The association between fingolimod and mental health outcomes in a cohort of Multiple Sclerosis patients with stress

OBJECTIVE

The primary objective was to study the association between fingolimod and the frequency of depression, anxiety, and insomnia symptoms among a cohort of Multiple Sclerosis (MS) patients with stress. The secondary objective was to examine the association between patient characteristics and these psychiatric symptoms.

PATIENTS AND METHODS

Patients with MS and stress were recruited according to the Arabic version of the Perceived Stress Scale (PSS). Psychiatric outcomes were measured by validated scales. Logistic regression was used to estimate adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Data from 324 participants were analyzed.

RESULTS

Fingolimod was associated with a significantly lower adjusted odds ratio for depression (aOR 0.58, 95% CI 0.35-0.97, p<0.05) but less associated with anxiety (aOR 0.63, 95% CI 0.35-1.01, p=0.05) and insomnia (aOR 0.88, 95% CI 0.52-1.51, p=0.64).

CONCLUSIONS

Close monitoring of mental health is required for patients with MS using disease-modifying therapies.

Awareness and Knowledge of Pharmacists toward Biosimilar Medicines: A Survey in Jordan

Aims

Pharmacists in all clinical settings are recognized drug experts and integral educators of biosimilar medicines. Therefore, the objective of this study was to assess pharmacists' knowledge, predictors of knowledge, and views toward biosimilar medicines in Jordan.

Methods

A cross-sectional study was conducted in Jordan during October-December 2020. An Internet-based self-administrated questionnaire on knowledge and views was distributed using social media groups to the pharmacists among different areas in Jordan. A descriptive and univariate analysis was performed. Binary logistic regression was conducted to determine the predictors of knowledge including all variables with p < 0.20 on univariate analysis.

Results

A total 536 responses were received, 502 of which were completed (93.7% response rate). A total of 52.6% of the pharmacists were knowledgeable about biosimilar medicines and the mean of knowledge level was 6.47 ± 1.62 (range 2-10). Multivariate analysis identified that respondents who had heard about biosimilars before (OR = 1.942, 95% CI = 1.231-3.063, p < 0.05) was more likely to be knowledgeable. Respondents who had not taken the course or the postgraduating training course about biosimilars that were less likely to be knowledgeable (OR = 0.548, 95% CI = 0.357-0.839, p < 0.05). A positive response was noted in pharmacist's view regarding the implementation of biosimilar medicines in healthcare setting, biosimilar medicine prescription related to decreased costs, self-study about biosimilar medicine, and incorporating biosimilar education program at the pharmacy school curriculum universities level.

Conclusions

Pharmacists' views and knowledge vary regarding the particularities and key issues on biosimilar medicines in Jordan. Incorporating biosimilar course in pharmacy school curriculum could improve their acceptance for future pharmacy jobs.

Extraction of foetal ECG by combination of singular value decomposition and neuro-fuzzy inference system

Extraction of foetal ECG that is embedded in the maternal ECG is a challenging problem. This paper presents a combined system to extract foetal ECG from maternal abdominal ECG. The system uses a combination of singular value decomposition (SVD) and a neuro-fuzzy inference system. The SVD is used to construct two reference signals, while the fuzzy system is used as an adaptive canceller. The algorithm is applied on synthetic as well as real data and the results are presented. In addition, the paper presents an example of using the same system as a noise removal tool.

Combined coding and wavelet transform for ECG compression

This paper presents a combined wavelet and a modified run-length encoding schemefor the compression of electrocardiogram (ECG) signals. First, a discrete wavelet transform is applied to the ECG signal. The resulting coefficients are classified into significant and insignificant ones based on the required PRD (percent root mean square difference). Second, both coefficients are encoded using a modified run-length coding method. The scheme has been tested using ECG signals obtained from the MIT-BIH Compression Database. A compression of 20:1 (which is equivalent to 150 bit per second) is achieved with PRD less than 10.