bluuebunny/crossref_metadata_2025 huggingface dataset:
Biovera-Epi: A new database on species diversity, community composition and leaf functional traits of vascular epiphytes along gradients of elevation and forest-use intensity in Mexico
Authors: Guzmán-Jacob Valeria , Weigelt Patrick , Craven Dylan , Zotz Gerhard , Krömer Thorsten , Kreft Holger
Published: October 2021

This data paper describes a new, comprehensive database (BIOVERA-Epi) on species distributions and leaf functional traits of vascular epiphytes, a poorly studied plant group, along gradients of elevation and forest-use intensity in the central part of Veracruz State, Mexico. The distribution data include frequencies of 271 vascular epiphyte species belonging to 92 genera and 23 families across 120 20 m × 20 m forest plots at eight study sites along an elevational gradient from sea level to 3500 m a.s.l. In addition, BIOVERA-Epi provides information on 1595 measurements of nine morphological and chemical leaf traits from 474 individuals and 102 species. For morphological leaf traits, we provide data on each sampled leaf. For chemical leaf traits, we provide data at the species level per site and land-use type. We also provide complementary information for each of the sampled plots and host trees. BIOVERA-Epi contributes to an emerging body of synthetic epiphytes studies combining functional traits and community composition.

BIOVERA-Epi includes data on species frequency and leaf traits from 120 forest plots distributed along an elevational gradient, including six different forest types and three levels of forest-use intensity. It will expand the breadth of studies on epiphyte diversity, conservation and functional plant ecology in the Neotropics and will contribute to future synthetic studies on the ecology and diversity of tropical epiphyte assemblages.
First successful hybridization experiment between native European weatherfish (Misgurnus fossilis) and non-native Oriental weatherfish (M. anguillicaudatus) reveals no evidence for postzygotic barriers
Authors: Wanzenböck Josef , Hopfinger Mathias , Wanzenböck Sylvia , Fuxjäger Lukas , Rund Hans , Lamatsch Dunja K.
Published: October 2021

The European weatherfish Misgurnus fossilis (Linnaeus, 1758) is a threatened freshwater species in large parts of Europe and might come under pressure from currently establishing exotic weatherfish species. Additional threats might arise if those species hybridize which has been questioned in previous research. Regarding the hybridization of M. fossilis × M. anguillicaudatus (Cantor, 1842), we demonstrate that despite the considerable genetic distance between parental species, the estimated long divergence time and different ploidy levels do not represent a postzygotic barrier for hybridization of the European and Oriental weatherfish. The paternal species can be easily differentiated based on external pigment patterns with hybrids showing intermediate patterns. No difference in standard metabolic rate, indicating a lack of hybrid vigour, renders predictions of potential threats to the European weatherfish from hybridization with the Oriental weatherfish difficult. Therefore, the genetic and physiological basis of invasiveness via hybridization remains elusive in Misgurnus species and requires further research. The existence of prezygotic reproductive isolation mechanisms and the fertility of F1 hybrids remains to be tested to predict the potential threats of globally invasive Oriental weatherfish species.
Comparing environmental impacts of alien plants, insects and pathogens in protected riparian forests
Authors: Lapin Katharina , Bacher Sven , Cech Thomas , Damjanić Rok , Essl Franz , Georges Freya-Isabel , Hoch Gernot , Kavčič Andreja , Koltay András , Kostić Saša , Lukić Ivan , Marinšek Aleksander , Nagy László , Agbaba Sanja Novak , Oettel Janine , Orlović Saša , Poljaković-Pajnik Leopold , Sallmannshofer Markus , Steinkellner Martin , Stojnic Srdjan , Westergren Marjana , Zlatkovic Milica , Zolles Anita , de Groot Maarten
Published: October 2021

The prioritization of alien species according to the magnitude of their environmental impacts has become increasingly important for the management of invasive alien species. In this study, we applied the Environmental Impact Classification of Alien Taxa (EICAT) to classify alien taxa from three different taxonomic groups to facilitate the prioritisation of management actions for the threatened riparian forests of the Mura-Drava-Danube Biosphere Reserve, South East Europe. With local experts we collated a list of 198 alien species (115 plants, 45 insects, and 38 fungi) with populations reported in southeast European forest ecosystems and included them in the EICAT. We found impact reports for 114 species. Eleven of these species caused local extinctions of a native species, 35 led to a population decrease, 51 to a reduction in performance in at least one native species and for 17 alien species no effects on individual fitness of native species were detected. Fungi had significantly highest impact and were more likely to have information on their impacts reported. Competition and parasitism were the most important impact mechanisms of alien species. This study is, to our knowledge, the first application of EICAT to all known alien species of several taxonomic groups in a protected area. The impact rankings enabled to identify taxa that generally cause high impacts and to prioritize species for the management in protected areas according to their impact magnitudes. By following a standardized impact protocol, we identified several alien species causing high impacts that do not appear on any expert-based risk list, which are relevant for policymakers. Thus, we recommend that alien species be systematically screened to identify knowledge gaps and prioritize their management with respect to spatio-temporal trends in impact magnitudes.
La reconfiguration d’un modèle d’affaires : une analyse de la hiérarchisation des composantes dans une organisation publique certifiée ISO 9001
Authors: Dagou Dagou Hermann-Wenceslas
Published: October 2021

