Review of Clinical Questions Submitted to Norwegian Drug Information Centres Concerning Administration and Dosage to Older Patients of Relevance to Patient-Centric Care

Patient-centric care entails optimising healthcare provision to patients based on their perspective and opinion. It involves appropriate treatment at a reasonable cost and a focus on patient characteristics in the decision-making process to make it more personally useful. The optimisation of medicines in the older population is a challenge due to physiological changes, comorbidity, and polypharmacy. Furthermore, patient-centric care is difficult to achieve due to the high proportion of patients with dementia and frailty. Decision support concerning the appropriateness of indication, formulation, dose, administration, co-prescribing, and length of treatment to older patients is frequently in demand. In the current study, we aimed to review clinical questions concerning administration and dosage to older patients of relevance to patient-centric care. We analysed questions concerning medicines to patients 65 years or older in the database of the network of Norwegian drug information centres from 2010 to 2020. The analysis included the distribution of drugs, diseases, and recurring topics among the questions. Through a Boolean search that combined the indexed categories of “older” and “administration and dosage”, we retrieved 84 question-answer pairs. Questions about psychotropic and cardiovascular drugs in relation to therapy, adverse drug reactions, and pharmacokinetics dominated, and more than 60% of the questions came from physicians. Topics relevant to patient-centric pharmacotherapy were drug withdrawal (10 questions), drug formulation (8 questions), drug initiation (8 questions), and switching drugs (5 questions). One question concerned drug withdrawal and switching, and one question drug formulation and switching. Answers provided decision support regarding appropriate formulations of drugs to patients with dementia who chew capsules or tablets, the use of parenteral administration in patients who refuse to take oral formulations, and the pharmacokinetics of transdermal or rectal drug administration. The results highlight the importance of including pharmacological factors in the assessment of the acceptability and appropriateness of oral and parenteral medicine to older patients.publishedVersio

An iterative deep learning procedure for determining electron scattering cross-sections from transport coefficients

We propose improvements to the Artificial Neural Network (ANN) method of determining electron scattering cross-sections from swarm data proposed by coauthors. A limitation inherent to this problem, known as the inverse swarm problem, is the non-unique nature of its solutions, particularly when there exists multiple cross-sections that each describe similar scattering processes. Considering this, prior methods leveraged existing knowledge of a particular cross-section set to reduce the solution space of the problem. To reduce the need for prior knowledge, we propose the following modifications to the ANN method. First, we propose a Multi-Branch ANN (MBANN) that assigns an independent branch of hidden layers to each cross-section output. We show that in comparison with an equivalent conventional ANN, the MBANN architecture enables an efficient and physics informed feature map of each cross-section. Additionally, we show that the MBANN solution can be improved upon by successive networks that are each trained using perturbations of the previous regression. Crucially, the method requires much less input data and fewer restrictive assumptions, and only assumes knowledge of energy loss thresholds and the number of cross-sections present

Suspended particulates at the Point Loma, California wastewater outfall

A recent study conducted at the Point Loma wastewater outfall in San Diego used a novel sampling technique, the Pelagic Laser Tomographer (PLT), in combination with traditional water column profiling instruments to analyze suspended particulate distributions and effluent plume dynamics. Coastal wastewater discharges create buoyant plumes that interact with the surrounding water, and the tracking and mapping of the resulting diluted effluent is essential for monitoring outfall system performance. The results from the PLT sampling highlight the utility of high spatial and temporal resolution estimates of suspended particulate size spectra to help capture the dynamics of the plume interactions with the coastal current flow field. In addition, new tools like the PLT can help marine scientists estimate natural and anthropogenic particulate size distributions that are essential to our understanding sediment and pollutant transport, nutrient cycling, and ecosystem energy dynamics

Simulating the Feasibility of Using Liquid Micro-Jets for Determining Electron–Liquid Scattering Cross-Sections

