Qualitative exploration of the experiences of community pharmacists delivering the Diabetes MedsCheck service

What is known and objective:The Diabetes MedsCheck (DMC) pharmacist service improves patient medication use and provides education on diabetes self-management. The original 2012 program evaluation identified barriers and facilitators in implementation. There are no recent studies exploring pharmacists' experiences with the DMC service. This pilot study may contribute to achieving an optimal diabetes management service in Australia. To explore the experiences of community pharmacists in providing the DMC service.Methods:A purposive sampling approach was used to recruit practising Australian community pharmacists from July to December 2019. Inclusion criteria included provision of DMC service for more than 1 year and having delivered the service within 3 months of recruitment. Semi-structured interviews elicited pharmacists' experience with the DMC service.Results and discussion:Twelve interviews of community pharmacist owners, managers and employees (including three who had additional medication review and diabetes qualifications), resulted in four primary themes: benefit of and need for training in diabetes management, challenges of service delivery and implementation, the challenge of patients' diabetes management and the positive effect of DMC on pharmacists' professional satisfaction from the positive impact on patient interactions and diabetes management. Pharmacists highlighted the need for continuous training on diabetes management and patient communication, and a dedicated time and space for service provision for optimal implementation and delivery of DMC. DMC helped to fulfil pharmacists' desires to provide health care. Pharmacists perceived through patient engagement and patient feedback that DMC benefits patient health care.What is new and conclusion:Positively, the implementation of the DMC service has promoted engagement with other health professionals while also contributing to pharmacists' professional satisfaction. Patient satisfaction and awareness of the health knowledge that pharmacists provide promotes pharmacist capabilities to the public. To ensure that accessible diabetes care in community pharmacy is optimized for greatest patient care, pharmacists delivering DMC should be supported by provision of contemporary diabetes management training and communication skills. Additional investment in community pharmacy operational set-up, such as dedicated pharmacist time, dedicated consulting space, upskilling of staff and investment in technology is also required to support optimal delivery of DMC

X-Ray Groups of Galaxies in the Aegis Deep and Wide Fields

We present the results of a search for extended X-ray sources and their corresponding galaxy groups from 800-ks Chandra coverage of the All-wavelength Extended Groth Strip International Survey (AEGIS). This yields one of the largest X-ray selected galaxy group catalogs from a blind survey to date. The red-sequence technique and spectroscopic redshifts allow us to identify 100$$ of reliable sources, leading to a catalog of 52 galaxy groups. The groups span the redshift range $z\sim0.066-1.544$ and virial mass range $M_{200}\sim1.34\times 10^{13}-1.33\times 10^{14}M_\odot$. For the 49 extended sources which lie within DEEP2 and DEEP3 Galaxy Redshift Survey coverage, we identify spectroscopic counterparts and determine velocity dispersions. We select member galaxies by applying different cuts along the line of sight or in projected spatial coordinates. A constant cut along the line of sight can cause a large scatter in scaling relations in low-mass or high-mass systems depending on the size of cut. A velocity dispersion based virial radius can more overestimate velocity dispersion in comparison to X-ray based virial radius for low mass systems. There is no significant difference between these two radial cuts for more massive systems. Independent of radial cut, overestimation of velocity dispersion can be created in case of existence of significant substructure and also compactness in X-ray emission which mostly occur in low mass systems. We also present a comparison between X-ray galaxy groups and optical galaxy groups detected using the Voronoi-Delaunay method (VDM) for DEEP2 data in this field.Comment: Accepted for publication in AP

Stellar mass-halo mass relation for the brightest central galaxies of X-ray clusters since z similar to 0.65

We present the brightest cluster galaxies (BCGs) catalog for SPectroscoic IDentification of eROSITA Sources (SPIDERS) DR14 cluster program value-added catalog. We list the 416 BCGs identified as part of this process, along with their stellar mass, star formation rates (SFRs), and morphological properties. We identified the BCGs based on the available spectroscopic data from SPIDERS and photometric data from SDSS. We computed stellar masses and SFRs of the BCGs on the basis of SDSS, WISE, and GALEX photometry using spectral energy distribution fitting. Morphological properties for all BCGs were derived by Sersic profile fitting using the software package SIGMA in different optical bands (g,r,i). We combined this catalog with the BCGs of galaxy groups and clusters extracted from the deeper AEGIS, CDFS, COSMOS, XMM-CFHTLS, and XMM-XXL surveys to study the stellar mass-halo mass relation using the largest sample of X-ray groups and clusters known to date. This result suggests that the mass growth of the central galaxy is controlled by the hierarchical mass growth of the host halo. We find a strong correlation between the stellar mass of BCGs and the mass of their host halos. This relation shows no evolution since z similar to 0.65. We measure a mean scatter of 0.21 and 0.25 for the stellar mass of BCGs in a given halo mass at low (0.1 <z <0.3) and high (0.3 <z <0.65) redshifts, respectively. We further demonstrate that the BCG mass is covariant with the richness of the host halos in the very X-ray luminous systems. We also find evidence that part of the scatter between X-ray luminosity and richness can be reduced by considering stellar mass as an additional variable.Peer reviewe

