Providing alternative measures for addressing adverse drug-drug interactions

First Online 30 March 2019Clinical Practice Guidelines (CPGs) are documents used in daily clinical practice that provide advice on how to best diagnose and treat diseases in the form of a list of clinical recommendations. When simultaneously applying multiple CPGs to patients, this can lead to complex multiple drug regimens (polypharmacy) with the potential for harmful combinations of drugs. The need to address these adverse drug events calls forth for systems capable of not only automatically represent the common potential conflicts or interactions that can happen when merging CPGs but also systems capable of providing conflict-free alternatives. This paper presents a solution that represents CPGs as Computer-Interpretable Guidelines (CIGs) and allows the automatic identification of drug conflicts and the provision of alternative measures to resolve these conflicts.This work has been supported by COMPETE: POCI-01-0145-FEDER-0070 43 and FCT – Fundação para a Ciência e Tecnologia within the Project Scope UID/CEC/ 00319/2013. The work of Tiago Oliveira was supported by JSPS KAKENHI Grant Number JP18K18115

Kinematic analisys of the knee when climbing up/down stairs in patellofemoral instability

OBJECTIVE: To analyze and to identify possible gait adaptations by individuals with objective patellofemoral instability when climbing up/down stairs. METHODS: A control group (group A) composed by nine women with mean age = 25 years (±1.87), height = 1.62 m (±0.05) and weight = 56.20 kg (±7.34), and; nine women with objective patellofemoral instability (group B) with mean age = 24 years (±6.02), height = 1.62 m (±0.06) and weight = 60.33 kg (±10.31) were analyzed. The groups underwent kinematic analysis while climbing up/down stairs, in a previously determined area. Images were obtained by six cameras (Qualysis) and data analysis utilized the Q gait software program. RESULTS: Group B presented, in the support phase, less knee flexion when climbing up (p = 0.0268), and lower speed (p = 0.0076/ p =0.0243) and pace (p = 0.0027/ p = 0.0165) when climbing up and down stairs, respectively. CONCLUSION: It is suggested that group B used functional changes such as reduced knee flexion, speed and pace when climbing up and down stairs.OBJETIVO: Analisar e identificar possíveis adaptações da marcha em indivíduos com diagnóstico de instabilidade patelofemoral objetiva, durante a atividade de subida e descida de escada. MÉTODOS: Foram analisados um grupo controle (grupo A), composto por 9 mulheres com média de idade de 25 anos (±1,87), média de altura de 1,62m (±0,05) e média de peso de 56,20kg (±7,34); e, um grupo de 9 mulheres com instabilidade patelofemoral objetiva (grupo B), média de idade de 24 anos (±6,02), média de altura de 1,62m (±0,06) e média de peso de 60,33kg (±10,31). Os grupos foram submetidos a uma análise cinemática, onde as voluntárias subiram e desceram degraus, em uma área previamente selecionada. As imagens foram obtidas por seis câmeras (Qualysis) e a análise dos dados foi realizada através do programa Q gait. RESULTADOS: O grupo B apresentou, no período de apoio, menor flexão do joelho durante a subida (p=0,0268), além de menores velocidade (p=0,0076/ p=0,0243) e cadência (p=0,0027/ p=0,0165) na subida e na descida, respectivamente. CONCLUSÃO: Sugere-se que o grupo B utilizou adaptações funcionais como redução da flexão do joelho, da velocidade e da cadência, durante a subida e a descida de degraus.UNICAMP FCM Departamento de Ortopedia e TraumatologiaUniversidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Posterior shoulder tightness; an intersession reliability study of 3 clinical tests.

Background Although posterior shoulder tightness (PST) has been associated with shoulder pathology and altered glenohumeral joint kinematics, uncertainty remains regarding its cause and definition. To understand the efficacy of treatments for PST, it must be possible to identify people with PST for the purposes of research and clinical decision-making. Clinical tests for PST must demonstrate acceptable levels of measurement reliability in order to identify the condition and to evaluate the response to intervention. There is currently a lack of research describing intersession reliability for measures of PST. The aim of this study was to quantify the inter-session reliability for three clinical tests used to identify PST over a 6–10 week interval. Methods A convenience sample of 26 asymptomatic adult participants (52 shoulders) were recruited from a university setting over a five-month duration. Participants attended the human movement laboratory for measurement of glenohumeral joint internal rotation, horizontal adduction and low flexion on two occasions separated by an interval of 6–10 weeks. Intra-class correlation coefficients were calculated from the mean square values derived from the within-subject, single factor (repeated measures) ANOVA. Test-retest measurement stability was evaluated by calculating the standard error of measurement and the minimum detectable change for each measurement. Results All 3 tests demonstrated good intersession intra-rater reliability (0.86–0.88), and the standard error of measurement (95%) were 7.3° for glenohumeral horizontal adduction, 9.4° for internal rotation, and 6.9° for low flexion. The minimum detectable change for glenohumeral horizontal adduction was 10.2°, internal rotation was 13.3°, and low flexion was 9.7°. Conclusion In this population of people without symptoms, the 3 measures of PST all demonstrated acceptable inter-session reliability. The standard error of measurement and minimum detectable change results can be used to determine if a change in measures of PST are due to measurement error or an actual change over time.Peer reviewe

Cognitive and social functioning correlates of employment among people with severe mental illness

