PROTECTED-UK – Clinical pharmacist interventions in the UK critical care unit: exploration of relationship between intervention, service characteristics and experience level

PURPOSE: Clinical pharmacist (CP) interventions from the PROTECTED-UK cohort, a multi-site critical care interventions study, were further analysed to assess effects of: time on critical care, number of interventions, CP expertise and days of week, on impact of intervention and ultimately contribution to patient care. METHODS: Intervention data were collected from 21 adult critical care units over 14 days. Interventions could be error, optimisation or consults, and were blind-coded to ensure consistency, prior to bivariate analysis. Pharmacy service demographics were further collated by investigator survey. KEY FINDINGS: Of the 20 758 prescriptions reviewed, 3375 interventions were made (intervention rate 16.1%). CPs spent 3.5 h per day (mean, ±SD 1.7) on direct patient care, reviewed 10.3 patients per day (±SD 4.2) and required 22.5 min (±SD 9.5) per review. Intervention rate had a moderate inverse correlation with the time the pharmacist spent on critical care (P = 0.05; r = 0.4). Optimisation rate had a strong inverse association with total number of prescriptions reviewed per day (P = 0.001; r = 0.7). A consultant CP had a moderate inverse correlation with number of errors identified (P = 0.008; r = 0.6). No correlation existed between the presence of electronic prescribing in critical care and any intervention rate. Few centres provided weekend services, although the intervention rate was significantly higher on weekends than weekdays. CONCLUSIONS: A CP is essential for safe and optimised patient medication therapy; an extended and developed pharmacy service is expected to reduce errors. CP services should be adequately staffed to enable adequate time for prescription review and maximal therapy optimisation

Analytic binary alloy volume-concentration relations and the deviation from Zen`s law

Alloys expand or contract as concentrations change, and the resulting relationship between atomic volume and alloy content is an important property of the solid. While a well-known approximation posits that the atomic volume varies linearly with concentration (Zen`s law), the actual variation is more complicated. Here we use an apparent size of the solute (solvent) atom and the elasticity to derive explicit analytical expressions for the atomic volume of binary solid alloys. Two approximations, continuum and terminal, are proposed. Deviations from Zen`s law are studied for 22 binary alloy systems

Growth, age estimation and corroboration of northeast Atlantic chub mackerel (Scomber colias) in northern Iberian waters: a first attempt.

Updated information on growth of Atlantic chub mackerel in several areas of its distribution is required for the first stock assessment. Its growth pattern in Northern Iberian waters (2011-2017) is here analyzed with different approaches: those based on otoliths analyses (direct age estimation-DAE, back-calculation-BC and otolith marginal analyses) and those based on length frequency analyses (Bhattacharya, SLCA and PROJMAT methods). Two main different growth patterns are obtained, a "slow" one based on DAE, BC and LFDA from surveys; and a "fast" one based on Bhattacharya and LFDA from commercial landings. The divergence between both patterns begins to be evident at age 3 and older. Otolith marginal analyses that show an annual periodicity in the formation of the hyaline and opaque edge, the unimodal distribution of the annuli radius and the similarity of the back-calculated mean lengths to those obtained by DAE, support the age estimation criteria used in our analysis. The VBGF growth parameters (L∞=45.34, k=0.28, t0=1.18) obtained by otolith age estimation are available for the upcoming stock assessment process

Advances in the study on sexual maturity of Atlantic chub mackerel (Scomber colias) in Cantabrian Sea.

Atlantic chub mackerel (Scomber colias) is a middle size pelagic species distributed on both sides of the Atlantic Ocean. Landings of this species have increased recently in the Iberian Peninsula, likely associated to the increase of its abundance and expansion northwards, probably related to an increment of the sea temperature. The aim of this study is to improve the knowledge of the reproductive biology of the Atlantic chub mackerel and to present updated information on spawning period and maturity ogives that can be used for analytical stock assessment in ICES and its management

Regression, developmental trajectory and associated problems in disorders in the autism spectrum: the SNAP study

