Doctors and nurses perceptions towards the introduction of clinical pharmacy service to the Sri Lankan healthcare system- Experience from a tertiary care hospital

Objectives: To evaluate the rate of acceptance of the clinical pharmacist’s (CP’s) recommendations regarding Drug Related Problems (DRPs) by healthcare team, to determine the quality and quantity of drug information queries directed to the CP and to assess the level of acceptance of clinical pharmacy service (CPS) by other members of the ward staff.Methods: This was a controlled trial conducted in a tertiary care hospital. The control group received standard care. The intervention group received a CPS in addition to the standard care. DRPs were classified according to the adapted PCNE classification system V5.01. The CP discussed the identified potential DRPs with healthcare team. All the drug related questions directed to the CP by healthcare staff were recorded. A staff survey was carried out before and after the study.Results: A total of 270 drug related recommendations were directed to the healthcare team. 83% (P < 0.001) of the recommendations were accepted by doctors and 74% (P < 0.001) were acted upon. 17 medication-related questions were directed to the CP from the team. The perceptions of doctors regarding ward-based CPS were satisfactory at baseline period. At end of study, the majority of doctors were happy to welcome a service from a competent CP. Nurses were resistant to this collaboration.Conclusions: There was high acceptance of CP’s recommendations regarding DRPs by the medical team. Doctors were satisfied with the inclusion of a ward-based pharmacist to the healthcare team. However there is a need to improve liaisons between CP and nursing staff

Impact of a ward based clinical pharmacy service on drug-related hospital re-admissions - Evidence from a controlled clinical trial in a tertiary care hospital in Sri Lanka

Objective: To determine the impact of a ward-based clinical pharmacy service on drug related hospital re-admissions.Methods: This was a part of a controlled trial conducted in a tertiary care hospital in Sri Lanka to evaluate the clinical pharmacy service. The control group received the standard care whereas the intervention group received a ward-based pharmacist’s service in addition to the standard care. The pharmacist performed a prospective medications review of patients with chronic non-communicable diseases during their hospital stay and made recommendations to the health care team when appropriate. At discharge reconciliation of discharge prescription was done. Patients were educated about discharge medicines to improve knowledge and compliance. Both groups were followed up monthly for six months to identify drug-related hospital re-admissions.Results: Of 137 drug-related re-admissions, 93 (involving 87/356 patients) were from the control group, and 44 (involving 42/361 patients) were from the intervention group (P < 0.001). Non-compliance was the main reason for re-admissions in the control group and it was significantly higher in the control group (control vs. intervention: 53.8% vs. 34.1%; P = 0.013). Adverse drug reactions were the most common reason for re-admission in the intervention group (23/44; 52.3%). There was a significantly larger percentage of re-admissions in the control group due to unintentional omission of drugs on discharge prescription (control vs. intervention: 17.2% vs. 2.3%; P = 0.012).Conclusion: Ward based clinical pharmacy service was useful to reduce drug related hospital re-admissions in patients with chronic non-communicable diseases. Establishing a ward based clinical pharmacy service is recommended

The statistical analyses of flares detected in B band photometry of UV Ceti type stars

In this study, we present the unpublished flare data collected from 222 flares detected in the B band observations of five stars and the results derived by statistical analysis and modeling of these data. Six basic properties have been found with a statistical analysis method applied to all models and analyses for the flares detected in the B band observation of UV Ceti type stars. We have also compared the U and B bands with the analysis results. This comparison allowed us to evaluate the methods used in the analyses. The analyses provided the following results. (1) The flares were separated into two types, fast and slow flares. (2) The mean values of the equivalent durations of the slow and the fast flares differ by a factor of 16.2 \pm 3.7. (3) Regardless of the total flare duration, the maximum flare energy can reach a different Plateau level for each star. (4) The Plateau values of EV Lac and EQ Peg are higher than the others. (5) The minimum values of the total flare duration increase toward the later spectral types. This value is called the Half-Life value in models. (6) Both the maximum flare rise times and the total flare duration obtained from the observed flares decrease toward the later spectral types.Comment: 17 pages, 10 figures, 8 table

