Analyzing Medication Documentation in Electronic Health Records: Dental Students’ Self-Reported Behaviors and Charting Practices

The aim of this two-part study was to assess third- and fourth-year dental students’ perceptions, self-reported behaviors, and actual charting practices regarding medication documentation in axiUm, the electronic health record (EHR) system. In part one of the study, in fall 2015, all 125 third- and 85 fourth-year dental students at one U.S. dental school were invited to complete a ten-item anonymous survey on medication history-taking. In part two of the study, the EHRs of 519 recent dental school patients were randomly chosen via axiUm query based on age >21 years and the presence of at least one documented medication. Documentation completeness was assessed per EHR and each medication based on proper medication name, classification, dose/frequency, indication, potential oral effects, and correct medication spelling. Consistency was evaluated by identifying the presence/absence of a medical reason for each medication. The survey response rate was 90.6% (N=187). In total, 64.5% of responding students reported that taking a complete medication history is important and useful in enhancing pharmacology knowledge; 90.4% perceived it helped improve their understanding of patients’ medical conditions. The fourth-year students were more likely than the third-year students to value the latter (p=0.0236). Overall, 48.6% reported reviewing patient medications with clinic faculty 76-100% of the time. The respondents’ most frequently cited perceived barriers to medication documentation were patients’ not knowing their medications (68.5%) and, to a much lesser degree, axiUm limitations (14%). Proper medication name was most often recorded (93.6%), and potential oral effects were recorded the least (3.0%). Medication/medical condition consistency was 70.6%. In this study, most of the students perceived patient medication documentation as important; however, many did not appreciate the importance of all elements of a complete medication history, and complete medication documentation was low

Global regularity for a logarithmically supercritical hyperdissipative dyadic equation

We prove global existence of smooth solutions for a slightly supercritical dyadic model. We consider a generalized version of the dyadic model introduced by Katz-Pavlovic [KatPav2004] and add a viscosity term with critical exponent and a supercritical correction. This model catches for the dyadic a conjecture that for Navier-Stokes equations was formulated by Tao [Tao2009

Markovianity and ergodicity for a surface growth PDE

The paper analyzes a model in surface growth where the uniqueness of weak solutions seems to be out of reach. We prove existence of a weak martingale solution satisfying energy inequalities and having the Markov property. Furthermore, under nondegeneracy conditions on the noise, we establish that any such solution is strong Feller and has a unique invariant measure

Global regularity for a slightly supercritical hyperdissipative Navier-Stokes system

We prove global existence of smooth solutions for a slightly supercritical hyperdissipative Navier--Stokes under the optimal condition on the correction to the dissipation. This proves a conjecture formulated by Tao [Tao2009]

Standard and Null Weak Values

Weak value (WV) is a quantum mechanical measurement protocol, proposed by Aharonov, Albert, and Vaidman. It consists of a weak measurement, which is weighed in, conditional on the outcome of a later, strong measurement. Here we define another two-step measurement protocol, null weak value (NVW), and point out its advantages as compared to WV. We present two alternative derivations of NWVs and compare them to the corresponding derivations of WVs.Comment: 11 pages, 2 figures. To appear in Quantum Theory: A Two-Time Success Story: Yakir Aharonov Festschrif

Phospholipase activity of yeasts from wild birds and possible implications for human disease

Over the last decades, reports on yeast infections in humans have increased especially with respect to immunocompromised individuals. Phospholipases are enzymes which may be associated with pathogenic processes caused by opportunistic yeasts. Phospholipase activity (ph.a.) was investigated in 163 isolates of 13 species of yeasts. A total of 133 isolates were obtained through the screening of a total of 768 cloacae of wild birds (Group I: 182 birds of prey; Group II: 165 passeriformes and Group III: 421 other wild migratory birds), while 30 isolates were recovered from the droppings of birds housed in 32 distinct aviaries (Group IV). Phospholipase production was evaluated and quantified at 2 and 5 day pre-incubation (Pr.t) and incubation times (I.t). Isolates from cloacae (48.1%) and excreta (73.3%) produced ph.a. with the highest values registered after 5 days of I.t. Candida albicans, C. tropicalis, C. glabrata, C. lusitaniae, C. pelliculosa, Cryptococcus albidus, C. laurentii, Trichosporon beigelii, and Saccharomyces cerevisiae displayed the highest ph.a. after 2 days of Pr.t while Candida famata, C. guilliermondii and Cryptococcus neoformans after 5 days of Pr.t. Ph.a. was never found in Rhodotorula rubra isolates recovered from the cloacae of wild birds. Isolates (73.3%) from bird droppings showed a higher ph.a. than those from cloacae thus indicating that wild birds not only act as carriers but may also spread phospholipase-producing yeasts in the environment

Minimal inhibitory and Mutant prevention concentrations of enrofloxacin for Pasteurella multocida from rabbits affected by pasteurellosis

Pasteurella multocida is the agent of one of the most significant diseases in rabbits and it is associated with a heterogeneous clinical picture. Drugs belonging to the fluoroquinolones class are useful to control pasteurellosis. Among them, enrofloxacin is one of the most used molecules in rabbit industry and it is the only one fluoroquinolone registered for this species in Italy. Enrofloxacin adopted dosages are currently based on Minimum Inhibitory Concentration (MIC). Nevertheless, MIC is not effective against possible pathogen sub-populations with lower susceptibility that may be selectively amplified, leading to possible problems of antibiotic resistance. Mutant Prevention Concentration (MPC) could represent an approach to minimize the risk of resistance selection in pathogens. The aim of this work was to test the sensitivity to enrofloxacin of P. multocida strains isolated from rabbits affected by pasteurellosis to evaluate if MPC-based dosages can represent a valid option. The study was performed on ten strains of P. multocida isolated from rabbits from two industrial farms of Puglia, South Italy. The sensitivity to enrofloxacin has been evaluated by MIC tests by microdilution method and MPC tests performed according to Marcusson et al. (2005) with minor modifications. The results of MIC and MPC tests have revealed that MPC dosages are on average 8,4 times higher than MIC dosages. This data highlight that, although MPC-based dosages are useful to prevent the selection of potential mutant, they could be higher than MIC-based ones, leading to possible issues related to their application in field, for example the potential risk of possible toxicity for animals and residues in meat

Pumped heat and charge statistics from Majorana braiding

We examine the heat and charge transport of a driven topological superconductor. Our particular system of interest consists of a Y-junction of topological superconducting wires, hosting non-Abelian Majorana zero modes at their edges. The system is contacted to two leads which act as continuous detectors of the system state. We calculate, via a scattering matrix approach, the full counting statistics of the driven heat transport, between two terminals contacted to the system, for small adiabatic driving and characterize the energy transport properties as a function of the system parameters (driving frequency, temperature). We find that the geometric, dynamic contribution to the pumped heat statistics results in a correction to the Gallavotti-Cohen type fluctuation theorem for quantum heat transfer. Notably, the correction term to the fluctuation theorem extends to cycles which correspond to topologically protected braiding of the Majorana zero modes. This geometric correction to the fluctuation theorem differs from its analogs in previously studied systems in that (i) it is nonvanishing for adiabatic cycles of the system's parameters, without the need for cyclic driving of the leads and (ii) it is insensitive to small, slow fluctuations of the driving parameters due to the topological protection of the braiding operation