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European Journal of Hospital Pharmacy :... Jun 2024Medication dispensing errors cause wastage of medicines and increase healthcare costs, with serious consequences for patients. However, few studies have systematically...
Exploring susceptibility factors to medication dispensing errors through a retrospective study of patient-reported dispensing errors over 11 years: are dispensing errors indeed due to personal reasons for pharmacists?
BACKGROUND
Medication dispensing errors cause wastage of medicines and increase healthcare costs, with serious consequences for patients. However, few studies have systematically and completely reviewed dispensing errors, with inadequate attention to the objective regularity and risk factors for dispensing errors.
OBJECTIVES
To explore the potential causes and risk factors influencing the prevalence of medication dispensing errors.
METHODS
We collected patient-reported medication dispensing errors from a large tertiary care hospital in South China over 11 years. We assessed the characteristics of dispensing errors, labelled the causes, compared them with more than 25 million prescriptions from 2012 to 2022, identified the susceptibility factors for the occurrence of dispensing errors, and analysed the characteristics and patterns of the errors.
RESULTS
A total of 376 patient-reported dispensing errors were recorded. It took an average of 5.2 days for a patient to find an error. Only 37.5% of errors were reviewed by the patient within 24 hours. These errors directly contributed to a medication loss of US$188 406. Of the 160 recorded pharmacists, 112 (70%) committed dispensing errors. Dispensing errors were affected by the pharmacists' use of the machine, workload and the length of monthly vacation. Of the dispensing errors, 47.9% (n=180) were caused by medication packaging or names that were similar. Antibiotics (n=32, 8.5%) were the most common types of drugs dispensed incorrectly, and traditional Chinese medicines (n=31, 8.2%) and immunosuppressants (n=21, 5.6%) were the most likely to be dispensed in inaccurate quantities.
CONCLUSIONS
Organising adequate staff and using machines to prepare medicines may be necessary to reduce dispensing errors. When pharmacists have been away from work for more than 72 hours they should find their rhythm in other positions before dispensing medicines. It is more important to prioritise the differentiation of medicines with similar packaging over those with similar names when arranging drug shelving.
PubMed: 38839267
DOI: 10.1136/ejhpharm-2023-004064 -
Cortex; a Journal Devoted To the Study... May 2024Stroke often causes long-term motor and somatosensory impairments. Motor planning and tactile perception rely on spatial body representations. However, the link between...
Stroke often causes long-term motor and somatosensory impairments. Motor planning and tactile perception rely on spatial body representations. However, the link between altered spatial body representations, motor deficit and tactile spatial coding remains unclear. This study investigates the relationship between motor deficits and alterations of anatomical (body) and tactile spatial representations of the hand in 20 post-stroke patients with upper limb hemiparesis. Anatomical and tactile spatial representations were assessed from 10 targets (nails and knuckles) respectively cued verbally by their anatomical name or using tactile stimulations. Two distance metrics (hand width and finger length) and two structural measures (relative organization of targets positions and angular deviation of fingers from their physical posture) were computed and compared to clinical assessments, normative data and lesions sites. Over half of the patients had altered anatomical and/or tactile spatial representations. Metrics of tactile and anatomical representations showed common variations, where a wider hand representation was linked to more severe motor deficits. In contrast, alterations in structural measures were not concomitantly observed in tactile and anatomical representations and did not correlate with clinical assessments. Finally, a preliminary analysis showed that specific alterations in tactile structural measures were associated with dorsolateral prefrontal stroke lesions. This study reveals shared and distinct characteristics of anatomical and tactile hand spatial representations, reflecting different mechanisms that can be affected differently after stroke: metrics and location of tactile and anatomical representations were partially shared while the structural measures of tactile and anatomical representations had distinct characteristics.
PubMed: 38838560
DOI: 10.1016/j.cortex.2024.04.015 -
Psychogeriatrics : the Official Journal... Jun 2024Understanding the development of cognitive impairment and its influencing factors in older adults is crucial for formulating early intervention strategies.
BACKGROUND
Understanding the development of cognitive impairment and its influencing factors in older adults is crucial for formulating early intervention strategies.
PURPOSE
To identify the early dimensions of cognitive impairment and provide a comprehensive description of the trajectories of cognitive decline in older adults prior to death.
METHODS
Based on the data of 9883 older adults in the Chinese Longitudinal Healthy Longevity Survey from 2002 to 2018, a longitudinal item response theory (Longitudinal IRT) model including covariates was applied to estimate the following parameters. The items in which older adults encountered obstacles first had the least difficulty parameters (δ). The earlier the information curve of an item is lifted, the more information it provides in the early stages of cognitive impairment. Regression coefficient (β) represents the relative rate of cognitive decline. The cognitive impairment values estimated from the Longitudinal IRT were fitted to a mixed-effects model to examine cognitive impairment trajectories.