CFHTLenS: weak lensing calibrated scaling relations for low-mass clusters of galaxies

We present weak lensing and X-ray analysis of 12 low-mass clusters from the Canada-France-Hawaii Telescope Lensing Survey and XMM-CFHTLS surveys. We combine these systems with high-mass systems from Canadian Cluster Comparison Project and low-mass systems from Cosmic Evolution Survey to obtain a sample of 70 systems, spanning over two orders of magnitude in mass. We measure core-excised LX-TX, M-LX and M-TX scaling relations and include corrections for observational biases. By providing fully bias-corrected relations, we give the current limitations for LX and TX as cluster mass proxies. We demonstrate that TX benefits from a significantly lower intrinsic scatter at fixed mass than LX. By studying the residuals of the bias-corrected relations, we show for the first time using weak lensing masses that galaxy groups seem more luminous and warmer for their mass than clusters. This implies a steepening of the M-LX and M-TX relations at low masses. We verify the inferred steepening using a different high-mass sample from the literature and show that variance between samples is the dominant effect leading to discrepant scaling relations. We divide our sample into subsamples of merging and relaxed systems, and find that mergers may have enhanced scatter in lensing measurements, most likely due to stronger triaxiality and more substructure. For the LX-TX relation, which is unaffected by lensing measurements, we find the opposite trend in scatter. We also explore the effects of X-ray cross-calibration and find that Chandra calibration leads to flatter LX-TX and M-TX relations than XMM-Newto

Comparison of the global prevalence and trend of human intestinal carriage of ESBL-producing Escherichia coli between healthcare and community settings: a systematic review and meta-analysis

Objectives:The widespread intestinal carriage of ESBL-producing Escherichia coli (ESBL E. coli) among both patients and healthy individuals is alarming. However, the global prevalence and trend of this MDR bacterium in healthcare settings remains undetermined. To address this knowledge gap, we performed a comparative meta-analysis of the prevalence in community and healthcare settings.Methods:Our systematic review included 133 articles published between 1 January 2000 and 22 April 2021 and indexed in PubMed, EMBASE or Google Scholar. A random-effects meta-analysis was performed to obtain the global pooled prevalence (community and healthcare settings). Subgroup meta-analyses were performed by grouping studies using the WHO regions and 5 year intervals of the study period.Results:We found that 21.1% (95% CI, 19.1%-23.2%) of inpatients in healthcare settings and 17.6% (95% CI, 15.3%-19.8%) of healthy individuals worldwide carried ESBL E. coli in their intestine. The global carriage rate in healthcare settings increased 3-fold from 7% (95% CI, 3.7%-10.3%) in 2001-05 to 25.7% (95% CI, 19.5%-32.0%) in 2016-20, whereas in community settings it increased 10-fold from 2.6% (95% CI, 1.2%-4.0%) to 26.4% (95% CI, 17.0%-35.9%) over the same period.Conclusions:The global and regional human intestinal ESBL E. coli carriage is increasing in both community and healthcare settings. Carriage rates were generally higher in healthcare than in community settings. Key relevant health organizations should perform surveillance and implement preventive measures to address the spread of ESBL E. coli in both settings

CFHTLenS: Weak lensing calibrated scaling relations for low mass clusters of galaxies

We present weak lensing and X-ray analysis of 12 low mass clusters from the CFHTLenS and XMM-CFHTLS surveys. We combine these systems with high-mass systems from CCCP and low-mass systems from COSMOS to obtain a sample of 70 systems, spanning over two orders of magnitude in mass. We measure core-excised Lx-Tx, M-Lx and M-Tx scaling relations and include corrections for observational biases. By providing fully bias corrected relations, we give the current limitations for Lx and Tx as cluster mass proxies. We demonstrate that Tx benefits from a significantly lower intrinsic scatter at fixed mass than Lx. By studying the residuals of the bias corrected relations, we show for the first time using weak lensing masses that galaxy groups seem more luminous and warmer for their mass than clusters. This implies a steepening of the M-Lx and M-Tx relations at low masses. We verify the inferred steepening using a different high mass sample from the literature and show that variance between samples is the dominant effect leading to discrepant scaling relations. We divide our sample into subsamples of merging and relaxed systems, and find that mergers may have enhanced scatter in lensing measurements, most likely due to stronger triaxiality and more substructure. For the Lx-Tx relation, which is unaffected by lensing measurements, we find the opposite trend in scatter. We also explore the effects of X-ray cross-calibration and find that Chandra calibration leads to flatter Lx-Tx and M-Tx relations than XMM-Newton.Comment: Analysis modified to include bias correction. Updated CCCP measurements. Comments are welcome, submitted to MNRAS, 26 pages, 20 figure

