Evaluation of three brands of drug interaction software for use in intensive care units

Objective To evaluate drug interaction software programs and determine their accuracy in identifying drug-drug interactions that may occur in intensive care units. Setting The study was developed in Brazil. Method Drug interaction software programs were identified through a bibliographic search in PUBMED and in LILACS (database related to the health sciences published in Latin American and Caribbean countries). The programs` sensitivity, specificity, and positive and negative predictive values were determined to assess their accuracy in detecting drug-drug interactions. The accuracy of the software programs identified was determined using 100 clinically important interactions and 100 clinically unimportant ones. Stockley`s Drug Interactions 8th edition was employed as the gold standard in the identification of drug-drug interaction. Main outcome Sensitivity, specificity, positive and negative predictive values. Results The programs studied were: Drug Interaction Checker (DIC), Drug-Reax (DR), and Lexi-Interact (LI). DR displayed the highest sensitivity (0.88) and DIC showed the lowest (0.69). A close similarity was observed among the programs regarding specificity (0.88-0.92) and positive predictive values (0.88-0.89). The DIC had the lowest negative predictive value (0.75) and DR the highest (0.91). Conclusion The DR and LI programs displayed appropriate sensitivity and specificity for identifying drug-drug interactions of interest in intensive care units. Drug interaction software programs help pharmacists and health care teams in the prevention and recognition of drug-drug interactions and optimize safety and quality of care delivered in intensive care units.

Care during the intensive phase: promotion of adherence

The standards in this chapter focus on maximising the patient`s ability to adhere to the treatment prescribed. Many people are extremely shocked when they are told they have TB, some refuse to accept it and others are relieved to find out what is wrong and that treatment is available. The reaction depends on many factors, including cultural beliefs and values, previous experience and knowledge of the disease. Even though TB is more common among vulnerable groups, it can affect anyone and it is important for patients to be able to discuss their concerns in relation to their own individual context. The cure for TB relies on the patient receiving a full, uninterrupted course of treatment, which can only be achieved if the patient and the health service work together. A system needs to be in place to trace patients who miss their appointments for treatment (late patients). The best success will be achieved through the use of flexible, innovative and individualised approaches. The treatment and care the patient has received will inevitably have an impact on his or her willingness to attend in the future. A well-defined system of late patient tracing is mandatory in all situations. However, when the rates are high (above 10%), any tracing system will be useless without also examining the service as a whole.

On the use of Gram matrix in observability analysis

This letter presents some notes on the use of the Gram matrix in observability analysis. This matrix is constructed considering the rows of the measurement Jacobian matrix as vectors, and it can be employed in observability analysis and restoration methods. The determination of nonredundant pseudo-measurements (normally injections pseudo-measurements) for merging observable islands into an observable (single) system is carried out analyzing the pivots of the Gram matrix. The Gram matrix can also be used to verify local redundancy, which is important in measurement system planning. Some numerical examples` are used to illustrate these features. Others features of the Gram matrix are under study.

An exploratory analysis of relationships between socioeconomic, land use, activity participation variables and travel patterns

This paper aims to find relations between the socioeconomic characteristics, activity participation, land use patterns and travel behavior of the residents in the Sao Paulo Metropolitan Area (SPMA) by using Exploratory Multivariate Data Analysis (EMDA) techniques. The variables influencing travel pattern choices are investigated using: (a) Cluster Analysis (CA), grouping and characterizing the Traffic Zones (17), proposing the independent variable called Origin Cluster and, (b) Decision Tree (DT) to find a priori unknown relations among socioeconomic characteristics, land use attributes of the origin TZ and destination choices. The analysis was based on the origin-destination home-interview survey carried out in SPMA in 1997. The DT application revealed the variables of greatest influence on the travel pattern choice. The most important independent variable considered by DT is car ownership, followed by the Use of Transportation ""credits"" for Transit tariff, and, finally, activity participation variables and Origin Cluster. With these results, it was possible to analyze the influence of a family income, car ownership, position of the individual in the family, use of transportation ""credits"" for transit tariff (mainly for travel mode sequence choice), activities participation (activity sequence choice) and Origin Cluster (destination/travel distance choice). (c) 2010 Elsevier Ltd. All rights reserved.