L’innovation dans le management public s’offre de multiples voies comme l’importation d’un système de management de la qualité. Ce système devenu le modèle d’affaires initial, a eu tendance à reconfigurer par le biais de l’activité les composantes d’un modèle d’affaires. Cette recherche qualifie les configurations hiérarchiques des composantes d’un modèle d’affaires dans une organisation publique après quinze ans de pratiques de certification de type ISO 9001. Partant d’un cas singulier en Afrique de l’Ouest, un repérage est établi entre la théorie de l’activité et le modèle d’affaires. Les données sont analysées par la méthode procustéenne pour ressortir la reconfiguration hiérarchique des composantes. Les résultats montrent une priorité accordée au renforcement des réseaux avec les clients, ensuite des modalités de répartition des retombés entre la direction et les agents, puis la coproduction de la valeur entre direction et client et enfin l’organisation d’un percolât aux interfaces entre agents et clients.
La guerre du Golfe, première guerre info-centrée
Authors: Mazzucchi Nicolas
Published: October 2021

L’information a été au cœur de la guerre du Golfe avec, d’une part la conduite info-centrée des opérations, modifiant en profondeur les modes d’action et, d’autre part les médias, acteurs à part entière. La donnée numérique est essentielle, phénomène accru désormais par les réseaux sociaux. L’information est devenue centrale.
Les effets de la guerre du Golfe sur le positionnement de la France à l’égard de l’Otan
Authors: de Rougé Guillaume
Published: October 2021

La guerre du Golfe a obligé la France à revoir sa position face à l’Otan. La volonté française d’une Europe plus autonome pour sa défense a été contrecarrée tant par les États-Unis que les autres pays européens, peu enclins à appuyer les projets de Paris, développant ainsi une contradiction croissante entre ambitions et réalités.
Du Golfe à Sarajevo : héritage de Daguet et perspectives pour la haute intensité
Authors: Jordan Frédéric
Published: October 2021

Daguet fut une opération de haute intensité dont les enseignements ont été fructueux dès 1992 avec l’engagement en ex-Yougoslavie, même si les modes d’action se révélèrent peu efficaces, en raison des choix politiques de l’époque. Aujourd’hui encore, les leçons demeurent utiles.
La guerre du Golfe : un précédent qui continue de façonner la structure de commandement française
Authors: Pena Louis
Published: October 2021

La guerre du Golfe a entraîné de profondes évolutions pour les armées françaises, ayant pris conscience de lacunes structurelles. Aujourd’hui encore, la structure de commandement national a été nettement améliorée, permettant à la France de démontrer une grande efficacité dans la conduite des opérations.
Les conséquences de la guerre du Golfe sur le modèle de l’Armée de terre
Authors: Delion Michel
Published: October 2021

L’expérience de Daguet a transformé l’Armée de terre en soulignant le besoin de formation des officiers à la manœuvre interarmées, en s’appuyant sur l’excellence et la rusticité de ses soldats, tout en assurant le renouvellement des capacités. Aujourd’hui, le retour de la haute intensité s’appuie sur ces décennies d’expérience.
La Marine et la guerre du Golfe : de la gestion de crise à l’action contre terre
Authors: Guillemin Dominique
Published: October 2021

La Marine nationale, bien qu’engagée durant la guerre du Golfe, a eu le sentiment d’une certaine marginalisation. Elle a alors entrepris une profonde mutation, tirant les leçons de ce conflit. Cette modernisation lui a permis de retrouver une capacité majeure de projection de force autour du porte-avions.
The Hip–Spine Connection: How to Differentiate Hip Conditions From Spine Pathology
Authors: Ashberg Lyall , Close Mary R. , Perets Itay , Walsh John P. , Chaharbakhshi Edwin O. , Domb Benjamin G.
Published: October 2021

Practitioners treating spine pathology commonly encounter patients with hip pain. These patients frequently manifest groin, buttock, trochanteric, or knee pain. Complex biomechanical interaction between the axial and the appendicular skeleton may result in compensatory adaptation. Cross-innervation of the hip and surrounding tissues may make diagnosis of the primary source difficult, leading to delayed diagnosis. This review elucidates the interaction between the hip and the spine and can assist clinicians in recognizing the hip as a potential source of pain. Diagnostic guidelines enabling a streamlined workup of patients presenting with confusing symptoms related to the hip that masquerade as a spine disorder are presented. [
Orthopedics
. 2021;44(6):e699–e706.]
Risk Factors for Mortality Associated With Pelvic Fractures at a Level I Trauma Center
Authors: Chung Hoe Jeong , Kim Doo Sup , Kwon Hye Youn , Bae Keum Seok , Park Jisu
Published: October 2021

