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Background: The effective management of epilepsy in women of child-bearing age necessitates a concerted effort from multidisciplinary teams. Nevertheless, there exists an inadequacy in the seamless exchange of knowledge among healthcare providers within this context. Consequently, it is imperative to enhance the availability of informatics resources and the development of decision support tools to address this issue comprehensively. Materials and methods: The development of the Women with Epilepsy of Child-Bearing Age Ontology (WWECA) adhered to established ontology construction principles. The ontology's scope and universal terminology were initially established by the development team and subsequently subjected to external evaluation through a rapid Delphi consensus exercise involving domain experts. Additional entities and attribute annotation data were sourced from authoritative guideline documents and specialized terminology databases within the respective field. Furthermore, the ontology has played a pivotal role in steering the creation of an online question-and-answer system, which is actively employed and assessed by a diverse group of multidisciplinary healthcare providers. Results: WWECA successfully integrated a total of 609 entities encompassing various facets related to the diagnosis and medication for women of child-bearing age afflicted with epilepsy. The ontology exhibited a maximum depth of 8 within its hierarchical structure. Each of these entities featured three fundamental attributes, namely Chinese labels, definitions, and synonyms. The evaluation of WWECA involved 35 experts from 10 different hospitals across China, resulting in a favorable consensus among the experts. Furthermore, the ontology-driven online question and answer system underwent evaluation by a panel of 10 experts, including neurologists, obstetricians, and gynecologists. This evaluation yielded an average rating of 4.2, signifying a positive reception and endorsement of the system's utility and effectiveness. Conclusions: Our ontology and the associated online question and answer system hold the potential to serve as a scalable assistant for healthcare providers engaged in the management of women with epilepsy (WWE). In the future, this developmental framework has the potential for broader application in the context of long-term management of more intricate chronic health conditions. [ABSTRACT FROM AUTHOR]

Background: Epilepsy comorbidities adversely affect the quality of life of patients. Women with epilepsy are at a high risk of comorbid endocrine disorders. Among them, the polycystic ovary syndrome (PCOS) has a threefold higher prevalence in women with epilepsy than in healthy women and is the main cause of infertility among the patients. Clinically, women with epilepsy show heterogeneity in the susceptibility to PCOS. This heterogeneity may be associated with genetic factor. Methods: To test this, we retrospectively collected clinical data from 45 female patients with epilepsy and divided them into three groups according to their susceptibility to PCOS. Groups A and B represented a high susceptibility to PCOS. Patients in Group A were diagnosed with PCOS before their first seizure, while patients in Group B were diagnosed with PCOS after a short period of monotherapy with a low dose of antiseizure medication (ASM) following the diagnosis of epilepsy. Patients in Group C did not develop PCOS despite a prolonged treatment with high-dose ASM. We compared the clinical data and genetic profiles among the three groups. Results: We found a clear trend of impaired metabolism in Group B patients and this may be associated with high-frequency mutations in MYO10 and ADGRL3. Conclusions: Our study suggests that women with epilepsy are heterogeneous in the susceptibility to PCOS and this is associated with mutations in specific genes. Therefore, genetic screening should be conducted to screen for women with epilepsy who are more likely to have comorbid PCOS, so that they can receive targeted interventions at an early stage to reduce the risk. [ABSTRACT FROM AUTHOR]

