WRITING GROUP MEMBERS Emelia J. Benjamin, MD, SCM, FAHA Michael J. Blaha, MD, MPH Stephanie E. Chiuve, ScD Mary Cushman, MD, MSc, FAHA Sandeep R. Das, MD, MPH, FAHA Rajat Deo, MD, MTR Sarah D. de Ferranti, MD, MPH James Floyd, MD, MS Myriam Fornage, PhD, FAHA Cathleen Gillespie, MS Carmen R. Isasi, MD, PhD, FAHA Monik C. Jiménez, ScD, SM Lori Chaffin Jordan, MD, PhD Suzanne E. Judd, PhD Daniel Lackland, DrPH, FAHA Judith H. Lichtman, PhD, MPH, FAHA Lynda Lisabeth, PhD, MPH, FAHA Simin Liu, MD, ScD, FAHA Chris T. Longenecker, MD Rachel H. Mackey, PhD, MPH, FAHA Kunihiro Matsushita, MD, PhD, FAHA Dariush Mozaffarian, MD, DrPH, FAHA Michael E. Mussolino, PhD, FAHA Khurram Nasir, MD, MPH, FAHA Robert W. Neumar, MD, PhD, FAHA Latha Palaniappan, MD, MS, FAHA Dilip K. Pandey, MBBS, MS, PhD, FAHA Ravi R. Thiagarajan, MD, MPH Mathew J. Reeves, PhD Matthew Ritchey, PT, DPT, OCS, MPH Carlos J. Rodriguez, MD, MPH, FAHA Gregory A. Roth, MD, MPH Wayne D. Rosamond, PhD, FAHA Comilla Sasson, MD, PhD, FAHA Amytis Towfighi, MD Connie W. Tsao, MD, MPH Melanie B. Turner, MPH Salim S. Virani, MD, PhD, FAHA Jenifer H. Voeks, PhD Joshua Z. Willey, MD, MS John T. Wilkins, MD Jason HY. Wu, MSc, PhD, FAHA Heather M. Alger, PhD Sally S. Wong, PhD, RD, CDN, FAHA Paul Muntner, PhD, MHSc On behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee Heart Disease and Stroke Statistics—2017 Update

Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association

The 11th edition of Harrison's Principles of Internal Medicine welcomes Anthony Fauci to its editorial staff, in addition to more than 85 new contributors. While the organization of the book is similar to previous editions, major emphasis has been placed on disorders that affect multiple organ systems. Important advances in genetics, immunology, and oncology are emphasized. Many chapters of the book have been rewritten and describe major advances in internal medicine. Subjects that received only a paragraph or two of attention in previous editions are now covered in entire chapters. Among the chapters that have been extensively revised are the chapters on infections in the compromised host, on skin rashes in infections, on many of the viral infections, including cytomegalovirus and Epstein-Barr virus, on sexually transmitted diseases, on diabetes mellitus, on disorders of bone and mineral metabolism, and on lymphadenopathy and splenomegaly. The major revisions in these chapters and many

Harrison's Principles of Internal Medicine

March 5, 2019 e1 WRITING GROUP MEMBERS Emelia J. Benjamin, MD, ScM, FAHA, Chair Paul Muntner, PhD, MHS, FAHA, Vice Chair Alvaro Alonso, MD, PhD, FAHA Marcio S. Bittencourt, MD, PhD, MPH Clifton W. Callaway, MD, FAHA April P. Carson, PhD, MSPH, FAHA Alanna M. Chamberlain, PhD Alexander R. Chang, MD, MS Susan Cheng, MD, MMSc, MPH, FAHA Sandeep R. Das, MD, MPH, MBA, FAHA Francesca N. Delling, MD, MPH Luc Djousse, MD, ScD, MPH Mitchell S.V. Elkind, MD, MS, FAHA Jane F. Ferguson, PhD, FAHA Myriam Fornage, PhD, FAHA Lori Chaffin Jordan, MD, PhD, FAHA Sadiya S. Khan, MD, MSc Brett M. Kissela, MD, MS Kristen L. Knutson, PhD Tak W. Kwan, MD, FAHA Daniel T. Lackland, DrPH, FAHA Tené T. Lewis, PhD Judith H. Lichtman, PhD, MPH, FAHA Chris T. Longenecker, MD Matthew Shane Loop, PhD Pamela L. Lutsey, PhD, MPH, FAHA Seth S. Martin, MD, MHS, FAHA Kunihiro Matsushita, MD, PhD, FAHA Andrew E. Moran, MD, MPH, FAHA Michael E. Mussolino, PhD, FAHA Martin O’Flaherty, MD, MSc, PhD Ambarish Pandey, MD, MSCS Amanda M. Perak, MD, MS Wayne D. Rosamond, PhD, MS, FAHA Gregory A. Roth, MD, MPH, FAHA Uchechukwu K.A. Sampson, MD, MBA, MPH, FAHA Gary M. Satou, MD, FAHA Emily B. Schroeder, MD, PhD, FAHA Svati H. Shah, MD, MHS, FAHA Nicole L. Spartano, PhD Andrew Stokes, PhD David L. Tirschwell, MD, MS, MSc, FAHA Connie W. Tsao, MD, MPH, Vice Chair Elect Mintu P. Turakhia, MD, MAS, FAHA Lisa B. VanWagner, MD, MSc, FAST John T. Wilkins, MD, MS, FAHA Sally S. Wong, PhD, RD, CDN, FAHA Salim S. Virani, MD, PhD, FAHA, Chair Elect On behalf of the American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee

