Mosegaardmosegaard2093

We aimed to develop and validate an instrument to detect hospital medication prescribing errors using repurposed clinical decision support system data. Despite significant efforts to eliminate medication prescribing errors, these events remain common in hospitals. Data from clinical decision support systems have not been used to identify prescribing errors as an instrument for physician-level performance. We evaluated medication order alerts generated by a knowledge-based electronic prescribing system occurring in one large academic medical center's acute care facilities for patient encounters between 2009 and 2012. We developed and validated an instrument to detect medication prescribing errors through a clinical expert panel consensus process to assess physician quality of care. Six medication prescribing alert categories were evaluated for inclusion, one of which - dose - was included in the algorithm to detect prescribing errors. The instrument was 93% sensitive (recall), 51% specific, 40% precise, 62% accurate, with an F1 score of 55%, positive predictive value of 96%, and a negative predictive value of 32%. Using repurposed electronic prescribing system data, dose alert overrides can be used to systematically detect medication prescribing errors occurring in an inpatient setting with high sensitivity.The notion that procedural learning and memory is spared in Alzheimer's disease (AD) has important implications for interventions aiming to build on intact cognitive functions. However, despite these clinical implications, there are mixed findings in the literature about whether or not procedural learning remains intact. This meta-analysis examines the standard mean difference of all published studies regarding procedural learning in AD dementia or amnestic Mild Cognitive Impairment (aMCI) compared to cognitively healthy older adults. Additionally, we conducted statistical equivalence analyses. Our systematic review showed that only a limited number of studies (k = 17) have compared procedural learning between individuals with aMCI or AD dementia and healthy controls. Our meta-analysis, which synthesized these studies, demonstrated that while procedural learning performance was not statistically equivalent between individuals with aMCI or AD dementia, and healthy older adults, the difference was clinically and statistically trivial. Although larger studies are needed, the present findings suggest that procedural learning does appear to remain spared in aMCI and AD dementia.To establish a practical and convenient method to expand hematopoietic cells (HCs), we applied chemically-fixed stromal cell layers formed within three-dimensional (3D) scaffolds to feeder of HC cultures. The HCs were expanded using two successive cultures. check details First, stromal cells were cultured within porous polymer scaffolds and formed tissue-engineered constructs (TECs); the scaffolds containing stromal cells, were fixed using aldehyde (formaldehyde or glutaraldehyde) or organic solvents (acetone, methanol or ethanol). Second, mouse fetal liver cells (FLCs), as a source of HCs, were cultured on the TECs for 2 weeks, and the effects of fixative solutions on expansion of primitive HCs (c-kit+ and CD34+ cells) were examined. In the cultures on aldehyde-fixed TECs, primitive HCs were expanded 2.5- to 5.1-fold in the cultures on TECs fixed with glutaraldehyde, whereas no expansions were detected in those fixed with formaldehyde. However, we achieved expansion of primitive HCs > fivefold in the cultures using TECs fixed with organic solvents. Among these solvents, the highest expansions-of roughly tenfold-were obtained using acetone fixation. Ethanol-fixed TECs also supported the expansion of the primitive HCs well (6.6- to 8.0-fold). In addition to these sufficient expansions, the procedure and storage of fixed TECs is fairly easy. Thus, HC expansion on chemically-fixed TECs may be a practical method for expanding primitive HCs.With respect to water crisis, using urban wastewater to irrigate urban green spaces is an upcoming strategy. The pollution of lands irrigated with wastewater is one of the upcoming challenges. The main purpose of the present study was to investigate contamination indices of soils irrigated with wastewater. In this study, field experimental method in statistical form of totally random blocks with three reiterations for considered treatments was employed. To this end, one piece of three-hectare grass irrigated with wastewater and one piece of land irrigated with well water (control sample) were selected out of the green spaces of Zahedan refinery. Then, 30 compound samples were randomly taken from the depth of 0-50 cm of three lands' soil. The refinery wastewater outlet and wall water were also sampled. Physicochemical and biological features of wastewater, wall water and soil samples irrigated with the refinery wastewater and well water were measured according to the standard methods. The obtained data were anstatuses (0  less then  Igeo ≤ 1). Other elements were in non-contaminated status (Igeo ≤ 0) in terms of Igeo. The results of investigation of soil contamination indices showed that the soil contamination status of the study area due to wastewater irrigation was low to medium. Therefore, periodic and more accurate monitoring of wastewater treatment plant of Zahedan can be used from this wastewater for landscapes irrigation.

To investigate the effect of different maintenance to target on radiologic outcomes in patients with rheumatoid arthritis (RA) in real-world setting.

RA patients enrolled were screened from a longitudinal cohort. The radiographies were evaluated at baseline, after 1-2 years and thereafter every 2 years. An increase of mTSS > 3 from baseline was taken as the primary outcome and accelerated annual radiological progression as the secondary outcome of radiological progression. The maintenance rate (MR) to target was calculated as the proportion of the year fulfilling preset criteria of target over the whole follow-up period. COX regression and logistic analysis were used to determine the effect of variables on radiological outcomes.

Two hundred forty-three patients were enrolled, with median follow-up of 2 years (3.00). Radiological progression was observed in 43 (17.7%) patients, with annual increase of mTSS 0.20 (1.33). In multivariate analysis, MR was the only independent protective factor of both primary and secondary radiological outcomes in two models [HR 0.