Evaluation of an enhanced service for medication review with follow up in Swiss community pharmacies: Pre-post study protocol.

In Switzerland, 20,000 people are hospitalized each year as result of drug related problems (DRPs). The sources of DRPs can be related to patients' behavior (i.e., wrong administration) or to health processes (i.e., drug-drug interaction). No community pharmacy (CP) service focus on DRPs related to patients' behavior is currently recognized or remunerated in Switzerland. A medication review with follow up (MRF) has been developed to evaluate prescription and non-prescription medication. To evaluate the impact of MRF service for the identification and management DRPs associated to patients' behavior and to describe pharmaceutical interventions carried out through MRF. A pre-post intervention study with a cluster design and one intervention group will be carried out in CPs in the canton of Vaud (Switzerland) for 15 months. Volunteer pharmacists will be trained on the identification and management of DRPs related to patients' behavior. After training, they will include randomly selected adults taking four or more chronic drugs prescribed for at least three months prior to recruitment. Then, they will conduct three pharmacist-patient face-to-face consultations at 6-month intervals. Tasks will be differentiated by pharmacy technician or pharmacist to triage expired medication or to manage DRPs in a structured manner, respectively. The primary outcome is the identification of DRPs associated to patients' behavior. Secondary outcomes are to assess patients' medication knowledge, number of expired medications, interventions carried out by pharmacists and pharmacists' satisfaction. The study will begin in April 2023 in 19 to 35 pharmacies that will recruit at least 162 patients. A sub analysis will be carried out for patients with 65 years old or over. The MRF intervention features a training designed for an enhanced evaluation of patient's behavior towards their medication. The study will allow the assessment and management of DRPs in Swiss CPs with the support of the local health authorities and pharmacist association. Clinicaltrials.gov NCT05348538

Democratización y representación legislativa en México

Artículo original¿Basta con que haya competitividad para que los gobernantes respondan a los intereses de sus representados? Investigaciones recientes sobre México sugieren que incluso sin reelección, la competitividad ha mejorado el desempeño gubernamental. Empero, estas pesquisas se basan en datos agregados que no logran probar la relación individual entre competitividad electoral y representación. En este texto examinamos dicha relación mediante un análisis individual de la actividad legislativa medida como presentación de iniciativas y direccionamiento de recursos por parte de los diputados federales. Nuestros hallazgos confirman que la competitividad incentiva la postulación de candidatos calificados, pero cuestionan que la competitividad afecte el comportamiento legislativo a nivel individual. Ello implica que, por sí mismas, las elecciones competitivas no son suficientes para inducir responsivida

HAADF-STEM Image Resolution Enhancement Using High-Quality Image Reconstruction Techniques: Case of the Fe3O4(111) Surface

From simple averaging to more sophisticated registration and restoration strategies, such as super-resolution (SR), there exist different computational techniques that use a series of images of the same object to generate enhanced images where noise and other distortions have been reduced. In this work, we provide qualitative and quantitative measurements of this enhancement for high-angle annular dark-field scanning transmission electron microscopy imaging. These images are compared in two ways, qualitatively through visual inspection in real and reciprocal space, and quantitatively, through the calculation of objective measurements, such as signal-to-noise ratio and atom column roundness. Results show that these techniques improve the quality of the images. In this paper, we use an SR methodology that allows us to take advantage of the information present in the image frames and to reliably facilitate the analysis of more difficult regions of interest in experimental images, such as surfaces and interfaces. By acquiring a series of cross-sectional experimental images of magnetite (Fe3O4) thin films (111), we have generated interpolated images using averaging and SR, and reconstructed the atomic structure of the very top surface layer that consists of a full monolayer of Fe, with topmost Fe atoms in tetrahedrally coordinated sites

DIPKIP: A connectionist Knowledge Management System to Identify Knowledge Deficits in Practical Cases

This study presents a novel, multidisciplinary research project entitled DIPKIP (data acquisition, intelligent processing, knowledge identification and proposal), which is a Knowledge Management (KM) system that profiles the KM status of a company. Qualitative data is fed into the system that allows it not only to assess the KM situation in the company in a straightforward and intuitive manner, but also to propose corrective actions to improve that situation. DIPKIP is based on four separate steps. An initial “Data Acquisition” step, in which key data is captured, is followed by an “Intelligent Processing” step, using neural projection architectures. Subsequently, the “Knowledge Identification” step catalogues the company into three categories, which define a set of possible theoretical strategic knowledge situations: knowledge deficit, partial knowledge deficit, and no knowledge deficit. Finally, a “Proposal” step is performed, in which the “knowledge processes”—creation/acquisition, transference/distribution, and putting into practice/updating—are appraised to arrive at a coherent recommendation. The knowledge updating process (increasing the knowledge held and removing obsolete knowledge) is in itself a novel contribution. DIPKIP may be applied as a decision support system, which, under the supervision of a KM expert, can provide useful and practical proposals to senior management for the improvement of KM, leading to flexibility, cost savings, and greater competitiveness. The research also analyses the future for powerful neural projection models in the emerging field of KM by reviewing a variety of robust unsupervised projection architectures, all of which are used to visualize the intrinsic structure of high-dimensional data sets. The main projection architecture in this research, known as Cooperative Maximum-Likelihood Hebbian Learning (CMLHL), manages to capture a degree of KM topological ordering based on the application of cooperative lateral connections. The results of two real-life case studies in very different industrial sectors corroborated the relevance and viability of the DIPKIP system and the concepts upon which it is founded