RESULTS
'Draw the figure on B Card' (δ = -0.816) was the most challenging item, followed by 'recalling 'clothes" (δ = 0.348) and 'recalling 'apples" (δ = 0.419), while 'name the 'pen" (δ = 4.402) was the simplest instruction for the old adults. The curves of the items in the recall dimension began to rise in the early stages of cognitive impairment. Cognitive impairment of older adults who were women (β = 0.061), elder (β = 0.111), smokers (β = 0.060), living in rural areas (β = 0.052), not participating in organised social activities (β = 0.092), suffering from hypertension (β = 0.022), hyperglycaemia (β = 0.035), dyslipidaemia (β = 0.314), low education levels (β = 0.128), manual labourers (β = 0.027), and eventual development of dementia (β = 0.212) exhibited a more accelerated progression. These individuals also had poorer cognitive trajectories.
CONCLUSION
Recall is the earliest dimension of cognitive impairment. The subjects who were women, elder, smokers, living in rural areas, not participating in organised social activities, suffering from hypertension, hyperglycaemia, dyslipidaemia, low education, manual labourers, and eventually development of dementia, had a faster descending speed and poorer trajectories.
PubMed: 38837636
DOI: 10.1111/psyg.13136 -
Journal of Law and Health 2024Medical research plays a vital role in advancing human knowledge, developing new therapies and procedures, and reducing human suffering. Following the atrocities...
Medical research plays a vital role in advancing human knowledge, developing new therapies and procedures, and reducing human suffering. Following the atrocities committed in the name of medical research by German physicians during the Nazi era, the Nuremberg trials were held, and an ethical code was created to establish the limits within which medical research can operate. Consequently, legal regimes built upon this ethical foundation to develop laws that ensure the integrity of medical research and the safety of human subjects. These laws sought to protect human subjects by minimizing conflicts of interest that may arise during the process. Furthermore, conflicts of interest may be financial such as monetary gain, or nonfinancial such as promotion and career advancement. However, with a $1.1 billion median cost of developing a new drug, the focus of these laws was directed towards financial conflicts of interest. But should we expand these laws to include nonfinancial conflicts of interest? This Article highlights prominent arguments in favor of and against the regulation of nonfinancial conflicts of interest in medical research. It further concludes that adequate institutional policies--not additional regulations--strike the right balance between the need to safeguard against the harmful effects of nonfinancial conflicts of interest on the one hand and avoiding the drawbacks of overregulation on the other.
Topics: Conflict of Interest; Humans; Biomedical Research; Germany
PubMed: 38833605
DOI: No ID Found -
Data in Brief Jun 2024Planch. and (A. Chev.) C.F. Liang et A.R. Ferguson are the botanical names for the two main closely related kiwifruit species that are cultivated worldwide [1]....
Planch. and (A. Chev.) C.F. Liang et A.R. Ferguson are the botanical names for the two main closely related kiwifruit species that are cultivated worldwide [1]. According to the Food and Agriculture Organisation (FAO) of the United Nation, kiwifruit is produced on 268,788 hectares of land worldwide, yielding 4,348,011 metric tonnes of fruit per year. China is the world's top producer, followed by Italy, New Zealand, Chile, and Greece, with a cumulative valuation of 2,907,580 thousand US dollars for export (http://www.fao.org/faostat/en/#data/QC). Several research using nutrient medium and other inorganic treatments on softwood cuttings for micro-propagation techniques have shown promising outcomes [2,3]. Several agricultural and horticultural crops have demonstrated significantly improved crop growth, quality, and reproduction when treated with seaweed extracts [4]. It is possible to utilise seaweed extracts to encourage cuttings from perennial fruit species, such as kiwifruit (), to root and flourish. Absence of a growth regulator permitted by organic methods is one of the main obstacles in kiwifruit production. Hardwood cuttings are the most popular technique of clonally reproducing kiwifruit, and the cuttings' ability to root depends on the application of synthetic auxins, which is not allowed in organic agriculture. Therefore, alternative biostimulants have been used to promote the rooting of kiwifruit cuttings in this study. For six hours, the cuttings in this investigation were submerged in base dipping solutions containing 1, 5, 10, and 50 % of G Sap (), K Sap (), AN (), EM (), HA (Humic acid), and control (water). After that, for a period of six months, the treatments of G Sap, K Sap, AN, EM, HA, and control were applied (at the rate of 50 ml of solutions) to the potted cuttings at intervals of fifteen days. The dataset provided the data of the rooting percent in all the kiwifruit cultivars, namely 'Monty', 'Abott', 'Hayward', 'Allison' and 'Bruno' ( ≤ 0.01), shoot and root growth parameters including leaf number per cutting, number of roots per cutting, number of branches, plant height, shoot diameter, root length, root diameter and root weight with the application of seaweed extracts. Also data of pigments (chlorophyll , chlorophyll and total carotenoids), metabolites (total carbohydrates and soluble phenols) and electrolyte leakage were collected after the treatments. Data of four root promoting candidate genes ( and ) were also described which indicated the influence of the biostimulants on the cuttings. The application of seaweed extracts resulted in a positive increase in all shoot and root growth parameters, including the number of leaves per cutting, the number of roots per cutting, the number of branches, plant height, shoot diameter, root length, root diameter, and root weight ( ≤ 0.05). In comparison to the control cuttings, the seaweed extract-treated cuttings showed significantly greater levels of pigments (such as chlorophyll a, chlorophyll b, and total carotenoids), metabolites (such as total carbohydrates and soluble phenols), and reduced electrolyte leakage. Various treatments (1, 5 and 10% solutions of G Sap, K Sap, AN, EM, HA and control) gave positive impact on nutrient parameters of kiwifruit cultivar 'Hayward'. Moreover, the relative positive expressions of root inducing genes ( and ) was observed in leaves and roots of cultivar 'Hayward' by qRT-PCR after treatment with G Sap, K Sap, AN, EM, HA @ 10 % and control. Thus, it can be said that seaweed extract and humic acid are good substitutes for synthetic hormones in encouraging kiwifruit cuttings to root and flourish.
