Constraint Programming (CP) solvers typically tackle optimization problems by repeatedly finding solutions to a problem while placing tighter and tighter bounds on the solution cost. This approach is somewhat naive, especially for soft-constraint optimization problems in which the soft constraints are mostly satisfied. Unsatisfiable-core approaches to solving soft constraint problems in SAT (e.g. MAXSAT) force all soft constraints to be hard initially. When solving fails they return an unsatisfiable core, as a set of soft constraints that cannot hold simultaneously. These are reverted to soft and solving continues. Since lazy clause generation solvers can also return unsatisfiable cores we can adapt this approach to constraint programming. We adapt the original MAXSAT unsatisfiable core solving approach to be usable for constraint programming and define a number of extensions. Experimental results show that our methods are beneficial on a broad class of CP-optimization benchmarks involving soft constraints, cardinality or preferences.
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The boxed warning (also known as 'black box warning [BBW]') is one of the strongest drug safety actions that the U.S. Food & Drug Administration (FDA) can implement, and often warns of serious risks. The objective of this study was to comprehensively characterize BBWs issued for drugs after FDA approval.We identified all post-marketing BBWs from January 2008 through June 2015 listed on FDA's MedWatch and Drug Safety Communications websites. We used each drug's prescribing information to classify its BBW as new, major update to a preexisting BBW, or minor update. We then characterized these BBWs with respect to pre-specified BBW-specific and drug-specific features.There were 111 BBWs issued to drugs on the US market, of which 29% (n = 32) were new BBWs, 32% (n = 35) were major updates, and 40% (n = 44) were minor updates. New BBWs and major updates were most commonly issued for death (51%) and cardiovascular risk (27%). The new BBWs and major updates impacted 200 drug formulations over the study period, of which 64% were expected to be used chronically and 58% had available alternatives without a BBW.New BBWs and incremental updates to existing BBWs are frequently added to drug labels after regulatory approval.
This paper aims to identify some of the determinants of firm performance on social and environmental issues. Specifically, we look at the effect of corporate boards’ gender diversity. Then, we measure the impact of corporate directors’ social networks as captured by centrality measures. We focus on a sample of Italian-listed companies over the period 2010-2018. We find evidence of a positive relationship between gender diversity and a firm’s environmental (E) and social (S) scores suggesting that social and environmental responsibility is higher when there are more women on the corporate board. Also, board member social networks matter as network centrality measures are positively linked to the E and S scores. This information is valuable not only to the company itself but also to policymakers who are interested in improving firms’ environmental and social performance.
Background: The incidence of acute myocardial infarction (AMI) is growing rapidly in China, but there is limited information about the patient experience in the post-acute period. Specifically, long-term outcomes and patient-reported outcomes (PROs), including quality of life, symptoms and mood, after AMI, have not been systematically studied in China. Objectives: To conduct a nationwide prospective study following patients after AMI that 1) measures long-term clinical outcomes, PROs, cardiovascular risk factor control and adherence to medications for secondary prevention; and 2) identifies patient characteristics and hospital attributes that are associated with these outcomes. Methods: The China PEACE Prospective Study of AMI has recruited 4000 consecutive patients from 55 hospitals across China and is following them for 1-year. The first patient was enrolled in December 2012, and the last follow-up visit is scheduled for June 2015. After obtaining informed consent from patients, we abstracted details of their medical history, treatment, and in-hospital outcomes from medical charts. We conducted comprehensive baseline interviews characterizing patient demographics, risk factors, clinical presentation, and healthcare utilization. In addition, we used validated PRO instruments to measure quality of life, symptoms, mood, sleep, cognition and sexual activity. Follow-up interviews, measuring PROs, medication adherence and risk factor control were conducted at 1-, 6-, and 12-months after discharge. At these interviews, patients were asked to self-report major health events and to provide supporting materials (e.g., hospital discharge record for a readmission), which were subsequently validated by a National Coordinating Center. Blood and urine samples were obtained at baseline and 12-month follow-up, and stored for further biomarker analysis and genetic studies. To complement these patient-level data, we surveyed participating hospitals to characterize their facilities, processes and organizational learning culture. Together, these data will be used to identify factors associated with various outcomes following AMI. Conclusion: This study is uniquely positioned to generate new information regarding patient experience and determinants of outcomes after AMI in China.
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