Background Pattern mining utilizes multiple algorithms to explore objective and sometimes unexpected patterns in real-world data. This technique could be applied to electronic medical record data mining; however, it first requires a careful clinical assessment and validation. Objective The aim of this study was to examine the use of pattern mining techniques on a large clinical dataset to detect treatment and medication use patterns for childhood pneumonia. Methods We applied 3 pattern mining algorithms to 680,138 medication administration records from 30,512 childhood inpatients with diagnosis of pneumonia during a 6-year period at a children’s hospital in China. Patients’ ages ranged from 0 to 17 years, where 37.53% (11,453/30,512) were 0 to 3 months old, 86.55% (26,408/30,512) were under 5 years, 60.37% (18,419/30,512) were male, and 60.10% (18,338/30,512) had a hospital stay of 9 to 15 days. We used the FP-Growth, PrefixSpan, and USpan pattern mining algorithms. The first 2 are more traditional methods of pattern mining and mine a complete set of frequent medication use patterns. PrefixSpan also incorporates an administration sequence. The newer USpan method considers medication utility , defined by the dose, frequency, and timing of use of the 652 individual medications in the dataset. Together, these 3 methods identified the top 10 patterns from 6 age groups, forming a total of 180 distinct medication combinations. These medications encompassed the top 40 (73.66%, 500,982/680,138) most frequently used medications. These patterns were then evaluated by subject matter experts to summarize 5 medication use and 2 treatment patterns. Results We identified 5 medication use patterns: (1) antiasthmatics and expectorants and corticosteroids, (2) antibiotics and (antiasthmatics or expectorants or corticosteroids), (3) third-generation cephalosporin antibiotics with (or followed by) traditional antibiotics, (4) antibiotics and (medications for enteritis or skin diseases), and (5) (antiasthmatics or expectorants or corticosteroids) and (medications for enteritis or skin diseases). We also identified 2 frequent treatment patterns: (1) 42.89% (291,701/680,138) of specific medication administration records were of intravenous therapy with antibiotics, diluents, and nutritional supplements and (2) 11.53% (78,390/680,138) were of various combinations of inhalation of antiasthmatics, expectorants, or corticosteroids. Fleiss kappa for the subject experts’ evaluation was 0.693, indicating moderate agreement. Conclusions Utilizing a pattern mining approach, we summarized 5 medication use patterns and 2 treatment patterns. These warrant further investigation.
Manufacturing API and pharmaceutical intermediates requires the development of scalable, safe, and environmentally friendly processes. Reactions with high exothermicity or otherwise hazardous in nature, as well as reactions involving the formation of unstable intermediates, can benefit from continuous processing. This technology has been broadly adopted across the pharmaceutical industry due to its intrinsic ability to operate at low reaction volumes, facilitate improved temperature control, and safely accommodate higher pressures. Two such industrially relevant examples are aromatic nitration and regioselective aryl ring metalation, followed by trapping with an electrophile. Both reaction classes commonly face scale-up challenges when performed in batch processing. The nitration reaction usually features a multiphase, mixing-sensitive reaction associated with a large exotherm that can lead to the formation of potentially hazardous overnitrated byproducts. Similarly, metalation reactions of aryl rings often require cryogenic conditions, which are challenging to achieve on scale. In this study, a mixing-limited solid−liquid−liquid (S−L−L) nitration reaction was evaluated to understand the transport phenomena. The determination of the Hatta number and impact of the impeller power on the kinetics enabled the design of a safe, scalable, high-yielding, and robust continuous stirred tank (CSTR) flow process. A study of critical formylation reaction parameters led to a first-generation tubular flow reactor design to process >10 kg of a substrate in the pilot plant. A more practical CSTR reactor system in series was developed to support a resupply delivery. This reactor configuration enabled superior temperature control, alleviated the risks associated with salt formation, and increased the throughput and yield.
The current literature suggests that tranexamic acid may be used to reduce postoperative blood loss in addition to reducing the risk of requiring blood transfusions following the surgical repair of hip fractures. Furthermore, it may have the potential to improve patient outcomes and decrease the overall costs of caring for this patient population. CONCLUSIONS CONCLUSIONS Further studies are needed to truly gauge the effect of tranexamic acid on long-term patient outcomes and hospital costs.
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