PubMed: 38831905
DOI: 10.1016/j.dib.2024.110538 -
Heliyon May 2024Alternative fuels can be produced from both non-edible feedstocks and edible crops. The higher production costs and contaminating nature of vegetable biofuels, which...
Evaluating the effect of diethyl ether and moringa oleifera antioxidant additives on the performance and emission characteristics of jatropha biodiesel-diesel blended fuel on CI engine - An experimental investigation.
Alternative fuels can be produced from both non-edible feedstocks and edible crops. The higher production costs and contaminating nature of vegetable biofuels, which cause engine component failure, make it conceivable to encourage the synthesis of biodiesel from non-edible sources. One of the most widely utilized alternative fuels is Jatropha biofuel, which has performance levels comparable to diesel fuels and can be used with CI (Compression Ignition) engines without any modifications. However when it comes to oxidative stability properties that impact shelf life and commercialization, the majority of biodiesels-including Jatropha-are lacking. Therefore, the objective of this study was to enhance the oxidative stability and other physicochemical parameters, such performance and emission characteristics, of Jatropha biodiesel with diesel blends by adding additives like DEE (diethyl ether) and MA (moringa oleifera antioxidant). The seeds of jatropha and moringa were harvested by hand and then mechanically extracted with a screw press. A conical flask containing the precisely weighed amount of oil is filled with 50 mL of neutral alcohol. The combination is then heated for an hour using a water condenser over a bath. Using phenolphthalein indicator, the contents are titrated with KOH solution after cooling. Weight of oil taken (w)/volume of KOH used (mL) × normality of KOH is the formula used to determine the acidity value of jatropha oil. It is therefore below the minimum level set by ASTM D 675, which is 2.5 mg KOH/g. Methanol was used in the transesterification process to produce biodiesel, and potassium hydroxide (KOH) was used as a catalyst. Then, using 5 % DEE and 10 % MA additives, the physicochemical properties of jatropha biodiesel-such as density, kinematics viscosity, calorific value, and oxidative stability-were characterized. The percentage of improvement of the biodiesel's mentioned properties with these additives was 0.68 %, 2.8 %, 0.73 %, and 33.8 %, respectively. The brake thermal efficiency (BTE) of B40MA10DEE05D45 increased by 8.52 % whereas the brake specific fuel consumption (BSFC) of B50MA10DEE05D35, which is Made up of 44 % diesel, 50 % jatropha biodiesel, 5 % DEE, and 10 % MA fuels, declined by 5.14 %. As a result of these additions, the blended fuel's CO, HC, and NOx emissions were reduced by 3.51 %, 2.25 %, and 8.64 %, respectively. Therefore, a 20 % blend of Jatropha biodiesel and diesel containing antioxidants from Moringa can be used in compression ignition engines without the need for engine modifications and with high oxidation stability.
PubMed: 38831843
DOI: 10.1016/j.heliyon.2024.e31436 -
International Journal of Systematic and... Jun 2024
Topics: Terminology as Topic; Publishing
PubMed: 38828845
DOI: 10.1099/ijsem.0.006275 -
Zhonghua Bing Li Xue Za Zhi = Chinese... Jun 2024The 5th edition of the World Health Organization (WHO) classification of haematolymphoid tumours used the hierarchical system to classify T-cell and NK-cell lymphoid...