Heart Disease and Stroke Statistics—2019 Update: A Report From the American Heart Association

http://diposit.ub.edu/dspace/bitstream/2445/122776/1/gbd2016riskfactorscollaborators2017_3028.pdf

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013

Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the Global Burden of Disease Study 2017

The combination of diverse health data (IoT, EHR, and clinical surveys) and scalable-adaptable Artificial Intelligence (AI), has enabled the discovery of physical, behavioral, and psycho-social indicators of pain status. Despite the hype and promise to fundamentally alter the healthcare system with technological advancements, much AI adoption in clinical pain evaluation has been hampered by the heterogeneity of the problem itself and other challenges, such as personalization and fairness. Studies have revealed that many AI (i.e., machine learning or deep learning) models display biases and discriminate against specific population segments (such as those based on gender or ethnicity), which breeds skepticism among medical professionals about AI adaptability. In this paper, we propose a Multi-attribute Fairness Loss (MAFL) based CNN model that aims to account for any sensitive attributes included in the data and fairly predict patients' pain status while attempting to minimize the discrepancies between privileged and unprivileged groups. In order to determine whether the trade-off between accuracy and fairness can be satisfied, we compare the proposed model with well-known existing mitigation procedures, and studies reveal that the implemented model performs favorably in contrast to state-of-the-art methods. Utilizing NIH All-Of-US data, where a cohort of 868 distinct individuals with wearables and EHR data gathered over 1500 days has been taken into consideration to analyze our suggested fair pain assessment system.

Unbiased Pain Assessment through Wearables and EHR Data: Multi-attribute Fairness Loss-based CNN Approach

Background Antidepressants exert an anticholinergic effect in varying degrees, and various classes of antidepressants can produce a different effect on immune function. While the early use of antidepressants has a notional effect on COVID-19 outcomes, the relationship between the risk of COVID-19 severity and the use of antidepressants has not been properly investigated previously owing to the high costs involved with clinical trials. Large-scale observational data and recent advancements in statistical analysis provide ample opportunity to virtualize a clinical trial to discover the detrimental effects of the early use of antidepressants. Objective We primarily aimed to investigate electronic health records for causal effect estimation and use the data for discovering the causal effects of early antidepressant use on COVID-19 outcomes. As a secondary aim, we developed methods for validating our causal effect estimation pipeline. Methods We used the National COVID Cohort Collaborative (N3C), a database aggregating health history for over 12 million people in the United States, including over 5 million with a positive COVID-19 test. We selected 241,952 COVID-19–positive patients (age >13 years) with at least 1 year of medical history. The study included a 18,584-dimensional covariate vector for each person and 16 different antidepressants. We used propensity score weighting based on the logistic regression method to estimate causal effects on the entire data. Then, we used the Node2Vec embedding method to encode SNOMED-CT (Systematized Nomenclature of Medicine-Clinical Terms) medical codes and applied random forest regression to estimate causal effects. We used both methods to estimate causal effects of antidepressants on COVID-19 outcomes. We also selected few negatively effective conditions for COVID-19 outcomes and estimated their effects using our proposed methods to validate their efficacy. Results The average treatment effect (ATE) of using any one of the antidepressants was −0.076 (95% CI −0.082 to −0.069; P<.001) with the propensity score weighting method. For the method using SNOMED-CT medical embedding, the ATE of using any one of the antidepressants was −0.423 (95% CI −0.382 to −0.463; P<.001). Conclusions We applied multiple causal inference methods with novel application of health embeddings to investigate the effects of antidepressants on COVID-19 outcomes. Additionally, we proposed a novel drug effect analysis–based evaluation technique to justify the efficacy of the proposed method. This study offers causal inference methods on large-scale electronic health record data to discover the effects of common antidepressants on COVID-19 hospitalization or a worse outcome. We found that common antidepressants may increase the risk of COVID-19 complications and uncovered a pattern where certain antidepressants were associated with a lower risk of hospitalization. While discovering the detrimental effects of these drugs on outcomes could guide preventive care, identification of beneficial effects would allow us to propose drug repurposing for COVID-19 treatment.

