Self-reported clinical pharmacy service provision in Austria: an analysis of both the community and hospital pharmacy sector: a national study.

Background: With expansion of more advanced clinical roles for pharmacists we need to be mindful that the extent to which clinical pharmacy services (CPS) are implemented varies from one country to another. To date no comprehensive assessment of number and types of CPS provided by either community or hospital pharmacies in Austria exists. Objective: To analyse and describe the number and types of CPS provided in both community and hospital pharmacies, as well as the level of clinical pharmacy education of pharmacists across Austria. Setting: Austrian community and hospital pharmacies. Method: An electronic questionnaire to determine number and types of CPS provided was issued to all chief pharmacists at all community (n=1365) and hospital pharmacies (n=40) across Austria. Besides current and future CPS provision, education and training provision were determined. Main outcome measure: Extent of and attitude towards CPS in Austria. Results: Response rates to the surveys were 19.1% (n=261/1365) in community and 92.5% (n=37/40) in hospital pharmacies. 59.0% and 89.2% of community and hospital pharmacies, respectively, indicated that CPS provision has increased substantially in the past 10 years. 51.0% of community pharmacies reported to provide a medication review service, while 97.3% of hospitals provide a range of CPS. Only 18.0% of community pharmacies offer services other than medication review services at dispensing. Binary regressions show that provision of already established medication management is a predictor for the willingness of community pharmacists to extend the range of CPS (p [less than] 0.01), while completed training in the area of clinical pharmacy is not (p [greater than] 0.05). More hospital than community pharmacists have postgraduate education in clinical pharmacy (17.4% vs 6.5%). A desire to complete postgraduate education was shown by 28.3% of community and 14.7% of hospital pharmacists. Lack of time, inadequate remuneration, lack of resources and poor relationship between pharmacists and physicians were highlighted as barriers. Conclusion: Both community and hospital pharmacists show strong willingness to expand their CPS provision and will need continued support, such as improved legislative structures, more supportive resources and practice focused training opportunities, to further these services

Mitochondrial Utilization of Competing Fuels Is Altered in Insulin Resistant Skeletal Muscle of Non-obese Rats (Goto-Kakizaki)

Aim: Insulin-resistant skeletal muscle is characterized by metabolic inflexibility with associated alterations in substrate selection, mediated by peroxisome-proliferator activated receptor δ (PPARδ). Although it is established that PPARδ contributes to the alteration of energy metabolism, it is not clear whether it plays a role in mitochondrial fuel competition. While nutrient overload may impair metabolic flexibility by fuel congestion within mitochondria, in absence of obesity defects at a mitochondrial level have not yet been excluded. We sought to determine whether reduced PPARδ content in insulin-resistant rat skeletal muscle of a non-obese rat model of T2DM (Goto-Kakizaki, GK) ameliorate the inhibitory effect of fatty acid (i.e., palmitoylcarnitine) on mitochondrial carbohydrate oxidization (i.e., pyruvate) in muscle fibers. Methods: Bioenergetic function was characterized in oxidative soleus (S) and glycolytic white gastrocnemius (WG) muscles with measurement of respiration rates in permeabilized fibers in the presence of complex I, II, IV, and fatty acid substrates. Mitochondrial content was measured by citrate synthase (CS) and succinate dehydrogenase activity (SDH). Western blot was used to determine protein expression of PPARδ, PDK isoform 2 and 4. Results: CS and SDH activity, key markers of mitochondrial content, were reduced by ∼10–30% in diabetic vs. control, and the effect was evident in both oxidative and glycolytic muscles. PPARδ (p < 0.01), PDK2 (p < 0.01), and PDK4 (p = 0.06) protein content was reduced in GK animals compared to Wistar rats (N = 6 per group). Ex vivo respiration rates in permeabilized muscle fibers determined in the presence of complex I, II, IV, and fatty acid substrates, suggested unaltered mitochondrial bioenergetic function in T2DM muscle. Respiration in the presence of pyruvate was higher compared to palmitoylcarnitine in both animal groups and fiber types. Moreover, respiration rates in the presence of both palmitoylcarnitine and pyruvate were reduced by 25 ± 6% (S), 37 ± 6% (WG) and 63 ± 6% (S), 57 ± 8% (WG) compared to pyruvate for both controls and GK, respectively. The inhibitory effect of palmitoylcarnitine on respiration was significantly greater in GK than controls (p < 10–3). Conclusion: With competing fuels, the presence of fatty acids diminishes mitochondria ability to utilize carbohydrate derived substrates in insulin-resistant muscle despite reduced PPARδ content

