Pharmacy needs global professional standards for education and workforce development.

Catherine Duggan, director of professional development at the Royal Pharmaceutical Society (RPS) and Ian Bates, education adviser to the RPS English Pharmacy Board, discuss the importance of developing a global standard of education and training for pharmacists

Feasibility study ASCS remote sensing/compliance determination system

A short-term technical study was performed by the MSC Earth Observations Division to determine the feasibility of the proposed Agricultural Stabilization and Conservation Service Automatic Remote Sensing/Compliance Determination System. For the study, the term automatic was interpreted as applying to an automated remote-sensing system that includes data acquisition, processing, and management

An Evolving Understanding of Sense of Place in Social-Ecological Systems Research and the Barriers and Enablers to its Measurement

Social-ecological systems (SES) are changing more in the Anthropocene than ever before. With this also comes a change in Sense of Place (SoP), that is, the emotional bond that a person (or group of people) has with a place. This impacts how individuals and groups interact with a place (i.e., their behaviours) and respond to disturbance or change (i.e., their adaptive capacity). To understand how SoP is changing across space and time and to be able to compare this across social-ecological contexts, we must first take stock of how SoP is conceptualised so as to understand how to capture and measure the phenomena in a meaningful way (e.g., to inform policy). Based on in-depth qualitative interviews with leading SoP researchers (n = 17 from 8 countries) this paper aims to identify: (1) the current breadth of theoretical conceptualisations for SoP; (2) the methodologies that have been used to measure SoP in different contexts and settings; and (3) the barriers and (4) enablers to the use of different methodologies. Results show that there has been a change in how SoP has been conceptualised over time, whereby it was traditionally considered as something singular and limited, towards something much more dynamic. Results also show that diverse methods (both quantitative and qualitative) have been used to measure SoP, but the choice of method is often a result of resource constraints that limit research design. These findings suggest that broader collaboration among stakeholders and increased interdisciplinarity would undoubtedly lead to improved outcomes in our understanding of SoP, specifically how it is changing in response to anthropogenic pressures, and how the results can be integrated into policy and practice to support environment conservation and management. It is hoped these findings can help establish a community of practice around how we conceptualise SoP, and hence understand it, to create space for methodological integration and shared learnings as a field

Transcriptional profiling of zebrafish identifies host factors controlling susceptibility to Shigella flexneri

Shigella flexneri is a human-adapted pathovar of Escherichia coli that can invade the intestinal epithelium, causing inflammation and bacillary dysentery. Although an important human pathogen, the host response to S. flexneri has not been fully described. Zebrafish larvae represent a valuable model to study human infections in vivo. Here we use a Shigella-zebrafish infection model to generate mRNA expression profiles of host response to Shigella infection at the whole animal level. Immune response-related processes dominate the signature of early Shigella infection (6 hours post-infection). Consistent with its clearance from the host, the signature of late Shigella infection (24 hours post-infection) is significantly changed, and only a small set of immune-related genes remain differentially expressed, including acod1 and gpr84. Using mutant lines generated by ENU, CRISPR mutagenesis and F0 Crispants, we show that acod1- and gpr84-deficient larvae are more susceptible to Shigella infection. Together, these results highlight the power of zebrafish to model infection by bacterial pathogens and reveal the mRNA expression of the early (acutely infected) and late (clearing) host response to Shigella infection

The Broad Absorption Line Tidal Disruption Event iPTF15af: Optical and Ultraviolet Evolution

We present multi-wavelength observations of the tidal disruption event (TDE) iPTF15af, discovered by the intermediate Palomar Transient Factory (iPTF) survey at redshift $z=0.07897$. The optical and ultraviolet (UV) light curves of the transient show a slow decay over five months, in agreement with previous optically discovered TDEs. It also has a comparable black-body peak luminosity of $L_{\rm{peak}} \approx 1.5 \times 10^{44}$ erg/s. The inferred temperature from the optical and UV data shows a value of (3$-$5) $\times 10^4$ K. The transient is not detected in X-rays up to $L_X < 3 \times 10^{42}$erg/s within the first five months after discovery. The optical spectra exhibit two distinct broad emission lines in the He II region, and at later times also H$\alpha$ emission. Additionally, emission from [N III] and [O III] is detected, likely produced by the Bowen fluorescence effect. UV spectra reveal broad emission and absorption lines associated with high-ionization states of N V, C IV, Si IV, and possibly P V. These features, analogous to those of broad absorption line quasars (BAL QSOs), require an absorber with column densities $N_{\rm{H}} > 10^{23}$ cm$^{-2}$. This optically thick gas would also explain the non-detection in soft X-rays. The profile of the absorption lines with the highest column density material at the largest velocity is opposite that of BAL QSOs. We suggest that radiation pressure generated by the TDE flare at early times could have provided the initial acceleration mechanism for this gas. Spectral UV line monitoring of future TDEs could test this proposal.Comment: 20 pages, 12 figures, published in Ap

Amonafide: An active agent in the treatment of previously untreated advanced breast cancer--a cancer and leukemia group B study (CALGB 8642)

