The impact of a post-take ward round pharmacist on the risk score and enactment of medication-related recommendations

There is a scarcity of published research describing the impact of a pharmacist on the post-take ward round (PTWR) in addition to ward-based pharmacy services. The aim of this paper was to evaluate the impact of clinical pharmacists' participation on the PTWR on the risk assessment scores of medication-related recommendations with and without a pharmacist. This includes medication-related recommendations occurring on the PTWR and those recommendations made by the ward-based pharmacist on the inpatient ward. A pre-post intervention study was undertaken that compared the impact of adding a pharmacist to the PTWR compared with ward-based pharmacist services alone. A panel reviewed the risk of not acting on medication recommendations that was made on the PTWR and those recorded by the ward-based pharmacist. The relationship between the risk scores and the number and proportion of recommendations that led to action were compared between study groups. There were more medication-related recommendations on the PTWR in the intervention group when a pharmacist was present. Proportionately fewer were in the 'very high and extreme' risk category. Although there was no difference in the number of ward pharmacist recommendations between groups, there was a significantly higher proportion of ward pharmacist recommendations in the "very high and extreme" category in those patients who had been seen on a PTWR attended by a pharmacist than when a pharmacist was not present. There were a greater proportion of "low and medium" risk actionable medication recommendations actioned on the PTWR in the intervention group; and no difference in the risk scores in ward pharmacist recommendations actioned between groups. Overall, the proportion of recommendations that were actioned was higher for those made on the PTWR compared with the ward. The addition of a pharmacist to the PTWR resulted in an increase in low, medium, and high risk recommendations on the PTWR, more very high and extreme risk recommendations made by the ward-based pharmacist, plus an increased number of recommendations being actioned during the patients' admission

Solid-phase epitaxial regrowth of amorphous layers in Si(100) created by low-energy, high-fluence phosphorus implantation

Medium energy ion scattering has been used to study the kinetics of solid-phaseepitaxial regrowth (SPEG) of ultrathin amorphous layers formed by room-temperature implantation of 5keV energy phosphorus ions into Si (100). The implants create P distributions with peak concentrations up to ∼7×10²¹cm⁻³. SPEG has been driven by rapid thermal annealing, 475°C⩽TA⩽600°C, for times up to 2000s. At each temperature, the regrowth velocity is enhanced in the early stages due to the presence of phosphorus but then slows sharply to a value more than an order of magnitude below the intrinsic rate. The critical phosphorus concentration at the transition point for TA=475°C regrowth is ∼6×10²⁰cm⁻³ and increases steadily with anneal temperature. Time-of-flight secondary ion mass spectroscopy profiles confirm the onset of phosphorus push out, where the advancing recrystallization front enters the transition region. Supplementary cross-sectional transmission electron microscopy evidence confirms the existence of a local strain field.This work has been supported by the Natural Sciences and Engineering Research Council of Canada

Autistic traits and positive psychotic experiences modulate the association of psychopathic tendencies with theory of mind in opposite directions

Various clinical disorders, including psychopathy, and autism and schizophrenia spectrum disorders, have been linked with impairments in Theory of Mind (ToM). However, although these conditions can co-occur in the same individual, the effect of their inter-play on ToM abilities has not been investigated. Here we assessed ToM abilities in 55 healthy adults while performing a naturalistic ToM task, requiring participants to watch a short film and judge the actors' mental states. The results reveal for the first time that autistic traits and positive psychotic experiences interact with psychopathic tendencies in opposite directions to predict ToM performance-the interaction of psychopathic tendencies with autism traits was associated with a decrement in performance, whereas the interaction of psychopathic tendencies and positive psychotic experiences was associated with improved performance. These effects were specific to cognitive rather than affective ToM. These results underscore the importance of the simultaneous assessment of these dimensions within clinical settings. Future research in these clinical populations may benefit by taking into account such individual differences

Dynamical Response to the QBO in the Northern Winter Stratosphere: Signatures in Wave Forcing and Eddy Fluxes of Potential Vorticity

Wave–mean flow interactions associated with the Holton–Tan effect (HTE), whereby the tropical quasi-biennial oscillation (QBO) modulates the Northern Hemisphere wintertime stratospheric polar vortex, are studied using the ERA-Interim dataset. Significant evidence of the HTE in isentropic coordinates is found, with a weaker and warmer polar vortex present when the lower-stratospheric QBO is in its easterly phase (QBOe). For the first time, the authors quantify the QBO modulation of wave propagation, wave–mean flow interaction, and wave decay/growth via a calculation of potential vorticity (PV)-based measures, the zonal-mean momentum budget, and up-/downgradient eddy PV fluxes. The effect of the tropospheric subtropical jet on QBO modulation of the wave activity is also investigated. In the subtropical-to-midlatitude lower stratosphere, QBOe is associated with an enhanced upward flux of wave activity, and corresponding wave convergence and wave growth, which leads to a stronger poleward zonal-mean meridional circulation and consequently a warmer polar region. In the middle stratosphere, QBOe is associated with increased poleward wave propagation, leading to enhanced wave convergence and in situ wave growth at high latitudes and contributing to the weaker polar vortex. In agreement with recent studies, the results suggest that the critical-line effect cannot fully account for these wave anomalies associated with the HTE. Instead, it is suggestive of a new, additional mechanism that hinges on the QBO-induced meridional circulation effect on the latitudinal positioning of the subtropical jet. Under QBOe, the QBO-induced meridional circulation causes a poleward shift of the subtropical jet, encouraging more waves to propagate into the stratosphere at midlatitudes

