A study comparing the change in drug utilization pattern in medical intensive care unit of a tertiary care hospital in seven years

Background: Medical intensive care unit is a type of intensive care unit that takes care of a range of medical illnesses with patients who are seriously ill and/or suffer from severe chronic illnesses. These patients are usually prescribed multiple drugs. Use of antimicrobial agents and injectable medications in setting of MICU is high as compared with other class of drugs and other hospital settings respectively. Periodic evaluation of drug utilization pattern needs to be done to enable suitable modifications in prescription of drugs to increase the therapeutic benefit and decrease the adverse effects. There could be changes in drug utilization pattern due to changes in disease pattern, development of newer drugs, resistance to antimicrobial agents. Hence comparison of past and present data needs to be done to find out the changes that occurred in drug utilization pattern over the years. Methods: Data was collected from June 2021 to Dec 2021 for prospective arm and June 2014 to December 2014 for retrospective arm was obtained from MICU of tertiary care hospital and Medical Record Department. Drug utilization pattern was analysed and compared with appropriate statistical tests. Results: Most common cause of MICU admission was infective diseases (71% and 67% respectively in retrospective and prospective arm). The drug prescribed frequently was pantoprazole and antimicrobial was ceftriaxone in both the study arms. Half of the drugs were prescribed by generic names in both arms. Conclusions: There was no change observed in drug utilization pattern and disease pattern in patients admitted to medical intensive care unit over the years in our institute

Small Changes Huge Impact: The Role of Protein Posttranslational Modifications in Cellular Homeostasis and Disease

Posttranslational modifications (PTMs) modulate protein function in most eukaryotes and have a ubiquitous role in diverse range of cellular functions. Identification, characterization, and mapping of these modifications to specific amino acid residues on proteins are critical towards understanding their functional significance in a biological context. The interpretation of proteome data obtained from the high-throughput methods cannot be deciphered unambiguously without a priori knowledge of protein modifications. An in-depth understanding of protein PTMs is important not only for gaining a perception of a wide array of cellular functions but also towards developing drug therapies for many life-threatening diseases like cancer and neurodegenerative disorders. Many of the protein modifications like ubiquitination play a decisive role in various drug response(s) and eventually in disease prognosis. Thus, many commonly observed PTMs are routinely tracked as disease markers while many others are used as molecular targets for developing target-specific therapies. In this paper, we summarize some of the major, well-studied protein alterations and highlight their importance in various chronic diseases and normal development. In addition, other promising minor modifications such as SUMOylation, observed to impact cellular dynamics as well as disease pathology, are mentioned briefly

Subnatural linewidth using electromagnetically induced transparency in Doppler-broadened vapor

We obtain subnatural linewidth (i.e. $<\Gamma$) for probe absorption in room-temperature Rb vapor using electromagnetically induced transparency (EIT) in a $\Lambda$ system. For stationary atoms, the EIT dip for a resonant control laser is as wide as the control Rabi frequency $\Omega_c$. But in thermal vapor, the moving atoms fill the transparency band so that the final EIT dip remains subnatural even when $\Omega_c > \Gamma$. We observe linewidths as small as $\Gamma/7$ in the $D_2$ line of Rb.Comment: 6 pages, 7 figure

Photosynthate Regulation of the Root System Architecture Mediated by the Heterotrimeric G Protein Complex in Arabidopsis

Assimilate partitioning to the root system is a desirable developmental trait to control but little is known of the signaling pathway underlying partitioning. A null mutation in the gene encoding the Gβ subunit of the heterotrimeric G protein complex, a nexus for a variety of signaling pathways, confers altered sugar partitioning in roots. While fixed carbon rapidly reached the roots of wild type and agb1-2 mutant seedlings, agb1 roots had more of this fixed carbon in the form of glucose, fructose, and sucrose which manifested as a higher lateral root density. Upon glucose treatment, the agb1-2 mutant had abnormal gene expression in the root tip validated by transcriptome analysis. In addition, PIN2 membrane localization was altered in the agb1-2 mutant. The heterotrimeric G protein complex integrates photosynthesis-derived sugar signaling incorporating both membrane-and transcriptional-based mechanisms. The time constants for these signaling mechanisms are in the same range as photosynthate delivery to the root, raising the possibility that root cells are able to use changes in carbon fixation in real time to adjust growth behavior

Detection Efficiencies and Generalized Breakdown Probabilities for Nanosecond-Gated Near Infrared Single-Photon Avalanche Photodiodes

