Background: Fangcang hospital (cabin hospitals) played a key role in isolation and control of the infection sources during COVID-19 epidemic. The patients at Fangcang hospitals were complicated, and many had different symptoms of COVID-19, some had comorbidities or mental stress, and many were confused with the drug usages etc. Objective: Due to the limitation and high work pressure of first line medical workers, patients’ various problems couldn’t be explained well. Under this circumstance, online pharmaceutical care was provided by clinical pharmacists. This study was a retrospective study to evaluate the role and usefulness of clinical pharmacists at Jianghan Fangcang Hospital. Besides, this new mode of service was also introduced in detail to provide options for pharmacists in other hospitals. Methods: The pharmaceutical care included medication education via broadcast station, and medication reconciliation, optimization of drug use, monitor of adverse drug events, and psychological comfort via WeChat® one-to-one service. In this study, we analyzed patients’ characteristics and drug usages, concluded almost 200 patients’ problems classified into 6 aspects solved by clinical pharmacists, and also assessed the patients’ satisfaction with our service. Results: The clinical pharmacist help patients solved almost 200 questions, which mainly focused on the drug related problems including drug usage (65.38%), medication reconciliation (55.13%), drug precautions (23.1%), adverse drug reactions (35.9%), and psychological counseling (32.05%). Through 35 days’ services, Most patients were satisfied with clinical pharmacist service(66.7%great, 18.0%good). Besides, most patients thought the service had positive effect on their mental stress(16.7%great, 43.6%good, 26.9%fair). Conclusion: The results of the retrospective study indicated that clinical pharmacist can effectively reduce and prevent drug-related, life-related and COVID-19-related problems for COVID-19 patients. This work may provide possible work patterns for clinical pharmacist in other hospital and give more professional service for Fangcang hospital patients.
One knowledge translation method, of putting evidence into practice, is the use of clinical practice guidelines (CPG). The purpose of this brief report is to describe an 8-step process of “how to” contextualise a training programme to increase CPG-uptake for a targeted audience in a clearly defined setting. This process may assist implementalists to fast-track the development of contextualised training to improve CPG-uptake.
In this paper, we deal with the numerical approximation of the coupled wave equation of Kirchhoff type with nonlinear boundary damping and memory term. Since the equation is a nonlinear equation, the Raviart-Thomas mixed finite element method is one of the most suitable techniques to obtain the approximated solution. In this paper, we will show that using the Raviart-Thomas method the optimal convergence order of the scheme can be achieved. To that end, we prove the necessary lemmas and the main theorem. Finally, the efficiency of the method is certified by numerical examples.
Assuming non-Fourier thermal effects, Tzou's dual-phase-lag model has been applied to introduce the governing heat conduction equation in the presented mathematical model. Moreover, in order to design a well-posed stable dual-phase-lag model, the governing time fractional dual-phase-lag heat equation has been established by introducing conductive temperature and thermodynamical temperature, satisfying the two-temperature theory. Due to the application of phase-lags the heat conduction equation became hyperbolic. The corresponding governing equations of motion and stresses have been considered in two-dimensional bounded spherical domain. The spherical boundaries are assumed to be traction free. The Laplace and the Legendre integral transforms have been applied to obtain the analytical solutions of conductive and thermodynamical temperatures, displacement components and thermal stresses. The Gaver-Stehfest algorithm has been employed to achieve the time domain inversions of Laplace transforms numerically, satisfying the Kuznetsov convergence criteria. Classical, fractional and generalized thermoelasticity theories has been recovered theoretically and numerically as well for various fractional orders and phase-lags values.
