Perspectives of community pharmacists on extended pharmacy services and value-added services in Malaysia: a cross-sectional survey:a cross-sectional survey

ObjectiveThis study aimed to investigate patterns of extended pharmacy services (EPS) provided by Malaysian community pharmacists and their willingness to provide value-added services (VAS) in addition to EPS. Additionally, this study examined the barriers to the effective implementation of these two services.MethodA cross-sectional survey was conducted using a self-administered questionnaire among community pharmacists in Selangor and Kuala Lumpur. Convenience sampling was done, and descriptive statistics and correlation analysis were performed.ResultsTwo hundred and thirty-six pharmacists participated. The most rendered EPS were nutritional supplements, hypertension management, and diabetic management, while chronic kidney disease management, smoking cessation, and mental health services were the least rendered. Pharmacists were willing to provide medication waste management and vaccination as VAS but were less inclined towards therapeutic drug monitoring and sterile compounding. Barriers included limited access to medical records of patients, lack of designated counselling areas, and concerns about remuneration. High sales pressure and busy workloads were additional barriers to providing VAS. Continuous professional development (CPD) positively influenced pharmacists’ engagement in EPS and VAS.ConclusionsThis study highlights service provision trends and areas for improvement. Addressing identified barriers, such as enhancing access to patient records and establishing designated counselling areas, can improve service delivery. Remuneration models and workload management strategies should be considered to alleviate barriers related to sales pressure and time constraints. Promoting CPD opportunities is crucial for enhancing pharmacist engagement and optimizing EPS and VAS

CDNA-SNN: A New Spiking Neural Network for Pattern Classification using Neuronal Assemblies

Spiking neural networks (SNNs) mimic their biological counterparts more closely than their predecessors and are considered the third generation of artificial neural networks. It has been proven that networks of spiking neurons have a higher computational capacity and lower power requirements than sigmoidal neural networks. This paper introduces a new type of spiking neural network that draws inspiration and incorporates concepts from neuronal assemblies in the human brain. The proposed network, termed as CDNA-SNN, assigns each neuron learnable values known as Class-Dependent Neuronal Activations (CDNAs) which indicate the neuron’s average relative spiking activity in response to samples from different classes. A new learning algorithm that categorizes the neurons into different class assemblies based on their CDNAs is also presented. These neuronal assemblies are trained via a novel training method based on Spike-Timing Dependent Plasticity (STDP) to have high activity for their associated class and low firing rate for other classes. Also, using CDNAs, a new type of STDP that controls the amount of plasticity based on the assemblies of pre- and post-synaptic neurons is proposed. The performance of CDNA-SNN is evaluated on five datasets from the UCI machine learning repository, as well as MNIST and Fashion MNIST, using nested cross-validation for hyperparameter optimization. Our results show that CDNA-SNN significantly outperforms SWAT (p<0.0005) and SpikeProp (p<0.05) on 3/5 and SRESN (p<0.05) on 2/5 UCI datasets while using the significantly lower number of trainable parameters. Furthermore, compared to other supervised, fully connected SNNs, the proposed SNN reaches the best performance for Fashion MNIST and comparable performance for MNIST and N-MNIST, also utilizing much less (1-35%) parameters

How far can low emission retrofit of terraced housing in Northern Ireland go?

With both global and national targets to reduce greenhouse gas (GHG) emissions the improvement of existing buildings will be key to realising these ambitions. How this can be achieved, and the impact of whole-life emissions from retrofit remains a key question. This paper investigates the potential of retrofit to reduce and limit lifecycle GHG emissions resulting from an existing house, typical of one of the predominant housing typologies in Northern Ireland. Through the use of lifecycle assessment a range of retrofit scenarios are considered for an early 20th century, solid wall, terraced house, to understand the impacts of retrofit on lifecycle emissions. A range of retrofit scenarios were modelled and simulated, considering both embodied and operational emissions over the building’s lifetime, to understand how net emissions can be reduced. The results show that although fabric and some technological measures can reduce emissions by over 60% when applied in isolation, a holistic approach is required to achieve the greatest reductions. Although operation remains the largest single source of emissions, the results also show the importance of taking a holistic approach to the assessment of retrofit with varying lifecycle stages responsible for considerable emissions. It is seen that emissions reductions of up to 99% may be possible when taking a holistic approach to retrofit and its assessment, considering whole-life emissions. This study highlights the potential benefits of retrofit and how it could be effectively applied to the existing housing stock in Northern Ireland creating low-emission or net-zero emission buildings

Flexible Bifunctional Electrode for Alkaline Water Splitting with Long-Term Stability

