Drug related problems and pharmacist interventions in a geriatric unit employing electronic prescribing

Background Computerised physician order entry (CPOE) and the integration of a pharmacist in clinical wards have been shown to prevent drug related problems (DRPs). Objectives The primary objective was to make an inventory of the DRPs and resident pharmacist on-ward interventions (PIs) identified in a geriatric acute care unit using CPOE system. The secondary objective was to evaluate the physicians\u27 acceptance of the proposed interventions. Setting A 26-bed geriatric ward of a 1,300-bed teaching hospital. Method A 6-month descriptive study with prescription analysis and recommendations to physicians by a resident pharmacist during five half days a week. Main outcome measures Patients\u27 characteristics, number of prescribed drugs per patient, nature and frequency of DRPs and PIs, physicians\u27 acceptance and drugs questioned. Results Resident pharmacist reviewed 311 patients and identified 241 DRPs. One hundred and fifty-two patients (49 %) had at least one DRP (mean +/- A SD age 87 +/- A 6 years, mean +/- A SD number of prescribed drugs 10.7 +/- A 3.4). Most frequent DRPs were: untreated indication (n = 58, 24.1 %), dose too high (n = 46, 19.1 %), improper administration (n = 31, 12.9 %) and drug interactions (n = 23, 9.5 %). The rate of physicians\u27 acceptance was 90.0 % (7.5 % refusals, 2.5 % not assessable). DRPs related to CPOE system misuse (n = 35, 14.5 %) appeared as a worrying phenomenon (e.g., errors in selecting dosage or unit, or duplication of therapy). Conclusion A resident pharmacist detected various DRPs. Most PIs were accepted. DRPs related to the misuse of the CPOE system appeared potentially dangerous and need particular attention by healthcare professionals. The description of the DRPs is an essential step for implementation of targeted clinical pharmacy services in order to optimize pharmacists\u27 job time

Empowering open science with reflexive and spatialised indicators

Bibliometrics have become commonplace and widely used by authors and journals to monitor, to evaluate and to identify their readership in an ever-increasingly publishing scientific world. This contribution introduces a multi-method corpus analysis tool, specifically conceived for scientific corpuses with spatialised content. We propose a dedicated interactive application that integrates three strategies for building semantic networks, using keywords (self-declared themes), citations (areas of research using the papers) and full-texts (themes derived from the words used in writing). The networks can be studied with respect to their temporal evolution as well as to their spatial expressions, by considering the countries studied in the papers under inquiry. The tool is applied as a proof-of-concept on the papers published in the online open access geography journal Cybergeo since its creation in 1996. Finally, we compare the three methods and conclude that their complementarity can help go beyond simple statistics to better understand the epistemological evolution of a scientific community and the readership target of the journal. Our tool can be applied by any journal on its own corpus, fostering thus open science and reflexivity

Seasonal survey of the composition and degradation state of particulate organic matter in the Rhône River using lipid tracers

International audienceLipid tracers including fatty acids, hydroxyacids, n-alkanols, sterols and triterpenoids were used to determine the origin and fate of suspended particulate organic matter (POM) collected in the Rhône River (France). This seasonal survey (April 2011 to May 2013) revealed a year-round strong terrestrial higher-plant contribution to the particulate organic matter (POM), with significant algal inputs observed in March and attributed to phytoplanktonic blooms likely dominated by diatoms. Major terrigenous contributors to our samples are gymnosperms, and more precisely their roots and stems, as evidenced by the presence of high proportions of ω-hydroxydocosanoic acid (a suberin biomarker). The high amounts of coprostanol detected clearly show that the Rhône River is significantly affected by sewage waters. Specific sterol degradation products were quantified and used to assess the part of biotic and abiotic degradation of POM within the river. Higher-plant-derived organic matter appears to be mainly affected by photo-oxidation and au-toxidation (free radical oxidation), while organic matter of mammal or human origin, evidenced by the presence of co-prostanol, is clearly more prone to bacterial degradation. Despite the involvement of an intense autoxidation-inducing ho-molytic cleavage of peroxy bonds, a significant proportion of hydroperoxides is still intact in higher plant debris. These compounds could affect the degradation of terrestrial material by inducing an intense autoxidation upon its arrival at sea

Nutrients limitation of primary productivity in the Southeast Pacific (BIOSOPE cruise)

Revue sans Comité de lectureInternational audienceIron is an essential nutrient involved in a variety of biological processes in the ocean, including photosynthesis, respiration and nitrogen fixation. Atmospheric deposition of aerosols is recognized as the main source of iron for the surface ocean. In high nutrient, low chlorophyll areas, it is now clearly established that iron limits phytoplankton productivity but its biogeochemical role in low nutrient, low chlorophyll environments has been poorly studied. We investigated this question in the unexplored southeast Pacific, arguably the most oligotrophic area of the global ocean. Situated far from any continental aerosol source, the atmospheric iron flux to this province is amongst the lowest of the world ocean. Here we report that, despite low dissolved iron concentrations (~0.1 nmol l-1) measured across the whole gyre (3 stations situated in the center, the western and the eastern edge), photosynthesis and primary productivity are only limited by iron availability at the border of the gyre, but not in the center. The seasonal stability of the gyre has apparently allowed for the development of populations acclimated to these extreme oligotrophic conditions. Moreover, despite clear evidence of nitrogen limitation in the central gyre, we were unable to measure nitrogen fixation in our experiments, even after iron and/or phosphate additions, and cyanobacterial nifH gene abundances were extremely low compared to the North Pacific Gyre. The South Pacific gyre is therefore unique with respect to the physiological status of its phytoplankton populations

