Knowledge of sexual consent as a protective factor against sexual violence perpetration among first-year college men: a moderation analysis

This study examined whether knowledge of sexual consent buffers the relationship between risk factors for sexual violence (SV) and SV perpetration among first-year college men. The study data were drawn from a longitudinal study with 1144 first-year college men. A series of generalized linear models were conducted to examine whether knowledge of sexual consent moderated the relationship between SV risk factors and SV perpetration. Knowledge of sexual consent moderated the effect of hypermasculinity (P < 0.001), binge drinking (P < 0.001), rape-supportive social norms (P = 0.007) and peer support for SV (P < 0.001) such that there was a positive association between risk factors and SV perpetration among those with lower, but not higher, knowledge of sexual consent. Knowledge of sexual consent did not significantly moderate the relationship between SV perpetration and outcome expectancies for non-consensual sex (P = 0.387) and pornography use (P = 0.494). Knowledge of sexual consent may counteract risk factors for SV perpetration among young college men. The findings highlight the need for consent education to be incorporated in youth comprehensive sexual education to increase knowledge of sexual consent prior to college and campus-based SV prevention programming delivered to college students.

Can machine learning augment clinician adjudication of events in cardiovascular trials? A case study of major adverse cardiovascular events (MACE) across CVRM trials

Background and introduction

Accurate identification of clinical outcome events is critical to obtaining reliable results in cardiovascular outcomes trials (CVOTs). Current processes for event adjudication are expensive and hampered by delays. As part of a larger project to more reliably identify outcomes, we evaluated the use of machine learning to automate event adjudication using data from the SOCRATES trial (NCT01994720), a large randomized trial comparing ticagrelor and aspirin in reducing risk of major cardiovascular events after acute ischemic stroke or transient ischemic attack (TIA).

Purpose

We studied whether machine learning algorithms could replicate the outcome of the expert adjudication process for clinical events of ischemic stroke and TIA. Could classification models be trained on historical CVOT data and demonstrate performance comparable to human adjudicators?

Methods

Using data from the SOCRATES trial, multiple machine learning algorithms were tested using grid search and cross validation. Models tested included Support Vector Machines, Random Forest and XGBoost. Performance was assessed on a validation subset of the adjudication data not used for training or testing in model development. Metrics used to evaluate model performance were Receiver Operating Characteristic (ROC), Matthews Correlation Coefficient, Precision and Recall. The contribution of features, attributes of data used by the algorithm as it is trained to classify an event, that contributed to a classification were examined using both Mutual Information and Recursive Feature Elimination.

Results

Classification models were trained on historical CVOT data using adjudicator consensus decision as the ground truth. Best performance was observed on models trained to classify ischemic stroke (ROC 0.95) and TIA (ROC 0.97). Top ranked features that contributed to classification of Ischemic Stroke or TIA corresponded to site investigator decision or variables used to define the event in the trial charter, such as duration of symptoms. Model performance was comparable across the different machine learning algorithms tested with XGBoost demonstrating the best ROC on the validation set for correctly classifying both stroke and TIA.

Conclusions

Our results indicate that machine learning may augment or even replace clinician adjudication in clinical trials, with potential to gain efficiencies, speed up clinical development, and retain reliability. Our current models demonstrate good performance at binary classification of ischemic stroke and TIA within a single CVOT with high consistency and accuracy between automated and clinician adjudication. Further work will focus on harmonizing features between multiple historical clinical trials and training models to classify several different endpoint events across trials. Our aim is to utilize these clinical trial datasets to optimize the delivery of CVOTs in further cardiovascular drug development.

Funding Acknowledgement

Type of funding sources: Private company. Main funding source(s): AstraZenca Plc

0374 Decline in Habitual Sleep Duration Over 10 Years and Worsening Sleep Disparities: Data From NHIS (2006-2015)

Introduction

Despite claims in the media, evidence that habitual sleep has declined in recent years is scant. Few data sources exist that systematically document sleep duration in a nationally representative sample, in the same way, over several years.

