Outcome of pharmacists’ counseling infusion center patients on chemotherapy

Patient education for patients getting chemotherapy is vital to their survival. The purpose of this study is to discuss the outcomes of counseling patients in an infusion center getting chemotherapy in terms of impact on quality of life, satisfaction and emergency room visitations. This study was conducted to determine patient satisfaction after being counseled by a pharmacist and if hospitalizations were prevented after education by a pharmacist.This was a single center, prospective, survey-based study at a small community hospital infusion center that consists of approximately five chairs. The study consisted of 15 patients, over the course of six months (April-October 2016). At the end of the cycle, a Likert-scale and short answer survey was administered to determine patient satisfaction and whether any hospitalizations occurred. Additional questions included if they experienced side effects; if knowledge was attainted as to what to do when the side effects were experienced; if hospitalization occurred, and if so, what required hospitalization and when was it. All patients ranked their experiences with the pharmacist/counseling at neutral or greater, meaning no negative interactions or disagreeing with the prompts. Nine patients were analyzed for Emergency Department (ED) admissions. Of the nine, three had no ED admission and the three patients who had been admitted were based on pharmacist counseling. The three patients who had a “bad admission” were due to improper patient response to counseling, improper evaluation of antiemetic therapy and counseling, and admissions prior to pharmacy counseling. Based on the results of the survey, patients at North Fulton Hospital felt confident in their knowledge of the chemotherapy regimen, of what to do in the occurrence of side effects, and how/why their drugs work. In regards to Emergency Department admissions, half of them were “good admissions” based on pharmacists’ recommendations; and the other half were before counseling, due to patient nonadherence to recommendations or uncontrolled antiemetic therapy

EVALUASI KONDISI PERKERASAN LENTUR DAN IDENTIFIKASI PENYEBAB KERUSAKAN DI JALAN MAGELANG –KALIANGKRIK

Ruas jalan Magelang – Kaliangkrik STA 13+000 – STA 15+000 merupakan jalan yang menghubungkan antara Kecamatan Bandongan dan Kecamatan Kaliangkrik. Secara visual di jalan ini banyak dijumpai permukaan jalan dalam kondisi rusak. Penelitian ini bertujuan untuk mengetahui kondisi dan tingkat kerusakan jalan sesuai metode Pavement Condition Index (PCI) serta memberikan alternatif perbaikan sesuai kondisi permukaan perkerasan jalan tersebut.Evaluasi perkerasan jalan dilakukan dengan mencari data karakteristik beton aspal menggunakan alat Core Drill dan pengujian  Dynamic Cone Penetrometer (DCP) untuk mencari nilai CBR lapangan, serta evaluasi kondisi permukaan perkerasan dengan metode PCI untuk menentukan nilai kondisi jalan yang nantinya digunakan sebagai acuan pemilihan perbaikan.Hasil evaluasi perkerasan pengujian Core Drill didapatkan rata-rata kepadatan beton aspal sebesar 97,79%, rata-rata kadar aspal sebesar 3,18% , dan rata-rata presentase berat agregat yang lolos saringan 1/2”, 3/8”, NO. 8, NO. 16, NO. 50, NO. 100, NO. 200 berada dibawah spesifikasi dari Bina Marga. Berdasarkan pengujian DCP diperoleh nilai CBR rata-rata sebesar 3,006%. Hasil evaluasi kondisi perkerasan diperoleh nilai PCI sebesar 39,4 % dengan rating buruk (poor). Berdasarkan nilai PCI maka alternatif penanganan dengan cara pemeliharaan rutin dengan biaya sebesar Rp 39.636.409,72, sedangkan lapis tambah (overlay) dengan metode Bina Marga 2017 didapat tebal lapis sebesar 3 cm biayanya sebesar  Rp 484.882.886,00. Penanganan yang tepat sesuai dengan tingkat kerusakan jalan adalah memberi lapis tambah (overlay) untuk meningkatkan rating jalan menjadi lebih baik

Comparison between the calculated and measured dose distributions for four beams of 6 MeV linac in a human-equivalent phantom

Radiation dose distributions in various parts of the body are of importance in radiotherapy. Also, the percent depth dose at different body depths is an important parameter in radiation therapy applications. Monte Carlo simulation techniques are the most accurate methods for such purposes. Monte Carlo computer calculations of photon spectra and the dose ratios at surfaces and in some internal organs of a human equivalent phantom were performed. In the present paper, dose distributions in different organs during bladder radiotherapy by 6 MeV X-rays were measured using thermoluminescence dosimetry placed at different points in the human-phantom. The phantom was irradiated in exactly the same manner as in actual bladder radiotherapy. Four treatment fields were considered to maximize the dose at the center of the target and minimize it at non-target healthy organs. All experimental setup information was fed to the MCNP-4b code to calculate dose distributions at selected points inside the proposed phantom. Percent depth dose distribution was performed. Also, the absorbed dose as ratios relative to the original beam in the surrounding organs was calculated by MCNP-4b and measured by thermoluminescence dosimetry. Both measured and calculated data were compared. Results indicate good agreement between calculated and measured data inside the phantom. Comparison between MCNP-4b calculations and measurements of depth dose distribution indicated good agreement between both

