Extent and nature of unlicensed and off-label medicine use in hospitalised children in Palestine

Objective of the study To determine the extent and nature of unlicensed/off-label prescribing patterns in hospitalised children in Palestine. Setting Four paediatric wards in two public health system hospitals in Palestine [Caritas children’s hospital (Medical and neonatal intensive care units) and Rafidia general hospital (Medical and surgical units)]. Method A prospective survey of drugs administered to infants and children <18 years old was carried out over a five-week period in the four paediatric wards. Main outcome measure Drug-licensing status of all prescriptions was determined according to the Palestinian Registered Product List and the Physician’s Desk Reference. Results Overall, 917 drug prescriptions were administered to 387children. Of all drug prescriptions, 528 (57.5%) were licensed for use in children; 65 (7.1%) were unlicensed; and 324 (35.3%) were used off-label. Of all children, 49.6% received off-label prescriptions, 10.1% received unlicensed medications and 8.2% received both. Seventy-two percent of off-label drugs and 66% of unlicensed drugs were prescribed for children <2 years. Multivariate analysis showed that patients who were admitted to the neonatal intensive care unit and infants aged 0–1 years were most likely to receive a greater number of off-label or unlicensed medications (OR 1.80; 95% CI 1.03–3.59 and OR 1.99; 95% CI 0.88–3.73, respectively). Conclusion The present findings confirmed the elevated prevalence of unlicensed and off-label paediatric drugs use in Palestine and strongly support the need to perform well designed clinical studies in children.

Organised crime and the law:a comparative analysis, by Liz Campbell

Book review

Managing supply chain knowledge in the new product development process:a social network analysis approach

The aim of this paper is to propose a conceptual framework for studying the knowledge transfer problem within the supply chain. The social network analysis (SNA) is presented as a useful tool to study knowledge networks within supply chain, to visualize knowledge flows and to identify the accumulating knowledge nodes of the networks. © 2011 IEEE.

Learning user and product distributed representations using a sequence model for sentiment analysis

In product reviews, it is observed that the distribution of polarity ratings over reviews written by different users or evaluated based on different products are often skewed in the real world. As such, incorporating user and product information would be helpful for the task of sentiment classification of reviews. However, existing approaches ignored the temporal nature of reviews posted by the same user or evaluated on the same product. We argue that the temporal relations of reviews might be potentially useful for learning user and product embedding and thus propose employing a sequence model to embed these temporal relations into user and product representations so as to improve the performance of document-level sentiment analysis. Specifically, we first learn a distributed representation of each review by a one-dimensional convolutional neural network. Then, taking these representations as pretrained vectors, we use a recurrent neural network with gated recurrent units to learn distributed representations of users and products. Finally, we feed the user, product and review representations into a machine learning classifier for sentiment classification. Our approach has been evaluated on three large-scale review datasets from the IMDB and Yelp. Experimental results show that: (1) sequence modeling for the purposes of distributed user and product representation learning can improve the performance of document-level sentiment classification; (2) the proposed approach achieves state-of-The-Art results on these benchmark datasets.

Elemental analysis of glass and ink by laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS) and laser induced breakdown spectroscopy (LIBS)

The necessity of elemental analysis techniques to solve forensic problems continues to expand as the samples collected from crime scenes grow in complexity. Laser ablation ICP-MS (LA-ICP-MS) has been shown to provide a high degree of discrimination between samples that originate from different sources. In the first part of this research, two laser ablation ICP-MS systems were compared, one using a nanosecond laser and another a femtosecond laser source for the forensic analysis of glass. The results showed that femtosecond LA-ICP-MS did not provide significant improvements in terms of accuracy, precision and discrimination, however femtosecond LA-ICP-MS did provide lower detection limits. In addition, it was determined that even for femtosecond LA-ICP-MS an internal standard should be utilized to obtain accurate analytical results for glass analyses. In the second part, a method using laser induced breakdown spectroscopy (LIBS) for the forensic analysis of glass was shown to provide excellent discrimination for a glass set consisting of 41 automotive fragments. The discrimination power was compared to two of the leading elemental analysis techniques, μXRF and LA-ICP-MS, and the results were similar; all methods generated >99% discrimination and the pairs found indistinguishable were similar. An extensive data analysis approach for LIBS glass analyses was developed to minimize Type I and II errors en route to a recommendation of 10 ratios to be used for glass comparisons. Finally, a LA-ICP-MS method for the qualitative analysis and discrimination of gel ink sources was developed and tested for a set of ink samples. In the first discrimination study, qualitative analysis was used to obtain 95.6% discrimination for a blind study consisting of 45 black gel ink samples provided by the United States Secret Service. A 0.4% false exclusion (Type I) error rate and a 3.9% false inclusion (Type II) error rate was obtained for this discrimination study. In the second discrimination study, 99% discrimination power was achieved for a black gel ink pen set consisting of 24 self collected samples. The two pairs found to be indistinguishable came from the same source of origin (the same manufacturer and type of pen purchased in different locations). It was also found that gel ink from the same pen, regardless of the age, was indistinguishable as were gel ink pens (four pens) originating from the same pack.