DEVELOPMENT OF STATIC MIXERS FOR MISCIBLE FLUIDS IN LAMINAR FLOW WITH THE USE OF COMPUTATIONAL FLUID DYNAMICS (CFD)

Static mixers with improved performance were developed from CFD simulations in a stepwise approach. The relevant geometric features of simple mixer designs and the corresponding mixing mechanisms-laminar shear, elongational flow, and distributive mixing-were identified first. This information was used to formulate guidelines for the development of new geometries. The solid elements of the static mixer should: (a) provide restrictions to the flow; (b) deflect the flow; (c) be sequentially rotated around the flow direction to provide symmetry; (d) extend from the center of the pipe to the vicinity of the walls to avoid short-circuiting; and (e) distribute and remix the flow. Based on these guidelines, two improved mixer designs were developed: the DS A-I mixer has a good mixing efficiency and an acceptable pressure drop; the Fins 35 degrees mixer is more efficient and compact, but requires a larger pressure drop. Their performance indicates that their use is possible on industrial applications.

AN ASSESSMENT ON THE USE OF THE DEBYE-HUCKEL EQUATION FOR THE THERMODYNAMIC MODELING OF AQUEOUS SYSTEMS CONTAINING POLYMERS AND SALTS

In this work, a study on the role of the long-range term of excess Gibbs energy models in the modeling of aqueous systems containing polymers and salts is presented. Four different approaches on how to account for the presence of polymer in the long-range term were considered, and simulations were conducted considering aqueous solutions of three different salts. The analysis of water activity curves showed that, in all cases, a liquid-phase separation may be introduced by the sole presence of the polymer in the long-range term, regardless of how it is taken into account. The results lead to the conclusion that there is no single exact solution for this problem, and that any kind of approach may introduce inconsistencies.

Use of SECM to study the electrochemical behavior of DIN 1.4575 superferritic stainless steel aged at 475 degrees C

In order to lower the excessive costs of metallic prosthesis materia Is alternatives to Ti and Ti alloys have been searched. in this study, the corrosion resistance of the DIN 1.4575 superferritic stainless steel, either solution annealed or solution annealed and aged at 475 degrees C for periods varying from 100 to 1080 h, was investigated by electrochemical impedance spectroscopy (EIS) and potentiodynamic polarization methods in Hanks` solution. The solution annealed and the aged for 1080 h samples were also tested using scanning electrochemical microscopy (SECM) in a 0.1 mol/L NaCl solution at 25 degrees C. The EIS results showed that the corrosion resistance of the DIN 1.4575 steel decreases with heat treatment time at 475 degrees C probably due to alpha prime formation. Besides the diminution of the overall impedance values, the low frequency limit of the Nyquist diagrams show a progressive change from an almost capacitive response to a resistive behavior as the heat treatment time increases. Pitting corrosion resistance also decreased with aging time at 475 degrees C.

USE OF SOLAR ENERGY IN THE TREATMENT OF WATER CONTAMINATED WITH PHENOL BY PHOTOCHEMICAL PROCESSES

The solar driven photo-Fenton process for treating water containing phenol as a contaminant has been evaluated by means of pilot-scale experiments with a parabolic trough solar reactor (PTR). The effects of Fe(II) (0.04-1.0 mmol L(-1)), H(2)O(2) (7-270 mmol L(-1)), initial phenol concentration (100 and 500 mg C L(-1)), solar radiation, and operation mode (batch and fed-batch) on the process efficiency were investigated. More than 90% of the dissolved organic carbon (DOC) was removed within 3 hours of irradiation or less, a performance equivalent to that of artificially-irradiated reactors, indicating that solar light can be used either as an effective complementary or as an alternative source of photons for the photo-Fenton degradation process. A non-linear multivariable model based on a neural network was fit to the experimental results of batch-mode experiments in order to evaluate the relative importance of the process variables considered on the DOC removal over the reaction time. This included solar radiation, which is not a controlled variable. The observed behavior of the system in batch-mode was compared with fed-batch experiments carried out under similar conditions. The main contribution of the study consists of the results from experiments under different conditions and the discussion of the system behavior. Both constitute important information for the design and scale-up of solar radiation-based photodegradation processes.