A spatial econometric approach to spillover effects between protected areas and deforestation in the Brazilian Amazon

Etudes & documentsProtected areas are increasingly used as a tool to fight against deforestation. This paper presents new evidence on the spillover effects that occur in the decision to deforest and the creation of protected areas in local administrative entities in Brazilian Legal Amazon over the 2001-2011 period. We also highlight the interdependence between these two decisions. We proceed in two steps. First, we assumed that protected areas are created to stop the negative effects of deforestation on biodiversity. In order to control for the non-random location of protected areas, biodiversity indicators are used as excluded instruments. This model is estimated using a spatial model with instrumental variables. Second, a simultaneous system of spatially interrelated cross sectional equations is used to take into account the interdependence between the decision to deforest and the creation of protected areas. Our results show (i) that deforestation activities of neighboring municipalities are complements and that (ii) there is evidence of leakage in the sense that protected areas may shift deforestation to neighboring municipalities. The net effect of protected areas on deforestation remains however negative; it is moreover stable across two sub-periods. Our results confirm the important role of protected areas to curb deforestation and thereby biodiversity erosion. Moreover, they show that strategic interactions deserve attention in the effectiveness of conservation policies

Development of multiplex real-time quantitative PCR for simultaneous detection of Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum, and Mycoplasma genitalium in infertile women

Purpose: Sexually Transmitted Diseases (STDs) can cause sterility and many other problems for women planning pregnancy. Currently, almost 340 million people worldwide suffer from Sexually Transmitted Infections (STIs). This study made attempts to quickly identify STDs' most critical infectious agents using dedicated primers and probes. Methods: The present study was done on the cervical samples of 200 infertile women. After extracting the total DNA of Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum, and Mycoplasma genitalium, quantitative methods were employed to determine the rate of target bacteria using multiplex real-time PCR. Results: The multiplex qPCR showed the rates of 47%, 16%, 46%, and 16.5% for Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum, and Mycoplasma genitalium in infertile women, respectively. In some patients, there were co-infections with two or three bacteria. The diagnostic approach used in our research could be employed as an alternative detection tool to identify the four most common STD-associated bacterial agents while detecting mixed infections. Conclusions: Infertile women with no biological problems could have their genital tract checked using this newly designed identification technique and get proper treatment for their infections as quickly as possible

Genomic, Lipidomic and Metabolomic Analysis of Cyclooxygenase-null Cells: Eicosanoid Storm, Cross Talk, and Compensation by COX-1

AbstractThe constitutively-expressed cyclooxygenase 1 (COX-1) and the inducible COX-2 are both involved in the conversion of arachidonic acid (AA) to prostaglandins (PGs). However, the functional roles of COX-1 at the cellular level remain unclear. We hypothesized that by comparing differential gene expression and eicosanoid metabolism in lung fibroblasts from wild-type (WT) mice and COX-2-/- or COX-1-/- mice may help address the functional roles of COX-1 in inflammation and other cellular functions. Compared to WT, the number of specifically-induced transcripts were altered descendingly as follows: COX-2-/->COX-1-/->WT+IL-1β. COX-1-/- or COX-2-/- cells shared about 50% of the induced transcripts with WT cells treated with IL-1β, respectively. An interactive “anti-inflammatory, proinflammatory, and redox-activated” signature in the protein–protein interactome map was observed in COX-2-/- cells. The augmented COX-1 mRNA (in COX-2-/- cells) was associated with the upregulation of mRNAs for glutathione S-transferase (GST), superoxide dismutase (SOD), NAD(P)H dehydrogenase quinone 1 (NQO1), aryl hydrocarbon receptor (AhR), peroxiredoxin, phospholipase, prostacyclin synthase, and prostaglandin E synthase, resulting in a significant increase in the levels of PGE2, PGD2, leukotriene B4 (LTB4), PGF1α, thromboxane B2 (TXB2), and PGF2α. The COX-1 plays a dominant role in shifting AA toward the LTB4 pathway and anti-inflammatory activities. Compared to WT, the upregulated COX-1 mRNA in COX-2-/- cells generated an “eicosanoid storm”. The genomic characteristics of COX-2-/- is similar to that of proinflammatory cells as observed in IL-1β induced WT cells. COX-1-/- and COX-2-/- cells exhibited compensation of various eicosanoids at the genomic and metabolic levels

New Insights into the Genetic Etiology of Alzheimer’s Disease and Related Dementias

Characterization of the genetic landscape of Alzheimer’s disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/‘proxy’ AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele

Effect of Organic Fertilizer on the Growth of Tea ((Camellia sinensis L.)