Lepton Flavour Violating Leptonic/Semileptonic Decays of Charged Leptons in the Minimal Supersymmetric Standard Model

We consider the leptonic and semileptonic (SL) lepton flavour violating (LFV) decays of the charged leptons in the minimal supersymmetric standard model (MSSM). The formalism for evaluation of branching fractions for the SL LFV charged-lepton decays with one or two pseudoscalar mesons, or one vector meson in the final state, is given. Previous amplitudes for the SL LFV charged-lepton decays in MSSM are improved, for instance the $\gamma$-penguin amplitude is corrected to assure the gauge invariance. The decays are studied not only in the model-independent formulation of the theory in the frame of MSSM, but also within the frame of the minimal supersymmetric SO(10) model within which the parameters of the MSSM are determined. The latter model gives predictions for the neutrino-Dirac Yukawa coupling matrix, once free parameters in the model are appropriately fixed to accommodate the recent neutrino oscillation data. Using this unambiguous neutrino-Dirac Yukawa couplings, we calculate the LFV leptonic and SL decay processes assuming the minimal supergravity scenario. A very detailed numerical analysis is done to constrain the MSSM parameters. Numerical results for SL LFV processes are given, for instance for tau -> e (mu) pi0, tau -> e (mu) eta, tau -> e (mu) eta', tau -> e (mu) rho0, tau -> e (mu) phi, tau -> e (mu) omega, etc.Comment: 36 pages, 3 tables, 5 .eps figure

Dark matter and Colliders searches in the MSSM

We study the complementarity between dark matter experiments (direct detection and indirect detections) and accelerator facilities (the CERN LHC and a $\sqrt{s}= 1$ TeV $e^+e^-$ Linear Collider) in the framework of the constrained Minimal Supersymmetric Standard Model (MSSM). We show how non--universality in the scalar and gaugino sectors can affect the experimental prospects to discover the supersymmetric particles. The future experiments will cover a large part of the parameter space of the MSSM favored by WMAP constraint on the relic density, but there still exist some regions beyond reach for some extreme (fine tuned) values of the supersymmetric parameters. Whereas the Focus Point region characterized by heavy scalars will be easily probed by experiments searching for dark matter, the regions with heavy gauginos and light sfermions will be accessible more easily by collider experiments. More informations on both supersymmetry and astrophysics parameters can be thus obtained by correlating the different signals.Comment: 25 pages, 10 figures, corrected typos and reference adde

RP105 deficiency attenuates early atherosclerosis via decreased monocyte influx in a CCR2 dependent manner

AbstractObjective: Toll like receptor 4 (TLR4) plays a key role in inflammation and previously it was established that TLR4 deficiency attenuates atherosclerosis. RadioProtective 105 (RP105) is a structural homolog of TLR4 and an important regulator of TLR4 signaling, suggesting that RP105 may also be an important effector in atherosclerosis. We thus aimed to determine the role of RP105 in atherosclerotic lesion development using RP105 deficient mice on an atherosclerotic background. Methods and results: Atherosclerosis was induced in Western-type diet fed low density lipoprotein receptor deficient (LDLr−/−) and LDLr/RP105 double knockout (LDLr−/−/RP105−/−) mice by means of perivascular carotid artery collar placement. Lesion size was significantly reduced by 58% in LDLr−/−/RP105−/− mice, and moreover, plaque macrophage content was markedly reduced by 40%. In a model of acute peritonitis, monocyte influx was almost 3-fold reduced in LDLr−/−/RP105−/− mice (P = 0.001), while neutrophil influx remained unaltered, suggestive of an altered migratory capacity of monocytes upon deletion of RP105. Interestingly, in vitro stimulation of monocytes with LPS induced a downregulation of CCR2, a chemokine receptor crucially involved in monocyte influx to atherosclerotic lesions, which was more pronounced in LDLr−/−/RP105−/− monocytes as compared to LDLr−/− monocytes. Conclusion: We here show that RP105 deficiency results in reduced early atherosclerotic plaque development with a marked decrease in lesional macrophage content, which may be due to disturbed migration of RP105 deficient monocytes resulting from CCR2 downregulation