The extraction of electron–liquid phase cross-sections (surface and bulk) is proposed through the measurement of (differential) energy loss spectra for electrons scattered from a liquid micro-jet. The signature physical elements of the scattering processes on the energy loss spectra are highlighted using a Monte Carlo simulation technique, originally developed for simulating electron transport in liquids. Machine learning techniques are applied to the simulated electron energy loss spectra, to invert the data and extract the cross-sections. The extraction of the elastic cross-section for neon was determined within 9% accuracy over the energy range 1–100 eV. The extension toward the simultaneous determination of elastic and ionisation cross-sections resulted in a decrease in accuracy, now to within 18% accuracy for elastic scattering and 1% for ionisation. Additional methods are explored to enhance the accuracy of the simultaneous extraction of liquid phase cross-sections

Penguins and seals transport limiting nutrients between offshore pelagic and coastal regions of Antarctica under changing sea ice

Large animals such as sea birds and marine mammals can transport limiting nutrients between different regions of the ocean, thereby stimulating and enhancing productivity. In Antarctica this process is influenced by formation and breakup of sea ice and its influence on the feeding behaviour of predators and their prey. We used analyses of bioactive metals (for example, Fe, Co, Mn), macronutrients (for example, N) and stable isotopes (δ13C and δ15N) in the excreta of Adélie (Pygoscelis adeliae) and emperor penguins (Aptenodytes forsteri) as well as Weddell seals (Leptonychotes weddellii) from multiple sites, among multiple years (2012–2014) to resolve how changes in sea ice dynamics, as indicated by MODIS satellite images, were coincident with prey switching and likely changes in nutrient fluxes between the offshore pelagic and coastal zones. We also sampled excreta of the south polar skua (Stercorarius maccormicki), which preys on penguins and scavenges the remains of both penguins and seals. We found strong coincidence of isotopic evidence for prey switching, between euphausiids (Euphausia superba and E. crystallorophias) and pelagic/cryopelagic fishes (for example, Pleuragramma antarcticum) in penguins, and between pelagic/cryopelagic fishes and Antarctic toothfish (Dissostichus mawsoni) in Weddell seals, with changes in sea ice cover among years. Further, prey switching was strongly linked to changes in the concentrations of nutrients (Fe and N) deposited in coastal environments by both penguins and seals. Our findings have important implications for understanding how the roles of large animals in supporting coastal productivity may shift with environmental conditions in polar ecosystems.Accepted manuscrip

Source levels of social sounds in migrating humpback whales (Megaptera novaeangliae)

The source level of an animal sound is important in communication, since it affects the distance over which the sound is audible. Several measurements of source levels of whale sounds have been reported, but the accuracy of many is limited because the distance to the source and the acoustic transmission loss were estimated rather than measured. This paper presents measurements of source levels of social sounds (surface-generated and vocal sounds) of humpback whales from a sample of 998 sounds recorded from 49 migrating humpback whale groups. Sources were localized using a wide baseline five hydrophone array and transmission loss was measured for the site. Social vocalization source levels were found to range from 123 to 183 dB re 1 mu Pa @ 1 m with a median of 158 dB re 1 mu Pa @ 1 m. Source levels of surface-generated social sounds ("breaches" and "slaps") were narrower in range (133 to 171 dB re 1 mu Pa @ 1 m) but slightly higher in level (median of 162 dB re 1 mu Pa @ 1 m) compared to vocalizations. The data suggest that group composition has an effect on group vocalization source levels in that singletons and mother-calf-singing escort groups tend to vocalize at higher levels compared to other group compositions. VC 2013 Acoustical Society of America

Vivid visual mental imagery in the absence of the primary visual cortex

The role of the primary visual cortex in visual mental imagery has provided significant debate in the imagery literature. Functional neuroimaging studies show considerable variation depending on task and technique. Patient studies can be difficult to interpret due to the diverse nature of cortical damage. The type of cortical damage in patient SBR is exceedingly rare as it is restricted to the gray matter of the calcarine sulcus. In this study, we show that in spite of his near-complete cortical blindness, SBR exhibits vivid visual mental imagery both behaviorally and when measured with functional magnetic resonance imaging. The pattern of cortical activation to visual mental imagery in SBR is indistinguishable from individual sighted subjects, in contrast to the visual perceptual responses, which are greatly attenuated

