Prevalence and predictors of inadequate patient medication knowledge

© 2016 John Wiley & Sons, Ltd. Objectives: To assess medication knowledge in adult patients and to explore its determinants. Method: Cross-sectional study. Medication knowledge was the primary outcome and was assessed using a previously validated questionnaire. A multivariate logistic regression analysis was performed to explore the association between medication knowledge and the factors included in the model. Results: Seven thousand two hundred seventy-eight patients participated in the study. 71.9% (n = 5234) (95% CI: 70.9%–73.0%) of the surveyed patients had an inadequate knowledge of the medication they were taking. The dimensions obtaining the highest level of knowledge were the ‘medication use process’ and ‘therapeutic objective of medication’. The items ‘frequency’ (75.4%), ‘dosage’ (74.5%) and ‘indication’ (70.5%) had the highest percentage of knowledge. Conversely, ‘medication safety’ represented the dimension with the lowest scores, ranging from 12.6% in the item “contraindications” to 15.3% in the item ‘side effects’. The odds ratio (OR) of having an inadequate medication knowledge increased for unskilled workers (OR: 1.33; 85% CI:1.00–1.78; P = 0.050), caregivers (OR:1.46; 95% CI:1.18–1.81; P < 0.001), patients using more than one medication (OR: 1.14; 95% CI: 1.00–1.31; P = 0.050) and patients who did not know the name of the medication they were taking (OR: 2.14, 95% CI: 1.71–2.68 P < 0.001). Conclusion: Nearly three quarters of the analysed patients had inadequate knowledge regarding the medicines they were taking. Unskilled workers and caregivers were at a higher risk of lacking of medication knowledge. Other factors that correlated with inadequate medication knowledge were the use of more than one drug and not knowing the name of the medication dispensed

Toward Building a Semantic Network Inventory for Model-Driven Telemetry

Network telemetry based on data models is expected to become the standard mechanism for collecting operational data from network devices efficiently. But the wide variety of standard and proprietary data models along with the different implementations of telemetry protocols offered by network vendors, become a barrier when monitoring heterogeneous network infrastructures. To facilitate the integration and sharing of context information related to model-driven telemetry, this work proposes a semantic network inventory that integrates new information models specifically developed to capture context information in a vendor-agnostic fashion using current standards defined for context management. To automate the integration of this context information within the network inventory, a reference architecture is designed. Finally, a prototype of the solution is implemented and validated through a case study that illustrates how the network inventory can ease the operation of model-driven telemetry in multi-vendor networks.Comment: 8 pages, 5 figure

Magnetic properties of G-band bright points in a sunspot moat

We present simultaneous spectropolarimetric observations of four visible and three infrared spectral lines from the VTT (Tenerife), together with speckle-reconstructed filtergrams in the G band and the CaII H line core from the DOT (La Palma). After alignment of the data sets, we used the G-band intensity to locate bright points (BPs) in the moat of a regular sunspot. With the cospatial and cotemporal information provided by the polarimetric data, we characterize the magnetic, kinematic, and thermal properties of the BPs. We find that (a) 94 % of the BPs are associated with magnetic fields; (b) their field strengths range between 500 and 1400 G, with a rather flat distribution; (c) the contrast of BPs in the G band depends on the angle between the vector magnetic field and the line of sight; (d) the BPs harbor downflows of magnetized plasma and exhibit Stokes V profiles with large area and amplitude asymmetries; (e) the magnetic interior of BPs is hotter than the immediate field-free surroundings by about 1000 K at equal optical depth; and (f) the mean effective diameter of BPs in our data set is 150 km, with very few BPs larger than 300 km. Most of these properties can be explained by the classical magnetic flux tube model. However, the wide range of BP parameters found in this study indicates that not all G-band BPs are identical to stable long-lived flux tubes or sheets of kG strength.Comment: Accepted in A&A, 20 pages, 21 figures in main text, 6 fig. in the Appendices, 3 figures as jpg (fig. 5, C1, C2

Conjunctival vaccination against Brucella ovis in mice with mannosylated nanoparticles

