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

Fricke and polymer gel 2D dosimetry validation using Monte Carlo simulation

Complexity in modern radiotherapy treatments demands advanced dosimetry systems for quality control. These systems must have several characteristics, such as high spatial resolution, tissue equivalence, three-dimensional resolution, and dose-integrating capabilities. In this scenario, gel dosimetry has proved to be a very promising option for quality assurance. In this study, the feasibility of Fricke and polymer gel dosimeters suitably shaped in form of thin layers and optically analyzed by visible light transmission imaging has been investigated for quality assurance in external radiotherapy. Dosimeter irradiation was carried out with a 6-MV photon beam (CLINAC 600C). The analysis of the irradiated dosimeters was done using two-dimensional optical transmission images. These dosimeters were compared with a treatment plan system using Monte Carlo simulations as a reference by means of a gamma test with parameters of 1 mm and 2%. Results show very good agreement between the different dosimetric systems: in the worst-case scenario, 98% of the analyzed points meet the test quality requirements. Therefore, gel dosimetry may be considered as a potential tool for the validation of other dosimetric systems.Fil: Vedelago, José Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Física Enrique Gaviola. Universidad Nacional de Córdoba. Instituto de Física Enrique Gaviola; Argentina. Universidad Nacional de Córdoba; ArgentinaFil: Chacón Obando, D.. Universidad Nacional. Physics Department; Costa Rica. Universidad Nacional de Córdoba; ArgentinaFil: Malano, Francisco Mauricio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Física Enrique Gaviola. Universidad Nacional de Córdoba. Instituto de Física Enrique Gaviola; Argentina. Universidad Nacional de Córdoba; ArgentinaFil: Conejeros, R.. Servicio de Radioterapia, Icos. Temuco, Chile;Fil: Figueroa, R.. Universidad de la Frontera; ChileFil: Garcia, D.. Servicio de Imagenes por Resonancia Magnética; ChileFil: González, G.. Servicio de Imagenes por Resonancia Magnética; ChileFil: Romero, Marcelo Ricardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto Multidisciplinario de Biología Vegetal. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Instituto Multidisciplinario de Biología Vegetal; Argentina. Universidad Nacional de Córdoba; ArgentinaFil: Santibañez, M.. Servicio de Imagenes por Resonancia Magnética; ChileFil: Strumia, Miriam Cristina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto Multidisciplinario de Biología Vegetal. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Instituto Multidisciplinario de Biología Vegetal; ArgentinaFil: Velásquez, J.. Servicio de Radioterapia; ChileFil: Mattea, Facundo. Universidad Nacional de Córdoba. Facultad de Ciencias Químicas. Departamento de Química Orgánica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Valente, M.. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Física Enrique Gaviola. Universidad Nacional de Córdoba. Instituto de Física Enrique Gaviola; Argentina. Universidad de La Frontera. Departamento de Ciencias Físicas; Chil

Specific gene correction of the AGXT gene and direct cell reprogramming for the treatment of Primary Hyperoxaluria Type 1

P428 Primary Hyperoxaluria Type 1 (PH1) is an inherited rare metabolic liver disease caused by the deficiency in the alanine: glyoxylate aminotransferase enzyme (AGXT), involved in the glyoxylate metabolism. The only potentially curative treatment is organ transplantation. Thus, the development of new therapeutic approaches for the treatment of these patients appears as a priority.We propose the combination of site-specific gene correction and direct cell reprogramming for the generation of autologous phenotypically healthy induced hepatocytes (iHeps) from skin-derived fibroblast of PH1 patients. For the correction of AGXT mutations, we have designed specific gene editing tools to address gene correction by two different strategies, assisted by CRISPR/Cas9 system. Accurate specific point mutation correction (c.853T-C) has been achieved by homologydirected repair (HDR) with ssODN harbouring wild-type sequence. In the second strategy, an enhanced version ofAGXTcDNAhas been inserted near the transcription start codon of the endogenous gene, constituting an almost universal correction strategy for PH1 mutations. Direct reprogramming of fibroblasts has been conducted by overexpression of hepatic transcription factors and in vitro culture in defined media. In vitro characterization of healthy induced hepatocytes (iHeps) has demonstrated hepatic function of the reprogrammed cells. PH1 patient fibroblasts and , ,