A 3D-CTM with detailed online PSC-microphysics: analysis of the Antarctic winter 2003 by comparison with satellite observations

International audienceWe present the first detailed microphysical simulations which are performed online within the framework of a global 3-D chemical transport model (CTM) with full chemistry. The model describes the formation and evolution of four types of polar stratospheric cloud (PSC) particles. Aerosol freezing and other relevant microphysical processes are treated in a full explicit way. Each particle type is described by a binned size distribution for the number density and chemical composition. This set-up allows for an accurate treatment of sedimentation and for detailed calculation of surface area densities and optical properties. Simulations are presented for the Antarctic winter of 2003 and comparisons are made to a diverse set of satellite observations (optical and chemical measurements of POAM III and MIPAS) to illustrate the capabilities of the model. This study shows that a combined resolution approach where microphysical processes are simulated in coarse-grained conditions gives good results for PSC formation and its large-scale effect on the chemical environment through processes such as denitrification, dehydration and ozone loss. It is also shown that the influence of microphysical parameters can be measured directly from these processes

Mitochondrial Utilization of Competing Fuels is Altered in Insulin Resistant Skeletal Muscle of Non-Obese Rats (Goto-Kakizaki)

Aim: Insulin-resistant skeletal muscle is characterized by metabolic inflexibility with associated alterations in substrate selection, mediated by peroxisome-proliferator activated receptor (PPAR). Although it is established that PPAR contributes to the alteration of energy metabolism, it is not clear whether it plays a role in mitochondrial fuel competition. While nutrient overload may impair metabolic flexibility by fuel congestion within mitochondria, in absence of obesity defects at a mitochondrial level have not yet been excluded. We sought to determine whether reduced PPAR content in insulin-resistant rat skeletal muscle of a non-obese rat model of T2DM (Goto-Kakizaki, GK) ameliorate the inhibitory effect of fatty acid (i.e., palmitoylcarnitine) on mitochondrial carbohydrate oxidization (i.e., pyruvate) in muscle fibers. Methods: Bioenergetic function was characterized in oxidative soleus (S) and glycolytic white gastrocnemius (WG) muscles with measurement of respiration rates in permeabilized fibers in the presence of complex I, II, IV, and fatty acid substrates. Mitochondrial content was measured by citrate synthase (CS) and succinate dehydrogenase activity (SDH). Western blot was used to determine protein expression of PPAR, PDK isoform 2 and 4. Results: CS and SDH activity, key markers of mitochondrial content, were reduced by similar to 10-30% in diabetic vs. control, and the effect was evident in both oxidative and glycolytic muscles. PPAR (p\u3c 0.01), PDK2 (p\u3c 0.01), and PDK4 (p= 0.06) protein content was reduced in GK animals compared to Wistar rats (N= 6 per group). Ex vivorespiration rates in permeabilized muscle fibers determined in the presence of complex I, II, IV, and fatty acid substrates, suggested unaltered mitochondrial bioenergetic function in T2DM muscle. Respiration in the presence of pyruvate was higher compared to palmitoylcarnitine in both animal groups and fiber types. Moreover, respiration rates in the presence of both palmitoylcarnitine and pyruvate were reduced by 25 ± 6% (S), 37 ± 6% (WG) and 63 ± 6% (S), 57 ± 8% (WG) compared to pyruvate for both controls and GK, respectively. The inhibitory effect of palmitoylcarnitine on respiration was significantly greater in GK than controls (p \u3c 10-3). Conclusion: With competing fuels, the presence of fatty acids diminishes mitochondria ability to utilize carbohydrate derived substrates in insulin-resistant muscle despite reduced PPAR delta content