Pelvic bone fractures are usually caused by high-energy trauma and are often accompanied by organ injuries. For hemodynamically unstable patients with pelvic bone fractures, knowing the anatomic type of fracture—whether it is a pelvic ring injury or an acetabular fracture—might be helpful in prioritizing treatment. A total of 302 patients with pelvic bone fractures who received treatment at the authors' level I trauma center between March 1, 2015, and February 28, 2017, were included in this study. Patients with pelvic bone fractures were enrolled in the Korea Trauma Data Bank and classified by anatomic type of pelvic bone fracture: pelvic ring injury, acetabular fracture, or combined fractures. The authors used
t
tests to analyze survival and death groups and multivariate regression to analyze mortality factors. Different types of pelvic bone fractures had significantly different mortality rates (
P
<.001). Forty-four (22.6%) of 195 patients with pelvic ring injuries and 6 (18.8%) of 32 patients with combined fractures died. Meanwhile, only 1 of 75 patients with isolated acetabular fractures died (1.3%). The mortality rate was lowest for type A pelvic ring injuries (8.2%) and highest for type C pelvic ring injuries (68.2%). The difference was statistically significant (
P
<.001). It is commonly acknowledged that age, combined injuries, higher Injury Severity Score, and lower initial systolic blood pressure are risk factors for mortality, but research has shown that classification and anatomic type of pelvic bone fracture are also highly related. [
Orthopedics
. 2021;44(6):e724–e728.]
Short-term Outcomes of Concomitant Femoral Derotation Osteotomy and Hip Arthroscopy
Authors: Shapira Jacob , Kyin Cynthia , Rosinsky Philip J. , Maldonado David R. , Meghpara Mitchell B. , Ankem Hari K. , Lall Ajay C. , Domb Benjamin G.
Published: October 2021

The goal of this study is to report the short-term outcomes of concomitant hip arthroscopy and femoral derotational osteotomy (FRO) to treat femoral malrotation and intra-articular pathology. Data were retrospectively reviewed for patients undergoing concomitant hip arthroscopy and FRO between March 2013 and January 2017. Patients were included if they had a minimum of 1 year of follow-up for modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score-Sports Specific Subscale (HOS-SSS), International Hip Outcome Tool (iHOT-12) score, 12-item Short Form Health Survey Physical component and Mental component (SF-12 P and SF-12 M, respectively) scores, Veterans RAND 12-item Health Survey Physical and Mental (VR-12 P and VR-12 M, respectively) scores, visual analog scale (VAS) score for pain, and patient satisfaction ratings. Rates for meeting the patient acceptable symptomatic state (PASS) and minimal clinically important difference (MCID) were also recorded. Nine hips were included, and mean follow-up was 36.9 months. Mean preoperative femoral version was 33.0°. Patients underwent 1 or more concomitant procedures, such as labral treatment, capsular plication, acetabuloplasty, or femoroplasty. At latest follow-up, significant improvement was seen for mHHS, NAHS, HOS-SSS, and VAS score. Additionally, rates of meeting the PASS for mHHS, iHOT-12 score, and HOS-SSS were 100%, 88.9%, and 55.6%, respectively. Rates of achieving MCID for mHHS and HOS-SSS were 77.8% and 66.7%, respectively. One hip required revision derotational osteotomy to treat overcorrection, and 3 hips underwent secondary surgery for hardware removal. Concomitant hip arthroscopy and FRO may yield improved outcomes for patients with concurrent intra-articular pathology and excessive femoral anteversion. Considering that no major complications were diagnosed, this procedure is also relatively safe. [
Orthopedics
. 2021;44(6):e739–e746.]
Current Applications of Pediatric Abdominal Point-of-Care Ultrasound
Authors: Marks Amy , Hartrich Molly , Colla Joseph , Gottlieb Michael
Published: October 2021

Point-of-care ultrasound (POCUS) for pediatric abdominal symptoms has expanded in both the inpatient and outpatient settings. POCUS may be used to aid in the diagnosis of appendicitis, hypertrophic pyloric stenosis, and intussusception in the pediatric population. This article reviews the benefits of POCUS for the diagnosis of these pediatric pathologies. This article also provides instruction on how to perform these important examinations.

[
Pediatr Ann
. 2021;50(10):e419–e423.]
Evaluation of hydrogel use in the development of Rapanea ferruginea with water restriction by vibrational Fourier Transform Infrared Spectroscopy (FTIR-UATR)
Authors: Pereira Douglas Cubas , Pupin Breno , Sakane Kumiko Koibuchi
Published: October 2021

This study evaluated the use of hydrogel on the development of Rapanea ferruginea under water restriction through Vibrational Fourier Transform Infrared Spectroscopy (FTIR-UATR). Seedlings of approximately 30 cm height were transferred in pots with 3 L of soil. The group of seedlings was separated into 5 different triplicate treatments according to the amount of hydrogel, as follows: H1 (25%), H2 (20%), H3 (15%), H4 (10%) and S (control without hydrogel). The applied hydrogel was mixed homogeneously with the soil. All treatments were irrigated with 40 mL of water. FTIR spectra were obtained from fresh leaves collected during 13 months of monitoring. The correlation of the hydroxyl (water) band with the main biomolecules between treatments with the control was evaluated using the Mann-Whitney test (p<0.05). The biomolecule bands were subjected to principal component analysis (PCA) and hierarchical clustering analysis (HCA). The results indicate a significant correlation of the water band with the lipid, hemicellulose, cell wall and starch components in the species. The use of hydrogel resulted in a significant difference in the water absorption band in relation to the control group through the Mann-Whitney test and in biomolecules as the HCA and PCA analysis suggested. The best development was observed in groups H4 (10%), H2 (20%) and H3 (15%). The use of hydrogel positively influences the biomolecular development of the Rapanea ferruginea and monitoring is viable by FTIR.