The discrimination and association of float glass and the quantitative analysis of liquids from aerosols and microdrops using laser induced breakdown spectroscopy

Glass is a common form of trace evidence found at many scenes of crimes in the form of small fragments. These glass fragments can transfer to surrounding objects and/or persons and may provide forensic investigators valuable information to link a suspect to the scene of a crime. Since the elemental composition of different glass sources can be very similar, a highly discriminating technique is required to distinguish between fragments that have originated from different sources. ^ The research presented here demonstrates that Laser Induced Breakdown Spectroscopy (LIBS) is a viable analytical technique for the association and discrimination of glass fragments. The first part of this research describes the optimization of the LIBS experiments including the use of different laser wavelengths to investigate laser-material interaction. The use of a 266 nm excitation laser provided the best analytical figures of merit with minimal damage to the sample. The resulting analytical figures of merit are presented. The second part of this research evaluated the sensitivity of LIBS to associate or discriminate float glass samples originating from the same manufacturing plants and produced at approximately the same time period. Two different sample sets were analyzed ranging in manufacturing dates from days to years apart. Eighteen (18) atomic emission lines corresponding to the elements Sr, K, Fe, Ca, Al, Ba, Na, Mg and Ti, were chosen because of their detection above the method detection limits and for presenting differences between the samples. Ten elemental ratios producing the most discrimination were selected for each set. When all the ratios are combined in a comparison, 99% of the possible pairs were discriminated using the optimized LIBS method generating typical analytical precisions of ∼5% RSD. ^ The final study consisted of the development of a new approach for the use of LIBS as a quantitative analysis of ultra-low volume solution analysis using aerosols and microdrops. Laser induced breakdown spectroscopy demonstrated to be an effective technique for the analysis of as low as 90 pL for microdrop LIBS with 1 pg absolute LOD and 20 µL for aerosol LIBS with an absolute LOD of ∼100 fg.^

Elemental analysis and forensic comparison of soils by laser-induced breakdown spectroscopy (LIBS) and laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS)

The elemental analysis of soil is useful in forensic and environmental sciences. Methods were developed and optimized for two laser-based multi-element analysis techniques: laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS) and laser-induced breakdown spectroscopy (LIBS). This work represents the first use of a 266 nm laser for forensic soil analysis by LIBS. Sample preparation methods were developed and optimized for a variety of sample types, including pellets for large bulk soil specimens (470 mg) and sediment-laden filters (47 mg), and tape-mounting for small transfer evidence specimens (10 mg). Analytical performance for sediment filter pellets and tape-mounted soils was similar to that achieved with bulk pellets. An inter-laboratory comparison exercise was designed to evaluate the performance of the LA-ICP-MS and LIBS methods, as well as for micro X-ray fluorescence (μXRF), across multiple laboratories. Limits of detection (LODs) were 0.01-23 ppm for LA-ICP-MS, 0.25-574 ppm for LIBS, 16-4400 ppm for μXRF, and well below the levels normally seen in soils. Good intra-laboratory precision (≤ 6 % relative standard deviation (RSD) for LA-ICP-MS; ≤ 8 % for μXRF; ≤ 17 % for LIBS) and inter-laboratory precision (≤ 19 % for LA-ICP-MS; ≤ 25 % for μXRF) were achieved for most elements, which is encouraging for a first inter-laboratory exercise. While LIBS generally has higher LODs and RSDs than LA-ICP-MS, both were capable of generating good quality multi-element data sufficient for discrimination purposes. Multivariate methods using principal components analysis (PCA) and linear discriminant analysis (LDA) were developed for discriminations of soils from different sources. Specimens from different sites that were indistinguishable by color alone were discriminated by elemental analysis. Correct classification rates of 94.5 % or better were achieved in a simulated forensic discrimination of three similar sites for both LIBS and LA-ICP-MS. Results for tape-mounted specimens were nearly identical to those achieved with pellets. Methods were tested on soils from USA, Canada and Tanzania. Within-site heterogeneity was site-specific. Elemental differences were greatest for specimens separated by large distances, even within the same lithology. Elemental profiles can be used to discriminate soils from different locations and narrow down locations even when mineralogy is similar.