The AdapLib Library for Execution of Adaptive Devices: Architecture and Use

In this paper it is presented the theoretical background, the architecture (using the ""4+1"" model), and the use of the library for execution of adaptive devices, AdapLib. This library was created seeking to be accurate to the adaptive devices theory, and to allow its easy extension considering the specific details of solutions that employ this kind of device. As an example, it is presented a case study in which the library was used to create a proof of concept to monitor and diagnose problems in an online news portal.

Measuring the eco-efficiency of cement use

At present, the cement industry generates approximately 5% of the world`s anthropogenic CO(2) emissions. This share is expected to increase since demand for cement based products is forecast to multiply by a factor of 2.5 within the next 40 years and the traditional strategies to mitigate emissions, focused on the production of cement, will not be capable of compensating such growth. Therefore, additional mitigation strategies are needed, including an increase in the efficiency of cement use. This paper proposes indicators for measuring cement use efficiency, presents a benchmark based on literature data and discusses potential gains in efficiency. The binder intensity (bi) index measures the amount of binder (kg m(-3)) necessary to deliver 1 MPa of mechanical strength, and consequently express the efficiency of using binder materials. The CO(2) intensity index (ci) allows estimating the global warming potential of concrete formulations. Research benchmarks show that bi similar to 5 kg m(-3) MPa(-1) are feasible and have already been achieved for concretes >50 MPa. However, concretes with lower compressive strengths have binder intensities varying between 10 and 20 kg m(-3) MPa(-1). These values can be a result of the minimum cement content established in many standards and reveal a significant potential for performance gains. In addition, combinations of low bi and ci are shown to be feasible. (c) 2010 Elsevier Ltd. All rights reserved.

Pitfalls driven by the sole use of local updates in dynamical

The recent claim that the exit probability (EP) of a slightly modified version of the Sznadj model is a continuous function of the initial magnetization is questioned. This result has been obtained analytically and confirmed by Monte Carlo simulations, simultaneously and independently by two different groups (EPL, 82 (2008) 18006; 18007). It stands at odds with an earlier result which yielded a step function for the EP (Europhys. Lett., 70 (2005) 705). The dispute is investigated by proving that the continuous shape of the EP is a direct outcome of a mean-field treatment for the analytical result. As such, it is most likely to be caused by finite-size effects in the simulations. The improbable alternative would be a signature of the irrelevance of fluctuations in this system. Indeed, evidence is provided in support of the stepwise shape as going beyond the mean-field level. These findings yield new insight in the physics of one-dimensional systems with respect to the validity of a true equilibrium state when using solely local update rules. The suitability and the significance to perform numerical simulations in those cases is discussed. To conclude, a great deal of caution is required when applying updates rules to describe any system especially social systems. Copyright (C) EPLA, 2011

Use of Sugar Cane Vinasse to Mitigate Aluminum Toxicity to Saccharomyces cerevisiae

Owing to its toxicity, aluminum (Al), which is one of the most abundant metals, inhibits the productivity of many cultures and affects the microbial metabolism. The aim of this work was to investigate the capacity of sugar cane vinasse to mitigate the adverse effects of Al on cell growth, viability, and budding, as the likely result of possible chelating action. For this purpose, Fleischmann`s yeast (Saccharomyces cerevisiae) was used in growth tests performed in 125-mL Erlenmeyer flasks containing 30 mL of YED medium (5.0 g/L yeast extract plus 20 g/L glucose) supplemented with the selected amounts of either vinasse or Al in the form of AlCl(3) center dot A H(2)O. Without vinasse, the addition of increasing levels of Al up to 54 mg/L reduced the specific growth rate by 18%, whereas no significant reduction was observed in its presence. The toxic effect of Al on S. cerevisiae growth and the mitigating effect of sugar cane vinasse were quantified by the exponential model of Ciftci et al. (Biotechnol Bioeng 25:2007-2023, 1983). The cell viability decreased from 97.7% at the start to 84.0% at the end of runs without vinasse and to 92.3% with vinasse. On the other hand, the cell budding increased from 7.62% at the start to 8.84% at the end of runs without vinasse and to 17.8% with vinasse. These results demonstrate the ability of this raw material to stimulate cell growth and mitigate the toxic effect of Al.