Keywords: FTIR infrared spectroscopy, plant water management, superabsorbent polymer.
Evaluation of Antibiotic Prescribing in a Veterans Affairs Outpatient Setting: Identification of Stewardship Targets
Authors: Clark Collin M. , White Alexis T. , Sellick John A. , Mergenhagen Kari A.
Published: October 2021

OBJECTIVE: To evaluate antibiotic prescribing practices for geriatric outpatients in a Veterans Affairs (VA) health care system.
 DESIGN: This is a single-center, observational, prospective cohort study.
 SETTING: Veterans Affairs Healthcare
System.
 PATIENTS: Outpatients treated with oral antibiotics between June and September 2017.
 INTERVENTIONS: None.
 MAIN OUTCOME MEASURE(S): Appropriate therapy was assessed based on clinical practice guidelines. Multivariable logistic regression
was used to identify predictors of appropriate treatment.
 RESULTS: This study yielded 1,063 prescriptions for analysis. No significant difference was observed for antibiotic indicated (60%), correct drug (50%), or correct duration (75%). Patients older than 65 years of age
were more likely to receive an inappropriate dose (86% vs. 76%; P < 0.002). In the multivariable analysis, patients with chronic obstructive pulmonary disease (COPD) were more than 1.4 times likely to be treated appropriately (95% confidence interval 1.03-1.9) versus those without
COPD. Older patients were not more likely to be re-treated or admitted within 30 days.
 CONCLUSION: Antibiotics are often inappropriately used in the outpatient setting; but not more frequently in elderly patients. Older adults were more likely to be prescribed an antibiotic
at an inappropriate dose. Opportunities exist for stewardship teams to provide value in the outpatient setting to ensure appropriate antibiotic prescribing with a focus on dosing.
Impact of the Pharmacists' Patient Care Process on Medication Adherence in Older Adults With Multimorbidity
Authors: Whittaker Chanel F. , Nelson Stephanie A. W. , Tom Sarah E.
Published: October 2021

OBJECTIVE: To determine whether the pharmacistled Geriatric Education and Medication Management (GEMM) clinic utilizing the Pharmacists' Patient Care Process (PPCP) improves therapeutic and safety outcomes in ambulatory older adults. DESIGN/PATIENTS: This is a retrospective,
case series of veterans newly enrolled into the GEMM clinic from September 2013 to September 2015. SETTING: This study was conducted in an ambulatory pharmacist-led clinic at the Baltimore Veteran Affairs Medical Center in Maryland. INTERVENTION: Demographic, clinical, laboratory,
and pharmacy fill data were collected from the computerized patient record system. Medication use patterns were collected using the clinic's supplemental medication reconciliation flowsheet. Descriptive statistics were used to analyze data. MAIN OUTCOME MEASURE(S): Change in adherence
rate, number of potentially inappropriate medications, and number of care transitions within the 12-month study period. RESULTS: The primary outcome of medication adherence was high throughout the 12-month study period; beginning at 91.1% at baseline and increasing to 99.0% by the fourth
quarter. There was a 36.4% decrease in number of potentially inappropriate medications (PIMs) from 22 at baseline to 14 at 12 months. Medication-related, short-term care transitions decreased from 10 to 4 in the pre- to post-clinic enrollment time frame. Only one subject experienced a long-term
care transition during the study period. CONCLUSIONS: Implementing the PPCP in the pharmacist-led GEMM clinic improved medication adherence and persistence, decreased number of PIMs, and assisted in preventing care transitions in ambulatory older adults with multimorbidity and polypharmacy.
The View from the Emergency Department: An Emergency Medicine Pharmacist's Perspective
Authors: Doran Elizabeth
Published: October 2021

A medication-focused review of older patients in the emergency department is important in identifying medication-related problems, differential diagnoses, and associated complications. With rapid triage, assessment, and diagnosis, the emergency department is inherently an area of empirical
prescribing. Emergency department pharmacists are uniquely placed to review patients on presentation with a focus on both acute problem management and identifying and addressing long-standing medication issues.
Diabetic Eye Disease: Advancements in Technology, Detection, and Access to Care
Authors: Lyford Trevor , Sheppard John
Published: October 2021

OBJECTIVE: To educate pharmacists on advancements in, detection of, and access to care for diabetic eye disease (DED) by reviewing the etiologies, treatment options, and technological evolution in teleophthalmology for DED.
 DATA SYNTHESIS: The literature included
review articles, original research articles, treatment information, and advancements in teleophthalmology for DED.
 CONCLUSION: DED encompasses a group of eye conditions that affect people with diabetes, which primarily includes diabetic retinopathy and diabetic macular edema
but may also include cataracts, ocular surface disease, and glaucoma. Emerging technologies with retinal imaging tools and artificial intelligence have increased access to care for diabetic people with diabetes in many studies. Pharmacists familiar with diabetic screening advancements can
work closely with primary care physicians and ophthalmologists to better educate patients on treatment regimens.
Reducing 30-Day All-Cause Rehospitalizations: A Pharmacist-Led Telehealth Service
Authors: Kleven Casondra , Postolski Joshua , Hein Brad , Brown Bethanne
Published: October 2021

BACKGROUND: Use of skilled nursing facilities (SNFs) has grown as an intermediary step for patients unready to discharge to lower acuity care settings. Discharge planning from SNFs has become a critical component of the care continuum and may impact patient outcomes and facility
payment status. Currently, the discharge process does not include a pharmacist-led comprehensive medication review.
 OBJECTIVES: To determine the impact of a pharmacistdriven discharge consultation service on 30-day allcause rehospitalization. Secondary outcomes included hospital
readmission diagnosis, discharge consultation times, number of pharmacist interventions, and patient satisfaction.
 METHODS: The institutional review board approved this prospective cohort with a historical control pilot study to evaluate patients discharging from SNFs. Patients
who provided informed consent were enrolled to participate in a video consultation service at the time of discharge. The primary outcome measured was 30-day hospital readmission rate postdischarge compared with one year prior.
 RESULTS: One hundred ninety-six counseling sessions
were performed at three facilities. The average time per discharge was 15.4 ± 3.3 minutes, average number of medications was 15.5 ± 6.2, and average Charlson Comorbidity Index was 5.6 ± 2.2. Patient readmission data were tracked by diagnosis and reported by facility.