This study was conducted at National Tea and High value crops Research Institute, Shinkiari, Mansehra during 2014- 2015. The objective of the experiment was to evaluate the response of different doses of organic fertilizers to the growth of newly planted tea (Camellia sinensis L., variety, Turkish). Different doses of Hyosung applied as kg/acre were T0= Control, T1 = (400), T2 = (500), T3 = (600), T4 = (700) and T5 = (800). The data recorded during growth season during 2014 and 2015. Highest plant height (50 & 52 cm), Number of leaves per plant (39.67, 17.75) and Number of branches/plant (7.67, 6.29) were recorded in T4 respectively followed by T5 while maximum leaf area was recorded in T4 (48 cm2) during 2014 and T3 (47.87cm2) during 2015 respectively. Soil samples were collected at 0-20 cm and 21-40 cm depth and analyzed for physico-chemical characteristics. It is revealed that soil was sandy loam in texture with soil pH 6.25 and 2.90% organic matter and was supportive for the good growth of tea crop. A gradual increase in the organic matter content was observed with the increase of fertilizer dose. Soil pH was slightly decreased by the application of organic fertilizer which is a good sign to increase the growth of tea crop

Mosquito Microbiome Dynamics, a Background for Prevalence and Seasonality of West Nile Virus

Symbiotic microbial communities augment host phenotype, including defense against pathogen carriage and infection. We sampled the microbial communities in 11 adult mosquito host species from six regions in southern Ontario, Canada over 3 years. Of the factors examined, we found that mosquito species was the largest driver of the microbiota, with remarkable phylosymbiosis between host and microbiota. Seasonal shifts of the microbiome were consistently repeated over the 3-year period, while region had little impact. Both host species and seasonal shifts in microbiota were associated with patterns of West Nile virus (WNV) in these mosquitoes. The highest prevalence of WNV, with a seasonal spike each year in August, was in the Culex pipiens/restuans complex, and high WNV prevalence followed a decrease in relative abundance of Wolbachia in this species. Indeed, mean temperature, but not precipitation, was significantly correlated with Wolbachia abundance. This suggests that at higher temperatures Wolbachia abundance is reduced leading to greater susceptibility to WNV in the subsequent generation of C. pipiens/restuans hosts. Different mosquito genera harbored significantly different bacterial communities, and presence or abundance of Wolbachia was primarily associated with these differences. We identified several operational taxonomic units (OTUs) of Wolbachia that drive overall microbial community differentiation among mosquito taxa, locations and timepoints. Distinct Wolbachia OTUs were consistently found to dominate microbiomes of Cx. pipiens/restuans, and of Coquilletidia perturbans. Seasonal fluctuations of several other microbial taxa included Bacillus cereus, Enterococcus, Methylobacterium, Asaia, Pantoea, Acinetobacter johnsonii, Pseudomonas, and Mycoplasma. This suggests that microbiota may explain some of the variation in vector competence previously attributed to local environmental processes, especially because Wolbachia is known to affect carriage of viral pathogens

Epidemiology of intra-abdominal infection and sepsis in critically ill patients: "AbSeS", a multinational observational cohort study and ESICM Trials Group Project.

PURPOSE: To describe the epidemiology of intra-abdominal infection in an international cohort of ICU patients according to a new system that classifies cases according to setting of infection acquisition (community-acquired, early onset hospital-acquired, and late-onset hospital-acquired), anatomical disruption (absent or present with localized or diffuse peritonitis), and severity of disease expression (infection, sepsis, and septic shock). METHODS: We performed a multicenter (n = 309), observational, epidemiological study including adult ICU patients diagnosed with intra-abdominal infection. Risk factors for mortality were assessed by logistic regression analysis. RESULTS: The cohort included 2621 patients. Setting of infection acquisition was community-acquired in 31.6%, early onset hospital-acquired in 25%, and late-onset hospital-acquired in 43.4% of patients. Overall prevalence of antimicrobial resistance was 26.3% and difficult-to-treat resistant Gram-negative bacteria 4.3%, with great variation according to geographic region. No difference in prevalence of antimicrobial resistance was observed according to setting of infection acquisition. Overall mortality was 29.1%. Independent risk factors for mortality included late-onset hospital-acquired infection, diffuse peritonitis, sepsis, septic shock, older age, malnutrition, liver failure, congestive heart failure, antimicrobial resistance (either methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, extended-spectrum beta-lactamase-producing Gram-negative bacteria, or carbapenem-resistant Gram-negative bacteria) and source control failure evidenced by either the need for surgical revision or persistent inflammation. CONCLUSION: This multinational, heterogeneous cohort of ICU patients with intra-abdominal infection revealed that setting of infection acquisition, anatomical disruption, and severity of disease expression are disease-specific phenotypic characteristics associated with outcome, irrespective of the type of infection. Antimicrobial resistance is equally common in community-acquired as in hospital-acquired infection