Phenotypic profile of expanded NK cells in chronic lymphoproliferative disorders: a surrogate marker for NK-cell clonality

Currently, the lack of a universal and specific marker of clonality hampers the diagnosis and classification of chronic expansions of natural killer (NK) cells. Here we investigated the utility of flow cytometric detection of aberrant/altered NK-cell phenotypes as a surrogate marker for clonality, in the diagnostic work-up of chronic lymphoproliferative disorders of NK cells (CLPD-NK). For this purpose, a large panel of markers was evaluated by multiparametric flow cytometry on peripheral blood (PB) CD56low NK cells from 60 patients, including 23 subjects with predefined clonal (n = 9) and polyclonal (n = 14) CD56low NK-cell expansions, and 37 with CLPD-NK of undetermined clonality; also, PB samples from 10 healthy adults were included. Clonality was established using the human androgen receptor (HUMARA) assay. Clonal NK cells were found to show decreased expression of CD7, CD11b and CD38, and higher CD2, CD94 and HLADR levels vs. normal NK cells, together with a restricted repertoire of expression of the CD158a, CD158b and CD161 killer-associated receptors. In turn, NK cells from both clonal and polyclonal CLPD-NK showed similar/overlapping phenotypic profiles, except for high and more homogeneous expression of CD94 and HLADR, which was restricted to clonal CLPD-NK. We conclude that the CD94hi/HLADR+ phenotypic profile proved to be a useful surrogate marker for NK-cell clonality

Optimisations and challenges involved in the creation of various bioluminescent and fluorescent influenza a virus strains for in vitro and in vivo applications

Bioluminescent and fluorescent influenza A viruses offer new opportunities to study influenza virus replication, tropism and pathogenesis. To date, several influenza A reporter viruses have been described. These strategies typically focused on a single reporter gene (either bioluminescent or fluorescent) in a single virus backbone. However, whilst bioluminescence is suited to in vivo imaging, fluorescent viruses are more appropriate for microscopy. Therefore, the idea l reporter virus varies depending on the experiment in question, and it is important that any reporter virus strategy can be adapted accordingly. Herein, a strategy was developed to create five different reporter viruses in a single virus backbone. Specifically, enhanced green fluorescent protein (eGFP), far-red fluorescent protein (fRFP), near-infrared fluorescent protein (iRFP), Gaussia luciferase (gLUC) and firefly luciferase (fLUC) were inserted into the PA gene segment of A/PR/8/34 (H1N1). This study provides a comprehensive characterisation of the effects of different reporter genes on influenza virus replication and reporter activity. In vivo reporter gene expression, in lung tissues, was only detected for eGFP, fRFP and gLUC expressing viruses. In vitro, the eGFP-expressing virus displayed the best reporter stability and could be used for correlative light electron microscopy (CLEM). This strategy was then used to create eGFP-expressing viruses consisting entirely of pandemic H1N1, highly pathogenic avian influenza (HPAI) H5N1 and H7N9. The HPAI H5N1 eGFP-expressing virus infected mice and reporter gene expression was detected, in lung tissues, in vivo. Thus, this study provides new tools and insights for the creation of bioluminescent and fluorescent influenza A reporter viruses. Copyright

Detection of myxoma viruses encoding a defective M135R gene from clinical cases of myxomatosis; possible implications for the role of the M135R protein as a virulence factor

<p>Abstract</p> <p>Background</p> <p>Myxoma virus is a member of the <it>Poxviridae </it>and causes disease in European rabbits. Laboratory confirmation of the clinical disease, which occurs in the autumn of most years in Denmark, has been achieved previously using antigen ELISA and electron microscopy.</p> <p>Results</p> <p>An unusually large number of clinically suspected cases of myxomatosis were observed in Denmark during 2007. Myxoma virus DNA was detected, using a new real time PCR assay which targets the M029L gene, in over 70% of the clinical samples submitted for laboratory confirmation. Unexpectedly, further analysis revealed that a high proportion of these viral DNA preparations contained a frame-shift mutation within the M135R gene that has previously been identified as a virulence factor. This frame-shift mutation results in expression of a greatly truncated product. The same frame-shift mutation has also been found recently within an avirulent strain of myxoma virus (6918). However, three other frame-shift mutations found in this strain (in the genes M009L, M036L and M148R) were not shared with the Danish viruses but a single nucleotide deletion in the M138R/M139R intergenic region was a common feature.</p> <p>Conclusions</p> <p>It appears that expression of the full-length myxoma virus M135R protein is not required for virulence in rabbits. Hence, the frame-shift mutation in the M135R gene in the nonpathogenic 6918 virus strain is not sufficient to explain the attenuation of this myxoma virus but one/some of the other frame-shift mutations alone or in conjunction with one/some of the thirty two amino acid substitutions must also contribute. The real time PCR assay for myxoma virus is a useful diagnostic tool for laboratory confirmation of suspected cases of myxomatosis.</p