We assess how social and cognitive functioning is associated to gaining employment for 213 people diagnosed with severe mental illness taking part in employment programs in Andalusia (Spain). We used the Repeatable Battery for the Assessment of Neuropsychological Status and the Social Functioning Scale and conducted two binary logistical regression analyses. Response variables were: having a job or not, in ordinary companies (OCs) and social enterprises (SEs), and working in and OC or not. There were two variables with significant adjusted odds ratios for having a job: “attention” and “Educational level”. There were five variables with significant odds ratios for having a job in an OC: “Sex”, “Educational level”, “Attention”, “Communication”, and “Independence-competence”. The study looks at the possible benefits of combining employment with support and social enterprises in employment programs for these people and underlines how both social and cognitive functioning are central to developing employment models

Two-pion Bose-Einstein correlations in central Pb-Pb collisions at sNN\sqrt{s_{\rm NN}} = 2.76 TeV

The first measurement of two-pion Bose-Einstein correlations in central Pb-Pb collisions at $\sqrt{s_{\rm NN}} = 2.76$ TeV at the Large Hadron Collider is presented. We observe a growing trend with energy now not only for the longitudinal and the outward but also for the sideward pion source radius. The pion homogeneity volume and the decoupling time are significantly larger than those measured at RHIC.Comment: 17 pages, 5 captioned figures, 1 table, authors from page 12, published version, figures at http://aliceinfo.cern.ch/ArtSubmission/node/388

Suppression of charged particle production at large transverse momentum in central Pb-Pb collisions at sNN=2.76\sqrt{s_{\rm NN}} = 2.76 TeV

Inclusive transverse momentum spectra of primary charged particles in Pb-Pb collisions at $\sqrt{s_{_{\rm NN}}}$ = 2.76 TeV have been measured by the ALICE Collaboration at the LHC. The data are presented for central and peripheral collisions, corresponding to 0-5% and 70-80% of the hadronic Pb-Pb cross section. The measured charged particle spectra in $|\eta|<0.8$ and $0.3 < p_T < 20$ GeV/$c$ are compared to the expectation in pp collisions at the same $\sqrt{s_{\rm NN}}$, scaled by the number of underlying nucleon-nucleon collisions. The comparison is expressed in terms of the nuclear modification factor $R_{\rm AA}$. The result indicates only weak medium effects ($R_{\rm AA} \approx$ 0.7) in peripheral collisions. In central collisions, $R_{\rm AA}$ reaches a minimum of about 0.14 at $p_{\rm T}=6$-7GeV/$c$ and increases significantly at larger $p_{\rm T}$. The measured suppression of high-$p_{\rm T}$ particles is stronger than that observed at lower collision energies, indicating that a very dense medium is formed in central Pb-Pb collisions at the LHC.Comment: 15 pages, 5 captioned figures, 3 tables, authors from page 10, published version, figures at http://aliceinfo.cern.ch/ArtSubmission/node/98

Effect of cross exercise on quadriceps acceleration reaction time and subjective scores (Lysholm questionnaire) following anterior cruciate ligament reconstruction

Abstract Background Anterior cruciate ligament (ACL) injury or reconstruction can cause knee impairments and disability. Knee impairments are related to quadriceps performance – accelerated reaction time (ART) – and disability to performance of daily living activities which is assessed by questionnaires such as the Lysholm knee score. The purposes of this study were to investigate the effect of cross exercise, as supplementary rehabilitation to the early phase of ACL reconstruction: a) on quadriceps ART at the angles 45°, 60° and 90° of knee flexion and, b) on the subjective scores of disability in ACL reconstructed patients. Methods 42 patients who underwent ACL reconstruction were randomly divided into 3 groups, two experimental and one control. All groups followed the same rehabilitation program. The experimental groups followed 8 weeks of cross eccentric exercise (CEE) on the uninjured knee; 3 d/w, and 5 d/w respectively. Quadriceps ART was measured at 45°, 60° and 90° of knee flexion pre and nine weeks post-operatively using an isokinetic dynamometer. Patients also completed pre and post operatively the Lysholm questionnaire whereby subjective scores were recorded. Results Two factor ANOVA showed significant differences in ART at 90° among the groups (F = 4.29, p = 0.02, p Significant differences were also found in the Lysholm score among the groups (F = 4.75, p = 0.01, p Conclusion CEE showed improvements on quadriceps ART at 90° at a sequence of 3 d/w and in the Lysholm score at a sequence of 3 d/w and 5 d/w respectively on ACL reconstructed patients.</p

Review: Ivan Padjen, Metodologija pravne znanosti: pravo i susjedne discipline, Pravni fakultet Sveučilišta u Rijeci, Rijeka, 2015

Knjiga autora prof. dr. sc. Ivana Padjena, profesora teorije prava i države te znanstvenog savjetnika politologije Pravnog fakulteta Sveučilišta u Rijeci, jedinstvena je jer obrađuje središnje teme prava i pravne znanosti koje dosad nisu bile cjelovito i primjereno obrađene u hrvatskoj pravnoj literaturi. Knjiga je podijeljena u pet dijelova: 1. Uvod; 2. Istraživanja prava i društva; 3. Poimanja prava i društva; 4. Metodologija pravne znanosti: syllabus, te 5. Sažetak na engleskom jeziku (Methodology of Legal Science: Law and Related Disciplines – A Summary).Review of a book by a distinguished Croatian scholar of legal theory Ivan Padjen on various issues of methodology in law and legal science

Polymorphisms near EXOC4 and LRGUK on chromosome 7q32 are associated with Type 2 Diabetes and fasting glucose; The NHLBI Family Heart Study

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