The use of sub-unit vaccines can solve some drawbacks associated with traditional attenuated or inactivated ones. However, in order to improve their immunogenicity, these vaccines needs to be associated to an appropriate adjuvant which, adequately selected, may also offer an alternative pathway for administration. The aim of this work was to evaluate the protection offered by the hot saline complex extracted from Brucella ovis (HS) encapsulated in mannosylated nanoparticles (MAN-NP-HS) when instilled conjunctivally in mice. Nanoparticles displayed a size of 300 nm and the antigen loading was close to 30 μg per mg nanoparticle. Importantly, encapsulated HS maintained its protein profile, structural integrity and antigenicity during and after the preparative process of nanoparticles. The ocular immunization was performed on BALB/c mice. Eight weeks after vaccination animals were challenged with B. ovis, and 3 weeks later, were slaughtered for bacteriological examinations. Animals immunized with MAN-NP-HS displayed a 3-log reduction in spleen CFU compared with unvaccinated animals. This degree of protection was significantly higher than that observed for the commercial vaccine (Rev1) subcutaneously administered. Interestingly, the mucosal IgA response induced by MAN-NP-HS was found to be much more intense than that offered by Rev1 and prolonged in time. Furthermore, the elicited IL-2, IL-4 and γ-IFN levels showed good correlation with the degree of protection. On the other hand, biodistribution studies in animals were performed with nanoparticles labelled with either 99mtechnetium or rhodamine B isothiocyanate. The biodistribution revealed that, after instillation, MAN-NP-HS moved from the palpebral area to the nasal region and, the gastrointestinal tract. This profile of distribution was different to that observed for free 99mTcO4− colloids, which remained for at least 24 h in the site of administration. In summary, mannosylated nanoparticles appear to be a safe and suitable adjuvant for conjunctival vaccination

Artificial auroral effects from a bare conducting tether

An electrically floating metallic bare tether in a low Earth orbit would be highly negative with respect to the ambient plasma over most of its length, and would be bombarded by ambient ions.This would liberates secondary electrons which after acceleration through the same voltage, would form a magnetically guided two-sided planar e beam,and result in auroral effects(ionization and light emission)upon impacto on the atmospheric E layer, at about 120-140 km altitude.This papere examines in a preliminary way the feasibility of using this effecet as an uppeart atmospheric probe. Ionization rate can reach up to 10 3 cm 3 S -1 if a tape, instead of a wire, is used as tether. Contrary to standard e beams,the beam from the tether is free of spacecrafct charging and plasma interaction problems and its energy flux varies across the crosss ection,w hich is quite large;this would make possible continuous observation from the satellite, with high resolution both spectral and vertical, of the induced optical emissions. Ground observation might be possible at latitudes around 40ø , for night, magnetically quiet conditions

Enzyme-Powered Gated Mesoporous Silica Nanomotors for On-Command Intracellular Payload Delivery

[EN] The introduction of stimuli-responsive cargo release capabilities on self-propelled micro- and nano- motors holds enormous potential in a number of applications in the biomedical field. Herein, we report the preparation of mesoporous silica nano-particles gated with pH-responsive supramolecular nanovalves and equipped with urease enzymes which act as chemical engines to power the nanomotors. The nanoparticles are loaded with different cargo molecules ([Ru(bpy)(3)]Cl-2 (bpy = 2,2'-bipyridine) or doxorubicin), grafted with benzimidazole groups on the outer surface, and capped by the formation of inclusion complexes between benzimidazole and cyclodextrin-modified urease. The nanomotor exhibits enhanced Brownian motion in the presence of urea. Moreover, no cargo is released at neutral pH, even in the presence of the biofuel urea, due to the blockage of the pores by the bulky benzimidazole:cyclodextrin-urease caps. Cargo delivery is only triggered on-command at acidic pH due to the protonation of benzimidazole groups, the dethreading of the supramolecular nanovalves, and the subsequent uncapping of the nanoparticles. Studies with HeLa cells indicate that the presence of biofuel urea enhances nanoparticle internalization and both [Ru(bpy)(3)]Cl-2 or doxorubicin intracellular release due to the acidity of lysosomal compartments. Gated enzyme-powered nanomotors shown here display some of the requirements for ideal drug delivery carriers such as the capacity to self-propel and the ability to "sense" the environment and deliver the payload on demand in response to predefined stimuli.A.L.-L. is grateful to La Caixa Banking Foundation for his Ph.D. grant. A.G.-F. thanks the Spanish government for her FPU fellowship. The authors are grateful to the Spanish Government (MINECO Projects MAT2015-64139-C4-1, CTQ2014-58989- PCTQ2015-71936-REDT, CTQ2015-68879-R (MICRODIA) and CTQ2015-72471-EXP (Enzwim)), the BBVA foundation (MEDIROBOTS), the CERCA Programme by the Generalitat de Catalunya, and the Generalitat Valenciana (Project PROMETEO/2018/024 and PROMETEOII/2014/061) for support. T.P. thanks MINECO for the Juan de la Cierva postdoctoral fellowship and the European Union's Horizon 2020 research and innovation program, under the Marie Sk¿odowska-Curie Individual Fellowship (H2020-MSCA-IF2018, DNA-bots). A.C.H. thanks MINECO for the Severo Ochoa fellowship. The authors would like to thank A. Miguel Lopez for the development of the python code for motion analysis.Llopis-Lorente, A.; García-Fernández, A.; Murillo-Cremaes, N.; Hortelao, A.; Patiño, T.; Villalonga, R.; Sancenón Galarza, F.... (2019). Enzyme-Powered Gated Mesoporous Silica Nanomotors for On-Command Intracellular Payload Delivery. ACS Nano. 13(10):12171-12183. https://doi.org/10.1021/acsnano.9b067061217112183131