Methods

Data from 10 years of the National Health Interview Survey were used (N=305,555). During all years, habitual sleep duration, age, sex, race/ethnicity, and height/weight were recorded in the same way. Weighted regression analyses examined sleep duration as the outcome, year as linear predictor, and sociodemographics as covariates. Then, interaction terms examined whether the linear change associated with years was differentially experienced by different sociodemographic groups.

Results

The linear trend of sleep duration over the past 10 years is a loss of 0.78 minutes per year (95%CI -0.91,-0.64; p&lt;0.0001). After adjustment for age, sex, race/ethnicity and BMI, this remained relatively unchanged at 0.86 minutes (95%CI -0.99,-0.73; p&lt;0.0001). A year-by-race/ethnicity interaction was observed (p&lt;0.05). In stratified analyses, Non-Hispanic Whites showed a loss of 0.68 minutes per year (95%CI -0.84,-0.52, p&lt;0.0001). This was 1.33 minutes/year in Blacks/African-Americans (95%CI -1.74,-0.92; p&lt;0.0001), 1.57 minutes/year in Mexican-Americans (95%CI -1.98,-1.16; p&lt;0.0001), 0.99 minutes/year in other Hispanics/Latinos (95%CI -1.51,-0.47; p&lt;0.0001), 0.74 minutes/year in Asians (95%CI -1.24,-0.25; p=0.003), and 1.80 minutes/year in American Indians/Alaskan Natives (95%CI -3.57,-0.03, p=0.046).

Conclusion

On average, the US population has lost 47 seconds of nightly sleep per year over a 10-year period, equating to about 4.7 hours of sleep per year, but racial/ethnic groups were impacted differently. Compared to Non-Hispanic Whites, Blacks/African-Americans lost 96% more sleep, Mexicans lost 131% more sleep, other Hispanics/Latinos lost 46% more sleep, Asians lost 9% more sleep, and American Indians lost 165% more sleep. Thus, sleep disparities may be widening.

Support

Dr. Grandner is supported by R01MD011600

Safety and efficacy of biphasic insulin aspart 30 in type 2 diabetes patients switched from either biphasic or basal human insulin: results from the Gulf cohort of the A1 chieve study

AIM

The 24-week, international, non-interventional A1 chieve study aimed to evaluate the safety and efficacy of insulin analogues in type 2 diabetes (T2D) in different countries. This sub-analysis reports results for T2D patients who switched from either biphasic human insulin (BHI) or human neutral protamine Hagedorn (NPH) insulin to biphasic insulin aspart 30 (BIAsp 30) in the Gulf cohort.

METHODS

Gulf patients with T2D who switched to BIAsp 30 from either BHI or NPH insulin were included. Safety and efficacy measurements were made by the physicians as part of routine clinical care.

RESULTS

A total of 1486 patients switched from BHI to BIAsp 30 (BIP group) and 232 patients switched from NPH insulin to BIAsp 30 (NEU group). Baseline glycated haemoglobin A1c (HbA₁c ) was poor in patients in the BIP and NEU groups (mean value ± SD: 9.4 ± 1.8% and 9.7 ± 1.5%, respectively). Significant reductions in the proportion of patients reporting hypoglycaemia (overall, major, minor and nocturnal) were noted in the BIP group after 24 weeks of BIAsp 30 therapy (p < 0.001). No major hypoglycaemic events were reported at Week 24 in the NEU group. In both groups, the mean HbA1c , fasting plasma glucose and postprandial plasma glucose improved significantly after 24 weeks of BIAsp 30 therapy (p < 0.001). The mean body weight, lipid parameters and systolic blood pressure also improved significantly in both groups (p < 0.05).

CONCLUSION

BIAsp 30 therapy enhanced glycaemic control over 24 weeks and was well-tolerated in T2D patients poorly controlled on prestudy BHI or NPH insulin.

