Irradiation effects in oxide glasses doped with transition and rare-earth elements

International audienceThe effect of -irradiation on silicate and aluminoborosilicate glasses doped with transition metals (TM) and rare earth (RE) elements has been studied using Electron Paramagnetic Resonance (EPR), Raman and luminescence spectroscopy. Irradiation leads to the reduction of both Cr and Mn ions in both types of glass matrix. It is shown that even small amounts of TM dopants completely block defect production, as occurs under irradiation in non-doped glasses. As well, TM doping results in the disappearance of structural changes in the glass (densification, polymerization increase and Na migration) for doses of ~ 10 Gy. Unlike TM-doped matrices, incorporation of RE ions into aluminoborosilicate glass blocks neither defect production nor structural changes in glass matrices during irradiation. Simultaneously, we observe a reduction of RE ions, most clearly demonstrated for Ce ions in aluminoborosilicate glasses. We propose that the relative stability of the different charge states of the RE ions is linked to the efficiency of the reduction process, and therefore to the evolution of the glass structure during irradiation

I see what you mean: Co-speech gestures for reference resolution in multimodal dialogue

In face-to-face interaction, we use multiple modalities, including speech and gestures, to communicate information and resolve references to objects. However, how representational co-speech gestures refer to objects remains understudied from a computational perspective. In this work, we address this gap by introducing a multimodal reference resolution task centred on representational gestures, while simultaneously tackling the challenge of learning robust gesture embeddings. We propose a self-supervised pre-training approach to gesture representation learning that grounds body movements in spoken language. Our experiments show that the learned embeddings align with expert annotations and have significant predictive power. Moreover, reference resolution accuracy further improves when (1) using multimodal gesture representations, even when speech is unavailable at inference time, and (2) leveraging dialogue history. Overall, our findings highlight the complementary roles of gesture and speech in reference resolution, offering a step towards more naturalistic models of human-machine interaction

Evaluation of the implementation of a clinical pharmacy service on an acute internal medicine ward in Italy

© 2018 The Author(s). Published by Springer Nature. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.Background: Successful implementation of clinical pharmacy services is associated with improvement of appropriateness of prescribing. Both high clinical significance of pharmacist interventions and their high acceptance rate mean that potential harm to patients could be avoided. Evidence shows that low acceptance rate of pharmacist interventions can be associated with lack of communication between pharmacists and the rest of the healthcare team. The objective of this study was to evaluate the effect of a structured communication strategy on acceptance rate of interventions made by a clinical pharmacist implementing a ward-based clinical pharmacy service targeting elderly patients at high risk of drug-related problems. Characteristics of interventions made to improve appropriateness of prescribing, their clinical significance and intervention acceptance rate by doctors were recorded. Methods: A clinical pharmacy intervention study was conducted between September 2013 and December 2013 in an internal medicine ward of a teaching hospital. A trained clinical pharmacist provided pharmaceutical care to 94 patients aged over 70 years. The clinical pharmacist used the following communication and marketing tools to implement the service described: Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis; Specific, Measurable, Achievable, Realistic and Timely (SMART) goals; Awareness, Interest, Desire, Action (AIDA) model. Results: A total of 740 interventions were made by the clinical pharmacist. The most common drug classes involved in interventions were: antibacterials for systemic use (11.1%) and anti-parkinson drugs (10.8%). The main drug-related problem categories triggering interventions were: no specific problem (15.9%) and prescription writing error (12.0%). A total of 93.2% of interventions were fully accepted by physicians. After assessment by an external panel 63.2% of interventions (96 interventions/ per month) were considered of moderate clinical significance and 23.4% (36 interventions/ per month) of major clinical significance. The most frequent interventions were to educate a healthcare professional (20.4%) and change dose (16.1%). Conclusions: To our knowledge this is the first study evaluating the effect of a structured communication strategy on acceptance rate of pharmacist interventions. Pharmaceutical care delivered by the clinical pharmacist is likely to have had beneficial outcomes. Clinical pharmacy services like the one described should be implemented widely to increase patient safety.Peer reviewedFinal Published versio