The XXL Survey IV. Mass-temperature relation of the bright cluster sample

The XXL survey is the largest survey carried out by XMM-Newton. Covering an area of 50deg$^2$, the survey contains $\sim450$ galaxy clusters out to a redshift $\sim$2 and to an X-ray flux limit of $\sim5\times10^{-15}erg\,s^{-1}cm^{-2}$. This paper is part of the first release of XXL results focussed on the bright cluster sample. We investigate the scaling relation between weak-lensing mass and X-ray temperature for the brightest clusters in XXL. The scaling relation is used to estimate the mass of all 100 clusters in XXL-100-GC. Based on a subsample of 38 objects that lie within the intersection of the northern XXL field and the publicly available CFHTLenS catalog, we derive the $M_{WL}$ of each system with careful considerations of the systematics. The clusters lie at $0.1<z<0.6$ and span a range of $T\simeq1-5keV$. We combine our sample with 58 clusters from the literature, increasing the range out to 10keV. To date, this is the largest sample of clusters with $M_{WL}$ measurements that has been used to study the mass-temperature relation. The fit ($M\propto T^b$) to the XXL clusters returns a slope $b=1.78^{+0.37}_{-0.32}$ and intrinsic scatter $\sigma_{\ln M|T}\simeq0.53$; the scatter is dominated by disturbed clusters. The fit to the combined sample of 96 clusters is in tension with self-similarity, $b=1.67\pm0.12$ and $\sigma_{\ln M|T}\simeq0.41$. Overall our results demonstrate the feasibility of ground-based weak-lensing scaling relation studies down to cool systems of $\sim1keV$ temperature and highlight that the current data and samples are a limit to our statistical precision. As such we are unable to determine whether the validity of hydrostatic equilibrium is a function of halo mass. An enlarged sample of cool systems, deeper weak-lensing data, and robust modelling of the selection function will help to explore these issues further

Prophylactic Cefazolin Dosing and Surgical Site Infections: Does the Dose Matter in Obese Patients?

Background Most surgical prophylaxis guidelines recommend a 3-g cefazolin intravenous dose in patients weighing ≥ 120 kg. However, this recommendation is primarily based on pharmacokinetic studies rather than robust clinical evidence. This study aimed to compare the prevalence of surgical site infections (SSIs) in obese and non-obese patients (body mass index ≥ 30 kg/m2 and < 30 kg/m2), and those weighing ≥ 120 kg and < 120 kg, who received 2- g cefazolin preoperatively. Methods A retrospective case-control study was conducted in adult elective surgical patients. Patients receiving 2- g cefazolin were grouped as obese and non-obese, and by weight (≥ 120 kg or < 120 kg). The 90-day prevalence of SSI and potential contributing factors were investigated. Results We identified 152 obese (median 134 kg) and 152 non-obese control (median 73 kg) patients. Baseline characteristics were similar between groups, except for an increased prevalence in the obese group of diabetes (35.5% vs 13.2%; p < 0.001) and an American Society of Anaesthesiologists Score of 3 (61.8% vs 17.1%; p < 0.001). While not statistically significant, the prevalence of SSI in the obese group was almost double that in the non-obese group (8.6% vs 4.6%; p = 0.25) and in patients weighing ≥ 120 kg (n = 102) compared to those weighing < 120 kg (n = 202) (9.8% vs 5.0%; p = 0.17). Conclusion The prevalence of SSI was not significantly increased in obese patients, or those weighing ≥ 120 kg, who received cefazolin 2- g prophylactically; however, trends toward an increase were evident. Large-scale randomised trials are needed to examine whether a 2-g or 3-g cefazolin is adequate to prevent SSI in obese (and ≥ 120 kg) individuals

Stellar mass -- halo mass relation for the brightest central galaxies of X-ray clusters since z~0.65

We present the brightest cluster galaxies (BCGs) catalog for SPectroscoic IDentification of eROSITA Sources (SPIDERS) DR14 cluster program value-added catalog. We list the 416 BCGs identified as part of this process, along with their stellar mass, star formation rates, and morphological properties. We identified the BCGs based on the available spectroscopic data from SPIDERS and photometric data from SDSS. We computed stellar masses and SFRs of the BCGs on the basis of SDSS, WISE, and GALEX photometry using spectral energy distribution fitting. Morphological properties for all BCGs were derived by Sersic profile fitting using the software package SIGMA in different optical bands (g,r,i). We combined this catalog with the BCGs of galaxy groups and clusters extracted from the deeper AEGIS, CDFS, COSMOS, XMM-CFHTLS, and XMM-XXL surveys to study the stellar mass - halo mass relation using the largest sample of X-ray groups and clusters known to date. This result suggests that the mass growth of the central galaxy is controlled by the hierarchical mass growth of the host halo. We find a strong correlation between the stellar mass of BCGs and the mass of their host halos. This relation shows no evolution since z $\sim$ 0.65. We measure a mean scatter of 0.21 and 0.25 for the stellar mass of BCGs in a given halo mass at low ($0.1<z < 0.3$) and high ($0.3<z<0.65$) redshifts, respectively. We further demonstrate that the BCG mass is covariant with the richness of the host halos in the very X-ray luminous systems. We also find evidence that part of the scatter between X-ray luminosity and richness can be reduced by considering stellar mass as an additional variable