We report rates of regression and associated findings in a population derived group of 255 children aged 9-14 years, participating in a prevalence study of autism spectrum disorders (ASD); 53 with narrowly defined autism, 105 with broader ASD and 97 with non-ASD neurodevelopmental problems, drawn from those with special educational needs within a population of 56,946 children. Language regression was reported in 30% with narrowly defined autism, 8% with broader ASD and less than 3% with developmental problems without ASD. A smaller group of children were identified who underwent a less clear setback. Regression was associated with higher rates of autistic symptoms and a deviation in developmental trajectory. Regression was not associated with epilepsy or gastrointestinal problems

Predictive impact of rare genomic copy number variations in siblings of individuals with autism spectrum disorders.

Identification of genetic biomarkers associated with autism spectrum disorders (ASDs) could improve recurrence prediction for families with a child with ASD. Here, we describe clinical microarray findings for 253 longitudinally phenotyped ASD families from the Baby Siblings Research Consortium (BSRC), encompassing 288 infant siblings. By age 3, 103 siblings (35.8%) were diagnosed with ASD and 54 (18.8%) were developing atypically. Thirteen siblings have copy number variants (CNVs) involving ASD-relevant genes: 6 with ASD, 5 atypically developing, and 2 typically developing. Within these families, an ASD-related CNV in a sibling has a positive predictive value (PPV) for ASD or atypical development of 0.83; the Simons Simplex Collection of ASD families shows similar PPVs. Polygenic risk analyses suggest that common genetic variants may also contribute to ASD. CNV findings would have been pre-symptomatically predictive of ASD or atypical development in 11 (7%) of the 157 BSRC siblings who were eventually diagnosed clinically

Small world effect in an epidemiological model

A model for the spread of an infection is analyzed for different population structures. The interactions within the population are described by small world networks, ranging from ordered lattices to random graphs. For the more ordered systems, there is a fluctuating endemic state of low infection. At a finite value of the disorder of the network, we find a transition to self-sustained oscillations in the size of the infected subpopulation

Symmetry broken motion of a periodically driven Brownian particle: nonadiabatic regime

We report a theoretical study of an overdamped Brownian particle dynamics in the presence of both a spatially modulated one-dimensional periodic potential and a periodic alternating force (AF). As the periodic potential has a low symmetry (a ratchet potential) the Brownian particle displays a broken symmetry motion with a nonzero time average velocity. By making use of the Green function method and a mapping to the theory of Brillouin bands the probability distribution of the particle coordinate is derived and the nonlinear dependence of the macroscopic velocity on the frequency and the amplitude of AF is found. In particular, our theory allows to go beyond the adiabatic limit and to explain the peculiar reversal of the velocity sign found previously in the numerical analysis.Comment: 4 pages, 2 figure

Preliminary observation on sexual maturity of chub mackerel (Scomber colias) in the Northern Iberian Atlantic waters (ICES Divisions 27.8.c and 27.9.a.N)

A study of the reproductive biology of the Atlantic chub mackerel (Scomber colias) has been performed in Northern Iberian Atlantic waters (ICES Divisions 27.8.c and 27.9.a.N) based on samples of 14538 specimens (11-50 cm total length) from commercial landings and scientific surveys from 2011-2019. The spawning period was defined based on the monthly prevalence of active females (maturity stages 3, 4 and 5 according to Walsh maturity scale) and temporal variability of females gonado- and hepatosomatic indices (GSI/HSI). Length and age maturity ogives were also estimated for males and females pooling all sampled years together. The spawning period occurred from March to July, with a peak in June. In the 27.8.c area, the GSI, HSI and prevalence of active females increased from March to June and then GSI and prevalence decreased abruptly. In the 27.9.a.N, the peak of spawning was observed earlier (April-May) and with lower intensity than in 27.8.c, but sampling in 27.9.a area was limited to the northern zone (Spanish waters) and are not conclusive. L50 and A50 values estimated with annual data were 22.9 cm and 1.6 years old respectively for both sexes combined, similar to the values estimated with data only from the spawning period: 22.7 cm and 1.5 years old respectively for both sexes combined. Our results were compared with those from previous studies in the NE Atlantic