Amonafide is a new imide derivative of naphthalic acid. The drug had demonstrated significant activity in preclinical studies and some activity in Phase I trials. The drug is extensively metabolized and detected in plasma and urine. Its toxicity has previously been correlated to the formation of an active metabolite, N-acetyl-amonafide. Amonafide was chosen for inclusion in the Cancer and Leukemia Group B (CALGB) master metastatic breast cancer protocol. CALGB 8642 randomizes previously untreated metastatic breast cancer patients either to one of several Phase II agents given for up to four cycles and then followed by standard cyclophosphamide-doxorubicin-5-fluorouracil, or to immediate treatment with standard cyclophosphamide-doxorubicin-5-fluorouracil. The end point of CALGB 8642 is to assess the difference in survival, toxicity, and overall response when limited exposure to Phase II agents precedes standard chemotherapy. This report deals only with amonafide as a Phase II agent. Comparisons with the cyclophosphamide-doxorubicin-5-fluorouracil arm will not be addressed. Patients had to have histologically documented measurable breast cancer and a performance status of 0-1. Patients could not have had prior chemotherapy for metastatic disease. Prior adjuvant chemotherapy was permitted. Patients could not have visceral crisis. Amonafide was given at 300 mg/m2/day i.v. for 5 days, and repeated at 21-day intervals for a maximum of four cycles. Escalation and reduction in dose was mandated dependent on hematotoxicity or lack thereof. Toxicity was primarily hematological and bimodal: 32% had grade 3 or 4 leukopenia and 24% had grade 3 or 4 thrombocytopenia; 22% had no leukopenia and 44% had no thrombocytopenia. The response rate was 18%, including one complete response. When response was analyzed by hematological toxicity, there was a 35.7% response if patients had leukopenia grade 3/4 (versus 8.3%, P = 0.08). There was a 50% response if patients had thrombocytopenia grade 3/4 (versus 7.1%, P = \u3c0.01). We conclude that amonafide is somewhat active in previously untreated breast cancer patients. There may be a steep dose-response curve, based on the significant correlation between myelosuppression and response. Rates of responses in patients adequately dosed (i.e., with significant hematotoxicity) with amonafide ranged from 35 to 50%. Further studies will incorporate individualized dosing based on pretreatment acetylator phenotyping

Catch per unit effort dynamic of Yellowfin Tuna related to sea surface temperature and chlorophyll in southern Indonesia

Tuna fisheries are the most valuable fisheries in the world, with an estimated market value of at least US$42 billion in 2018. Indonesia plays an important role in the global tuna fisheries and has committed to improve its fisheries management; therefore, a pilot of long-term spatial-temporal data bases was developed in 2012, however none have utilized data to have better understanding for management improvement. In this study, the annual and seasonal variation of large (≥10 kg) Yellowfin Tuna (YFT) catch per unit effort (CPUE) have been investigated and the influence of sea surface temperature (SST) and chlorophyll-a on these variables examined. We used fish landing data from West Nusa Tenggara recorded every month between 2012 and 2017 and analyzed using generalized linear models and generalized additive models. We found a seasonal and annual pattern of tuna abundance affected by SST and chlorophyll-a (chl a) and related to upwelling and El Nino event. These results also suggest that a two-month closure to fishing in August and September in southern Lombok is worth considering by the Government to maximize conservation of stocks due to a high abundance of juveniles emerging during the upwelling months from June to August

Quality of medication use in primary care - mapping the problem, working to a solution: a systematic review of the literature

Background: The UK, USA and the World Health Organization have identified improved patient safety in healthcare as a priority. Medication error has been identified as one of the most frequent forms of medical error and is associated with significant medical harm. Errors are the result of the systems that produce them. In industrial settings, a range of systematic techniques have been designed to reduce error and waste. The first stage of these processes is to map out the whole system and its reliability at each stage. However, to date, studies of medication error and solutions have concentrated on individual parts of the whole system. In this paper we wished to conduct a systematic review of the literature, in order to map out the medication system with its associated errors and failures in quality, to assess the strength of the evidence and to use approaches from quality management to identify ways in which the system could be made safer. Methods: We mapped out the medicines management system in primary care in the UK. We conducted a systematic literature review in order to refine our map of the system and to establish the quality of the research and reliability of the system. Results: The map demonstrated that the proportion of errors in the management system for medicines in primary care is very high. Several stages of the process had error rates of 50% or more: repeat prescribing reviews, interface prescribing and communication and patient adherence. When including the efficacy of the medicine in the system, the available evidence suggested that only between 4% and 21% of patients achieved the optimum benefit from their medication. Whilst there were some limitations in the evidence base, including the error rate measurement and the sampling strategies employed, there was sufficient information to indicate the ways in which the system could be improved, using management approaches. The first step to improving the overall quality would be routine monitoring of adherence, clinical effectiveness and hospital admissions. Conclusion: By adopting the whole system approach from a management perspective we have found where failures in quality occur in medication use in primary care in the UK, and where weaknesses occur in the associated evidence base. Quality management approaches have allowed us to develop a coherent change and research agenda in order to tackle these, so far, fairly intractable problems

Using honey to heal diabetic foot ulcers

Diabetic ulcers seem to be arrested in the inflammatory/proliferative stage of the healing process, allowing infection and inflammation to preclude healing. Antibiotic-resistant bacteria have become a major cause of infections, including diabetic foot infections. It is proposed here that the modern developments of an ancient and traditional treatment for wounds, dressing them with honey, provide the solution to the problem of getting diabetic ulcers to move on from the arrested state of healing. Honeys selected to have a high level of antibacterial activity have been shown to be very effective against antibiotic-resistant strains of bacteria in laboratory and clinical studies. The potent anti-inflammatory action of honey is also likely to play an important part in overcoming the impediment to healing that inflammation causes in diabetic ulcers, as is the antioxidant activity of honey. The action of honey in promotion of tissue regeneration through stimulation of angiogenesis and the growth of fibroblasts and epithelial cells, and its insulin-mimetic effect, would also be of benefit in stimulating the healing of diabetic ulcers. The availability of honey-impregnated dressings which conveniently hold honey in place on ulcers has provided a means of rapidly debriding ulcers and removing the bacterial burden so that good healing rates can be achieved with neuropathic ulcers. With ischemic ulcers, where healing cannot occur because of lack of tissue viability, these honey dressings keep the ulcers clean and prevent infection occurring