Potential for Detection of Safety Signals for Over-the-Counter Medicines Using National ADR Spontaneous Reporting Data: The Example of OTC NSAID-Associated Gastrointestinal Bleeding.

One post-marketing surveillance challenge for many regulatory authorities is access to information regarding the safety of over-the-counter (OTC) medicines. National spontaneous adverse drug reaction (ADR) report data represent a rich potential data source for the detection of safety signals associated with OTC medicines, yet little is known regarding the possibility of detecting safety signals for OTC medicines within these datasets. The aim of this study was to evaluate the potential for detecting safety signals for OTC medicines in National ADR spontaneous reporting data, using OTC non-steroidal anti-inflammatory drugs (NSAIDs) and gastrointestinal bleeding as an example. Data from the Australian Adverse Drug Reactions System (ADRS) dataset (1971-2008) and the Canadian Vigilance Adverse Reaction Online Database (VAROD) (1965-2013) were used to explore the feasibility of using spontaneous reporting data, exploring the association between gastrointestinal bleeding and the use of OTC NSAIDs. Safety signals were examined using disproportionality analyses and reporting odds ratios calculated. After adjusting for age, gender, medications known to increase the risk of bleeding, and medications used for the management of conditions associated with an increased risk of bleeding, a two-fold increase in the risk of gastrointestinal (GI) bleeding with OTC NSAID was observed within each dataset. This study demonstrates that spontaneous ADR reporting data can be used in pharmacovigilance to monitor the safety of OTC medicines

Solar thermoelectric generator for micropower applications”.

Solar thermoelectric generators (STG) using cheap parabolic concentrators with high-ZT modules can be a cost-effective alternative to solar photovoltaics for micropower generation. A thermodynamic analysis is presented for predicting the thermal-to-electrical conversion efficiency for the generator. With solar concentration of 669 suns, a system efficiency of 3% was measured for a commercial Bi 2 Te 3 module with output power of 1.8 W. Using novel thermoelectric materials such as n-type ErAs:(InGaAs) 1Àx (InAlAs) x and p-type (AgSbTe) x (PbSnTe) 1Àx , a conversion efficiency of 5.6% can be achieved for a STG at 1209 suns

Trend for Thermoelectric Materials and Their Earth Abundance

The low crustal abundance of materials such as tellurium (Te) (0.001 ppm by weight), antimony (Sb) (0.2 ppm), and germanium (Ge) (1.4 ppm) contributes to their price volatility as applications (competing with thermoelectrics) continue to grow, for example, cadmium telluride photovoltaics, antimony-lead alloy for batteries, and Ge for fiber optics and infrared optical technologies. Previous consideration of material scarcity has focused on Te-based thermoelectrics. Here, we broaden the analysis to include recent high-figure-of-merit (ZT) materials such as skutterudites, Zintl phase compounds, and clathrates that employ Sb, ytterbium (2.8 ppm), and Ge. The maximum demonstrated ZT for each particular alloy exhibits an empirical dependence on the crustal abundance, A, such that ZT = A Àb , where b is in the range from 0.05 to 0.10. This analysis shows that no material with crustal abundance of 30 ppm ($4 9 10 18 metric tons) has ZT greater than 0.8

Impact of bedside lung ultrasound on physician clinical decision-making in an emergency department in Nepal

Background Lung ultrasound is an effective tool for the evaluation of undifferentiated dyspnea in the emergency department. Impact of lung ultrasound on clinical decisions for the evaluation of patients with dyspnea in resource-limited settings is not well-known. The objective of this study was to evaluate the impact of lung ultrasound on clinical decision-making for patients presenting with dyspnea to an emergency department in the resource-limited setting of Nepal. Methods A prospective, cross-sectional study of clinicians working in the Patan Hospital Emergency Department was performed. Clinicians performed lung ultrasounds on patients presenting with dyspnea and submitted ultrasounds with their pre-test diagnosis, lung ultrasound interpretation, post-test diagnosis, and any change in management. Results Twenty-two clinicians participated in the study, completing 280 lung ultrasounds. Diagnosis changed in 124 (44.3%) of patients with dyspnea. Clinicians reported a change in management based on the lung ultrasound in 150 cases (53.6%). Of the changes in management, the majority involved treatment (83.3%) followed by disposition (13.3%) and new consults (2.7%). Conclusions In an emergency department in Nepal, bedside lung ultrasound had a significant impact on physician clinical decision-making, especially on patient diagnosis and treatment

COMPARISON OF DRAINMOD BASED WATERSHED SCALE MODELS

Watershed scale hydrology and water quality models (DRAINMOD-DUFLOW, DRAINMOD-W, DRAINMOD-GIS and WATGIS) that describe the nitrogen loadings at the outlet of poorly drained watersheds were examined with respect to their accuracy and uncertainty in model predictions. Latin Hypercube Sampling (LHS) was applied to determine the impact of uncertainty in estimating field exports and decay coefficients on the uncertainty of the simulated nitrogen loads at the outlet of a 2950 ha coastal plain watershed in eastern North Carolina. Mean daily flow predictions were all within 1 % of the observed flows. Except for the WATGIS model, mean daily nitrate-nitrogen load predictions were within 2 % of the observed load. Statistical test indicated no difference between the predictions of the different models. Uncertainty analysis indicated that uncertainty in quantifying the field exports has greater impact on the uncertainty of outlet loads than does the uncertainty associated with decay coefficient. The uncertainty of predicted outputs from the DRAINMOD-GIS and WATGIS models are similar