How to understand the dynamical collective performances is of particular significance in both theories and applications. In this paper, we are interested in investigating the combined influences of local interaction and processing delay on the asymptotic behaviour in a particle model with local communication weights. As new observations, we show that the desired particle system undergoes both periodic flocking and periodic clustering behaviors when the processing delay crosses a threshold value and the eigenvalue $1$ of average matrix is semi-simple. In this case, the connectedness of the particle system may be absent. Also, the number of clusters is discussed by using the subspace analysis. In results, some criterion of flocking and clustering emergence with exponential convergent rate are established by the standard functional differential equations analysis when the processing delay is small. When the processing delay reaches the threshold value, the system undergoes periodic flocking and periodic clustering emergence. It also shows that the processing time lags qualitatively change the emergent performances in a nonlinear way. Finally, we conclude this study with several numerical simulations that intuitively illustrate the validity of the theoretical results and address some discussions for both variable communication weight and distributed processing delay.
Background NT-proBNP plasma levels may predict a future cancer diagnosis(CD)in patients with coronary artery disease(CAD).In this paper we test whether this could merely represent the detection of increased NT-proBNP levels in subclinical tumors. Methods We studied 962 patients with stable CAD and free of cancer and heart failure at baseline. NT-proBNP, galectin-3, monocyte chemoattractant protein-1,high-sensitivity C-reactive protein, high-sensitivity cardiac troponin I(hsTnI),and calcidiol plasma levels were assessed.The primary outcome was new CD. Results After 5.40(2.81-6.94)years of follow-up,59 patients received a CD.We divided the population in three subgroups: those not developing cancer during follow-up (group A;N=903),and those receiving a CD in the first 3 years of follow up(group B; N=30),or later (group C;N=29).At baseline, 3.3% of patients of group B,0.0% in groups C and 12.3% in group A(p=0.036) presented a previous history of heart failure.In group B,NT-proBNP[HR1.036 CI(1.015-1.056)per increase in 100 pg/ml;p=0.001],previous atrial fibrillation[HR3.140 CI(1.196-8.243);p=0.020],and previous heart failure[HR0.067 CI(0.006-0.802);p=0.033]were independent predictors of CD at multivariate analysis.In group C there were not significant predictors of CD. Conclusions In patients with CAD,NT-proBNP is an independent predictor of CD in the first three years of follow-up,but not later,suggesting that it could be detecting subclinical undiagnosed cancers.New studies in large populations are needed to confirm these findings. What is already known about this topic? It has been linked in previous studies that NT-Pro-BNP elevation could be related to future diagnosis of some cancers especially renal tumors. It has also seen that NT-ProBNP is related to mortality in cancer patients.Finally, our group has previously seen that NT-Pro-BNP predicts cancer diagnosis in patients with myocardial infarction. What does this article add? According to our previous investigations this study support the idea that NT-Pro-BNP is a good marker for further cancer diagnosis not only in patients with myocardial infarction but across the spectrum of the whole CAD
Cadmium (Cd) contamination in the environment has becoming a hot issue worldwide, as it has posed a great risk to human health through food chain. Cd accumulation in the edible parts of crops are involved in four processes: uptake, translocation, sequestration and (re)distribution, which are all controlled by membrane transporters. In this review, the advance in studies on physiological and molecular mechanisms of Cd accumulation in plants was summarized, and then the functional evolution was discussed based on oneKP database. Cd accumulation in plants is a derived and polyphyletic trait that has evolved convergently by several times. During their evolution, the membrane transporter families, such as NRAMPs, HMAs, ABCCs, ZIPs, CDFs, CAXs and OPTs, have undergone the lineage specific expansion due to gene duplication. The orthologues of OsHMA2 in higher plants are stepwisely evolved from monophyletic evolutionary lineage with one common ancestor; whereas the orthologues of OsNRAMP5 from a polyphyletic evolutionary lineage with several ancestors. In addition, phylogenetic clusters of the orthologues of OsNRAMP5 have occurred rampant intermixing, suggesting horizontal gene transfer. It may be concluded that evolution of Cd accumulation in plants could provide an adaptive advantage for colonization of plants to the new habitats like metalliferous soil.