China's 2060 carbon neutrality goal has significant implications for energy, water, and land systems. However, the multi-sector dynamics among China's energy-water-land system have rarely been examined explicitly. This study adopts an integrated assessment framework to simulate China's energy-water-land system co-evolution under alternative carbon neutrality scenarios and climate impacts. Results show that although the net zero emission target provides the incentive for the energy system to move away from fossil fuels, total water withdrawal will increase due to the deployment of nuclear, bioenergy, and coal power plants with carbon capture and storage. Diversifying the negative emission technologies, by leveraging direct air capture technology, can alleviate the potential water stress and land use conflicts, which would otherwise be exacerbated by large-scale deployment of afforestation and bioenergy with carbon capture and storage. Northwest and northeast regions of China are the hotspots experiencing water withdrawal increases, while Bohai Rim and coastal regions are identified to experience fierce land competition. This study demonstrates the potential for general applicability to carry out resource planning and policy evaluation from the multi-sector coordination perspective. • Water-intensive electricity generation technologies drive up water withdrawal. • Diversifying negative emission technologies can reduce the impacts on water system. • Climate policy imposes more significant impacts than climate change. • Water withdrawal increases concentrate in Northwestern and Northeastern China. • Land competition mostly occurs in China's population-dense area. [ABSTRACT FROM AUTHOR]

Background: Obtaining and describing semiology efficiently and classifying seizure types correctly are crucial for the diagnosis and treatment of epilepsy. Nevertheless, there exists an inadequacy in related informatics resources and decision support tools., Objective: We developed a symptom entity extraction tool and an epilepsy semiology ontology (ESO) and used machine learning to achieve an automated binary classification of epilepsy in this study., Methods: Using present history data of electronic health records from the Southwest Epilepsy Center in China, we constructed an ESO and a symptom-entity extraction tool to extract seizure duration, seizure symptoms, and seizure frequency from the unstructured text by combining manual annotation with natural language processing techniques. In addition, we achieved automatic classification of patients in the study cohort with high accuracy based on the extracted seizure feature data using multiple machine learning methods., Results: Data included present history from 10,925 cases between 2010 and 2020. Six annotators labeled a total of 2500 texts to obtain 5844 words of semiology and construct an ESO with 702 terms. Based on the ontology, the extraction tool achieved an accuracy rate of 85% in symptom extraction. Furthermore, we trained a stacking ensemble learning model combining XGBoost and random forest with an F1-score of 75.03%. The random forest model had the highest area under the curve (0.985)., Conclusions: This work demonstrated the feasibility of natural language processing-assisted structural extraction of epilepsy medical record texts and downstream tasks, providing open ontology resources for subsequent related work., (© Yilin Xia, Mengqiao He, Sijia Basang, Leihao Sha, Zijie Huang, Ling Jin, Yifei Duan, Yusha Tang, Hua Li, Wanlin Lai, Lei Chen. Originally published in JMIR Medical Informatics (https://medinform.jmir.org).)

Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by vascular thrombosis and obstetric morbidity, with accurate laboratory examination of antiphospholipid antibodies (aPLs) being crucial for diagnosis. This study focused on anti-β2 glycoprotein I (aβ2GPI) antibodies and aimed to establish the first population-based cutoff values for aβ2GPI IgA/IgM/IgG antibodies in non-pregnant women of reproductive age in Southwest China. The study cohort comprised 181 healthy women of reproductive age for study. Blood samples were collected on an early morning fast. Anti-β2GPI antibodies including IgA, IgM and IgG were measured in serum using the HOB ® BioCLIA kit. According to the Clinical and Laboratory Standards Institute (CLSI) guidelines, the study used non-parametric percentile methods to calculate the 95th, 97.5th, and 99th percentiles cutoff values for aβ2GPI IgA/IgM/IgG antibodies, along with corresponding 90% confidence intervals (CI), while excluding outliers. A total of 168 independent samples were collected for verification, including 85 samples from healthy subjects and 83 samples from APS patients, in order to evaluate the analytical performance of the obtained cutoff values. The 99th percentile cutoff values were 3.36 RU/mL for aβ2GPI IgA, 27.54 RU/mL for aβ2GPI IgM and 1.81 RU/mL for aβ2GPI IgG, which indicated that the levels of aβ2GPI IgM antibodies were generally higher compared to those of IgA and IgG antibodies. Our established reference range was confirmed to be successful in validating the detected values of aβ2GPI antibodies in all healthy controls. With the 99th percentile cutoff value, the sensitivity was 14.46% for aβ2GPI IgA, 22.89% for aβ2GPI IgG, and 9.64% for aβ2GPI IgM in APS patients. This study established population-based cutoff values that are applicable to the local population for the accurate laboratory examination of aβ2GPI antibodies in non-pregnant women of reproductive age. The study also recommends paying more attention to IgM positivity in women of reproductive age., (© 2024. The Author(s).)