Relationship between Determinants of Health, Equity, and Dimensions of Health Literacy in Patients with Cardiovascular Disease

Background: Health literacy (HL) has been linked to empowerment, use of health services, and equity. Evaluating HL in people with cardiovascular health problems would facilitate the development of suitable health strategies care and reduce inequity. Aim: To investigate the relationship between different dimensions that make up HL and social determinants in patients with cardiovascular disease. Methods: Observational, descriptive, cross-sectional study in patients with cardiovascular disease, aged 50-85 years, accessing primary care services in Valencia (Spain) in 2018-2019. The Health Literacy Questionnaire was used. Results: 252 patients. Age was significantly related with the ability to participate with healthcare providers (p = 0.043), ability to find information (p = 0.022), and understanding information correctly to know what to do (p = 0.046). Level of education was significant for all HL dimensions. Patients without studies scored lower in all dimensions. The low- versus middle-class social relationship showed significant results in all dimensions. Conclusions: In patients with cardiovascular disease, level of education and social class were social determinants associated with HL scores. Whilst interventions at individual level might address some HL deficits, inequities in access to cardiovascular care and health outcomes would remain unjustly balanced unless structural determinants of HL are taken into account

Male infant patient with a mesenteric cyst in the greater and lesser omenta: a case report

Background: Mesenteric cysts are intra-abdominal masses of congenital origin, which most frequently occur in children, with an incidence of approximately 1 case per 20,000 pediatric admissions. Its progression can be asymptomatic, and its diagnosis can be incidental. However, it usually occurs with symptoms such as nausea, vomiting, constipation, sensation of a mass, and/or diarrhea. The diagnostic imaging method of choice is abdominal ultrasound. Case presentation: Below, we present the case of a previously healthy 1-year-old male patient with nonspecific symptoms, who was referred to a tertiary hospital. The presence of a mesenteric cyst was detected at the end of the diagnostic approach. Conclusion: It is important to know these pathologies even though they are infrequent, because although they are benign masses by definition, they can lead to complications such as intestinal torsion, intestinal obstruction, and even peritonitis. © 2020 The Author(s)

Radiomarcaje y estudios de biodistribución de nanopartículas poliméricas como adyuvantes para la vacunación oftálmica frente a la brucelosis

Objetivos: Optimizar el radiomarcaje con 99mTc de nanopartículas de Gantrez® manosiladas y cargadas con el antígeno de Brucella Ovis (Man-NP-HS) y llevar a cabo estudios de biodistribución en ratón tras la administración de las nanopartículas por vía ocular. Metodología: Las Man-NP-HS se obtuvieron por el método de desplazamiento de disolvente. Se purificaron, liofilizaron y caracterizaron. A continuación, se marcaron con 74 MBq de 99mTcO4 - previamente reducido con una disolución ácida de cloruro de estaño, trabajando en ausencia de oxígeno y con un pH final de 4. El rendimiento del marcaje se evaluó mediante TLC. Los estudios de biodistribución se llevaron a cabo en ratones tras la administración oftálmica de la formulación y de un control de 99mTcO4 - libre. Para ello, se sacrificaron los animales a las 2 y a las 24 horas tras la administración ocular y se contaron los órganos en un contador gamma. Resultados: Se obtuvo un rendimiento de marcaje superior al 90%. Los estudios de biodistribución de 99mTc-Man-NP-HS permitieron detectar la actividad concentrada en mucosa nasal y ocular y tracto gastrointestinal tanto a las 2 como a las 24 horas, frente a la biodistribución de 99mTcO4 - libre que permaneció concentrado en la piel alrededor del ojo y en tracto gastrointestinal. Conclusión: Los estudios de biodistribución de 99mTc-Man-NP-HS tras administración oftálmica han permitido demostrar su biodistribución en mucosas y tracto gastrointestinal, característica indispensable como sistema de liberación de antígenos a través de mucosa ocular. Esto, junto con su elevada respuesta inmune, efectiva protección y no virulencia, convierte a estas nanopartículas en una vacuna ideal anti Brucelosis