Methods This prospective observational study included 44 patients who underwent isolated ASD closures in the department of cardiac surgery at the National Heart Foundation Hospital and Research Institute (NHFH & RI) from July 2014 to June 2016. After fulfilling the enrolment criteria, participants were divided into two groups.
Current study investigates thermal-hydraulic performances of turbulent forced hybrid nanofluid flow and heat transfer inside a parabolic through solar collector equipped with turbulators. The main aim of present work is to simulate and investigate the effects of different Reynolds numbers and geometrical parameters on thermal and hydraulic characteristics of the system to achieve the maximum PEC value. The heat transfer fluid is water-based MWCNT-Al2O3 (80%:20%) hybrid nanofluid which makes a Newtonian nanofluid. The RANS equations with the shear-stress (SST) k–ω turbulence model have been employed for modeling the turbulence regime. Based on obtained results, usage of turbulators leads to higher thermal diffusion because of destroying the laminar sub layer, increasing heat transfer surface and convection heat transfer. For θ=180°, the maximum values of average Nusselt number (Nuave) are achieved during all studied range of Reynolds numbers followed by θ=90° and θ=0°, respectively. For HO=15mm, the maximum values of Nuave are achieved followed by HO=10mm and HO=5mm, respectively. The model with HO=5mm has not the maximum Nuave; but, it has lower pressure drop than HO=15mm. For BO=1000mm, the maximum values of Nuave are achieved followed by BO=800mm and smooth channel, respectively. Furthermore, for δ=60°, the maximum Nuave are achieved followed by δ=40° and δ=20°, respectively. For model δ=40° the maximum values of PEC are achieved followed by smooth channel, δ=20° and δ=60°, respectively. The parabolic through solar collector model with θ=180°, HO=15, BO=1000mm, δ=40° and bO=20mm filled with hybrid nanofluid suggested as the optimum model in the present investigation.
Tissue engineering (TE) constitutes a multidisciplinary scientific discipline focused on the construction of artificial tissues to regenerate end-stage organs. The impact of TE has led to a clinical revolution since novel therapies are available to attend several conditions. In this sense, its onset has supposed the communication of innovative discoveries in the age of social and mass media. This study aims to evaluate the global online dimension of TE from 2012 to 2018 by using data from the Web of Science (WoS) and Altmetrics. We have analysed 23,719 documents through descriptive and statistical methodologies. First, the descriptive analysis showed the evolution of TE original articles in five online platforms (Twitter, Patents, Facebook, Mendeley readers and News) and compared the most relevant TE documents ranked by their traditional and alternative metrics of impact. Secondly, we carried out a correlation and factorial analysis and then constructed a linear regression model to define a mathematical equation for the prediction of future TE citations counts from Altmetric scores. The obtained results suggest a growing presence of TE in the online social web and the feasibility in the context of global science to anticipate TE traditional academic impact by using social media
We use recent plot-level panel data from Tanzanian smallholder farmers to investigate maize yield responses to inorganic fertilizer under variable soil carbon conditions. Unlike many prior studies which consider total carbon measurements, we focus on active soil carbon, which is the component that most influences key soil functions, such as nutrient cycling and availability. Active soil organic carbon is found to strongly influence maize yield response to nitrogen fertilizer. These results highlight important sources of variation in the returns to fertilizer investments across plots and smallholder farmers in the region. When farmgate prices for maize and fertilizer are incorporated into calculations of economic returns, we find that the profitability of fertilizer use is strongly dependent upon farmgate price ratio assumptions: under our most optimistic agronomic response estimates, 71% of farmer plots have an average value-cost ratio (AVCR) greater than 1.5 at a maize-nitrogen price ratio of 0.15. That share drops to 30% at a price ratio of 0.12 and 2% at a price ratio of 0.09. Our findings provide insights into the intertwined biophysical and economic underpinnings of low levels of fertilizer use in Tanzania and elsewhere in the region. Raising active carbon stocks in smallholder systems may be a strategic priority in many areas for incentivizing greater use of inorganic fertilizer, reversing land degradation, and achieving sustainable agricultural intensification.