Electrical sensing of the dynamical structure of the planetary boundary layer

Turbulent and convective processes within the planetary boundary layer are responsible for the transport of moisture, momentum and particulate matter, but are also important in determining the electrical charge transport of the lower atmosphere. This paper presents the first high resolution vertical charge profiles during fair weather conditions obtained with instrumented radiosonde balloons over Alqueva, Portugal during the summer of 2014. The short intervals (4 hours) between balloon flights enabled the diurnal variation in the vertical profile of charge within the boundary layer to be examined in detail, with much smaller charges (up to 20pCm-3) observed during stable night time periods than during the day. Following sunrise, the evolution of the charge profile was complex, demonstrating charged ultrafine aerosol, lofted upwards by daytime convection. This produced charge up to 92pCm-3 up to 500m above the surface. The diurnal variation in the integrated column of charge above the site tracked closely with the diurnal variation in near surface charge as derived from a nearby electric field mill, confirming the importance of the link between surface charge generation processes and aloft. The local aerosol vertical profiles were estimated using backscatter measurements from a collocated ceilometer. These were utilised in a simple model to calculate the charge expected due to vertical conduction current flow in the global electric circuit through aerosol layers. The analysis presented here demonstrates that charge can provide detailed information about boundary layer transport, particularly in regard to the ultrafine aerosol structure, that conventional thermodynamic and ceilometer measurements do not

2002-2003 Arctic ozone loss deduced from POAM III satellite observations and the SLIMCAT chemical transport model

The SLIMCAT three-dimensional chemical transport model (CTM) is used to infer chemical ozone loss from Polar Ozone and Aerosol Measurement (POAM) III observations of stratospheric ozone during the Arctic winter of 2002-2003. Inferring chemical ozone loss from satellite data requires quantifying ozone variations due to dynamical processes. To accomplish this, the SLIMCAT model was run in a 'passive' mode from early December until the middle of March. In these runs, ozone is treated as an inert, dynamical tracer. Chemical ozone loss is inferred by subtracting the model passive ozone, evaluated at the time and location of the POAM observations, from the POAM measurements themselves. This 'CTM Passive Subtraction' technique relies on accurate initialization of the CTM and a realistic description of vertical/horizontal transport, both of which are explored in this work. The analysis suggests that chemical ozone loss during the 2002-2003 winter began in late December. This loss followed a prolonged period in which many polar stratospheric clouds were detected, and during which vortex air had been transported to sunlit latitudes. A series of stratospheric warming events starting in January hindered chemical ozone loss later in the winter of 2003. Nevertheless, by 15 March, the final date of the analysis, ozone loss maximized at 425K at a value of about 1.2ppmv, a moderate amount of loss compared to loss during the unusually cold winters in the late-1990s. SLIMCAT was also run with a detailed stratospheric chemistry scheme to obtain the model-predicted loss. The SLIMCAT model simulation also shows a maximum ozone loss of 1.2ppmv at 425K, and the morphology of the loss calculated by SLIMCAT was similar to that inferred from the POAM data. These results from the recently updated version of SLIMCAT therefore give a much better quantitative description of polar chemical ozone loss than older versions of the same model. Both the inferred and modeled loss calculations show the early destruction in late December and the region of maximum loss descending in altitude through the remainder of the winter and early spring

Modification of aerosol mass and size distribution due to aqueous‐phase SO 2 oxidation in clouds: Comparisons of several models

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/94761/1/jgrd10053.pd

Effect of Nanoclay Content on Void Morphology in Resin Transfer Molded Composites