The 5th edition of the World Health Organization (WHO) classification of haematolymphoid tumours used the hierarchical system to classify T-cell and NK-cell lymphoid proliferations and lymphomas (T/NK-LPD/LYM) based on research advances and clinicopathological characteristics of the diseases. In this edition of classification, tumour-like lesions were included, some tumors were added/deleted, the names or terms of certain diseases were refined, and the diagnostic criteria or subtypes of some diseases were revised. This group of diseases was reintegrated from non-clonal hyperplasia to highly aggressive lymphoma, which would further reflect the nature of T/NK-LPD/LYM and benefit to clinical application.
Topics: Humans; World Health Organization; Killer Cells, Natural; T-Lymphocytes; Lymphoma; Lymphoma, T-Cell; Lymphoproliferative Disorders
PubMed: 38825896
DOI: 10.3760/cma.j.cn112151-20230823-00094 -
Appetite May 2024Consuming enough energy to meet high energy demands can be challenging for military personnel wherein logistical constraints limit food availability. Increasing dietary...
Consuming enough energy to meet high energy demands can be challenging for military personnel wherein logistical constraints limit food availability. Increasing dietary energy density (ED) and/or volume density (VD) of rations may be countermeasures, but whether positive linear associations between ED and energy intake (EI) hold at moderate-to-high ED and VD is unclear. This study examined the effects of covertly increasing the ED and VD of moderate ED (≥1.6 kcal/g) foods on appetite and energy intake. Twenty healthy men completed four 2-day treatments in random order by consuming a standardized diet containing three experimental food items (EXP) engineered using leavening, physical compression and fat manipulation to be isovolumetric but lower (L) or higher (H) in ED and VD creating four treatments: LED/LVD, LED/HVD, HED/LVD, HED/HVD. Consumption of EXP was compulsory during two meals and a snack, but remaining intake was self-selected (SSF). Results failed to show any ED-by-VD interactions. During LVD, EI was lower for EXP (-417 kcal [95%CI: 432, -402], p < 0.01) and TOTAL (SSF + EXP) (-276 kcal [95%CI: 470, -83], p = 0.01) compared to HVD, while SSF EI did not differ (140 kcal [-51, 332], p = 0.15). During LED, EI for EXP (-291 kcal [95%CI: 306, -276], p < 0.01) was lower than HED, while SSF EI was higher than HED (203 kcal 95%CI: [12, 394], p = 0.04) and TOTAL EI did not differ (-88 kcal [-282, 105], p = 0.36). Thus, when a small isovolumetric portion of the diet was manipulated, increasing the VD of moderate ED foods failed to elicit compensatory reductions in ad libitum EI while increasing the ED of moderate ED foods did. Findings may support VD manipulation of moderate ED foods as a strategy to promote increased short-term EI in environments wherein logistical burden may limit food volume.
PubMed: 38825013
DOI: 10.1016/j.appet.2024.107537 -
BMC Public Health Jun 2024Globally, the counting of deaths based on gender identity and sexual orientation has been a challenge for health systems. In most cases, non-governmental organizations...
Accuracy, potential, and limitations of probabilistic record linkage in identifying deaths by gender identity and sexual orientation in the state of Rio De Janeiro, Brazil.
BACKGROUND
Globally, the counting of deaths based on gender identity and sexual orientation has been a challenge for health systems. In most cases, non-governmental organizations have dedicated themselves to this work. Despite these efforts in generating information, the scarcity of official data presents significant limitations in policy formulation and actions guided by population needs. Therefore, this manuscript aims to evaluate the accuracy, potential, and limits of probabilistic data relationships to yield information on deaths according to gender identity and sexual orientation in the State of Rio de Janeiro.
METHODS
This study evaluated the accuracy of the probabilistic record linkage to obtain information on deaths according to gender and sexual orientation. Data from two information systems were used from June 15, 2015 to December 31, 2020. We constructed nine probabilistic data relationship strategies and identified the performance and cutoff points of the best strategy.
RESULTS
The best data blocking strategy was established through logical blocks with the first and last names, birthdate, and mother's name in the pairing strategy. With a population base of 80,178 records, 1556 deaths were retrieved. With an area under the curve of 0.979, this strategy presented 93.26% accuracy, 98.46% sensitivity, and 90.04% specificity for the cutoff point ≥ 17.9 of the data relationship score. The adoption of the cutoff point optimized the manual review phase, identifying 2259 (90.04%) of the 2509 false pairs and identifying 1532 (98.46%) of the 1556 true pairs.
CONCLUSION
With the identification of possible strategies for determining probabilistic data relationships, the retrieval of information on mortality according to sexual and gender markers has become feasible. Based on information from the daily routine of health services, the formulation of public policies that consider the LGBTQ + population more closely reflects the reality experienced by these population groups.
Topics: Humans; Brazil; Female; Male; Gender Identity; Sexual Behavior; Medical Record Linkage; Data Accuracy; Death Certificates; Adult
PubMed: 38824562
DOI: 10.1186/s12889-024-19002-x