Rare-metal granites as a potential source of critical metals: A geometallurgical case study

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this recordBecause of their low grades in critical metals such as Light Rare Earth Elements (LREE) or Sn, rare-metal granites are not considered as economic for metal recovery but, when altered, they are often exploited for their industrial minerals. The St Austell rare-metal granite is well known for its world-class kaolin deposits which formed as a result of the extensive weathering and alteration of the underlying granite. The St Austell granite body is composed of several granite components, each having its own accessory minerals assemblage. As a result of the kaolinisation process, some metal-bearing accessory minerals of the granite, such as monazite (LREE) or cassiterite (Sn), are partially liberated from the gangue which allow their pre-concentration in the micaceous residue which is considered as a potential source for critical metals recovery. Similarities with other similar rare-metal granites suggest that topaz granite is the most prospective for disseminated magmatic Sn-Nb-Ta-REE mineralization. However, comparison of the potentiality of 3 granite types i.e., biotite, topaz and tourmaline granites suggest that biotite granites is actually the most prospective due to higher degree of kaolinisation of the biotite granite which favour pre-concentration of its accessory mineral in the micaceous residue. In order to develop a geometallurgical framework for extraction of kaolin and metals from the selected granite component, a field sampling campaign is performed. Core samples are processed in the laboratory using a characterisation program that mimics the full-scale kaolin refining route. Two main products are recovered through this program, viz. MR180 (−180 +53 µm) and P5 (−5 µm), which correspond to a fine micaceous residue and a fine kaolin product respectively. These products are both analysed routinely for major and minor trace elements by XRF and yields are recorded to indicate process performance. A selected number of MR180 samples are also being characterised in terms of particle size by laser light scattering, geochemistry by ICP-MS, and mineralogy by QEMSCAN®. Comparison of characterisation results of MR180 samples and corresponding industrial residue samples shows a good correlation, suggesting that sample analyses are representative for the in-situ deposit and the processing behaviour. Monazite is found to be either fully liberated or fully locked from one sample to the other. Next, pilot-scale gravity concentration tests are performed on micaceous residue samples. Characterisation of the processing products shows that monazite lost in the tailings is mostly locked within tourmaline or micas and is fine grained. Then, predictive regression models for spiral separation performance in terms of recovery, product grade and enrichment as a function of the feed grade are developed for MR180 LREE grade data. Finally, kaolin resources can be classified using quantitative indicators such as yield of the P5 product and the iron oxides content which provides insight into the kaolin quality in terms of whiteness. This geometallurgical classification can be used to delineate zones of interest within the deposit. Although kaolin quality and recovery primarily inform extraction planning, zones which are also of interest for metal recovery can be identified. The proposed model predicts whether the expected LREE grade and recovery satisfy the by-product requirements.European CommissionNatural Environment Research Council (NERC)French National Research Agenc

The young HD 73583 (TOI-560) planetary system: two 10-M_earth mini-Neptunes transiting a 500-Myr-old, bright, and active K dwarf

Stars and planetary system

Thermal sensitivity of uncoupling proteins in polar and temperate fish

Uncoupling proteins (UCP), capable of increasing proton leakage across the inner mitochondrial membrane, may play a role in the temperature dependent setting of energy turnover in animals (and their mitochondria). Therefore, the genes and expression of fish UCP were investigated in the Antarctic eelpout Pachycara brachycephalum and a temperate confamilial species, the common eelpout Zoarces viviparus. UCP full-length cDNA was amplified from liver and muscle using RT-PCR and rapid amplification of cDNA ends (RACE). The fish UCP mRNA consists of 1906bp in P. brachycephalum and of 1876bp in Z. viviparus. Both zoarcid sequences contain open reading frames of 939bp, encoding 313 amino acids, with 98 and 99% identity, respectively. Protein sequences of zoarcid UCP are closest related to fish and mammalian UCP2. For analysis of temperature dependent expression common eelpouts were cold-acclimated from 10°C to 2°C and Antarctic eelpouts were warm-acclimated from 0°C to 5°C. Identical cDNA probes for both species were developed to investigate fish UCP mRNA expression, and protein expression levels were detected by Western Blot in the enriched membrane fraction. During cold-acclimation in Z. viviparus, mRNA levels increased by a factor up to 2.0, protein levels increased up to 1.5, in line with mitochondrial proliferation during cold-acclimation. Despite decreased mitochondrial protein content, in Antarctic eelpout UCP levels rose upon warm acclimation by a factor up to 2.0 (mRNA) and 1.6 (protein), respectively. Besides the ongoing discussion of UCP function in vertebrates, the data are indicative of a significant role of fish UCP in thermal adaptation of fish mitochondria