabilistic view on machine learning that enables us to deal with uncertainty in the predictions we make. Finally, we discuss various basic machine learning models such as support vector machines, neural networks, autoencoders, and autoregressive neural networks. Together, these topics form the machine learning preliminaries needed for understanding the contents of the rest of the book.
In this chapter, we review the growing field of research aiming to represent quantum states with machine learning models, known as neural quantum states. We introduce the key ideas and methods and review results about the capacity of such representations. We discuss in details many applications of neural quantum states, including but not limited to finding the ground state of a quantum system, solving its time evolution equation, quantum tomography, open quantum system dynamics and steady-state solution, and quantum chemistry. Finally, we discuss the challenges to be solved to fully unleash the potential of neural quantum states.
In this chapter, we introduce the reader to basic concepts in machine learning. We start by defining the artificial intelligence, machine learning, and deep learning. We give a historical viewpoint on the field, also from the perspective of statistical physics. Then, we give a very basic introduction to different tasks that are amenable for machine learning such as regression or classification and explain various types of learning. We end the chapter by explaining how to read the book and how chapters depend on each other.