Effects of Antidepressants on COVID-19 Outcomes: Retrospective Study on Large-Scale Electronic Health Record Data

Background: Sexually transmitted infections (STIs), including human immunodeficiency virus (HIV), continue to present major health, social, and economic problems in the developing world, leading to considerable morbidity, mortality, stigma and long-term disability, economic loss and death throughout the world. Despite the availability of effective treatment and preventive measures, incidence of STIs is increasing even in developed countries. Objectives: To determine the pattern of sexually transmitted infections in patients presenting with genital symptoms. Material and Methods: A cross sectional, descriptive study was carried in the Dermatology-Venereology Clinic of Holy Lab Diagnostic & Consultation Centre, Uttara, Dhaka, Bangladesh from January to December 2019. During one year period, a total of 140 consecutive cases were enrolled in this study. The diagnosis of infections was made clinically with relevant laboratory investigations and they were interviewed for their sexual behaviour after taking consent and assuring confidentiality. Results: A total of one hundred forty (140) patients who presented with genital symptoms were studied. The average age of this population was 28.84 years (±9.15) and it ranged from 18-58 years. 3.7% belonged to age group 18-27 years, followed by 28-37 years (22.1%); 38-47 yrs (52.8%); 48-57 yrs (18.5%) and > 57 yrs (2.8%). Majority patients of 38-47 yrs 74 cases 52.8%. Males outnumbered females, constituting 76.2% of the total patients, with male to female ratio of 3.37:1. Out of the total 140, some had multiple complaints while others were asymptomatic. Majority cases of burning micturition in both male and female patients 39(24%). Burning micturition and discharge from genitalia was also observed in both sexes. The most frequently encountered infection in both male and female was Gonococcal Urethritis (GU) 42 (30%). The infections were common among both married and unmarried people. Other group of people who had no STI (23.5%) was suffering from venereophobia, pearly penile papules and some form of dermatitis. No case of HIV infection was encountered in this study. Gonococcal Urethritis was common mainly among businessman, transportation worker, security personnel and housewives. Other infections were equally dispersed in all other occupation groups. Conclusions: The prevention and control of STI is based on health education, appropriate diagnosis and treatment. Sexually active people adolescents and young adults should be provided with proper sex education about delaying sex debut and protective measures (correct and consistent use of barrier method during every sexual act) to prevent these infections with especial focus on monogamous relationship.

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“Pattern of Sexually Transmitted Infections: Treated in A Private Clinic at Dhaka, Bangladesh”

The purpose of this research was to determine how we can optimize both customer and seller experiences in a super shop using hyperautomation technology. Here, a smart bot was employed to speed up responses of simple consumer queries by utilizing natural language processing in real time. We also used machine learning frameworks, such as XGBoost, linear regression, random forest, and hybrid models together, to predict future product demand. In addition, data mining methods, such as the Apriori algorithm, FP growth algorithm, and GSP algorithm, were used to find out which algorithm can be used to determine the right way to place a product to increase the super shop sale. 

/pdf/hyperautomation-in-super-shop-using-machine-learning-3a3duk7s.pdf

Hyperautomation in Super Shop Using Machine Learning

We present a new semi-supervised domain adaptation framework that combines a novel auto-encoder-based domain adaptation model with a simultaneous learning scheme providing stable improvements over state-of-the-art domain adaptation models. Our framework holds strong distribution matching property by training both source and target auto-encoders using a novel simultaneous learning scheme on a single graph with an optimally modified MMD loss objective function. Additionally, we design a semi-supervised classification approach by transferring the aligned domain invariant feature spaces from source domain to the target domain. We evaluate on three datasets and show proof that our framework can effectively solve both fragile convergence (adversarial) and weak distribution matching problems between source and target feature space (discrepancy) with a high ‘speed’ of adaptation requiring a very low number of iterations.

Mahmudur Rahman

Papers

Unbiased Pain Assessment through Wearables and EHR Data: Multi-attribute Fairness Loss-based CNN Approach

Effects of Antidepressants on COVID-19 Outcomes: Retrospective Study on Large-Scale Electronic Health Record Data

“Pattern of Sexually Transmitted Infections: Treated in A Private Clinic at Dhaka, Bangladesh”

Hyperautomation in Super Shop Using Machine Learning

Semi-Supervised Domain Adaptation with Auto-Encoder via Simultaneous Learning