As the global population continues to shift into cities, urban hydrologic systems are becoming increasingly important drivers of overall water quality. Engineered waterways and impervious surfaces strongly influence baseline flow, peak flow, and the transport of pollutants in the urban environment. Between May 2016 -- May 2019, we systematically measured water temperature, pH, dissolved oxygen, biochemical oxygen demand, and the concentrations of nitrate-N, ammonia-N, and orthophosphate in the South Platte River in the Denver metropolitan area, Colorado, USA. We found that the overall water quality of the river decreased through the study area. In addition, there appear to be several hotspots with consistently poor water quality. While it is beyond the scope of this paper to determine the specific sources of the hotspots, it seems likely that wastewater treatment facilities contribute to elevated pollution levels. We also found that water quality was strongly influenced by season. Decreased natural flows during the late fall and winter lead to higher concentrations of nutrients and lower dissolved oxygen levels. Most of the samples collected in this study had nutrient levels that were out of compliance with state regulations for nitrogen and phosphorus concentrations while dissolved oxygen and temperature levels were better than threshold values. Urban hydrologic systems are complex and improving water-quality may be difficult. However, tightening of water-quality standards could result in positive changes to this system.
Drug reaction with eosinophilia and systemic symptoms is a quite unusual condition related to drug reaction. A case report of sulfasalazine-induced liver failure is described. The patient was submitted to liver transplantation. Liver transplantation is an option when DRESS is associated with acute liver failure, but the prognosis remains poor.
After surgical removal of bone tumors, elimination of the remains of cancer cells along with tissue healing and functionality is a therapeutic goal. Regarding the destructive effect of chemo-/radiotherapy on healthy cells, the development of multimodal scaffolds with simultaneous anticancer and osteo-regenerative potency is of particular importance as regenerative medicine for bone tissue engineering. Our previous study demonstrated that hollow pollen grain (HPG) of Pistacia vera L. offers a unique bone-forming activity and encapsulating capacity that it can be considered as an excellent scaffolding building block in bottom-up bone engineering. In the present study, for the first time, the anticancer potential of Pistacia vera L. HPG was investigated in-vitro using human osteosarcoma cell line MG63. Optical imaging of the HPG-cell interface indicated large focal adhesion due to the HPG unique surface features such as functionality and ornamentation. MTT assay results showed an anti-proliferative effect of HPG on the MG63 cells. Moreover, from the gene expression and DAPI staining analyses, HPG of Pistacia vera L. was found to be an apoptosis-inducing building block against MG63 bone cancer cells. So therefore, such a multifunctional building block with the ability of discriminatory killing human osteosarcoma cell line is proposed to be used after surgery to not only hinder cancer recurrence after surgery but also to stimulate bone healing.
Antimicrobial photodynamic therapy (APDT) is a promising alternative to traditional antibiotics for bacterial infections, which inactivates a broad spectrum of bacteria. However, it has some disadvantages including poor water solubility and easy aggregation of hydrophobic photosensitizers (PS), and poor tissue penetration and cytotoxicity when using UV as light source, leading to photodynamic therapy efficacy. Herein, we develop a novel water-soluble natural PS (sorbicillinoids) obtained by microbial fermentation using filamentous fungus Trichoderma reesei (T. reesei). Sorbicillinoids could effectively generate singlet oxygen (1O2) under UV light irradiation, and ultimately display photoinactivation activity on Gram-positive bacteria, but not Gram-negative ones. Staphylococcus aureus (S. aureus) treated with sorbicillinoids and UV light displayed high levels of intracellular reactive oxygen species (ROS), notable DNA photocleavage, and compromised membrane permeability without overt cell membrane disruption. Moreover, the dark toxicity, phototoxicity or hemolysis activity of sorbicillinoids is negligible, showing its excellent biocompatibility.