A Computational Investigation of Cardiac Caveolae as a Source of Persistent Sodium Current

Recent studies of cholesterol-rich membrane microdomains, called caveolae, reveal that caveolae are reservoirs of “recruitable” sodium ion channels. Caveolar channels constitute a substantial and previously unrecognized source of sodium current in cardiac cells. In this paper we model for the first time caveolar sodium currents and their contributions to cardiac action potential morphology. We show that the β-agonist-induced opening of caveolae may have substantial impacts on peak overshoot, maximum upstroke velocity, and ultimately conduction velocity. Additionally, we show that prolonged action potentials and the formation of potentially arrhythmogenic afterdepolarizations, can arise if caveolae open intermittently throughout the action potential. Our simulations suggest that caveolar sodium current may constitute a route, which is independent of channelopathies, to delayed repolarization and the arrhythmias associated with such delays

Boldness psychopathic traits predict reduced gaze toward fearful eyes in men with a history of violence

Research with developmental and adult samples has shown a relationship of psychopathic traits with reduced eye gaze. However, these relationships remained to be investigated among forensic samples. Here we examined the eye movements of male violent offenders during an emotion recognition task. Violent offenders performed similar to non-offending controls, and their eye movements varied with the emotion and intensity of the facial expression. In the violent offender group Boldness psychopathic traits, but not Meanness or Disinhibition, were associated with reduced dwell time and fixation counts, and slower first fixation latencies, on the eyes compared with the mouth. These results are the first to show a relationship of psychopathic traits with reduced attention to the eyes in a forensic sample, and suggest that Boldness is associated with difficulties in orienting attention toward emotionally salient aspects of the face

Psychopathic traits are associated with reduced attention to the eyes of emotional faces among adult male non-offenders

Psychopathic traits are linked with impairments in emotional facial expression recognition. These impairments may, in part, reflect reduced attention to the eyes of emotional faces. Although reduced attention to the eyes has been noted among children with conduct problems and callous-unemotional traits, similar findings are yet to be found in relation to psychopathic traits among adult male participants. Here we investigated the relationship of primary (selfish, uncaring) and secondary (impulsive, antisocial) psychopathic traits with attention to the eyes among adult male non-offenders during an emotion recognition task. We measured the number of fixations, and overall dwell time, on the eyes and the mouth of male and female faces showing the six basic emotions at varying levels of intensity. We found no relationship of primary or secondary psychopathic traits with recognition accuracy. However, primary psychopathic traits were associated with a reduced number of fixations, and lower overall dwell time, on the eyes relative to the mouth across expressions, intensity, and sex. Furthermore, the relationship of primary psychopathic traits with attention to the eyes of angry and fearful faces was influenced by the sex and intensity of the expression. We also showed that a greater number of fixations on the eyes, relative to the mouth, was associated with increased accuracy for angry and fearful expression recognition. These results are the first to show effects of psychopathic traits on attention to the eyes of emotional faces in an adult male sample, and may support amygdala based accounts of psychopathy. These findings may also have methodological implications for clinical studies of emotion recognition

Emotional expression recognition and attribution bias among sexual and violent offenders:a signal detection analysis

Research with violent offenders has consistently shown impaired recognition of other’s facial expressions of emotion. However, the extent to which similar problems can be observed among sexual offenders remains unknown. Using a computerized task, we presented sexual and violent offenders, and non-offenders, with male and female expressions of anger, disgust, fear, happiness, sadness, and surprise, morphed with neutral expressions at varying levels of intensity (10%, 55%, and 90% expressive). Based on signal detection theory, we used hit rates and false alarms to calculate the sensitivity index d-prime (d’) and criterion (c) for each emotional expression. Overall, sexual offenders showed reduced sensitivity to emotional expressions across intensity, sex, and type of expression, compared with non-offenders, while both sexual and violent offenders showed particular reduced sensitivity to fearful expressions. We also observed specific effects for high (90%) intensity female faces, with sexual offenders showing reduced sensitivity to anger compared with non-offenders and violent offenders, and reduced sensitivity to disgust compared with non-offenders. Furthermore, both sexual and violent offenders showed impaired sensitivity to high intensity female fearful expressions compared with non-offenders. Violent offenders also showed a higher criterion for classifying moderate and high intensity male expressions as fearful, indicative of a more conservative response style, compared with angry, happy, or sad. These results suggest that both types of offender show problems in emotion recognition, and may have implications for understanding the inhibition of violent and sexually violent behaviors