CONCLUSION: A positive correlation between reduced readmission rates and participation in consultation service were observed. Second, positive patient satisfaction surveys indicated patients value medication education. The use of a pharmacist-led telehealth service like the one described
in this study may lead to a reduction in facility readmission penalties and improve patient access to pharmacist services in remote locations.
Empathy or Empath? increasing Self-Awareness for Healthy Patient-Provider interactions
Authors: Hilas Olga
Published: October 2021

Dr. Olga Hilas, associate professor from St. John's University, reflects on her Pain Management Traineeship with the American Society of Consultant Pharmacists Foundation.
A Review of Beta-Blocker Toxicity and Management Strategies
Authors: Colunga Kayla N. , Reinert Justin P.
Published: October 2021

In 2017, a total of 26,431 beta-blocker exposures were reported to United States poison centers, with 21% of adult exposures attributed to patients 60 years of age and older. Beta-blockers are a major component of therapy in numerous cardiovascular diseases, which have a higher incidence
in older people. Along with polypharmacy and neurocognitive decline, potentially limiting reliable medication adherence, older patients may be more sensitive to the hypotensive and bradycardic effects of beta-blockers. Additionally, because of a lack of success of traditional management methods,
evidence of newer therapies such as highdose insulin euglycemia therapy and intravenous lipid emulsion has shown success in various patient cases. This review seeks to summarize the mechanisms and effects of beta-blocker toxicity and review management strategies in older people.
Close to Home
Authors: Baldwin Paul
Published: October 2021

Nursing facilities have suffered the double injury of an immediate reduction in occupancy and the reputational harm of the high number of COVID-19 deaths and infections.
ASCP's Long Journey With DEA
Authors: Baldwin Paul
Published: October 2021

The Drug Enforcement Administration has agreed to publish a proposed rule that, if approved, would give nurses the legal authority to contact the pharmacy on behalf of the prescriber concerning controlled substances.
Improving Medication Management by Understanding Patient and Caregiver Preferences for Medication Packaging
Authors: Chou Joshua , Lee Merton , Kaminsky Taylor , Namvar Tarlan , Cooke Catherine E. , Brandt Nicole J.
Published: October 2021

OBJECTIVE: To assess older adults' perceptions and preferences when comparing multi-medication packaging products.
 DESIGN: Qualitative study involving focus group interviews (FGIs) and key informant interviews (KIIs).
 SETTING: Interviews were
conducted in multiple cities within the United States during June-July 2019.
 PATIENTS, PARTICIPANTS: FGI participants (N=36) included community dwelling adults, 65 years of age or older, who took 5+ chronic medications, or their caregivers. KII participants (N=15) included
health care professionals caring for similar populations.
 INTERVENTIONS: Participants were given samples of blister packs and pouches and asked about medication management and appearance and usability of medication packaging. Interviews were audio-recorded with participants'
consent, then transcribed and coded using Atlas. ti. Recurrent and emergent themes were identified, and selected quotes served as examples of identified themes.
 MAIN OUTCOME MEASURE: Participants' perceptions regarding medication packaging.
 RESULTS: Participants'
preferences varied for different multi-medication packaging systems. Similarly, most FGI participants did not communicate a strong attitude for or against their existing management systems. However, many FGI participants perceived a need for larger font size than seen on the either of the
multimedication packaging samples. KII participants also preferred a larger font size on both packagings. KII participants thought the blister packs offered better visual organization and enabled caregivers to quickly assess adherence. However, KII participants expressed concern about integrating
as-needed and short-term use medications and noted difficulty opening both types of packages.
 CONCLUSION: Visual appearance is important to both patients and health care providers. Continued research in this area is vital for tailoring packaging types and technology to patients.
Kevin Fearon 2020-2021 ASCP PRESIDENT
Authors: Scheina Carol
Published: October 2021

With more than 3 decades of experience in the institutional pharmacy field, Kevin Fearon steps into the role of the ASCP President with a keen desire to help pharmacy and business leaders collaborate toward a common goal of helping care for older people.
Impact of COVID-19 Pandemic on Pharmacy Education in Malaysia and Indonesia
Authors: Efendie Benny , Abdullah Ibrahim , Yusuf Eddy
Published: October 2021

The pandemic has affected all walks of life and businesses, including education at all levels. Movement controls have forced the schools and universities to migrate the teaching and learning to be fully online. Some universities in large cities in Malyasia had already implemented blended
learning and thus, were better prepared to adjust to the current situation. However, the universities, which practiced mainly traditional didactic courses, were struggling to suddenly change the mode of delivery. Many relied on the creativity of the lecturers and students.
Covid-19 pandemic: chronicle of responses and experiences of the infection prevention and control committee at a tertiary hospital in southwest Nigeria
Authors: Ayodeji Akinbodewa Akinwumi , Simidele Odimayo Michael , Akinbode Ogundele Olorunfemi , Oluwapelumi Ogunleye Tosin , Olayinka Johnson Olanrewaju , Abiola Lamidi Oluwakemi , Akinmurele Mathew , Motunrayo Oyebade Oluwabunmi
Published: October 2021