Early exercise in blunt chest wall trauma: protocol for a mixed-methods, multicentre, parallel randomised controlled trial (ELECT2 trial)

Introduction: Chronic pain and disability are now well-recognised long-term complications of blunt chest wall trauma. Limited research exists regarding therapeutic interventions that can be used to address these complications. A recent feasibility study was completed testing the methods of a definitive trial. This protocol describes the proposed definitive trial, the aim of which is to investigate the impact of an early exercise programme on chronic pain and disability in patients with blunt chest wall trauma. Methods/analysis: This mixed-methods, multicentre, parallel randomised controlled trial will run in four hospitals in Wales and one in England over 12-month recruitment period. Patients will be randomised to either the control group (routine physiotherapy input) or the intervention group (routine physiotherapy input plus a simple exercise programme completed individually by the patient). Baseline measurements including completion of two surveys (Brief Pain Inventory and EuroQol 5-dimensions, 5-Levels) will be obtained on initial assessment. These measures and a client services receipt inventory will be repeated at 3-month postinjury. Analysis of outcomes will focus on rate and severity of chronic pain and disability, cost-effectiveness and acceptability of the programme by patients and clinicians. Qualitative feedback regarding acceptability will be obtained through patient and clinician focus groups. Ethics/dissemination: London Riverside Research Ethics Committee (Reference number: 21/LO/0782) and the Health Research Authority granted approval for the trial in December 2021. Patient recruitment will commence in February 2022. Planned dissemination is through publication in a peer-reviewed Emergency Medicine Journal, presentation at appropriate conferences and to stakeholders at professional meetings. Trial registration number: ISRCTN65829737; Pre-results

Measurement of the polarisation of W bosons produced with large transverse momentum in pp collisions at sqrt(s) = 7 TeV with the ATLAS experiment

This paper describes an analysis of the angular distribution of W->enu and W->munu decays, using data from pp collisions at sqrt(s) = 7 TeV recorded with the ATLAS detector at the LHC in 2010, corresponding to an integrated luminosity of about 35 pb^-1. Using the decay lepton transverse momentum and the missing transverse energy, the W decay angular distribution projected onto the transverse plane is obtained and analysed in terms of helicity fractions f0, fL and fR over two ranges of W transverse momentum (ptw): 35 < ptw < 50 GeV and ptw > 50 GeV. Good agreement is found with theoretical predictions. For ptw > 50 GeV, the values of f0 and fL-fR, averaged over charge and lepton flavour, are measured to be : f0 = 0.127 +/- 0.030 +/- 0.108 and fL-fR = 0.252 +/- 0.017 +/- 0.030, where the first uncertainties are statistical, and the second include all systematic effects.Comment: 19 pages plus author list (34 pages total), 9 figures, 11 tables, revised author list, matches European Journal of Physics C versio

Observation of a new chi_b state in radiative transitions to Upsilon(1S) and Upsilon(2S) at ATLAS

The chi_b(nP) quarkonium states are produced in proton-proton collisions at the Large Hadron Collider (LHC) at sqrt(s) = 7 TeV and recorded by the ATLAS detector. Using a data sample corresponding to an integrated luminosity of 4.4 fb^-1, these states are reconstructed through their radiative decays to Upsilon(1S,2S) with Upsilon->mu+mu-. In addition to the mass peaks corresponding to the decay modes chi_b(1P,2P)->Upsilon(1S)gamma, a new structure centered at a mass of 10.530+/-0.005 (stat.)+/-0.009 (syst.) GeV is also observed, in both the Upsilon(1S)gamma and Upsilon(2S)gamma decay modes. This is interpreted as the chi_b(3P) system.Comment: 5 pages plus author list (18 pages total), 2 figures, 1 table, corrected author list, matches final version in Physical Review Letter