Progress in electrochemical water-splitting devices as future renewable and clean energy systems requires the development of electrodes composed of efficient and earth-abundant bifunctional electrocatalysts. This study reveals a novel flexible and bifunctional electrode (NiO@CNTR) by hybridizing macroscopically assembled carbon nanotube ribbons (CNTRs) and atmospheric plasma-synthesized NiO quantum dots (QDs) with varied loadings to demonstrate bifunctional electrocatalytic activity for stable and efficient overall water-splitting (OWS) applications. Comparative studies on the effect of different electrolytes, e.g., acid and alkaline, reveal a strong preference for alkaline electrolytes for the developed NiO@CNTR electrode, suggesting its bifunctionality for both HER and OER activities. Our proposed NiO@CNTR electrode demonstrates significantly enhanced overall catalytic performance in a two-electrode alkaline electrolyzer cell configuration by assembling the same electrode materials as both the anode and the cathode, with a remarkable long-standing stability retaining ∼100% of the initial current after a 100 h long OWS run, which is attributed to the “synergistic coupling” between NiO QD catalysts and the CNTR matrix. Interestingly, the developed electrode exhibits a cell potential (E10) of only 1.81 V with significantly low NiO QD loading (83 μg/cm2) compared to other catalyst loading values reported in the literature. This study demonstrates a potential class of carbon-based electrodes with single-metal-based bifunctional catalysts that opens up a cost-effective and large-scale pathway for further development of catalysts and their loading engineering suitable for alkaline-based OWS applications and green hydrogen generation

Seroepidemiological and biomolecular survey on Toxoplasma gondii in Sardinian wild boar (Sus scrofa)

Toxoplasma gondii is a zoonotic parasite able of infecting all warm-blooded animals. Toxoplasmosis is one of the major foodborne diseases globally. The consumption of wild boar (Sus scrofa) meat from recreational hunting has been linked to outbreaks of human toxoplasmosis. The island of Sardinia (Italy) contains a large wild boar population, thus providing an opportunity to assess the distribution of Toxoplasma in this species and the associated risks of transmission to humans. A total of 562 wild boars were screened: heart and meat juice samples were tested for T. gondii DNA via nested-PCR and IgG anti-Toxoplasma by commercial ELISA. Anti-Toxoplasma IgG were detected in 24.6% (138/562) of animals, while 37.2% (209/562) of the heart samples were PCR positive. The prevalence of T. gondii antibodies and DNA highlights the potential role of wild boar as an important reservoir for this parasite. The study suggests that wild boar could play a significant role in spreading the parasite to humans. As wild boar numbers are increasing throughout their range, their potential role in transmitting toxoplasmosis should be communicated to stakeholders, and the impact of different population control methods on disease transmission should be thoroughly assessed to mitigate potential threats effectively

Corporate capital structure effects on corporate performance pursuing a strategy of innovation in manufacturing companies

Within the sphere of finance, the concept of capital structure has long been a subject of intense debate, serving as a quantitative depiction of the balance between debt, preference shares, and common stock within a company. This structure serves a crucial role in optimizing the utilization of a company's existing resources while simultaneously elevating the revenue streams for stakeholders. This particular study delves into the intricate relationship between corporate performance and capital structure, focusing on 78 publicly listed firms within the Dhaka Stock Exchange (DSE). Bangladesh holds the 29th position globally in terms of purchasing power, lending significant weight to this investigation. To comprehensively analyze this correlation, panel data encompassing the span from 2017 to 2021 was collected for these 78 sample companies operating within the DSE. Several key determinants of capital structure were considered in this analysis, namely the debt-to-equity ratio, short-term leverage ratio, long-term leverage ratio, and total debt ratio. Meanwhile, the performance of these firms was gauged using key metrics such as Return on Assets (ROA), Return on Equity (ROE), and Earnings Per Share (EPS). To ensure a robust analysis, factors such as inflation, liquidity, growth rate, tax rate, and firm size were meticulously controlled for. The findings unveiled a compelling narrative: all forms of debt ratios—be it short-term, long-term, or the total debt ratio—exhibited a substantial negative impact on ROA at a significant level of 1 %. Conversely, specific debt ratios, like the short-term total debt and the total debt-to-total asset ratio, displayed a notable positive correlation with ROE at a 1 % significance level. Intriguingly, the long-term total debt ratio yielded a negative and insignificant effect on ROE. Moreover, within the spectrum of predictors influencing a firm's performance, the liquidity ratio emerged as a non-significant factor—a notable discovery that highlights the nuanced nature of the interplay between capital structure and performance within these companies.</p