Since the advent of 2019-Corona virus Disease (COVID-19) in Nigeria in February 2020, the number of confirmed cases has risen astronomically to over 61,307 cases within 8 months with more than 812 healthcare workers infected and some recorded deaths within their ranks. Infection prevention and control is a key component in ensuring safety of healthcare workers in the hospital as health- care-associated infection is one of the most common complications of healthcare management. Unbridled transmission of infection can lead to shortage of healthcare personnel, reduced system efficiency, increased morbidity and mortality among patients and in some instances, total collapse of healthcare delivery services. The Infection Prevention and Control Committee is a recognised group by the Centre for Disease Control and Prevention with their core programmes including drawing up activities, procedures and policies designed to achieve above-stated objectives before, during and after any disease outbreak, especially emerging and re-emerging ones such as the 2019 Coronavirus Disease. In this report, we highlight the roles played by the Infection Prevention and Control Committee of the University of Medical Sciences Teaching Hospital to prevent the spread of COVID-19 within and outside the hospital community and the lessons learned to date.

Keywords: COVID-19; infection prevention; infection control; Nigeria.
Insecticide resistance of Dengue vectors in South East Asia: a systematic review
Authors: Rohaizat Hassan Mohd , Atika Azit Noor , Mohd Fadzil Suhaiza , Abd Ghani Siti Rasidah , Ahmad Norfazilah , Mohammed Nawi Azmawati
Published: October 2021

Background: The insecticides used widely has led to resistance in the vector and impose a challenge to vector control op- eration.

Objectives: This review aims to analyse the distribution of insecticide resistance of dengue vectors in South East Asia and to describe the mechanism of insecticide resistance.

Methods: Literature search for articles published on 2015 to 2019 from PubMed, Scopus and ProQuest was performed. Total of 37 studies included in the final review from the initial 420 studies.

Results: Pyrethroid resistance was concentrated on the west coast of Peninsular Malaysia and Northern Thailand and scat- tered at Java Island, Indonesia while organophosphate resistance was seen across the Java Island (Indonesia), West Sumatera and North Peninsular Malaysia. Organochlorine resistance was seen in Sabah, Malaysia and scattered distribution in Nusa Tenggara, Indonesia. V1016G, S989P, F1269C gene mutation in Aedes Aegypti were associated with Pyrethroid resistance in Singapore and Indonesia. In Malaysia, over-expressed with monooxygenase P450 genes (CYP9J27, CYP6CB1, CYP9J26 and CYP9M4) Glutathione S-transferases, carboxylesterases commonly associated with pyrethroids resistance in Aedes Aegypti and CYP612 overexpressed in Aedes Albopictus. The genetic mutation in A302S in Aedes Albopictus was associated with organochlorine resistance in Malaysia.

Conclusions: Rotation of insecticide, integration with synergist and routine assessment of resistance profile are recom- mended strategies in insecticide resistance management.

Keywords: Insecticide resistance; vector management; Aedes; pyrethroid; mortality.
Assessment of hepatitis B surface antigen negative blood units for HBV DNA among replacement blood donors in a hospital based blood bank in Nigeria
Authors: Atinuke Fasola Foluke , Fowotade Adeola , Faneye Adedayo
Published: October 2021

Background: Hepatitis B virus infection is one of the greatest threats to blood safety all over the world. The laboratory algorithm based on only the detection of hepatitis B surface antigen (HBsAg) leaves a gap for infected HBsAg negative donors to donate blood during the “window period” (WP) and late stages of infection.

Objective: To estimate the frequency of the presence of HBV deoxyribonucleic acid (DNA) in HBsAg negative blood units screened using two different assays for HBsAg in a high endemic region.

Methods: Frozen serum aliquot of 100 replacement blood donors who donated blood units that were HBsAg negative were retrieved and tested for HBV DNA. Sample positive for HBV DNA was sequenced by Sanger’s method, genotyped and the viral load was determined.

Results: One sample (1%) was positive for HBV DNA. The HBV viral load of the sample was 768,000 IU/ml. The partial S-gene of the Hepatitis B virus isolated was genotype E using the NCBI viral genotyping tool.

Conclusions: There is still a risk of HBV infected blood unit escaping detection when donor testing is limited to HBsAg screening. The use of NAT which can substantially reduce HBV infected blood donors from the donor pool should be considered.

Keywords: Hepatitis B surface Antigen; Hepatitis B Virus; DNA; blood donors; blood safety.
Increased ambulatory arterial stiffness index and blood pressure load in normotensive obese patients
Authors: Kaplan Efe Fatma , Tek Mujgan , Etu Hastanesi̇ Tobb
Published: October 2021

Objectives: It has been shown that blood pressure (BP) values measured in obese subjects are higher than the individuals with normal weight, even in normotensive limits. However, data concerning the Ambulatory Arterial Stiffness Index (AASI) and blood pressure load in normotensive obese subjects is lacking. This study was aimed to compare the ambulatory arterial stiffness index and blood pressure load in normotensive obese and healthy controls.