Comprehensive forensic toxicological analysis of designer drugs

New designer drugs are constantly emerging onto the illicit drug market and it is often difficult to validate and maintaincomprehensive analytical methods for accurate detection of these compounds. Generally, toxicology laboratories utilize a screening method, such as immunoassay, for the presumptive identification of drugs of abuse. When a positive result occurs, confirmatory methods, such as gas chromatography (GC) or liquid chromatography (LC) coupled with mass spectrometry (MS), are required for more sensitive and specific analyses. In recent years, the need to study the activities of these compounds in screening assays as well as to develop confirmatory techniques to detect them in biological specimens has been recognized. Severe intoxications and fatalities have been encountered with emerging designer drugs, presenting analytical challenges for detection and identification of such novel compounds. The first major task of this research was to evaluate the performance of commercially available immunoassays to determine if designer drugs were cross-reactive. The second major task was to develop and validate a confirmatory method, using LC-MS, to identify and quantify these designer drugs in biological specimens.^ Cross-reactivity towards the cathinone derivatives was found to be minimal. Several other phenethylamines demonstrated cross-reactivity at low concentrations, but results were consistent with those published by the assay manufacturer or as reported in the literature. Current immunoassay-based screening methods may not be ideal for presumptively identifying most designer drugs, including the "bath salts." For this reason, an LC-MS based confirmatory method was developed for 32 compounds, including eight cathinone derivatives, with limits of quantification in the range of 1-10 ng/mL. The method was fully validated for selectivity, matrix effects, stability, recovery, precision, and accuracy. In order to compare the screening and confirmatory techniques, several human specimens were analyzed to demonstrate the importance of using a specific analytical method, such as LC-MS, to detect designer drugs in serum as immunoassays lack cross-reactivity with the novel compounds. Overall, minimal cross-reactivity was observed, highlighting the conclusion that these presumptive screens cannot detect many of the designer drugs and that a confirmatory technique, such as the LC-MS, is required for the comprehensive forensic toxicological analysis of designer drugs.^

Numerical heat transfer analysis of carbon-based foams for use in thermal protection system

The applicability of carbon-based foams as an insulating or active cooling material in thermal protection systems (TPSs) of space vehicles is considered using a computer modeling. This study focuses on numerical investigation of the performance of carbon foams for use in TPSs of space vehicles. Two kinds of carbon foams are considered in this study. For active cooling, the carbon foam that has a thermal conductivity of 100 W/m-k is used and for the insulation, the carbon foam having a thermal conductivity of 0.225 W/m-k is used. A 3D geometry is employed to simulate coolant flow and heat transfer through carbon foam model. Gambit has been used to model the 3D geometry and the numerical simulation is carried out in FLUENT. Numerical results from this thesis suggests that the use of CFOAM and HTC carbon foams in TPS's may effectively protect the aluminum structure of the space shuttle during reentry of the space vehicle.

Analysis of White Latex Paints using Laser Induced Breakdown Spectroscopy for Forensic Applications

The analysis of white latex paint is a problem for forensic laboratories because of difficulty in differentiation between samples. Current methods provide limited information that is not suitable for discrimination. Elemental analysis of white latex paints has resulted in 99% discriminating power when using LA-ICP-MS; however, mass spectrometers can be prohibitively expensive and require a skilled operator. A quick, inexpensive, effective method is needed for the differentiation of white latex paints. In this study, LIBS is used to analyze 24 white latex paint samples. LIBS is fast, easy to operate, and has a low cost. Results show that 98.1% of variation can be accounted for via principle component analysis, while Tukey pairwise comparisons differentiated 95.6% with potassium as the elemental ratio, showing that the discrimination capabilities of LIBS are comparable to those of LA-ICP-MS. Due to the many advantages of LIBS, this instrument should be considered a necessity for forensic laboratories.