Effects of nanoclay content on morphology and spatial distribution of voids in resin transfer molded nanoclay/E-glass/epoxy composite disks are investigated. Closite®25A nanoclay loads of 2, 5, and 10wt% are mixed by sonication with a low-viscosity epoxy resin prior to filling the mold cavity containing 13.6% E-glass preform by volume. A disk without nanoclay is also molded. Once the molded composites are cured, voids on radial composite samples are evaluated via microscopic image analysis. The addition of nanoclay is found to result in a significant increase in the apparent viscosity of the clay-epoxy mixture, thus increasing the molding pressure. Void occurrence is observed to increase considerably with increasing nanoclay content, from 2.1% in the composite without nanoclay to 5.1 and 8.3% in the composites molded with 5 and 10wt% nanoclay, respectively. However, the composite with 2wt% nanoclay yields the lowest void content of 0.7%. Voids are observed to be, in average, smaller after the addition of nanoclay at all nanoclay concentrations. Presence of nanoclay in the impregnating resin induces at least 60% reduction in voids located inside fiber tows, which are trapped by the fluid front motion during impregnation. Irregularly shaped voids are also observed to decrease with increasing nanoclay content. A nonuniform void content and morphology is observed radially, which seems to be affected by the flow kinematics as well as possible breakdown and filtration of clay clusters.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

Observations of aerosols in the free troposphere and marine boundary layer of the subtropical Northeast Atlantic: discussion of processes determining their size distribution

During July 1994, submicron aerosol size distributions were measured at two sites on Tenerife, Canary Islands. One station was located in the free troposphere (FT), the other in the marine boundary layer (MBL). Transport toward these two sites was strongly decoupled: the FT was first affected by dust and sulfate-laden air masses advecting from North Africa and later by clean air masses originating over the North Atlantic, whereas the MBL was always subject to the northeasterly trade wind circulation. In the FT the submicron aerosol distribution was predominantly monomodal with a geometric mean diameter of 120 nm and 55 nm during dusty and clean conditions, respectively. The relatively small diameter during the clean conditions indicates that the aerosol originated in the upper troposphere rather than over continental areas or in the lower stratosphere. During dusty conditions the physical and chemical properties of the submicron aerosol suggest that it has an anthropogenic origin over southern Europe and that it remains largely externally mixed with the supermicron mineral dust particles during its transport over North Africa to Tenerife. Apart from synoptic variations, a strong diurnal variation in the aerosol size distribution is observed at the FT site, characterized by a strong daytime mode of ultrafine particles. This is interpreted as being the result of photoinduced nucleation in the upslope winds, which are perturbed by anthropogenic and biogenic emissions on the island. No evidence was found for nucleation occurring in the undisturbed FT. The MBL site was not strongly affected by European pollution during the period of the measurements. The MBL aerosol size distribution was bimodal, but the relative concentration of Aitken and accumulation mode varied strongly. The accumulation mode can be related to cloud processing of the Aitken mode but also to pollution aerosol which was advected within the MBL or entrained from the FT. No bursts of nucleation were observed within the MBL

Low availability of carnitine precursors as a possible reason for the diminished plasma carnitine concentrations in pregnant women

<p>Abstract</p> <p>Background</p> <p>It has been shown that plasma carnitine concentrations decrease markedly during gestation. A recent study performed with a low number of subjects suggested that this effect could be due to a low iron status which leads to an impairment of carnitine synthesis. The present study aimed to confirm this finding in a greater number of subjects. It was moreover intended to find out whether low carnitine concentrations during pregnancy could be due to a reduced availability of precursors of carnitine synthesis, namely trimethyllysine (TML) and γ-butyrobetaine (BB).</p> <p>Methods</p> <p>Blood samples of 79 healthy pregnant women collected at delivery were used for this study.</p> <p>Results</p> <p>There was only a weak, non-significant (P > 0.05), correlation between plasma concentration of ferritin and those of free and total carnitine. There was no correlation between other parameters of iron status (plasma iron concentration, hemoglobin, MCV, MCH) and plasma concentration of free and total carnitine. There were, however, significant (P < 0.05) positive correlations between concentrations of TML and BB and those of free and total carnitine in plasma.</p> <p>Conclusions</p> <p>The results of this study suggest that an insufficient iron status is not the reason for low plasma carnitine concentrations observed in pregnant women. It is rather indicated that low plasma carnitine concentrations are caused by a low availability of precursors for carnitine synthesis during gestation.</p