Medication errors in the Middle East countries: a systematic review of the literature

Background: Medication errors are a significant global concern and can cause serious medical consequences for patients. Little is known about medication errors in Middle Eastern countries. The objectives of this systematic review were to review studies of the incidence and types of medication errors in Middle Eastern countries and to identify the main contributory factors involved. Methods: A systematic review of the literature related to medication errors in Middle Eastern countries was conducted in October 2011 using the following databases: Embase, Medline, Pubmed, the British Nursing Index and the Cumulative Index to Nursing & Allied Health Literature. The search strategy included all ages and languages. Inclusion criteria were that the studies assessed or discussed the incidence of medication errors and contributory factors to medication errors during the medication treatment process in adults or in children. Results: Forty-five studies from 10 of the 15 Middle Eastern countries met the inclusion criteria. Nine (20%) studies focused on medication errors in paediatric patients. Twenty-one focused on prescribing errors, 11 measured administration errors, 12 were interventional studies and one assessed transcribing errors. Dispensing and documentation errors were inadequately evaluated. Error rates varied from 7.1% to 90.5% for prescribing and from 9.4% to 80% for administration. The most common types of prescribing errors reported were incorrect dose (with an incidence rate from 0.15% to 34.8% of prescriptions), wrong frequency and wrong strength. Computerised physician rder entry and clinical pharmacist input were the main interventions evaluated. Poor knowledge of medicines was identified as a contributory factor for errors by both doctors (prescribers) and nurses (when administering drugs). Most studies did not assess the clinical severity of the medication errors. Conclusion: Studies related to medication errors in the Middle Eastern countries were relatively few in number and of poor quality. Educational programmes on drug therapy for doctors and nurses are urgently needed

Sea level changes during the last and present interglacials in Sal Island (Cape Verde archipelago)

Last interglacial and Holocene deposits are particularly well developed in the southern parts of Sal Island (Cape Verde Archipelago). They primarily consist of low-elevation (≤2 m above sea level [a.s.l.]) marine deposits made of a basal conglomerate embedded in carbonate mud, passing upwards to calcarenites. All deposits contain an abundant fauna with corals, algae and molluscs with Strombus latus Gmelin and accompanying warm water species of the “Senegalese” fauna. Small scale geomorphological mapping with detailed morphosedimentary analysis revealed lateral facies changes and imbricate (offlapping) structures that suggest small-scale oscillations of paleo-sealevels during high sea stand intervals. U-series measurements (in coral fragments) allowed unequivocal identification of Marine Isotope Substage (MIS) 5.5 units, but were not precise enough to date the sea level oscillations of the interval. However, geomorphological data and sedimentary facies analysis suggest a double sea level highstand during the peak of the last interglacial. MIS 5.5 age deposits occur at Sal and the Canary Islands at low topographic elevations, between 1 and 2 masl. However, these values are lower than the elevations measured for the correlative terraces outcropping at the western tropical Atlantic islands, widely considered to be tectonically stable. Combining the results in this paper with earlier investigations of the “Senegalese” fauna distribution as far north as the Mediterranean basin, it is suggested that the last-interglacial oceanic temperatures in this basin, as well as the temperatures in other islands of the Eastern Atlantic and the coasts of Morocco, were warmer than modern temperatures

International longitudinal registry of patients with atrial fibrillation and treated with rivaroxaban: RIVaroxaban Evaluation in Real life setting (RIVER)