Normative data and psychometric properties of short form 36 health survey (SF-36, version 1.0) in the population of north Jordan

This study aimed to assess the psychometric properties of the short form 36 health survey (SF-36, version 1.0) and to establish SF-36 population norms among the general population of north Jordan. A systematic sample of 157 households was selected from 6 districts in Irbid governorate in north Jordan. A total of 511 people aged 18 years or more agreed to participate. The reliability of the instrument using the Arabic version of SF-36 was satisfactory: Cronbacha o alphas for all 8 SF-36 scales exceeded 0.70. All items passed the tests for item internal consistency and item discriminant validity. SF-36 population norms amongthe general population of north Jordan were established. The highest mean was for social functioning (66.8) among men and for physical functioning (69.8) among women. The lowest mean was for vitality (55.8) among men and bodily pain (54.6) among women. The SF-36 is a valid and reliable instrument for measuring quality of life among Jordanians.

Stroke rehabilitation: application and analysis of the modified Barthel index in an Arab community

PURPOSE

The primary aim was to provide experience with a functional evaluation instrument (modified Barthel index MBI) that assures the quality of work and identify its deficiencies, familiarize our staff with the feasibility of its application on our local inpatients and educate our personnel in the field of stroke rehabilitation. The secondary aim was to collect data that are measurable and reproducible, identify specific local factors that adversely affect outcomes and serve as a feedback system to our national organizations.

METHODS

In this prospective/retrospective study we evaluated 80 hemiplegic patients with completed stroke, admitted to hospital during the year 1989 1990. They were assessed by a neurologist, physiatrist and physiotherapist on admission and discharge using the MBI. All patients received comprehensive inpatient rehabilitation. The study was interrupted at the beginning of the Gulf crisis. However, the data were revived and retrospectively studied in the year 1994-1995.

RESULTS

The MBI proved to be fully acceptable and easily applicable in our community. The rehabilitation staff became rapidly familiarized with its application and the reproduction of its data. The goals of rehabilitation were achieved through the reduction in the number of individuals in the more severe MBI scores and the increase in the number of individuals in the less severe ones. Significant improvements occurred in dressing of the upper and lower body, washing, grooming, care of perineum, transfer chair, toilet and walking on a level of 50 yards (p < or = 0.0005).

CONCLUSIONS

We conclude that MBI is simple, convenient, efficient, gives exact and accurate information about daily activities and ambulation and could be used in inpatient follow up sittings, in the Arab and culturally similar Middle East countries.

Metabolism of twelve herbicides by Streptomyces

Experiments were conducted to assess the ability of Streptomyces (strain PS1/5) to metabolize twelve herbicides representing several different classes including: acetanilides, triazines, ureas, uracils, and imidazoles. Incubations in aqueous culture with dextrin as carbon source and either ammonium or Casamino acids as nitrogen source resulted in transformations (> 50%) of eight of the herbicides tested: alachlor, metolachlor, atrazine, prometryne, ametryne, linuron, tebuthiuron, and bromacil; the remaining four herbicides (cyanazine, diuron, metribuzin, and imazapyr) were also transformed, but to a lesser extent. In most instances, biotransformations occurred concurrently with growth and results were consistent regardless of the nitrogen source (ammonium vs. Casamino acids). However, in some instances there were differences in rates of biotransformation as a consequence of the nitrogen source (e.g. alachlor, metribuzin), suggesting the selective induction of certain metabolic enzymes; in other instances biotransformations were not associated with growth, suggesting secondary metabolism. An experiment was also conducted to assess the ability of Streptomyces (strain PS1/5) to metabolize atrazine contaminated soil. Inoculation of soil amended with 20 micrograms/g of atrazine and 5% chitin as carbon source resulted in ca. 78% removal of atrazine within 28 days. These data suggest that Streptomyces species may be potential candidates for soil inoculation to bioremediate herbicide contaminated soils.