A detailed analysis of online pharmacy characteristics to inform safe usage by patients

Background: Evidence suggests that consumers potentially put themselves at risk when purchasing medicines on-line. Whilst logos provided by regulators may provide some level of reassurance there may be other indicators which could be used by consumers to identify those websites which may be safely used. Objectives: Identify characteristics of on-line pharmacies which are related to whether websites are regulated or non-regulated and those characteristics which could be used by patients to increase the likelihood of accessing regulated sites. Setting: Online pharmacies which supply diazepam, fluoxetine and simvastatin. Methods: Using piloted search terms via Google and Yahoo search engines, identified websites were screened for regulatory status, adherence to regulatory standards, administrative requirements, clinical assessment requirements and additional details deemed to be of relevance to a user. Characteristics of regulated and non-regulated (defined as those with an absence of a correctly linked regulatory logo) websites were compared to identify differences which could be used to improve patient safety. Main outcome measure: Regulatory status, adherence to regulatory standards, quality of information provision, barriers to medicines access. Results: 113 websites sold diazepam, fluoxetine and simvastatin; were identified within the first 100 results. Less than quarter were found to be regulated online pharmacies. 80 websites were willing to sell the medication without a prescription. The unregulated internet pharmacy websites (defined as those with an absence of a correctly linked regulatory logo) were found to adhere more closely to the clinical criteria, were less significantly likely to disclose a contact name and address, telephone number of the pharmacy or demand a prescription prior to sale (P\0.05, Fisher’s Exact). Conclusions: The three prescription-only medicines which are liable to abuse, have potentially serious interactions and require counselling to ensure patient safety are readily available via the internet. When purchasing medicines via this route UK consumers should be made aware of the importance of regulatory logos and additionally should ensure that the seller can be meaningfully contacted by the contact details provided. The provision of clinical information should not be used alone as an indication of the seller’s provenance

Mechanics and kinetics of dynamic instability.

During dynamic instability, self-assembling microtubules (MTs) stochastically alternate between phases of growth and shrinkage. This process is driven by the presence of two distinct states of MT subunits, GTP- and GDP-bound tubulin dimers, that have different structural properties. Here, we use a combination of analysis and computer simulations to study the mechanical and kinetic regulation of dynamic instability in three-dimensional (3D) self-assembling MTs. Our model quantifies how the 3D structure and kinetics of the distinct states of tubulin dimers determine the mechanical stability of MTs. We further show that dynamic instability is influenced by the presence of quenched disorder in the state of the tubulin subunit as reflected in the fraction of non-hydrolysed tubulin. Our results connect the 3D geometry, kinetics and statistical mechanics of these tubular assemblies within a single framework, and may be applicable to other self-assembled systems where these same processes are at play

Evolution of the second lowest extended state as a function of the effective magnetic field in the fractional quantum hall regime

It has been shown that, at a Landau level filling factor v=1/2, a two-dimensional electron system can be mathematically transformed into a composite fermion system interacting with a Chern-Simons gauge field. At v=1/2, the average of this Chern-Simons gauge field cancels the external magnetic field B-ext so that the effective magnetic field B-eff acting on the composite fermions is zero. Away from v=1/2, the composite fermions experience a net effective magnetic field B-eff. We present the first study of the evolution of the second lowest extended state in a vanishing effective magnetic field in the fractional quantum Hall regime. Our result shows that the evolution of the second lowest extended state has a good linear dependence on the effective magnetic field Beff within the composite fermion picture

A Relational Event Approach to Modeling Behavioral Dynamics

This chapter provides an introduction to the analysis of relational event data (i.e., actions, interactions, or other events involving multiple actors that occur over time) within the R/statnet platform. We begin by reviewing the basics of relational event modeling, with an emphasis on models with piecewise constant hazards. We then discuss estimation for dyadic and more general relational event models using the relevent package, with an emphasis on hands-on applications of the methods and interpretation of results. Statnet is a collection of packages for the R statistical computing system that supports the representation, manipulation, visualization, modeling, simulation, and analysis of relational data. Statnet packages are contributed by a team of volunteer developers, and are made freely available under the GNU Public License. These packages are written for the R statistical computing environment, and can be used with any computing platform that supports R (including Windows, Linux, and Mac).