A rigorous model is developed for determining single-photon quantum efficiency (SPQE) of single-photon avalanche photodiodes (SPADs) with simple or heterojunction multiplication regions. The analysis assumes nanosecond gated-mode operation of the SPADs and that band-to-band tunneling of carriers is the dominant source of dark current in the multiplication region. The model is then utilized to optimize the SPQE as a function of the applied voltage, for a given operating temperature and multiplication-region structure and material. The model can be applied to SPADs with In/sub 0.52/Al/sub 0.48/As or InP multiplication regions as well as In/sub 0.52/Al/sub 0.48/As--InP heterojunction multiplication regions for wavelengths of 1.3 and 1.55 /spl mu/m. The predictions show that the SPQE generally decreases with decreasing the multiplication-region thickness. Moreover, an InP multiplication region requires a lower breakdown electric field (and, hence, offers a higher SPQE) than that required by an In/sub 0.52/Al/sub 0.48/As layer of the same width. The model also shows that the fractional width of the In/sub 0.52/Al/sub 0.48/As layer in an In/sub 0.52/Al/sub 0.48/As--InP heterojunction multiplication region can be optimized to attain a maximum SPQE that is greater than that offered by an InP multiplication region. This effect becomes more pronounced in thin multiplication regions as a result of the increased significance of dead space

Evaluation of Smiles for Life : a caregiver focused oral health education programme

Background: People with an intellectual and/or developmental disability are at increased risk of adverse oral health outcomes and often require support from caregivers to assist in maintaining or seeking treatment for their oral health needs. However, caregivers and support workers are often family members with limited formal oral health training. Hence, the aim of this pilot study was to review the outcomes of the ‘Smiles for Life’ oral health education workshop with reference to their knowledge, attitudes, and practices of caregivers of people with an intellectual or developmental disability. Methods: A single group pre-test post-test intervention design was used to explore the preliminary effectiveness and appropriateness of the Smiles for Life oral health education workshop. Results: A total of 244 participants completed both the pre and post knowledge test. Oral health literacy scores decreased following the post test. Those with higher levels of education achieved higher post-training knowledge scores. Overall, caregivers reported satisfaction on the material presented however, it could be improved with more practical demonstrations. Conclusion: Providing an oral health education tool that caters to the diverse caregiver audience presents a unique set of challenges, despite oral health education in this professional group being vital. Future studies may benefit from reviewing the efficacy of a more tailored educational intervention

Enabling Automated, Rich, and Versatile Data Management for Android Apps with BlueMountain

Abstract Today&apos;s mobile apps often leverage cloud services to manage their own data as well as user data, enabling many desired features such as backup and sharing. However, this comes at a cost; developers have to manually craft their logic and potentially repeat a similar process for different cloud providers. In addition, users are restricted to the design choices made by developers; for example, once a developer releases an app that uses a particular cloud service, it is impossible for a user to later customize the app and choose a different service. In this paper, we explore the design space of an app instrumentation tool that automatically integrates cloud storage services for Android apps. Our goal is to allow developers to treat all storage operations as local operations, and automatically enable cloud features customized for individual needs of users and developers. We discuss various scenarios that can benefit from such an automated tool, challenges associated with the development of it, and our ideas to address these challenges

Anti-Lysophosphatidic Acid Antibodies Improve Traumatic Brain Injury Outcomes

BACKGROUND: Lysophosphatidic acid (LPA) is a bioactive phospholipid with a potentially causative role in neurotrauma. Blocking LPA signaling with the LPA-directed monoclonal antibody B3/Lpathomab is neuroprotective in the mouse spinal cord following injury. FINDINGS: Here we investigated the use of this agent in treatment of secondary brain damage consequent to traumatic brain injury (TBI). LPA was elevated in cerebrospinal fluid (CSF) of patients with TBI compared to controls. LPA levels were also elevated in a mouse controlled cortical impact (CCI) model of TBI and B3 significantly reduced lesion volume by both histological and MRI assessments. Diminished tissue damage coincided with lower brain IL-6 levels and improvement in functional outcomes. CONCLUSIONS: This study presents a novel therapeutic approach for the treatment of TBI by blocking extracellular LPA signaling to minimize secondary brain damage and neurological dysfunction

Temporal Patterns of Medications Dispensed to Children and Adolescents in a National Insured Population

This study aimed to comprehensively describe prevalence and temporal dispensing patterns for medications prescribed to children and adolescents in the United States. Participants were 1.6 million children (49% female) under 18 years old enrolled in a nation-wide, employer-provided insurance plan. All medication claims from 1999–2006 were reviewed retrospectively. Drugs were assigned to 16 broad therapeutic categories. Effects of trend over time, seasonality, age and gender on overall and within category prevalence were examined. Results: Mean monthly prevalence for dispensed medications was 23.5% (range 19.4–27.5), with highest rates in winter and lowest in July. The age group with the highest prevalence was one-year-old children. On average each month, 17.1% of all children were dispensed a single drug and 6.4% were dispensed two or more. Over time, prevalence for two or more drugs did not change, but the proportion of children dispensed a single drug decreased (slope -.02%, p = .001). Overall, boys had higher monthly rates than girls (average difference 0.9%, p = .002). However, differences by gender were greatest during middle childhood, especially for respiratory and central nervous system agents. Contraceptives accounted for a large proportion of dispensed medication to older teenage girls. Rates for the drugs with the highest prevalence in this study were moderately correlated (average Pearson r.66) with those from a previously published national survey. Conclusion: On average, nearly one quarter of a population of insured children in the United States was dispensed medication each month. This rate decreased somewhat over time, primarily because proportionally fewer children were dispensed a single medication. The rate for two or more drugs dispensed simultaneously remained steady