There is presently no efficient dose individualization strategy for the use of antiseizure medications in epileptic pregnant patients. This study aimed to develop a population pharmacokinetics model for levetiracetam and propose a tailored adaptive individualized dosage strategy for epileptic pregnant patients. A total of 322 levetiracetam plasma concentrations from 238 patients with epilepsy were included, including 216 women with epilepsy (20.83% of whom were pregnant). The levetiracetam plasma concentration was measured using a validated ultra-performance liquid chromatography-tandem mass spectrometry assay, and the data were modeled using a nonlinear mixed-effects model. The resultant model served as the basis for simulating the dosage adjustment strategy. A one-compartment model with first-order elimination best described the pharmacokinetic data of levetiracetam. The apparent clearance (CL/F) was 3.43 L/h (95% CI 3.30-3.56) and the apparent volume of distribution was 43.7 L (95% CI 40.4-47.0) for a typical individual of 57.2 kg. Pregnancy and body weight were found to be significant covariates of CL/F of levetiracetam. The recommended regimen of levetiracetam could be predicted by the population pharmacokinetic model based on body weight, gestational age, and the daily dose of levetiracetam taken before pregnancy., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 American Pharmacists Association. Published by Elsevier Inc. All rights reserved.)

Abstract: We aimed to assess the respiratory virus characteristics and forecasts among young children with acute respiratory tract infection (ARTI) in west China.This retrospective study investigated the epidemic characteristics of respiratory viruses among 11,813 paediatric ARTI patient samples (mean age, 2.25 years) between March 2018 and March 2020.The ratio of boys to girls was 1.36. The 2 predominant viruses were influenza (Flu) A and respiratory syncytial virus (RSV) in both years, with Flu A accounting for 47.3% and 47.5% in the first and second years and RSV accounting for 32.7% and 24.7% of the positive samples in the first and second years, respectively. The Flu B positive rates were 10.9% and 13.1%, and those of the other 4 viruses were <7%. The most common virus was RSV in children below 5 years and Flu A in those between 5 and 10 years. Flu A and RSV demonstrated pronounced seasonality, and their infection rates increased from October. During the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic, isolation measures led to a decline in the number of ARTI cases.This study provides surveillance data of the respiratory viruses in west China. It could guide medical staff in implementing necessary prevention and management strategies before future viral outbreaks., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Customer satisfaction is a key quality indicator of laboratory service. Patients and physicians are the ultimate customers in medical laboratory, and their opinions are essential components in developing a customer-oriented laboratory., Methods: A longitudinal investigation of customer satisfaction was conducted through questionnaires. We designed two different questionnaires and selected 1200 customers (600 outpatients and 600 physicians) to assess customer satisfaction every other year from 2012 to 2016. Items with scores <4 were considered unsatisfactory, and corrective actions should be taken., Results: The completion rates of physicians were 96.8% in 2012, 97% in 2014 and 96.5% in 2016, whereas the rates of patients were 95.3%, 96.2% and 95.2%, respectively. In 2012, the most dissatisfaction items were test turnaround time (3.77 points) and service attitude (3.87 points) from physicians, whereas waiting time (3.58 points) and examination environment (3.64 points) were the most dissatisfaction items from patients. After corrective actions were taken, the result of satisfaction in 2014 was better, which illustrated our strategy was effective. However, some items remained to be less than 4, so we repeated the survey after modifying questionnaires in 2016. However, the general satisfaction points of the physicians and patients reduced in 2016, which reminded us of some influential factors we had neglected., Conclusions: By using dynamic survey of satisfaction, we can continuously find deficiencies in our laboratory services and take suitable corrective actions, thereby improving our service quality.