Single channel wireless EEG device for real-time fatigue level detection

© 2015 IEEE. Driver fatigue problem is one of the important factors of traffic accidents. Recent years, many research had investigated that using EEG signals can effectively detect driver's drowsiness level. However, real-time monitoring system is required to apply these fatigue level detection techniques in the practical application, especially in the real-road driving. Therefore, it required less channels, portable and wireless, real-time monitoring and processing techniques for developing the real-time monitoring system. In this study, we develop a single channel wireless EEG device which can real-time detect driver's fatigue level on the mobile device such as smart phone or tablet. The developed device is investigated to obtain a better and precise understanding of brain activities of mental fatigue under driving, which is of great benefit for devolvement of detection of driving fatigue system. This system consists of a Bluetooth-enabled one channel EEG, a regression model, and smartphone, which was a platform recording and transforming the raw EEG data to useful driving status. In the experiment, this was a sustained-attention driving task to implement in a virtual-reality (VR) driving simulator. To training model and develop the system, we were performed for 15 subjects to study Electroencephalography (EEG) brain dynamics by using a mobile and wireless EEG device. Based on the outstanding training results, the leave-one-subject-out cross validation test obtained 90% fatigue detection accuracy. These results indicate that the combination of a smartphone and wireless EEG device constitutes an effective and easy wearable solution for detecting and preventing driver fatigue in real driving environments

Modelling reef hydrodynamics and sediment mobility under sea level rise in atoll reef island systems

This is the author accepted manuscript. The final version is available on open access from Elsevier via the DOI in this record. Low-lying coral reef islands will be significantly impacted by future sea level rise (SLR). It is generally expected that SLR will destabilise reef islands because increasing reef submergence allows larger waves, and therefore greater energy transmission, across reef flats. However, the impact of SLR on altering both reef flat sediment transport and sediment delivery to island shorelines is poorly understood. Here, we use the currents of removal approach (coupling two-dimensional wave modelling with settling velocity data from 186 benthic sediment samples) to model shifts in both reef hydrodynamics and benthic sediment transport under scenarios of mean reef submergence (MRS = +0 m, +0.5 m, +1 m) at two atoll rim reef sites in the Maldives. Under contemporary conditions (MRS = +0 m), we found that benthic sediment transport is likely occurring, consistent with active reef-to-island sediment connectivity. Under conditions of increased MRS, shifts in wave velocities, and in turn sediment potential mobility, were both non-linear and non-uniform. Significant between-site differences were found in the magnitude of projected shifts in sediment mobility under scenarios of increased MRS, which implies that morphological responses to increases in MRS are likely to be diverse, even over local scales. Under increased MRS, the largest increases in sediment mobility were projected on the inner reef flat, whereas lagoonal zones remained as sinks for sediment deposition. We thus hypothesize that while reef islands will persist as sedimentary landforms under projected rates of MRS, lagoonward reef island migration is likely to occur. Findings have implications for predicting the future adaptive capacity of atoll nations. The challenge is to incorporate such potential increases in island mobility and intra-regional diversity in reef system geomorphic responses to sea level rise into national-scale vulnerability assessments.NER

A Novel Strategy to Screen Bacillus Calmette-Guérin Protein Antigen Recognized by γδ TCR

BACKGROUND: Phosphoantigen was originally identified as the main γδ TCR-recognized antigen that could activate γδ T cells to promote immune protection against mycobacterial infection. However, new evidence shows that the γδ T cells activated by phosphoantigen can only provide partial immune protection against mycobacterial infection. In contrast, whole lysates of Mycobacterium could activate immune protection more potently, implying that other γδ TCR-recognized antigens that elicit protective immune responses. To date, only a few distinct mycobacterial antigens recognized by the γδ TCR have been characterized. METHODOLOGY/PRINCIPAL FINDINGS: In the present study, we established a new approach to screen epitopes or protein antigens recognized by the γδ TCR using Bacillus Calmette-Guérin- (BCG-) specific γ TCR transfected cells as probes to pan a 12-mer random-peptide phage-displayed library. Through binding assays and functional analysis, we identified a peptide (BP3) that not only binds to the BCG-specific γδ TCR but also effectively activates γδ T cells isolated from human subjects inoculated with BCG. Importantly, the γδ T cells activated by peptide BP3 had a cytotoxic effect on THP-1 cells infected with BCG. Moreover, the oxidative stress response regulatory protein (OXYS), a BCG protein that matches perfectly with peptide BP3 according to bioinformatics analysis, was confirmed as a ligand for the γδ TCR and was found to activate γδ T cells from human subjects inoculated with BCG. CONCLUSIONS/SIGNIFICANCE: In conclusion, our study provides a novel strategy to identify epitopes or protein antigens for the γδ TCR, and provides a potential means to screen mycobacterial vaccines or candidates for adjuvant

Recurrent Upper Quadrant Pain: A Fish Bone Secondary to Gastric Perforation and Liver Abscess

A 60-year-old male patient was admitted to our hospital for recurrent upper quadrant pain for 1 month. He had a past history of coronary artery disease. After admission, he repeatedly suffered from high-grade fever, chills and upper quadrant pain. Computed tomography (CT) showed a round hypodense mass in the left lobe of the liver, approximately 2.7 × 2.2 cm in size, and a fish bone was confirmed by surgery in the left lobe of liver. The patient was cured completely after surgical removal of the fish bone and liver abscess. CT scan 1 month after discharge showed that the liver abscess had disappeared completely