Advancing the Criminal Justice Pillar of Transitional Justice in Challenging Contexts::Preconditions for successful criminal justice

A distinctive characteristic of transitional justice is to seek mutually reinforcing advances across each of its dimensions: truth, justice, reparations and guarantees of non-repetition, considering which course(s) of action can contribute to the greatest forward movement overall, while avoiding possible backsliding. This interdependence means that justice cannot be treated as an agenda to be pursued separately from truth, reparation and guarantees of non-repetition, which may influence how justice decisions need to be defined, viewed and implemented.This document, which was prepared on request to inform considerations for review of the UN Secretary General's Guidance Note on TJ, focuses on preconditions and initial considerations regarding criminal justice in domestic accountability spaces. The paper contends that narrow “norm transfer” approaches are unlikely to succeed, with detailed country diagnostics needed to craft workable, locally grounded appreciations of how the best interests of justice can be served in a particular setting at a given tim

Embracing the <i>impact </i>from instrumented mouthguards (iMGs): A survey of iMG managers' perceptions of staff and player interest into the technology, data and barriers to use

Instrumented mouthguards (iMGs) are a novel technology being used within rugby to quantify head acceleration events. Understanding practitioners' perceptions of the barriers and facilitators to their use is important to support implementation and adoption. This study assessed men's and women's rugby union and league iMG managers' perceptions of staff and player interest in the technology, data and barriers to use. Forty‐six iMG managers (men's rugby union and league n = 20 and n = 9 and women's rugby union and league n = 7 and n = 10) completed an 18‐question survey. Perceived interest in data varied across staff roles with medical staff being reported as having the most interest. The iMG devices were perceived as easy to use but uncomfortable. Several uses of data were identified, including medical applications, player monitoring and player welfare. The comfort, size and fit of the iMG were reported as the major barriers to player use. Time constraints and a lack of understanding of data were barriers to engagement with the data. Continued education on how iMG data can be used is required to increase player and staff buy‐in, alongside improving comfort of the devices. Studies undertaken with iMGs investigating player performance and welfare outcomes will make data more useful and increase engagement

The Prevalence and Compliance of Health Claims Used in the Labelling and Information for Prepacked Foods within Great Britain

In the EU and Great Britain (GB), all health claims (HCs) on food must be authorised before use and should comply with Regulation 1924/2006. In GB, all HCs, authorised or not, are listed in the Great Britain Nutrition and Health Claims Register. This study reviews the prevalence and compliance of HCs on prepacked foods sold within three GB supermarkets and via their grocery shopping websites. In June 2023, food labels and online product information of 440 products were evaluated across three food categories—dairy and dairy alternatives; fruit juices, fruit juice drinks and fruit smoothies; and teas and infusions. In store, 26.3% of products carried an HC and 28.3% online. The prevalence of HCs was higher when compared with data from 2016. Overall compliance was high, in store (94.3%) and online (90.0%), with no statistically significant difference in overall HC compliance between in store and online products (p = 0.724). The HC violations observed in the present study were due to non-compliant wording of HCs or use of non-authorised HCs. This study demonstrates changes in the HC landscape and the need for continued monitoring of the prevalence and compliance of HCs as consumer trends alter

LARNet:Towards Lightweight, Accurate and Real-time Salient Object Detection

Salient object detection (SOD) has rapidly developed in recent years, and detection performance has greatly improved. However, the price of these improvements is increasingly complex networks that require more computing resources and sacrifice real-time performance. This makes it difficult to deploy these approaches on devices with limited computing resources (such as mobile phones, embedded platforms, etc.). Considering recently developed lightweight SOD models, their detection and real-time performance are always compromised in demanding practical application scenarios. To solve these problems, we propose a novel lightweight SOD method called LARNet and its corresponding extremely lightweight method LARNet* according to application requirements. These methods balance the relationship between lightweight requirements, detection accuracy and real-time performance. First, we propose a saliency backbone network tailored for SOD, which removes the need for pre-training with ImageNet and effectively reduces feature redundancy. Subsequently, we propose a novel context gating module (CGM), which simulates the physiological mechanism of human brain neurons and visual information processing, and realizes the deep fusion of multilevel features at the global level. Finally, the saliency map is output after fusion of multi-level features. Extensive experiments on popular benchmark datasets demonstrate that the proposed LARNet (LARNet*) achieves 98 (113) FPS on a GPU and 3 (6) FPS on a CPU. With approximately 680K (90K) parameters, the model has significant performance advantages over (extremely) lightweight methods, even surpassing some heavyweight model