Information theory analysis of Australian humpback whale song

Songs produced by migrating whales were recorded off the coast of Queensland, Australia, over six consecutive weeks in 2003. Forty-eight independent song sessions were analyzed using information theory techniques. The average length of the songs estimated by correlation analysis was approximately 100 units, with song sessions lasting from 300 to over 3100 units. Song entropy, a measure of structural constraints, was estimated using three different methodologies: (1) the independently identically distributed model, (2) a first-order Markov model, and (3) the nonparametric sliding window match length (SWML) method, as described by Suzuki et al. [(2006). “Information entropy of humpback whale song,” J. Acoust. Soc. Am. 119, 1849–1866]. The analysis finds that the song sequences of migrating Australian whales are consistent with the hierarchical structure proposed by Payne and McVay [(1971). “Songs of humpback whales,” Science 173, 587–597], and recently supported mathematically by Suzuki et al. (2006) for singers on the Hawaiian breeding grounds. Both the SWML entropy estimates and the song lengths for the Australian singers in 2003 were lower than that reported by Suzuki et al. (2006) for Hawaiian whales in 1976–1978; however, song redundancy did not differ between these two populations separated spatially and temporally. The average total information in the sequence of units in Australian song was approximately 35 bits/song. Aberrant songs (8%) yielded entropies similar to the typical songs

Applied Sport Science for Male Age-Grade Rugby Union in England

Rugby union (RU) is a skill-collision team sport played at junior and senior levels worldwide. Within England, age-grade rugby governs the participation and talent development of youth players. The RU player development pathway has recently been questioned, regarding player performance and well-being, which sport science research can address. The purpose of this review was to summarise and critically appraise the literature in relation to the applied sport science of male age-grade RU players in England focussing upon (1) match-play characteristics, (2) training exposures, (3) physical qualities, (4) fatigue and recovery, (5) nutrition, (6) psychological challenges and development, and (7) injury. Current research evidence suggests that age, playing level and position influence the match-play characteristics of age-grade RU. Training exposures of players are described as 'organised chaos' due to the multiple environments and stakeholders involved in coordinating training schedules. Fatigue is apparent up to 72 h post match-play. Well-developed physical qualities are important for player development and injury risk reduction. The nutritional requirements are high due to the energetic costs of collisions. Concerns around the psychological characteristics have also been identified (e.g. perfectionism). Injury risk is an important consideration with prevention strategies available. This review highlights the important multi-disciplinary aspects of sport science for developing age-grade RU players for continued participation and player development. The review describes where some current practices may not be optimal, provides a framework to assist practitioners to effectively prepare age-grade players for the holistic demands of youth RU and considers areas for future research

Search for the Θ+\Theta^+ pentaquark in the reaction γd→pK−K+n\gamma d \to p K^- K^+ n

A search for the \thp in the reaction $\gamma d \to pK^-K^+n$ was completed using the CLAS detector at Jefferson Lab. A study of the same reaction, published earlier, reported the observation of a narrow \thp resonance. The present experiment, with more than 30 times the integrated luminosity of our earlier measurement, does not show any evidence for a narrow pentaquark resonance. The angle-integrated upper limit on \thp production in the mass range of 1.52 to 1.56 GeV/c$^2$ for the $\gamma d \to pK^-\Theta^+$ reaction is 0.3 nb (95% CL). This upper limit depends on assumptions made for the mass and angular distribution of \thp production. Using \lamstar production as an empirical measure of rescattering in the deuteron, the cross section upper limit for the elementary $\gamma n \to K^-\Theta^+$ reaction is estimated to be a factor of 10 higher, {\it i.e.}, $\sim 3$ nb (95% CL).Comment: 5 figures, submitted to PRL, revised for referee comment