Conservative and disruptive modes of adolescent change in human brain functional connectivity

Adolescent changes in human brain function are not entirely understood. Here, we used multiecho functional MRI (fMRI) to measure developmental change in functional connectivity (FC) of resting-state oscillations between pairs of 330 cortical regions and 16 subcortical regions in 298 healthy adolescents scanned 520 times. Participants were aged 14 to 26 y and were scanned on 1 to 3 occasions at least 6 mo apart. We found 2 distinct modes of age-related change in FC: “conservative” and “disruptive.” Conservative development was characteristic of primary cortex, which was strongly connected at 14 y and became even more connected in the period from 14 to 26 y. Disruptive development was characteristic of association cortex and subcortical regions, where connectivity was remodeled: connections that were weak at 14 y became stronger during adolescence, and connections that were strong at 14 y became weaker. These modes of development were quantified using the maturational index (MI), estimated as Spearman’s correlation between edgewise baseline FC (at 14 y, FC14) and adolescent change in FC (ΔFC14−26), at each region. Disruptive systems (with negative MI) were activated by social cognition and autobiographical memory tasks in prior fMRI data and significantly colocated with prior maps of aerobic glycolysis (AG), AG-related gene expression, postnatal cortical surface expansion, and adolescent shrinkage of cortical thickness. The presence of these 2 modes of development was robust to numerous sensitivity analyses. We conclude that human brain organization is disrupted during adolescence by remodeling of FC between association cortical and subcortical areas

Certainty relations between local and nonlocal observables

We demonstrate that for an arbitrary number of identical particles, each defined on a Hilbert-space of arbitrary dimension, there exists a whole ladder of relations of complementarity between local, and every conceivable kind of joint (or nonlocal) measurements. E.g., the more accurate we can know (by a measurement) some joint property of three qubits (projecting the state onto a tripartite entangled state), the less accurate some other property, local to the three qubits, become. We also show that the corresponding complementarity relations are particularly tight for particles defined on prime dimensional Hilbert spaces.Comment: 4 pages, no figure

Formation of collimated sound beams by three-dimensional sonic crystals

A theoretical and experimental study of the propagation of sound beams in- and behind three-dimensional sonic crystals at frequencies close to the band edges is presented. An efficient collimation of the beam behind the crystal is predicted and experimentally demonstrated. This effect could allow the design of sources of high spatial quality sound beams

Introducing mobile edge computing capabilities through distributed 5G Cloud Enabled Small Cells

Current trends in broadband mobile networks are addressed towards the placement of different capabilities at the edge of the mobile network in a centralised way. On one hand, the split of the eNB between baseband processing units and remote radio headers makes it possible to process some of the protocols in centralised premises, likely with virtualised resources. On the other hand, mobile edge computing makes use of processing and storage capabilities close to the air interface in order to deploy optimised services with minimum delay. The confluence of both trends is a hot topic in the definition of future 5G networks. The full centralisation of both technologies in cloud data centres imposes stringent requirements to the fronthaul connections in terms of throughput and latency. Therefore, all those cells with limited network access would not be able to offer these types of services. This paper proposes a solution for these cases, based on the placement of processing and storage capabilities close to the remote units, which is especially well suited for the deployment of clusters of small cells. The proposed cloud-enabled small cells include a highly efficient microserver with a limited set of virtualised resources offered to the cluster of small cells. As a result, a light data centre is created and commonly used for deploying centralised eNB and mobile edge computing functionalities. The paper covers the proposed architecture, with special focus on the integration of both aspects, and possible scenarios of application.Peer ReviewedPostprint (author's final draft