Methods: One hundred normotensive obese and one hundred normal weight subjects were included in this study. All sub- jects underwent 24-hour ambulatory blood pressure monitoring. Ambulatory arterial stiffness index was calculated from 24-hour ambulatory blood pressure monitoring records. Ambulatory arterial stiffness index was defined as one minus the regression slope of unedited 24-h diastolic on systolic blood pressures. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) load values were calculated from 24-hour ambulatory blood pressure monitoring analysis.

Results: Ambulatory arterial stiffness index of the obese subjects was significantly higher than the healthy controls (0.48±0.2 vs. 0.33±0.11, p<0.001). 24-hours systolic blood pressure and diastolic blood pressure loads were significantly higher in obese subjects. Logistic regression analysis revealed that body mass index (BMI) was an independent predictor for an abnor- mal ambulatory arterial stiffness ındex (≥0.50) (OR: 1.137, 95% CI: 0.915-1.001, p=0.004).

Conclusion: Blood pressure load and ambulatory arterial stiffness index are increased in normotensive obese patients. Moreover, body mass index is an independent predictor for an abnormal ambulatory arterial stiffness index. Our results indicate that obese subjects are at higher risk for future cardiovascular events despite normal office BP levels.

Keywords: Ambulatory arterial stiffness index; blood pressure load; obesity; blood pressure.
Aerobic versus resistance exercises on systemic inflammation and sleep parameters in obese subjects with chronic insomnia syndrome
Authors: H Al-Jiffri Osama , M Abd El-Kader Shehab
Published: October 2021

Background: Chronic primary insomnia is a prevalent sleep disorder that is associated with adverse effects on health out- comes. Exercise is often considered a non-pharmacological approach that could have beneficial effects on sleep.

Objective: The aim of the study was to compare the impact of aerobic and resistance exercise training on quality of sleep and inflammatory markers among subjects with chronic primary insomnia.

Material and Methods: Sixty previously sedentary subjects with chronic primary insomnia subjects enrolled in this study, their age ranged from 31-52 years. All participants were randomly assigned to aerobic exercise intervention group (group A, n=35) or resistance exercise intervention group (group B, n=35). Polysomnographic recordings for sleep quality assessment, IL-6, IL-10 and TNF-α were measured before and at the end of the study after six months.

Results: There was a significant increase in the total sleep duration, sleep efficiency, sleep onset latency and IL-10 in group(A) and group (B) in addition to significant reduction in awake time after sleep onset, REM latency, IL-6 and TNF-α after 6 months of aerbic and resistance exercise training. However, there were significant differences between both groups at the end of the study.

Conclusion: Aerobic exercise training is more appropriately than resistance exercise training in modulation of inflammatory and sleep quality among subjects with chronic primary insomnia.

Keywords: Aerobic exercise; chronic primary insomnia; inflammatory cytokines; resistance exercise; sleep quality.
Prognostic significance of the preoperative neutrophil-to-lymphocyte ratio patients with giant cell tumor of bone
Authors: Yapar Aliekber , Burak Atalay Ismail , Ali Tokgoz Mehmet , Ulucakoy Coskun , Safak Gungor Bedii
Published: October 2021

Objective: To evaluate the prognostic significance of neutrophil-to-lymphocyte ratio (NLR) in giant cell tumor of bone (GCT).

Methods: The patients with GCT were identified in the hospital records and pre-treatment complete blood count results were acquired retrospectively. Whether preoperative NLR lymphocyte-to-monocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR) values had prognostic significance in predicting recurrence was evaluated by Receiver operating curve (ROC) analysis. Furthermore, the prognostic value of NLR was evaluated by Multivariable Cox Regression analysis.

Results: There were 96 patients with GCT. It was found that only NLR values had prognostic significance for predicting recurrence (AUC:0.647; 95% CI:0.533-0.762; P=0.021). The statistically significant cut-off value of NLR for predicting re- currence was ≥2.25.NLR was ≥2.25 in 51% (n = 49) of patients. Multivariable analysis showed that NLR ≥2.25 (HR=2.9, 95% CI:1.3-6.6; p=0.009) and lung metastasis (HR=7.9, 95% CI:2.2-28.2; p=0.001) were independent factors of recurrence. In patients with lung metastasis and patients with NLR ≥2.25, recurrence was observed in a sooner period (Log rank test; p=0.001; p=0.009, respectively).

Conclusion: Our findings showed that NLR is a new and promising inflammation-based prognostic factor in GCT patients.

Keywords: Giant cell tumor of bone; neutrophil-to-lymphocyte ratio; prognostic significance.
Ingestion of supplements and fortified food with iodine on the breast milk iodine concentration in deficiency areas: a systematic review
Authors: Abudo Leite Machamba Almeida , Eloiza Priore Silvia , De Souza Macedo Mariana , Do Carmo Castro Franceschini Sylvia
Published: October 2021

Introduction: The level of iodine in breast milk may be inadequate and compromise the health of this, both due to excess and lack, some population groups remain deficient because of the low consumption of iodate salt, because there is an in- crease in consumption of other sources of iodine, such as supplements and fortified foods.

Objective: To evaluate the effect of the consumption of fortified foods and nutritional supplements with iodine on mater- nal milk levels.