Elemental Analysis of Glass and Ink by Laser Ablation Inductively Coupled Plasma Mass Spectrometry (LA-ICP-MS) and Laser Induced Breakdown Spectroscopy (LIBS)

The necessity of elemental analysis techniques to solve forensic problems continues to expand as the samples collected from crime scenes grow in complexity. Laser ablation ICP-MS (LA-ICP-MS) has been shown to provide a high degree of discrimination between samples that originate from different sources. In the first part of this research, two laser ablation ICP-MS systems were compared, one using a nanosecond laser and another a femtosecond laser source for the forensic analysis of glass. The results showed that femtosecond LA-ICP-MS did not provide significant improvements in terms of accuracy, precision and discrimination, however femtosecond LA-ICP-MS did provide lower detection limits. In addition, it was determined that even for femtosecond LA-ICP-MS an internal standard should be utilized to obtain accurate analytical results for glass analyses. In the second part, a method using laser induced breakdown spectroscopy (LIBS) for the forensic analysis of glass was shown to provide excellent discrimination for a glass set consisting of 41 automotive fragments. The discrimination power was compared to two of the leading elemental analysis techniques, µXRF and LA-ICP-MS, and the results were similar; all methods generated >99% discrimination and the pairs found indistinguishable were similar. An extensive data analysis approach for LIBS glass analyses was developed to minimize Type I and II errors en route to a recommendation of 10 ratios to be used for glass comparisons. Finally, a LA-ICP-MS method for the qualitative analysis and discrimination of gel ink sources was developed and tested for a set of ink samples. In the first discrimination study, qualitative analysis was used to obtain 95.6% discrimination for a blind study consisting of 45 black gel ink samples provided by the United States Secret Service. A 0.4% false exclusion (Type I) error rate and a 3.9% false inclusion (Type II) error rate was obtained for this discrimination study. In the second discrimination study, 99% discrimination power was achieved for a black gel ink pen set consisting of 24 self collected samples. The two pairs found to be indistinguishable came from the same source of origin (the same manufacturer and type of pen purchased in different locations). It was also found that gel ink from the same pen, regardless of the age, was indistinguishable as were gel ink pens (four pens) originating from the same pack.

Radiological protection and the exposure of animals as patients in veterinary medicine

It is apparent that most of the techniques that make use of ionising radiation in human medical practices are now being applied in veterinary medicine. Steps are being taken by the IAEA to provide guidance for humans involved in such practices, but there appears to be no international initiative that considers the protection or welfare of the animal as a patient. There is therefore a risk that the deliberate exposure of an animal, particularly in the therapeutic application of radiation, could do more harm than good. In the light of recent developments in dosimetric modelling and the application of known effects of radiation on different types of animals, for the purposes of the protection of biota in an environmental context, it is argued that it would be sensible now to start a serious consideration of this issue. Some suggestions are made with regard to a number of areas that could be considered further, both specifically and with regard to the field of radiological protection as a whole.

Radiological protection and the exposure of animals as patients in veterinary medicine

It is apparent that most of the techniques that make use of ionising radiation in human medical practices are now being applied in veterinary medicine. Steps are being taken by the IAEA to provide guidance for humans involved in such practices, but there appears to be no international initiative that considers the protection or welfare of the animal as a patient. There is therefore a risk that the deliberate exposure of an animal, particularly in the therapeutic application of radiation, could do more harm than good. In the light of recent developments in dosimetric modelling and the application of known effects of radiation on different types of animals, for the purposes of the protection of biota in an environmental context, it is argued that it would be sensible now to start a serious consideration of this issue. Some suggestions are made with regard to a number of areas that could be considered further, both specifically and with regard to the field of radiological protection as a whole.

Invisible Victims: Recorded Crime and Children in the UK

While violence against children is a common occurrence only a minority of incidents come to the attention of the authorities. Low reporting rates notwithstanding, official data such as child protection referrals and recorded crime statistics provide valuable information on the numbers of children experiencing harm which come to the attention of professionals in any given year. In the UK, there has been a strong tendency to focus on child protection statistics while children as victims of crime remain largely invisible in annual crime reports and associated compendia. This is despite the implementation of a raft of policies aimed at improving the system response to victims and witnesses of crime across the UK. This paper demonstrates the utility of a more detailed analysis of crime statistics in providing information on the patterns of crime against children and examining case outcomes. Based on data made available by the Police Service for Northern Ireland, it highlights how violent crime differentially impacts on older children and how detection rates vary depending on case characteristics. It makes an argument for developing recorded crime practice to make child victims of crime more visible and to facilitate assessment of the effectiveness of current initiatives and policy developments. Copyright © 2013 John Wiley & Sons, Ltd.