Toward sustainable soil and water resources use in China`s highly erodible semi-arid loess plateau

The water-wind crisscross region of the Loess Plateau in China is comprised of 17.8 million hectares of highly erodible soil under limited annual rainfall. This requires a sustainable water balance for the restoration of dryland ecosystems to reduce and manage soil erosion. In this region, alfalfa has been one of the main legumes grown to minimize soil erosion. However, alfalfa yields were significantly lower in years of reduced rainfall suggesting that high water use and deep rooting alfalfa make it an unsustainable crop due to the long-term decline in soil water storage and productivity. Our objectives in this Study were to evaluate the soil water balance of Loess Plateau soils during vegetative restoration and to evaluate practices that prevent soil desiccation and promote ecosystem restoration and sustainability. Field observations of soil moisture recovery and soil erosion were carried out for five years after alfalfa was replaced with different crops and with bare soil. Soil water content changes in cropland, rangeland, and bare soil were tracked over several years, using a water balance approach. Results indicate that growing forages significantly reduced runoff and sediment transport. A forage-food-crop rotation is a better choice than other cropping systems for achieving sustainable productivity and preventing soil erosion and desiccation. However, economic considerations have prevented its widespread adoption by local farmers. Alternatively, this study recommends consideration of grassland crops or forest ecosystems to provide a sustainable water balance in the Loess Plateau of China. (C) 2009 Elsevier B.V. All rights reserved.

Impacts of land-use pattern on soil water-content variability on the Loess Plateau of China

Long-term vegetation restoration carried out on the slopes of the Loess Plateau of China employed different spatial and temporal land-use patterns but very little is known about the effects of these patterns on soil water-content variability. For this study the small Donggou catchment was selected to investigate soil water-content distributions for three spatial scales, including the entire catchment area, sampling transects, and land-use systems. Gravimetric soil water contents were determined incrementally to a soil depth of 1.20 m, on 10 occasions from April to October, 2007, at approximately 20-day intervals. Results indicated that soil water contents were affected by the six land-use types, resulting in four distinct patterns of vertical distribution of soil moisture (uniform, increasing, decreasing, and fluctuating with soil depth). The soil water content and its variation were also influenced in a complex manner by five land-use patterns distributed along transects following the gradients of five similar slopes. These patterns with contrasting hydrological responses in different components, such as forage land (alfalfa)-cropland-shrubland or shrubland-grassland (bunge needlegrass)-cropland-grassland, showed the highest soil water-content variability. Soil water at the catchment scale exhibited a moderate variability for each measurement date, and the variability of soil water content decreased exponentially with increasing soil water content. The minimum sample size for accurate data for use in a hydrological model for the catchment, for example, required many more samples for drier (69) than for wet (10) conditions. To enhance erosion and runoff control, this study suggested two strategies for land management: (i) to create a mosaic pattern by land-use arrangement that located units with higher infiltration capacities downslope from those with lower soil infiltrabilities; and (ii) raising the soil-infiltration capacity of units within the spatial mosaic pattern where possible.

On the use of correlated beta random variables with animal population modelling

We give reasons why demographic parameters such as survival and reproduction rates are often modelled well in stochastic population simulation using beta distributions. In practice, it is frequently expected that these parameters will be correlated, for example with survival rates for all age classes tending to be high or low in the same year. We therefore discuss a method for producing correlated beta random variables by transforming correlated normal random variables, and show how it can be applied in practice by means of a simple example. We also note how the same approach can be used to produce correlated uniform triangular, and exponential random variables. (C) 2008 Elsevier B.V. All rights reserved.