Background Real-world data on non-vitamin K oral anticoagulants (NOACs) are essential in determining whether evidence from randomised controlled clinical trials translate into meaningful clinical benefits for patients in everyday practice. RIVER (RIVaroxaban Evaluation in Real life setting) is an ongoing international, prospective registry of patients with newly diagnosed non-valvular atrial fibrillation (NVAF) and at least one investigator-determined risk factor for stroke who received rivaroxaban as an initial treatment for the prevention of thromboembolic stroke. The aim of this paper is to describe the design of the RIVER registry and baseline characteristics of patients with newly diagnosed NVAF who received rivaroxaban as an initial treatment. Methods and results Between January 2014 and June 2017, RIVER investigators recruited 5072 patients at 309 centres in 17 countries. The aim was to enroll consecutive patients at sites where rivaroxaban was already routinely prescribed for stroke prevention. Each patient is being followed up prospectively for a minimum of 2-years. The registry will capture data on the rate and nature of all thromboembolic events (stroke / systemic embolism), bleeding complications, all-cause mortality and other major cardiovascular events as they occur. Data quality is assured through a combination of remote electronic monitoring and onsite monitoring (including source data verification in 10% of cases). Patients were mostly enrolled by cardiologists (n = 3776, 74.6%), by internal medicine specialists 14.2% (n = 718) and by primary care/general practice physicians 8.2% (n = 417). The mean (SD) age of the population was 69.5 (11.0) years, 44.3% were women. Mean (SD) CHADS2 score was 1.9 (1.2) and CHA2DS2-VASc scores was 3.2 (1.6). Almost all patients (98.5%) were prescribed with once daily dose of rivaroxaban, most commonly 20 mg (76.5%) and 15 mg (20.0%) as their initial treatment; 17.9% of patients received concomitant antiplatelet therapy. Most patients enrolled in RIVER met the recommended threshold for AC therapy (86.6% for 2012 ESC Guidelines, and 79.8% of patients according to 2016 ESC Guidelines). Conclusions The RIVER prospective registry will expand our knowledge of how rivaroxaban is prescribed in everyday practice and whether evidence from clinical trials can be translated to the broader cross-section of patients in the real world

Systematic Review of Medicine-Related Problems in Adult Patients with Atrial Fibrillation on Direct Oral Anticoagulants

New oral anticoagulant agents continue to emerge on the market and their safety requires assessment to provide evidence of their suitability for clinical use. There-fore, we searched standard databases to summarize the English language literature on medicine-related problems (MRPs) of direct oral anticoagulants DOACs (dabigtran, rivaroxban, apixban, and edoxban) in the treatment of adults with atri-al fibrillation. Electronic databases including Medline, Embase, International Pharmaceutical Abstract (IPA), Scopus, CINAHL, the Web of Science and Cochrane were searched from 2008 through 2016 for original articles. Studies pub-lished in English reporting MRPs of DOACs in adult patients with AF were in-cluded. Seventeen studies were identified using standardized protocols, and two reviewers serially abstracted data from each article. Most articles were inconclusive on major safety end points including major bleeding. Data on major safety end points were combined with efficacy. Most studies inconsistently reported adverse drug reactions and not adverse events or medication error, and no definitions were consistent across studies. Some harmful drug effects were not assessed in studies and may have been overlooked. Little evidence is provided on MRPs of DOACs in patients with AF and, therefore, further studies are needed to establish the safety of DOACs in real-life clinical practice

Quaternary coastal uplift along the Talara Arc (Ecuador, Northern Peru) from new marine terrace data

Marine Geology, v. 228, n. 1-4, p. 73-91, 2006. http://dx.doi.org/10.1016/j.margeo.2006.01.004International audienceMarine terrace sequences have been investigated along the Talara Arc, a 1000-km-long stretch of the coast of Ecuador and northern Peru, characterized by subduction with a concave plan-view. Seven areas were investigated, evidencing flights of up to seven marine terraces with elevations reaching up to 360 m above mean sea level (amsl). Dating of the terraces was made using the Infra Red Stimulated Luminescence (IRSL) technique on sands as old as MIS 9 (∼330 ka). 14 C and U-series dates were obtained from fossil shells for geochronological cross control. Mean uplift rates along the Talara Arc range from about 0.10 up to 0.50 mm/ yr. The strongest uplift is observed in the Manta Peninsula of Ecuador in front of the subduction of the Carnegie Ridge. The uplift rate tends to slow down towards the northern and southern ends of the Talara Arc and then the transition toward the stable or subsiding coasts of central Peru and northern Ecuador and Colombia is sharp. The uplift appears to be homogeneous and related to 1) the map view curvature of the Arc, 2) the concave subduction pattern and 3) the Carnegie Ridge subduction