Methodology: Systematic review based on the Prism method, using the descriptors provided by DeCS. The reading, selec- tion and analysis of the methodological quality of the articles was done by two researchers independently.

Results: From 346 abstracts, 6 were eligible. The median iodination range between the studies ranged from 75 to 600 μg in supplements and 150 and 225 μg in fortified foods with effect on increased iodine concentration of breastmilk (BMIC), achieving the adequacy of the median BMIC in 4 of the 6 studies.

Conclusion: Iodine ingestion through supplements or fortified foods results in improved iodine levels in breast milk.

Keywords: Iodine; supplements; fortified foods; breastmilk; iodine concentration.
Suicidal tendencies and its association with psychoactive use predictors among university students in Uganda: a cross-sectional study
Authors: Wesonga Sheila , Osingada Charles , Nabisere Allen , Nkemijika Stanley , Olwit Connie
Published: October 2021

Background: Globally, suicide is one of the leading causes of death, and approximately 80% of all suicides occur in low- and middle-income countries. Younger people in Africa are at a higher risk of suicide than others.

Objective: To describe the prevalence and factors associated with suicidal tendencies among undergraduate university stu- dents using alcohol and other psychoactive substances.

Methods: Convenient sampling was used to identify 400 students who participated in the study. Socio-demographic and Mini-International Neuropsychiatric Interview tools were used to obtain information. Data were analyzed using SAS 9.4 and presented in descriptive and inferential statistics.

Results: Among the respondents, 80% were male, and 85% were using marijuana. 6.3% had suicidal tendencies. Respond- ents from the northern region had more suicidal tendencies than other regions, and unemployed students had more suicidal tendencies than those employed. After multivariate analysis, being abusive and dependent on other psychoactive substances was associated with suicidality. And having dependence on both alcohol and other psychoactive substances was associated with suicidality.

Conclusion: Suicidality screening and psychosocial support should be provided to this vulnerable population. Efforts There is a need to strengthen, implement more effective preventive strategies to reduce the use of alcohol and other psychoactive substances.

Keywords: Suicidal tendencies; psychoactive use; university students; Uganda.
Burnout and quality of life among nurses working in selected mental health institutions in South West Nigeria
Authors: A Alabi Morufat , G Ishola Adeyinka , C Onibokun Adenike , O Lasebikan Victor
Published: October 2021

Background: Burnout remains a huge public health problem among nurses.

Methods: A cross-sectional descriptive study assessed 259 nurses from two Neuropsychiatric hospitals in Nigeria. Data was collected using a sociodemographic/ job related questionnaire, the Maslach Burnout Inventory (MBI), and the Short-Form health survey (SF-12). The associations between sociodemographic characteristic and burnout was anaysed using Chi square test, between burnout and quality of life using Spearman correlation statistics. Predictors of burnout were determined using binary regression analysis

Results: Prevalence of emotional exhaustion (EE) was 44.4%, depersonalization (DEP) 31.7% and reduced personal ac- complishment was 98.8%. Predictors of EE were: poor funding from management, OR = 0.38 (95% CI 0.15-0.95) and role conflict, OR = 2.44 (95% CI 1.03-5.78), while the predictors of DEP, were age group, 31-40 years, OR = 0.37 (95% CI 0.18-0.77), male gender, OR = 2.55 (95% CI 1.40-4.65), role conflict, OR = 6.53 (95% CI 0.88-7.81) and working at more urban city, OR = 3.07 (95% CI 1.54-6.16). The mean total Quality of life (QOL) scores were significantly higher among respondents who had no EE and DEP p < 0.001.

Conclusion: Burnout is high among mental health nurses and is associated with poor quality of life.

Keywords: Nurses; burnout; quality of life; workplace; organizational factors; more-urban.
Detection of hepatitis C virus among HIV patients in Port Harcourt, Rivers State
Authors: Barinuaka Baeka Glory , Kola Oloke Julius , Oladele Opaleye Oluyinka
Published: October 2021

Background: Hepatitis C virus (HCV) a major human pathogen infecting millions of individuals worldwide, thereby in- creasing the risks for chronic liver diseases and has been discovered that HIV/HCV co-infected patients have a greater risk.

Objective: To determine the prevalence of HCV infection among HIV infected people in Port Harcourt, Rivers State.

Methodology: The patients were from the ages of 18 and above attending the antiretroviral clinic for over 6 months. The mean age of the participants was 36.91±8.38. Data were gotten from the 550 patients using a modified questionnaire and 5mls of blood samples were collected through venepuncture into EDTA bottles and spun at 3000rpm for 10 minutes sepa- rating the plasma from the whole blood. The CD4+ count was gotten from the patients’ file and the samples kept at -700C till analized. HCV antibody was detected using a commercially available third generation kit manufactured by Melsin Medical Co and statistical analysis was done using a Stata version 16. P value was determined using ANOVA.

Result: Total number positive to the HCV antibody was 24(4.4%) of which 8(33.3%) were males, while 16(66.7%) were females. Prevalence (29.2%) was among patients in the 31–35 age range. The CD4+ count ranged from 22-864 cells/µl with a mean value of 303.08±194.

Conclusion: From this study HIV/HCV co-infection occurs among HIV infected people in Port Harcourt. The CD4+ count was discovered to be low and was not age, nor gender dependent. HIV infected people should therefore be routinely screened for HCV.

Keywords: Serology; HCV; HIV; CD4+ Count.