Application of SWAT Hydrologic Model for TMDL Development on Chapel Branch Creek Watershed, SC

2008 S.C. Water Resources Conference - Addressing Water Challenges Facing the State and Regio

Leaf area index (LAI) of loblolly pine and emergent vegetation following a harvest. Trans

ABSTRACT. Forests provide goods and services to society and, often, refugia for plants and animals; forest managers utilize silviculture to provide ecosystem services and to create habitat. On the Coastal Plain of North Carolina, forest management objectives typically include wood fiber production but may also include the maintenance of environmental quality and, sometimes, species diversity. Silvicultural prescriptions alter stand structure and development trajectories by influencing the competitive interactions among plant species for site resources. Early site intervention may include nutrient additions and/or vegetation control; in coastal loblolly pine (Pinus taeda L.) stands, herbaceous and arborescent species can dominate the site leaf area index (LAI) for many years after a harvest (followed by planting). LAI is an important structural and functional component of a forest stand. Many eco‐hydrologic and water quality models do not accurately account for LAI as the process driver to evapotranspiration (ET), and thus they ignore the ecophysiological effects of LAI on site water balance and nutrient loading. We measured LAI of emergent vegetation following a harvest, mechanical site preparation, and then pine planting for a drained loblolly pine plantation in coastal North Carolina. For six years monthly, growing season estimates of LAI were obtained using a LI‐COR LAI 2000 Plant Canopy Analyzer (PCA) for control (D1), thinned (D3), and harvested (D2) watersheds. In this article, we present results from the D2 treatment. In D2, we “harvested ” all emergent vegetation in 18 randomly placed 1 m 2 clip plots for three growing seasons where we estimated LAI using species‐pooled estimates of specific leaf area and total leaf dry mass (i.e., LAICLIP); PCA measurements were recorded prior to clipping (LAIPCA). We als

Case Study Hydrologic Effects of Size and Location of Fields Converted from Drained Pine Forest to Agricultural Cropland

Abstract: Hydrological effects of land-use change are of great concern to ecohydrologists and watershed managers, especially in the Atlantic coastal plain of the southeastern United States. The concern is attributable to rapid population growth and the resulting pressure to develop forested lands. Many researchers have studied these effects in various scales, with varying results. An extended watershed-scale forest hydrologic model, calibrated with 1996–2000 data, was used to evaluate long-term hydrologic effects of conversion to agriculture (corn–wheat–soybean cropland) of a 29.5-km2 intensively managed pine-forested watershed in Washington County in eastern North Carolina. Fifty years of weather data (1951–2000) from a nearby weather station were used for simulating hydrology to evaluate effects on outflows, evapotranspiration, and water table depth compared with the baseline scenario. Other simulation scenarios were created for each of five different percentages (10, 25, 50, 75, and 100%) of land-use conversion occurring at upstream and downstream locations in the pine-forest watershed. Simulations revealed that increased mean annual outflow was significant (α 0.05) only for 100 % conversion from forest (261 mm) to agricultural crop (326 mm), primarily attributed to a reduction in evapotranspiration. Although high flow rates>5 mm day−1 increased from 2.3 to 2.6 % (downstream) and 2.6 to 4.2 % (upstream) for 25 to 50 % conversion, the frequency was higher for the upstream location than the downstream. These results were attributed to a substantial decrease in soil hydraulic conductivity of one of the dominant soils in the upstream location, which is expected after land-use conversion to agriculture. As a result, predicted subsurface drainage decreased, and surface runoff increased as soil hydraulic conductivity decreased for the soil upstream. These results indicate tha

Lung ultrasound training and evaluation for proficiency among physicians in a low-resource setting

Background: Lung ultrasound (LUS) is helpful for the evaluation of patients with dyspnea in the emergency department (ED). However, it remains unclear how much training and how many LUS examinations are needed for ED physicians to obtain proficiency. The objective of this study was to determine the threshold number of LUS physicians need to perform to achieve proficiency for interpreting LUS on ED patients with dyspnea. Methods: A prospective study was performed at Patan Hospital in Nepal, evaluating proficiency of physicians novice to LUS. After eight hours of didactics and hands-on training, physicians independently performed and interpreted ultrasounds on patients presenting to the ED with dyspnea. An expert sonographer blinded to patient data and LUS interpretation reviewed images and provided an expert interpretation. Interobserver agreement was performed between the study physician and expert physician interpretation. Cumulative sum analysis was used to determine the number of scans required to attain an acceptable level of training. Results: Nineteen physicians were included in the study, submitting 330 LUS examinations with 3288 lung zones. Eighteen physicians (95%) reached proficiency. Physicians reached proficiency for interpreting LUS accurately when compared to an expert after 4.4 (SD 2.2) LUS studies for individual zone interpretation and 4.8 (SD 2.3) studies for overall interpretation, respectively. Conclusions: Following 1 day of training, the majority of physicians novice to LUS achieved proficiency with interpretation of lung ultrasound after less than five ultrasound examinations performed independently