Privatization in the presence of foreign competition and strategic policies

Recent evidence shows that developing and transition economies are increasingly privatizing their public firms and also experiencing rapid growth of inward foreign direct investment (FDI). In an international mixed oligopoly with strategic tax/subsidy policies, we analyze the interaction between privatization and FDI. We find that the incentive for FDI increases with privatization. However, the possibility of FDI reduces the degree of privatization. Our paper shows that FDI policies reducing the fixed-cost of undertaking FDI may need to complement the privatization policies to attract FDI and to improve domestic welfare

Diagnóstico y evaluación de la sustentabilidad de la ganadería de monte en el Chaco Semiárido : El caso de Salta Forestal zona sur, departamento Anta, provincia de Salta

En este trabajo se realizó un diagnóstico de la sustentabilidad de los puestos ganaderos ubicados en la zona Sur de Salta Forestal, en la región del Chaco semiárido de la provincia de Salta. Se estimó para cada caso un índice de diagnóstico y evaluación de sustentabilidad compuesto por 15 indicadores que permite incluir en la evaluación los procesos de gobernanza y toma de decisiones de gestión. Los puestos evaluados presentaron un nivel de sustentabilidad regular. Los principales problemas detectados se relacionan con la falta de presencia estatal e infraestructura pública en la zona, lo que reduce considerablemente la productividad y la rentabilidad de la actividad ganadera en la región. El índice estimado permitió detectar numerosos puntos críticos de los sistemas productivos analizados, lo cual puede facilitar la identificación y la justificación de las medidas correctoras que deberían ser incluidas en un plan de desarrollo más sustentable para la región.This work carried out a diagnosis of the sustainability of livestock establishments located in the south region of the Salta Forestal, in the semi-arid Chaco in Salta Province. An index of diagnosis and evaluation of sustainability made up of 15 indicators that includes the evaluation of government and management decisions was used for each case. The cattle ranching farms studied presented a regular level of sustainability. The main problems observed are related to the lack of State presence and public infrastructure in the area, leading to reduced productivity and profitability of the livestock farmers in the region. The index identified numerous critical points of the productive systems analysed, therefore it can facilitate the identification and justification of the corrective measures that should be included in a plan of sustainable development for the region.Tema 1: Hábitat y energías renovables y ambiente.Facultad de Arquitectura y Urbanism

Diagnóstico y evaluación de la sustentabilidad de la ganadería de monte en el Chaco Semiárido : El caso de Salta Forestal zona sur, departamento Anta, provincia de Salta

En este trabajo se realizó un diagnóstico de la sustentabilidad de los puestos ganaderos ubicados en la zona Sur de Salta Forestal, en la región del Chaco semiárido de la provincia de Salta. Se estimó para cada caso un índice de diagnóstico y evaluación de sustentabilidad compuesto por 15 indicadores que permite incluir en la evaluación los procesos de gobernanza y toma de decisiones de gestión. Los puestos evaluados presentaron un nivel de sustentabilidad regular. Los principales problemas detectados se relacionan con la falta de presencia estatal e infraestructura pública en la zona, lo que reduce considerablemente la productividad y la rentabilidad de la actividad ganadera en la región. El índice estimado permitió detectar numerosos puntos críticos de los sistemas productivos analizados, lo cual puede facilitar la identificación y la justificación de las medidas correctoras que deberían ser incluidas en un plan de desarrollo más sustentable para la región.This work carried out a diagnosis of the sustainability of livestock establishments located in the south region of the Salta Forestal, in the semi-arid Chaco in Salta Province. An index of diagnosis and evaluation of sustainability made up of 15 indicators that includes the evaluation of government and management decisions was used for each case. The cattle ranching farms studied presented a regular level of sustainability. The main problems observed are related to the lack of State presence and public infrastructure in the area, leading to reduced productivity and profitability of the livestock farmers in the region. The index identified numerous critical points of the productive systems analysed, therefore it can facilitate the identification and justification of the corrective measures that should be included in a plan of sustainable development for the region.Tema 1: Hábitat y energías renovables y ambiente.Facultad de Arquitectura y Urbanism